Grounding and flooding of the ro-ro ferry Commodore Clipper

UK MAIB issues investigation report

UK MAIB issued a report on the grounding and flooding of the ro-ro ferry Commodore Clipper in the approaches to St Peter Port, Guernsey.

At 1515 on 14 July 2014, the Bahamas registered ro-ro passenger ferry Commodore Clipper grounded on a charted, rocky shoal in the approaches to St Peter Port, Guernsey. No-one was injured, there was no pollution and the vessel continued its passage into the harbour. However, there was significant raking damage including breaches of the hull resulting in flooding of double-bottom void spaces.

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The grounding caused a noisy, shuddering vibration that reverberated throughout the ship, but the crew did not check for damage, no external report was made and no safety announcements were made to the passengers. Once alongside in St Peter Port, cargo discharge, reloading and a lifeboat drill went ahead as planned. However, a pre-planned divers inspection of the hull soon discovered damage and the vessel was withdrawn from service.

The investigation found that there had been insufficient passage planning for the voyage; in particular, for the transit through the Little Russel, the extremely low tide and effect of squat were not properly considered. This resulted in the bridge team being unaware of the limits of safe water available and thus, despite their good positional awareness, they headed into danger without appreciation of the risk. Several course alterations intended to regain track were ineffective due to the tidal stream setting the vessel off course. Additionally, the absence of any alarm, steering and propulsion responding normally, and the masters conviction that there had been sufficient depth of water, led to a collective denial of the possibility that the vessel might have grounded.

The companys approved route for use through the Little Russel was not followed and the vessels electronic chart display and information system was not utilised effectively because key safety features were either disabled or ignored. It was also established that Guernsey Harbours did not have an effective safety management system for the conduct of pilotage within its statutory area.

Safety recommendations have been made to Condor Marine Services Limited and the Government of Guernsey designed to ensure appropriate levels of proficiency in the conduct of safe navigation.

Conclusions

Safety issues directly contributing to the accident that have been addressed or resulted in recommendations:

Commodore Clipper grounded on a charted, rocky shoal in the Little Russel because insufficient passage planning had been undertaken. In particular, the extremely low tide and the effect of squat had not been properly taken into account.
Had all the factors affecting under keel clearance been accurately assessed, it would have been apparent that it was potentially unsafe to pass over any charted depth less than 7.5m in the Little Russel.
The absence of sufficient passage planning meant that the bridge team was unaware of the limits of safe water so approached danger without appreciating the hazard. Furthermore, a safer course of action was available – use of the wider Big Russel channel.
Course alterations intended to regain track were insufficient given the strength of the tidal stream setting Commodore Clipper off course.
The highly repetitive nature of Commodore Clipper’s schedule induced a degree of planning complacency.
Although the primary method of navigating in the Little Russel was visual, ECDIS was not utilised effectively as a navigation aid. In particular, the safety contour value was inappropriate, the cross track error alarm was ignored and the audible alarm was disabled.
The layout of the central bridge console prevented the chief officer from utilising the ECDIS display to support the master during pilotage.
The significant navigational risk routinely being taken by the crew of Commodore Clipper and the ECDIS non-conformity went undetected by audits and inspections.

Safety issues not directly contributing to the accident that have been addressed or resulted in recommendations:

After the accident, Commodore Clipper passed within 100 yards of the Grune au Rouge rock and over the Boue de la Rade shoal; both events created an unnecessarily high risk of further groundings. These events reinforced the analysis that the bridge team was not distinguishing between safe and unsafe water.
The grounding caused significant damage, including flooding; however, it was extremely fortunate that this was contained within double-bottom void spaces.
Despite a noisy, shuddering vibration, the crew did not immediately search for damage or follow the grounding-raking checklist.
The possibility that the vessel had grounded was denied; this was reinforced by the absence of alarms, the steering and propulsion responding normally, and the master’s conviction that there had been sufficient depth of water where the vessel had passed.
No contingency planning or emergency response measures were activated by Guernsey Harbours’ staff as they were unaware of the grounding until over 2 hours after the incident.
As the responsible authority, Guernsey Harbours did not have an effective risk assessment or safety management plan for the conduct of navigation in the statutory pilotage area.
Special pilotage licence holders were thoroughly trained; however, there was no provision for continuous professional development after their initial qualification.
Guernsey harbour control was not routinely transmitting important navigational safety information to approaching vessels.
The grounding position was charted at 5.2m; however, it was subsequently established as being 4.6m below chart datum. Nevertheless, the difference between the charted and actual depths in the grounding position was within the source data accuracy for the quality of the survey of the area.