17 January 2020

Before HM Coroner Nadim Bashir
Pontypridd Coroner's Court
2 – 17 January 2020

Conner Jake Marshall was 18 years old when he was killed on 12 March 2015 by a man unknown to him who was on probation and had breached the terms of his license. The inquest concluded with the coroner finding Conner’s death was ‘unlawful killing’, and identifying major failings in probation services in an extensive fifty page document setting out his findings.  
Conner’s family described him as a sweet, polite boy, who was bright, inquisitive and had a wicked sense of humour. He enjoyed playing the saxophone, athletics and triathlons. Conner was a stranger to the man who killed him, David Braddon, who was under the supervision of Wales Community Rehabilitation Company (CRC). He was on probation following offences relating to drugs and assaulting a police officer. He also had previous convictions for domestic abuse.
While the coroner did not draw a direct link (causative or contributory) between failings in probation services and Conner’s death, he identified several major failures in the Wales CRC including:

  • Inadequate oversight of staff and workloads and caseload by Team Managers;
  • Inadequate management and supervision of staff with no management consistency;
  • Inadequate allocation and management of resources leaving some staff overwhelmed with their respective workload and caseload;
  • A lack of regular, meaningful supervision for staff, delivered in a timely manner.

In respect of the management and supervision of Brannon, the coroner found:

  • The Risk Assessment (known as OASys) and consequent Sentencing Plan was delayed by some eight months, which meant that it was not implemented effectively or in a timely manner.
  • Too much reliance on self-reporting and as a consequence, poor compliance was not identified at the earliest opportunity resulting in a possible failure to explore other avenues of robust management and supervision.
  • No effective communication to support a joint risk management plan in order to provide structured sessions, which would have highlighted the inconsistencies in the self-reporting by Brannon to both the Offender Manager and the Intervention Provider.

In May 2013, probation services were overhauled through the ‘Transforming Rehabilitation’ policy programme, which split delivery of services between the publicly run National Probation Service and mainly private sector CRCs. The changes were widely criticised, and in July 2018 the Justice Secretary announced CRC contracts would be terminated early as services were “falling short” of expectations.
The inquest heard that the probation officer supervising Braddon had recently started the role. The probation officer described being overwhelmed, juggling 60 cases at a time in a difficult working environment. The coroner described the support, management and supervision of the probation officer as “woefully inadequate”.
Despite being aware of Braddon’s previous domestic violence offences, the probation officer was unaware that he was in contact with an ex-partner against whom there was a history of violence. On the night of the attack, Braddon was heavily intoxicated with alcohol, Valium and cocaine, and described himself as “off his head”. Braddon had mistaken Conner for his ex-partner’s former boyfriend, and attacked him after he had an argument with her about their relationship.
The coroner found that, despite being alert to some of the risks presented by Braddon, the probation officer was readily accepting and over-tolerant of self-reporting as a consequence of being a brand new probation officer with inadequate management and supervision. The circumstances, he found, were not of her own making but of the Wales CRC in the levels of staffing, caseload and structures they had in place for managing and supervising new PSO’s.
Nadine Marshall, Conner’s mother, said on behalf of the family: “Today is the culmination of almost five years of struggle to obtain truth and justice for Conner, and to find out why our much loved son was the victim of a callous unprovoked attack. The coroner’s findings have vindicated what we have always known to be true. That the supervision of David Braddon was not robust and the management system of Wales CRC was inadequate. This was a direct consequence of the chaos caused by the privatisation of probation services in this country. The coroner identified seven major failures. Had these failures not occurred we will never know whether our son Conner would still be here today.”
Deborah Coles, Director of INQUEST said: “The Ministry of Justice and those responsible for the Transforming Rehabilitation programme must now take a long hard look at the consequences of their actions. The rushed privatisation of an essential service was done in the interests of profit over public safety. Conner’s death is one of many which relates to these catastrophic ‘reforms’. The findings of this inquest and others should be considered alongside the voices of bereaved families, and the probation staff who were in the midst of this chaos, to ensure such failures are not repeated.”


For further information, interview requests and to note your interest, please contact INQUEST Communications Team: 020 7263 1111 or [email protected]; [email protected]

The family is represented by INQUEST Lawyers Group members Sarah Kellas of Birnberg Peirce Ltd Solicitors and Kirsten Heaven 30 Park Place, Cardiff & Garden Court Chambers, London. The family are working with INQUEST caseworker Selen Cavcav.
The family campaign on Twitter and Facebook and using #AVoiceForConner #LifegoesonCJM. 
The other Interested Persons represented at the inquest are Wales CRC/Working Links, National Probation Service and one probation officer.
Other recent inquests involving homicides committed by people under supervision of probation services include:

  • Alex Malcolm, was five years old when he was killed by his mother’s ex-partner on 22 November 2016. The inquest concluded finding his death was an ‘unlawful killing’. In a detailed narrative conclusion, the jury identified a series of failures by the National Probation Service (NPS), as well as system defects following major changes to probation services under ‘Transforming Rehabilitation’, contributed to Alex’s death. Media release.
  • Quyen Ngoc Nguyen, 28, died in August 2017 following sexual and physical violence by two men who had been released from prison on licence and were under the supervision of the National Probation Service. The inquest exposed a ‘dysfunctional’ system for public protection. Media release.
  • Lisa Skidmore, 37, was killed by a man under National Probation Service supervision on 24 November 2016. The inquest identified a failure of the probation services and police to respond to a clear escalation of risk, and highlighted failures in communication between agencies involved. Media release.

‘Transforming Rehabilitation’: was a programme of work intended to reform the supervision of offenders in England and Wales. It was launched by Chris Grayling, then justice minister, in a white paper in May 2013. A deeply critical review of progress of the programme, published by the National Audit Office in March 2019, highlighted the admission of the Ministry of Justice that the reforms had failed to meet targets.

The reforms split the delivery of probation services in two with the National Probation Service (NPS), managing high-risk offenders, and the predominantly private Community Rehabilitation Companies managing mainly low or medium-risk offenders.