In his second admission to Highbury Hospital after being sectioned, Dr Faizal Seedat said Calocane was "calmer in general" with no "management problems".

In this second stay at the hospital in 2020, it was noted Calocane "likely" had schizophrenia.

Rachel Langdale KC said this would not mean that he would therefore be a lower risk in the community, and Seedat agreed "VC was clearly a high risk of aggression" but said his "risk of violence was low".

The inquiry has heard that in a ward review during Calocane's second admission in July 2020, it was recorded Seedat warned Calocane he "would end up killing someone".

He said: "That exchange arose having determined that VC was not demonstrating any remorse or any true understanding of what had happened. I wanted to have a very frank conversation, which is clearly documented.

"I painted a worst-case scenario in terms of what could happen if he continues with his behaviours."

Langdale KC asked: "Did you think he could end up killing someone?"

Seedat replied: "No I didn't."

Asked why he said that to Calocane if he didn't think he would kill someone, Seedat said he meant it would be "unintended".

"If he went and did the same thing, and somebody jumped out of the window and maybe if they were on a higher floor, the consequences could be very different," he said.

Seedat has been asked whether he believes triple killer Valdo Calocane was honest with him at the point of the first discharge from Highbury Hospital.

Seedat said he did not think Calocane was being dishonest.

Rachel Langdale KC, counsel to the inquiry, said: "Dealing with his level of intelligence generally and the ability to mask, did you factor that in when you were considering whether he was being honest with you about medication?"

Seedat replied: "I did not form that opinion that he said the right things to get out of hospital."

He added during that admission, Calocane had "developed insight" and understood his symptoms.

Proceedings have now resumed, with Dr Seedat returning to continue his evidence.

He is expected to finish his main evidence, before being cross-examined.

No other witnesses are scheduled to give evidence today.

Image source, The Nottingham Inquiry

Consultant psychiatrist Dr Faizal Seedat, from Nottinghamshire Healthcare NHS Foundation Trust, has been speaking about the care of Valdo Calocane over two admissions to Highbury Hospital's psychiatric ward in 2020.

Here were some of the key takeaways:

• Information on Calocane's risk assessments was inadequate, Dr Seedat admitted
• Calocane's family provided Dr Seedat with a journal of text messages between him and his family members, which was used to aid his assessment
• Dr Seedat explained there were no powers to force patients to reveal the contents of their phones and he was unaware Calocane had been watching footage of mass shootings and capital punishment
• Among Calocane's messages were a reference to "red rum", which Dr Seedat did not realise was a reference to murder
• Dr Seedat told the inquiry Calocane showed some awareness he was unwell and that his behaviour was "not normal"
• Police quizzed Dr Seedat about Calocane's mental health and he responded by email rather than filling the required form
• Calocane had been balancing his mental health and his university work and Dr Seedat had told the university he "hoped" he would recover
• The university, the inquiry heard, wanted Calocane to finish his course remotely and move to Wales with his family - but Calocane did not want to
• Calocane was discharged and left to manage his own medication - which he then stopped taking, the inquiry was told

Need to get up to speed on the evidence that's led up to today?

You can catch up by listening to the below as part of the BBC's Need to Know series.

Since 23 February, the judge-led public inquiry has heard more than 100 hours of evidence from over 70 witnesses.

Here are some of the key lines from the evidence so far:

Killer should have been arrested before attacks

The former chief constable of Nottinghamshire Police, Kate Meynell, admitted in her evidence that Calocane should have been arrested before he carried out the attacks as he had a warrant for failing to appear in court.

A number of police personnel have been challenged over the suggestion that executing the warrant would not have made a difference.

Police chiefs admitted not arresting Calocane had been a "serious and systemic and operational failure".

History of violence was known to police

Calocane had a history of police interactions linked to violent incidents, including the assault on a police officer which led to the warrant, dating back to 2020.

But at his sentencing hearing, the court was told he had no previous convictions.

Searches for the killer 'should have been better'

Temporary Deputy Chief Constable Rob Griffin, of Nottinghamshire Police, admitted that searches for the Nottingham attacks killer should have been better.

