When considering post incident analysis, the "Swiss Cheese" method usually gets mentioned, namely that it isn't one single failure that leads to an incident, but several (Hence the holes lining up)
Here we have:
1. Notoriously unreliable level crossing equipment
2. A signaller with two fairly serious safety of line incidents on record in tbe past 2 years (Pulling off for a train before getting line clear and granting a line blockage with a train in section) as well as other incidents
3. A failure to implement the rules of S5 correctly (From driver and signaller)
Several have stated that the barriers in question fail on a fairly regular basis; this is not acceptable and NWR should be compelled to come up with a better solution, ASAP.
The two incidents on the signallers recent record, particularly regarding the line blockage, are definitely at the more serious end of the spectrum; was the signaller being managed effectively?
The lack of proper implementation of the rules of module S5 (Passing signals at danger with authority) is obviously the greatest concern. Taking the position of the LX barriers out of the discussion for a moment, there is no evidence that the crossing has been considered for the purposes of S5. When I authorise a train past a signal at danger that is protecting a level crossing, my instructions are something along tbe lines of
"Driver I require you to pass signal AB123 at danger, approach Anytown Level Crossing at caution, being prepared to stop short of the crossing, only cross if you deem it safe to do so. When you are clear of the crossing proceed through the remainder of the section at caution and obey the next signal" When the driver repeats back, I give them authority to pass the signal at ddanger. Looking through the report there is no evidence that any such instructions were given. Whilst it is the signallers responsibility to pass these instructions on, I would not class 23MPH as an appropriate speed for a driver to cross a level crossing when the driver has just been talked past the signal.