“Clive was only ever seen as a risk, never his capabilities or possibilities. Clive’s Way is about living in the spirit of possibility and being ambitious” – Elaine Clarke, Clive’s sister
Clive Treacey was a kind, gentle, fun-loving man, with many talents, skills, goals and ambitions. He was incredibly creative and a talented artist with bags of potential, but devastatingly, his life was cut short.
On 31st January 2017, Clive Treacey died at an assessment and treatment unit in Nottingham after having an epileptic seizure. An independent inquiry found that Clive’s death was ‘potentially avoidable’, and there were ‘multiple system-wide failures in delivering his care and treatment that together placed him at a higher risk of sudden death.’
Not only was Clive’s health put at risk, but the review also found there was a “shocking lack of ambition that professionals and services held for him.” Clive was passed from setting to setting over a period of 30 years, 10 of which he spent detained under the Mental Health Act. Clive’s family say he was rarely encouraged to partake in activities or leave the grounds of his care homes, and he was not supported to do what he loved: photography, art and gardening.
The review also found there were multiple safeguarding failings at various care settings earlier in Clive’s life. Clive’s family believe he was sexually abused by a staff member at the care setting where he resided between 1989 and 1993. Despite a police report being filed, the perpetrator continued to visit Clive at a subsequent placement, without the family’s knowledge.
Yet Clive’s records show there is “very little acknowledgement” of the trauma that he experienced or consideration of this in the development of support plans, and no connections were made between the alleged sexual abuse and the impact of the trauma on Clive’s behaviour.
Since Clive’s death, Elaine Clarke, Clive’s sister, has worked tirelessly to try and improve care and support for others like Clive who become trapped in the care system. Elaine fought tooth and nail for answers to why Clive died, to get an inquest, and eventually an independent review and an Adult Safeguarding Review.
But Elaine says once these proceedings came to an end, there were no ‘next steps’ for her family or any other family in a similar position. Thus came Clive’s Way.
Clive’s Way is a Conscience Manual produced by Elaine and five others selected for their passion to drive meaningful improvement, including Beverley Dawkins, Hafsha Ali, Robert Ferris, Anne- Marie Holder and Catherine Nolan. This ‘Conscience Group’ came together to support the taking up of the recommendations, appealing to people’s hearts and minds.
“Clive’s Way is about being surrounded by believers, who support your ambitions, your goals and your dreams,” Elaine said. “It symbolises Clive’s attitude and approach to life despite the challenges life gave him; Clive was determined to reach his goals and grab his dreams.”
“See the person, hear the family, recognise the ambition!”
The Conscience Manual reflects on the impact of Clive’s review, what has been achieved so far, and the many challenges ahead. Importantly, it also provides an example of what real inclusion looks like.
Elaine says families are too often excluded from protocols and processes which take place after the death of a loved one, and the manual has become a way of ‘kicking the tyres’ of progress. It thematically reviews key recommendations laid out in previous reports with complete involvement of those at the centre of Clive’s life: his family.
“We were determined that they weren’t just going to write a report, but actually bring about action because of Clive’s experiences and his preventable death. I wasn’t going to let anyone shelve Clive’s life,” Elaine said.
The Conscience Manual includes chapters on Clive himself, the impact of his review and the learnings, as well as how NHS England Midlands are keeping an eye on progress in key areas such as specialist hospitals, epilepsy care, health inequalities, safety and safeguarding.
Finally, it challenges professionals, practitioners and commissioners to think and act in ways that bring people closer to finding a place to call home through five simple asks:
Elaine says she now wants NHS England and care providers to work with families beyond reviews, and ensure they are consulted and involved at every step going forward.
“We want the same thing as every other family, whether that’s an after-death investigation or an inquest, we need to know their lives mattered and that change to save others will happen,” Elaine said. “And where Clive’s review has shone a spotlight is the inadequacy, the deficiency, and the lack of interest in having those family connections. We weren’t going away and we’re still not going away.”
“We’ve proved that in the worst of circumstances, traumatised in life and in death, families are still willing and are capable of working for the greater good,” she said.
Clive’s ambitions and hopes for the future were simple: he wanted a good life in a good home, a pet, to go on holiday with his family, to be able to do his photography, art and gardening work. Yet he was never able to fulfil his life ambitions, and this is something Elaine will never forget and never stop fighting for.
“The biggest thing that drives me is that Clive mattered. It mattered what happened to him. It matters that he’s not here, and it matters that this is still happening to others,” she said.
You can read the Conscience Manual: Clive’s Way here.
