Nico Reed’s inquest made it to the Oxford edition of BBC South Today last night. A piece-to-camera from the journalist briefly (and, if I have understood Rosi Reed aright, not wholly accurately) outlined Nico’s life and the circumstances of his death.  Then a few items picked from the day’s proceedings were mentioned as a voiceover to shots of participants arriving at court: Nico’s family, bundled up against the cold and walking quickly, and a group of people whom I presumed from the commentary to be some of the healthcare team, one lugging along a trolley stacked high with file-boxes.

According to the journalist, the care staff on duty on the morning Nico died testified yesterday that all his care had been given according to his plan.  Probably in one (or more) of the file-boxes there was a sheaf of paper documenting the care given, with all the boxes ticked.  But under that care, Nico went from being a person who lit up his surroundings and other people’s lives with his sunny personality and beaming smiles, to being someone who had lost his hard-fought-for communication skills and had become ‘thin, depressed and frightened by the care he received’.

And I thought, surely the point is not so much about whether the care was performed to plan, but that the plan specifying the care was hugely, horribly inadequate?