A mentally ill St Albans man who stabbed a care worker to death had a lengthy criminal record prior to the attack, a new report has revealed.

Stephen Flatt, 55, stabbed Kathleen Bainbridge to death at a care home in Dunstable in August 2007 after being transferred there from Albany Lodge in St Albans.

He also attacked and seriously wounded her colleague Barbara Hill leaving her with post-traumatic stress disorder.

The independent investigation into Flatt’s care and treatment carried out for the NHS by independent consultancy Niche Patient Safety has revealed that between May 1972 and December 2002, Flatt had 12 convictions for 17 offences including actual bodily harm, assaulting a police officer and possession of an offensive weapon, a hammer, with which he attempted to hit another person.

The report, intended to identify if there were any aspects of his care which could have altered or prevented the incident, reveals that Flatt, who was detained for an indefinite period in a secure hospital because he was unable to plead, was the second of seven children born in St Albans and was brought up in the city and attended local schools.

He left at the age of 15 and went on to take evening classes, obtaining a Diploma in Agriculture and going on to obtain employment as a farm worker.

That continued until he was 23 and broke both his legs in a road traffic accident leaving him unable to work on a farm. He went on to work in the gardens and laundry at the then Hill End Hospital as well as volunteering for the Red Cross.

An unmarried man, he lived with his parents until he was 32. He had been in contact with mental health services since 1979 when he was diagnosed with paranoid schizophrenia which was later changed to a bipolar personality disorder.

He spent a period of time at The Causeway, social rehabilitation hostel in St Albans, before he successfully applied for housing and moved to his own flat where he stayed until December 2006 although he had a number of admissions to hospital.

Increasingly unable to care for himself, he was admitted to Albany Lodge prior to being assessed as suitable for a switch to Abacus House in Dunstable. While he said Abacus House was ‘alright’ he maintained it was not his ‘cup of tea’ and went on to say he was unhappy there and wanted to return to the St Albans area.

Flatt’s community psychiatric nurse who had visited him just before the stabbing had seen no sign of agitation or aggression although he said he had felt bullied by a member of staff.

The Hertfordshire Partnership Trust was subsequently fined £150,000 and ordered to pay nearly £330,000 in costs for health and safety breaches over the killing and the owner of Abacus House was fined £75,000 with costs of nearly £390,000.

Among the recommendations from Niche Patient Safety is that the trust should complete its review of rehabilitation services within three months and be able to demonstrate a clear plan for providing increased local capacity based upon needs.

It also has to give assurances that all staff are aware of what constitutes abuse and review the risk register with particular attention to underlying factors of staffing and recruitment.