The force had declared Operation Plato - a national identifier of a "marauding terrorist attack" - but a number of officers were not told immediately of this.

Victims' families waited hours for confirmation

Barnaby and Grace were attacked by Calocane at about 04:00 and, by 05:30, police had established their identities.

But Barnaby's parents were not told their son had died until after 10:00 despite contacting the police for information themselves.

Two of Ian's three sons - James and Lee - told the inquiry they waited even longer.

James said he found out his dad had died through social media at about 15:00.

Image source, PA Media

Calocane's mother Celeste had called mental health services after his first discharge to say she worried her son's mental state "may be deteriorating", Langdale said.

She said he might not have been taking his medication.

In July 2020, Calocane had denied he was unwell to medics and "appeared to be attempting to conceal his symptoms".

Following the incident with a neighbour escaping through a window to get away from Calocane, Dr Seedat said: "VC had become unwell again and this is more likely on the basis that he had stopped taking his medication.

"It was not surprising that his presentation was clearly suggestive of being unwell, presenting with a psychotic clinical picture and demonstrating poor insight."

Pills which had not been taken were found, the inquiry heard.

Dr Seedat wanted him to return to hospital and wrote at the time Calocane was "clearly a risk to others and to himself from retaliation".

The inquiry is now taking a break for lunch.

Seedat is continuing to be questioned on Calocane's first discharge from Highbury Hospital.

Rachel Langdale KC, counsel to the inquiry, said: "Were you confident that when you discharged him, with concerns about him masking and not being straightforward or open about his situation, that this was not a risky, risky situation to discharge him into the community at this point?"

Seedat replied: "I didn't think it was risky on the basis that at the time he was discharged, his mental health had improved and he was at a point where I felt he could be safely managed in the community."

When Valdo Calocane was discharged following his first admission to Highbury Hospital, the inquiry heard his notes did not mention the length of the psychotic episode, or his history before admission.

Seedat said the discharge note was a summarised version of what had brought him into hospital.

"I concur that I didn't include all the information," he said.

He added the summary was mostly read by GPs and that mental health services would be Calocane's primary caregivers and knew the relevant information.

Calocane's care was monitored by an early intervention psychosis team.

Asked if he would routinely contact patients' GPs, Seedat said: "It is very rare that I would discharge patients directly to a GP.

"If I was, then I would contact the GP because that would be the final period of care."

Calocane was discharged on 17 June 2020, the inquiry is told.

He was told that day he must continue his medication by Dr Seedat, but the consultant said it would be "very difficult" to know if he would do this.

Dr Seedat said: "At the time of discharge, we had come to a point where VC had understood our formulation in terms of his symptoms being labelled as illness.

"Having established treatment, it then becomes the responsibility of the individual to ensure they continue taking their medication."

Counsel to the inquiry, Rachel Langdale KC, has raised that Calocane's discharge notes refer to "politeness", when in fact Calocane is not engaging with professionals.

In response, Dr Seedat said: "It is not uncommon that patients may not have an interest, in terms of the activities that are being given.

"In activities like cooking, gardening... not everyone takes an interest."

He said Calocane would have preferred to use the gym, but due to coronavirus restrictions at the time, he was unable to be offered this.

Notes from Valdo Calocane's discharge from Highbury Hospital in June 2020 are now being scrutinised.

Dr Faizal Seedat had recorded that Calocane had "made a conscious effort to try and embrace his illness", and he "had not had thoughts about hurting himself or others".

Over where Calocane wanted to live - not with family, but in Nottingham or Birmingham - Dr Seedat said he was "concerned" but said: "I tend to have little control in terms of where someone will end up.

"There's a level of autonomy we need to respect.

"I don't have any legal powers or any remit to dictate where people live or don't live."

Image source, Google

Dr Seedat said Calocane had been “stable” on the ward despite an incident of “play fighting” with another patient where staff had to intervene.

Concerns had been raised by the university, the family and by other doctors about if Calocane was being released too soon.

Dr Seedat said some of this was due to a “lack of understanding of how things work within mental health services”.

Questioning Seedat on the initial assessments of Calocane, Langdale KC said: "So you were relying solely at this period in the assessment with information from his family, who were helping you the best they could?

