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US boy carrying replica gun shot dead by California police

"The deputies said they repeatedly ordered him to drop the rifle", reports Alastair Leithead

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A 13-year-old boy carrying a replica assault rifle has been shot dead by police in the US state of California.

Officers in the city of Santa Rosa say they opened fire after the boy refused orders to drop the rifle, which they believed to be real.

The shooting on Tuesday is now being investigated.

It comes a day after a 12-year-old boy in Nevada shot dead a maths teacher at his school and wounded two fellow pupils before taking his own life.

In the latest incident, two sheriff's deputies saw the teenager "with what appeared to be some type of rifle", a news release from the Sonoma County Sheriff's office said.

The deputies called for backup and repeatedly ordered the boy to drop the gun before firing several rounds from their handguns, police said.

Witnesses in Santa Rosa said they heard several shots

The boy, who was pronounced dead at the scene, was later identified by his family as Andy Lopez.

"He was holding the weapon in his left hand. He began to turn 

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A quarter of hospital trusts in England are at raised risk of providing poor care, a review by the regulator shows.

The findings are based on monitoring by the Care Quality Commission (CQC) of a host of data, including death rates, serious errors and patient surveys.

It found 44 out of 161 trusts fell into the two highest risk categories.

The exercise has been carried out as part of the regulator's new hospital inspection regime, which will see inspectors go into every trust by 2015.

The first inspections got under way in September and by Christmas the first 18 will have been completed.

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Analysis

This is the first time such comprehensive data has been pulled together in this way.

The work has involved the regulator pouring over a mountain of data.

But what does it tell us? The Care Quality Commission is being careful to stress it is not a final rating. Instead, it is being dubbed a screening tool - and like any screening it can throw up erroneous results.

For example, the scoring system actually suggests two of the 11 trusts already placed in special measures should be in band three (medium risk) - although they have been bumped up to band one anyway.

But even taking that into account, it provides one of the clearest indications yet of how trusts are performing against each other.

Patients will undoubtedly be interested in the results until the inspection programme is complete.

It will result in every trust being given a rating of either 'outstanding', 'good', 'requires improvement' or 'inadequate' as part of a shake-up in the system ordered after the Stafford Hospital scandal.

The CQC said the latest information was not a final judgement, but would be used to prioritise which trusts to inspect earlier in the process.

Hospital chief inspector Prof Sir Mike Richards likened the risk review to a form of "screening".

He added: "Our intelligent monitoring helps to give us a good picture of risk within trusts, showing us where we need to focus our inspections."

The regulator has assessed each trust's performance against up to 150 different