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UK: Social care in prisons in England and Wales

16th October 2018

Her Majesty’s Inspector of Prisons and the Care Quality Commission have published a thematic report on Social care in prisons in England and Wales. The report outlines current practice regarding social care in the prison system and makes recommendations for the improvement of such services. A summary of the report’s key findings and recommendations is outlined below.

Increasing prison populations, coupled with longer sentences has led to an increase in the number of prisoners aged 50 or over. Reports have also suggested that prisoners experience a faster ageing process than those in the community. This is due to a number of factors occurring both during a prison sentence and prior to detention.  This aging prison population, along with increased frailty and incidents of dementia has accelerated the need for prisons to address social care needs.

The process of identifying prisoners with social care needs varied between establishments. The majority of prisoners with social care needs were appropriately identified and referred on arrival but procedures were not in place to identify or comprehensively assess those with social care needs in all establishments. Delays in the identification of social care needs caused frustration for prisoners, and also led to some prisoners being inappropriately housed within the prison. 

Prisoners’ identified social care needs were not being consistently met, but many prisons had made progress in delivering effective care planning and delivery systems. Of those who had care plans developed, some prisoners reported that they were not involved in the development of the plans, or that they were not aware of the contents of the plan. 

In some establishments, all social care was delivered on vulnerable or older prisoner units. This limited the access to support leading to poorer outcomes for prisoners and meant that some prisoners had to accept vulnerable prisoner status to receive social support. Prisoners with high-level social care needs were often located in the inpatient health care units as suitable alternative accommodation was not available.

In some prisons social care staff received training in both social care and working in a prison setting. However, social care was not always delivered by the appropriate social care staff, when provision was underdeveloped prisoners were supported by healthcare staff. Prisoners often reported problems accessing support overnight, even on the health care units.

Not all prisons were able to meet the social care needs of prisoners regarding adaptations to the built environment to assist with mobility. Cells were often small, limiting the accessibility for those with mobility issues. Older establishments were also not able to provide accessible cells on their standard accommodations meaning prisoners had to be transferred to different units to access facilities. 

Adaptations to existing cells allowed for prisoners to get around their cells more easily but there were often delays in these being carried out causing frustration for prisoners.  Some prisons provided emergency call bells or provided extra night time checks for prisoners at risk of falling, and most prisons had personal emergency evaluation plans for prisoners receiving social care.

Processes surrounding the transfer and release of prisoners in need of social care are not well established and more should be done to ensure that continuity of care is maintained. Problems were encountered regarding information not being provided to receiving establishments, leading to gaps in care provision. There was also not always clear communication between prisons and community providers of social care when prisoners were released. 

The report on Social care in prisons in England and Wales is available on the HMIP website.

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