"But do you recognise there may well have been other information within his community and generally that would have been relevant to assessment?"

Seedat said: "I think that's relevant in all cases.

"I guess the challenge comes in terms of how you get access to all these individuals, ask and interview them and at the same time, have to maintain doctor-patient confidentiality."

The inquiry heard following the attacks, a witness contacted Nottinghamshire Police with information about her experiences of Calocane, when she lived with him in shared accommodation in 2014 and 2015.

She described how she regularly heard noises in the night and knew it was Calocane, based on the layout of the house.

She said there had been issues of food going missing, which she asked all the housemates about, but when she asked Calocane, he "raised his voice and asked why she was accusing him".

Seedat said it would have been helpful to have this information at the time.

Seedat said in conversations, Calocane "made it very clear" he was struggling when he moved from Portugal to the UK.

Calocane was born in Guinea-Bissau in 1991.

His family moved to Madeira when he was about three years old, and then to Lisbon in Portugal when he was about eight years old.

He and his family came to the UK in 2007 when he was 16 years old and lived in Wales.

Seedat said: "When he came to [the UK], due to language barriers - I think at the time probably was speaking Portuguese and he somehow learnt English - subsequently he found it difficult to make friends."

The doctor added Calocane spent a lot of time on his own and became comfortable with that.

The inquiry has heard Calocane told Seedat his grandfather had suffered from mental health issues.

Seedat said it was "never established" what those mental health difficulties were but he said they were considered.

The doctor got consent from Calocane - referred to throughout the inquiry as VC - to discuss his difficulties with his family.

He told the inquiry it would have made it "very difficult" to speak to Calocane's family without that consent due to doctor-patient confidentiality.

"I think I was quite convinced that the family were very interested and connected with VC and you know, wanting the best for him," Seedat said.

In June 2020, the inquiry heard Dr Seedat was communicating with Eleanor Turner at the University of Nottingham about Calocane, who is being referred to throughout the inquiry as VC.

He said: "We did have a conversation and she was made well aware [about] the incidences that had happened, the assessments we were making, and she stated that the university would be keen to help and support him.

"In an ideal situation, if there was alternative accommodation, that would definitely be considered."

Dr Seedat was told Calocane's studies and exams were online and both Dr Seedat and the university preferred he go to live with his family in Wales.

Dr Seedat said: "VC was very adamant that he did not want to take that course of action.

"VC had plans of either remaining in Nottingham or going to Birmingham, which we were not very supporting of."

With a programme of treatment under way, nurses informed Dr Seedat that Calocane was "isolating himself" while "not engaging in any meaningful way" with medical staff.

Seedat was asked why Calocane's risk was not assessed, but he claims it was.

"I think it's not correct to say we didn't. We did consider the risk of harm to others," he said.

Langdale said: "You didn't record that did you?"

Seedat said: "And maybe that is one of the areas I need to get better at."

He added recording risk was something he was working on to try to improve in his documentation.

Stresses from Calocane's studies were impacting him, Dr Seedat had been told in May 2020 by the university.

He said he was told Calocane had been suffering sleep deprivation and social isolation.

Dr Seedat said: "What I did find difficult is I was very unclear what the mental health unit at the university was able to provide support with.

"My understanding is that their support was more at a pastoral level and VC obviously required more support than that."

Dr Seedat told the university in a letter "we remain hopeful he’ll make a good recovery".

He explained to the inquiry that meant being well enough to complete his studies, and added: "With all patients, we do need to have a sense of hope, even for those who may have symptoms for longer."

Image source, The Nottingham Inquiry

Seedat has told the inquiry it would have been "difficult" to keep Valdo Calocane in hospital after his first admission.

Calocane had been detained under Section 2 of the Mental Health Act, which allows for a short detention time.

Asked about whether he could have converted that to a Section 3 detainment, Seedat said based on Calocane's presentation at the time, he would have found that difficult and said he did not believe keeping him longer "would have achieved anything".

"It was my belief and opinion that VC was showing improvement," Seedat said.

The doctor added Calocane's demeanour had changed and that he was able to recognise his symptoms, understand his illness and the need for treatment.