A mental health trust has been fined £200,000 after a “grossly psychotic” suicidal teenager in its care was found dead in his prison cell.
Jamie Osborne, 19, took his own life on the hospital wing of Lewes Prison, run by Sussex Partnership NHS Foundation Trust, in February 2016.
The trust admitted failing to provide care and treatment in a safe manner.
Sentencing at Brighton Magistrates Court, Judge Tessa Szagun described the case as “tragic”.
She said the care fell “far short of an appropriate standard”, procedures “were not adequately adhered to” and there were “systematic failings” in how staff were trained.
After sentencing, the trust said its own investigation had found “clear failings for which we are deeply sorry”.
In a statement, it said: “The safety and wellbeing of vulnerable people under our care is of the utmost importance.
“This includes acknowledging when things have gone wrong, learning from this and taking action.”
Mr Osborne had already attempted suicide in the general wing of the prison after he was remanded in custody in 2015.
He was moved to the hospital wing but staff failed to monitor properly and treat him, the court heard.
He died on 12 February 2016.
Bena Brown, prosecuting, previously told the court that despite being observed as “high risk” and “grossly psychotic”, there was “confusion” over Mr Osborne’s care.
“We say this was avoidable,” she said.
Sussex Partnership NHS Foundation Trust, based in Worthing, has come under fire for several deaths linked to its care.
These include the case of Donald Lock, who was stabbed 39 times by patient Matthew Daley after a car crash in 2015.
The trust was also ordered to pay £25,000 in court costs and a £170 surcharge following the prosecution brought by the Care Quality Commission (CQC).
The total of £225,170 must be paid within 14 days.