1 May 2019

Today, it has been announced that the Care Quality Commission has reached a decision to prosecute charity Richmond Psychosocial International Foundation (RPFI) as well as Peggy Jhugroo, the manager of Lancaster Lodge in the lead up to Sophie Bennett’s death.

 The CQC has informed RPFI that it will be prosecuted over an alleged failure to provide safe care and treatment, resulting in Sophie being exposed to the significant risk of avoidable harm, under the Health and Social Care Act 2008. By law, registered providers of health and social care services must take all reasonable steps and exercise all due diligence to ensure patients receive safe care and treatment. Peggy Jhugroo, who was involved in Sophie’s care will also be prosecuted under the Act. The case is listed for first hearing at Ealing Magistrates’ Court on 24 May 2019.

Separately, action is being taken by HM Assistant Coroner John Taylor, West London Coroner’s Court regarding a witness, Dr Duncan Lawrence. Today, the Coroner held an unprecedented hearing to deal with Duncan Lawrence’s non-compliance with Schedule 5 Notices to give evidence at the inquest into the death of Sophie Bennett.

 Mr Taylor ruled that a fine should be imposed on Duncan Lawrence, who was heavily involved in Sophie’s care. In January 2016 a number of changes were made to Sophie’s care home, Lancaster Lodge, following an audit by the consultant and ‘clinical lead’ Dr Duncan Lawrence, including the cancellation of all external therapies. Sophie, 19, later died on 4 May 2016 two days after having applied a ligature whilst in the care of Lancaster Lodge, a therapeutic community run by RPFI.

Duncan Lawrence failed to attend and disclose crucial evidence at the inquest into Sophie’s death in February 2019 (required under Schedule 5 of the Coroners and Justice 2009). The coroner also ruled that he would refer Duncan Lawrence to the Director of Public Prosecutions, Crown Prosecution Service and the police who will now consider further legal action.

The jury at the inquest found that neglect contributed to the death of Sophie Bennett. Sophie had diagnoses of Bipolar Affective Disorder, Social Anxiety Disorder, and atypical autism. She had been cared for at Lancaster Lodge since April 2015.

Following the inquest, on 5 April 2019 the Charity Commission opened a statutory inquiry into RPFI. The inquiry is ongoing.

 The family of Sophie Bennett said: "This week is the 3 year anniversary of our precious daughter Sophie’s death. We welcome the CQC’s announcement today that it is to bring criminal charges against RPFI and the manager of Lancaster Lodge at the time Peggy Jhugroo.

It has been a constant battle to get to the truth of what happened. The Coroner’s Inquest finally took place in January this year and it revealed, at last, the sequence of events leading to Sophie’s death. The Inquest Jury’s findings were damning of the actions of those responsible for running and managing the home.

Evidence through the course of the inquest also revealed the extent to which the founder of the charity Elly Jansen OBE had been allowed to instigate and direct, from the shadows, the reckless changes in the way the home was run. So, whilst we welcome the CQC’s action, we are extremely disappointed that they have decided not to prosecute Elly Jansen OBE. It is clearly evident that she was acting as a shadow director and we consider her conduct to be criminally culpable.

The Charity Commission recently announced its formal Inquiry and we will now need to rely on it to scrutinise and expose what we believe to be the gross failures in the governance including the control and direction of the organisation by Elly Jansen OBE and what we consider to be her financial conflicts of interest.

Deborah Coles, Director of INQUEST, said:

“That a man in charge of the care of a young woman in crisis could simply choose to not turn up to give evidence in connection to her death is truly shocking. We welcome the coroner’s decision to take action today, which sets an important precedent.

Sophie’s inquest exposed seriously unsafe systems of care and treatment, and a shocking lack of oversight and action on known issues. The CQC’s long awaited decision today to prosecute the providers of this care is welcome. We hope this will send a message to providers that those involved in potentially criminally unsafe standards of care will be held to account.”

Rachel Harger, of Bindmans LLP said:

The CQC’s decision to prosecute RPFI and Peggy Jhugroo is finally some recognition of the serious failures in Sophie’s care which led to her tragic death.

These failures have only been exposed because of the Bennett family’s remarkable determination and efforts over the last three years in repeatedly pushing for answers, particularly through a gruelling 3 week inquest. It has only been very recently that RPFI have even begun to acknowledge the extent of some its failings. It should not take the prospect of criminal legal proceedings and an inquest for RPFI to take responsibility for their catastrophic failures.



For further information please contact Lucy McKay on 020 7263 1111 or email. The family is represented by INQUEST Lawyers Group members Charlotte Haworth-Hird and Rachel Harger of Bindmans LLP and Caoilfhionn Gallagher QC and Sam Jacobs of Doughty Street Chambers.

Sophie is survived by her parents Ben and Nicki, and her siblings Natasha, Thomas and Jack.

The prosecution of RPFI is being brought by the CQC under regulations 12 and 221 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014; and that an individual will be prosecuted in this respect pursuant to section 91 of the Health and Social Care Act 2008. An individual will be prosecuted in this respect pursuant to section 91 of the Health and Social Care Act 2008.

Richmond Psychosocial Foundation International background:

Elly Jansen OBE established a therapeutic community under a charity, ‘Richmond Fellowship’ in 1959.  Richmond Fellowship was the subject of a Charity Commission inquiry in 1988 which reported concerns as to financial conflicts of interests concerning Ms Jansen. The Commission had reported that Ms Jansen had since “severed all links” with the charity. However, it is apparent that a similar charity was since established – RPFI – with Ms Jansen acting as a ‘consultant to the board’.

The jury at the inquest heard that the manager at Lancaster Lodge at the time of Sophie’s death, Peggy Jughroo, had been trained by Elly Jansen and continued to be supervised by her. A trustee of the Board, Jonathan Manson, told the inquest that he thought Ms Jansen’s role was “ambiguous.”  Lynn Dade, a former RPFI trustee who resigned in July 2015 following “grave concerns regarding the governance and financial affairs” of RPFI described Ms Jansen as a “sleeping director.”

Duncan Lawrence

In January 2016 a number of changes were made to the home following an audit by the consultant and ‘clinical lead’ Duncan Lawrence, including the cancellation of all external therapies. These decisions led senior staff to resign and a new regime which Sophie described to her family as being like a ‘boot camp’. After protests from residents and staff, therapies were continued, but the standard of care at the home fell to the extent that the Care Quality Commission (CQC) assessed the service in March 2016 as ‘inadequate’. 

The coroner will consider whether a fine should be imposed on Duncan Lawrence, as well as the monetary value of any fine. He will also consider whether the consent of the Director of Public Prosecutions should be sought to institute proceedings against Duncan Lawrence (pursuant to Schedule 6 of the Coroners and Justice 2009), which may result in imprisonment as an alternative or in addition to a fine.

In February 2019 the inquest heard evidence that Duncan Lawrence, although understood by other staff to have a medical degree and be a doctor, in fact had a doctorate in public management and administration from Knightsbridge university – an unaccredited institution in Denmark. At the inquest RPFI were unable to produce any record of Duncan Lawrence’s credentials.

On the first day of a CQC inspection of the home in March 2016, Duncan Lawrence, despite being the ‘clinical lead’, appeared unable to explain what and where the residents’ care plans were. He then subsequently disappeared from Lancaster Lodge, failing to appear for the second day of the inspection. 

Further information:

  • 5 April 2019 - Charity Commission opens inquiry into care charity following Coroner’s reportBindmans Media Release
  • 7 February 2019 - Jury find neglect contributed to self-inflicted death of teenager Sophie Bennett in care homeINQUEST Media Release