HMP Swansea / Swansea Bay University Health Board probably caused death

July 30 2025

On 1 December 2019 David Bassett was found dead in his cell on the induction wing of HMP Swansea following his remand in custody for an offence of arson endangering life.  He had poured petrol around his house and on himself and threatened to burn the house down with himself in it.  In the custody of the police and GEOAmey he was subjected to several checks per hour because of his suicide risk, and a suicide and self-harm form was completed.

On arrival at prison on 29 November 2019, an ACCT was not opened either by prison staff or by healthcare staff, despite David having a number of risk factors identified in the safer custody guidance.  David’s cell mate was moved after his first night in custody and was not replaced.  On his second night in custody when by himself, David used a ligature and was found deceased.  Attempts at resuscitation were unsuccessful.

In evidence, a number of prison staff and the mental health nurse accepted that an ACCT should have been opened.  Had that been done, David may have been subject to increased observations in prison and should have had a cell mate on the second night.

Yesterday, the jury concluded that an ACCT should have been opened. Insufficient information was provided to healthcare to allow them to open an ACCT but also that healthcare could have requested further information.  A cell mate could possibly have prevented David from taking his own life.  These failures probably contributed to David’s death.

Christian Howells acted on behalf of David’s family, instructed by Craig Court of Harding Evans.