An ex-convict who was found dead months after his release from prison at his home in Oldham died due to misadventure, a coroner has ruled.

Brian Gregory, who left prison following a 10-year sentence at the start of last year, was found dead by a friend at his home on August 18, 2021.

An inquest into the death of the 63-year-old father was held at Rochdale Coroners Court on Thursday and Friday last week.

On Friday (October 21), the court heard how Mr Gregory had overdosed twice in the weeks leading up to his death.

Mr Gregory's sister, Lynn Ferguson, had earlier expressed concerns over the role of the NHS and of the probation service, in particular as a result of the two attendances to A&E for overdoses in the time up to his death.

The court heard from Oliver Nugent, a liaison practitioner who assessed Mr Gregory after his second overdose following a referral.

Mr Nugent said Mr Gregory was "not open to the assessment" and that he became quite assertive and did not want to engage towards the end of the session.

Mr Nugent concluded that Mr Gregory did not meet the threshold to be detained under the mental health act, a conclusion coroner Julie Mitchell agreed with in her summary.

Ms Mitchell ruled in her closing statements that Mr Gregory died due to a combination of alcohol and the medication which he took for a number of health issues, but ruled out the possibility of his death being a suicide.

She said she had reached that decision due to the fact Mr Gregory would have taken "significantly more medication", which was at his disposal, if he had intended to end his life.

She stated that based on the evidence she had heard, he did not intend to kill himself, there was no third party involved and there were no suspicious circumstances.

She also ruled that there were "no missed opportunities from any of the agencies", which included Pennine Care and Northern Care Alliance, to detain Mr Gregory over concerns about his mental health.

Ms Mitchell concluded by saying: "I think having reflected on all the evidence, a misadventure conclusion would be most appropriate."

A misadventure conclusion suggests a person has died accidentally without intending to cause any harm to themself.