CALLS have been made for urgent changes to Police Scotland's call handling procedures after it emerged officers responding to concerns about the safety of a vulnerable woman who was later found dead were initially sent to the wrong house.
A police watchdog probe into the latest force blunder also discovered the force knew about the IT problem that sent officers to the wrong address in Dumfries.
It emerged that officers also failed to realise the woman they found at the wrong address had a different name from the 52-year-old they were actually looking for.
There have been cross-party calls for change as Police Investigations and Review Commissioner (Pirc) Kate Frame identified a series of failings but concluded the woman had likely already died before officers were contacted.
Her report found the woman's daughter had phoned the police area control room at Govan, Glasgow, shortly after 10pm on Friday February 19 concerned for her mother's safety.
A full description and address were passed on but as a result of a known issue between the Area Control Room's Gazetteer mapping system and the command and control systems used by Police Scotland, officers were sent to the wrong house.
Ms Frame has called for Police Scotland to take steps to address the known fault in the system.
The Commissioner also noted that as in a number of other PIRC investigations, there was disagreement between ACR staff and operational officers as to "who had ownership and responsibility for undertaking additional enquiries" and in particular, who had responsibility for updating those who originally reported the incident.
This often led to neither contacting the person reporting the issue and "missing the opportunity to identify errors sooner".
Ms Frame said that Police Scotland should examine the issues of command and control to incident management and provide clear guidance to ACR staff and operational officers on who should assume responsibility for undertaking particular lines of enquiry and investigation including responsibility for updating those that report incidents.
Ms Frame said it was "deeply troubling" that the systems issues had not been resolved and "disappointing" the officers had failed to realise the names had not matched up.
She added: "Whilst I recognise from the medical evidence obtained in this particular case that it is likely the 52-year-old woman was dead by the time the alarm was raised, it does not diminish the particular failures identified or the additional distress caused to the woman's family."
Ms Frame's report revealed that officers were given the name of the woman in question but no details of her age, physical description or the fact she was a vulnerable person.
As a result, at about 10.35pm they roused an 84-year-old woman at the wrong address, failing to notice her name was different from the person they were looking for.
The increasingly worried family of the 52-year-old were told officers had spoken to her and she was safe and well.
But she was found dead at around 2.40am the following day after officers finally forced entry to the right house more than four-and-a-half hours later.
Pirc found she was suspected to have died of an accidental overdose of prescribed medication and the time of death was likely to have been before the initial contact with police.
In a statement, the woman's family said: "The past 18 months have placed an incredible strain on our family as we have tried to come to terms with the loss of a loving mother and understand the tragic circumstances behind her death.
"We are aware of the Pirc report and are pleased to note that a number of recommendations have been made.
"None of this will bring our mother back but we hope that going forward Police Scotland will look carefully at these recommendations and that valuable lessons have been learned."
Scottish Labour’s justice spokesperson Claire Baker MSP said the critical report into the death of a vulnerable person "yet again raises serious concerns over Police Scotland’s call-handling procedures" and said "weaknesses in the system must be addressed by management as a matter of urgency to ensure public confidence in Police Scotland".
She added: "Not only is it unacceptable for dedicated police support staff to be working under such extreme pressure that our hard-working police officers were sent to the wrong location because of an IT blunder, this incident caused real distress to the family involved. “This is the latest in a series of concerning reports about Police Scotland’s ability to handle emergency calls."
Scottish Conservative shadow justice secretary Liam Kerr said:“The report is clear. This isn’t a case of human error or a chance mistake, the system used by the single force was to blame.
“It’s now up to the Scottish Government to explain why this system was being used and if there were any plans to replace it.
“And while the report stresses it’s likely the woman involved died before the initial alarm was raised, it still raises serious questions."
Nelson Telfer, Police Scotland's Assistant Chief Constable for service and protection, said moves were made last year "to improve" the Gazetteer system.
"We are sorry for the distress and upset caused by our initial response to the incident," he said.
"We acknowledge and accept the recommendations made by the commissioner in her report and took steps last year to address the issues she has now identified."
A Scottish Government spokesman said: “Our thoughts remain with the family at this time. We have noted the publication of the PIRC report and the statement by Police Scotland that they took steps last year to address the issues identified within it.”
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