A MENTAL health worker stabbed to death by a paranoid schizophrenic who was living in the community should not have been visiting him alone, a report has concluded.

Ronald Dixon stabbed 22-year-old Ashleigh Ewing 39 times when she went to deliver a letter from her employers at his home in Heaton, Newcastle, on May 19, 2006.

An independent investigation into the healthcare and treatment of her attacker published today (Tuesday, May 28) said it was “impossible to conclude with absolute certainty that the vicious attack could have been predicted or avoided”.

But it criticised health chiefs from Northumberland, Tyne and Wear NHS Foundation Trust for a series of failings in the case.

According to the report, a more robust approach to the care and treatment of Dixon - particularly in the five weeks leading up to Miss Ewing’s murder - would have concluded that Dixon had relapsed.

And given this fact, he probably could and should have been detained under the Mental Health Act.

Even if he was not detained a more robust care plan based on the reassessment would have meant Miss Ewing would not have been attending his house on her own on the fateful day.

Dixon, who had previously attacked his parents with a hammer while they were in bed, had disengaged from services.

In spite of this, Miss Ewing - a psychology student employed by housing support charity Mental Health Matters - was sent by herself to his home with a letter asking him to pay for damage to a phone in the rented flat.

The report describes the letter as “provocative” and said it was “entirely inappropriate” for her to have delivered to him.

And it criticised the over-reliance by mental health trust staff on Mental Health Matters reporting and interpreting Dixon’s behaviour.

In October 2007, Dixon pleaded guilty at Newcastle Crown Court to manslaughter on the grounds of diminished responsibility and was ordered to be detained indefinitely in a secure psychiatric unit.

Mental Health Matters have also previously admitted health and safety breaches and was fined £30,000.

Moira Angel, director of nursing and quality of NHS England’s area team covering Cumbria, Northumberland, Tyne and Wear said: “The final report explains in detail where the care provided to Ronald Dixon could and should have been better.

“It rightly highlights a number of issues around roles, responsibilities and working practices which fell below expected standard.

“The mental health trust needs to scrutinise fully the areas highlighted for improvement to make sure all of the recommendations are implemented and that positive progress is clearly demonstrated.”

A statement by the trust said: “It is important to remember that this tragic death occurred over seven years ago and much has changed since then.

“We would also so like to reassure Ashleigh’s family and members of the public that since these tragic events, the trust has rigorously and continually improved the areas of care that have been found by this report to fall short of good practice.”

A statement from Mental Health Matters said they acknowledged there had been failings in its procedures regarding risk assessment and have conducted a thorough review of their procedures.