AB — HMP Bedford

We recognise that there was an issue related to the sharing of information between the police and prison but do not consider that definitions of self-harm are the key to improvement. The official mechanism for sharing information between agencies is the Person Escort Record (PER) form. It is accepted that had this accurately reflected the risk presented by the prisoner, reception staff may have acted differently. There is currently a joint inspection looking at the quality of PER completion. Additionally escort staff can open a Suicide/Self Harm Warning Form if they believe a prisoner is at current risk of suicide or self harm. This will be based on the information they have available from other agencies. Prison Service Instruction (PSI) 64/11 Safer Custody came into force on 1 April 2012 [it replaces Prison Service Order 2700 Suicide Prevention & Self-harm Management]. Chapter 3 of the PSI sets out the risks and triggers that staff should consider when identifying prisoners at risk of self-harm and/or suicide. Staff must also check relevant documents, such as the PER, for evidence of risk. This recommendation has not been shared with the police but the investigator may wish to consider whether he wishes to raise this with ACPO in relation to the joint inspection.

HMP Bedford has accepted the recommendation and will prioritise the processing in Reception of those prisoners who are identified as having high media interest after those assessed as being at risk of self-harm where possible. The prison has issued an instruction to all Reception staff and those prisoners identified as high media interest will be brought to the attention of the senior management team at the daily operational meeting. A range of offenders will attract media attention and this may not always be due to the nature of their offence. NOMS policies already highlight the need to consider a range of circumstances when determining a prisoner’s risk of harm. PSI 64/2011 ‘Safer Custody’ recognises that a prisoner’s risk of self-harm and/or suicide may increase in certain situations. In particular it highlights that risk factors for suicide include the offence, particularly for those charged with violence against another person, especially against family members or partners, and arson. Additionally, PSI 74/2011 ‘Early Days’ requires all prisoners to be risk assessed for potential harm to themselves, to others and from others. The PER and any other available documentation (including Suicide & Self Harm Warning Forms, ACCT (Assessment, Care in Custody & Teamwork) documents and cell sharing risk assessment (CSRA) assessments) must be examined, and the prisoner interviewed in Reception, to assess the risk of self-harm or harm to others by the prisoner, or harm from others. Assessments must also be made of prisoners who by-pass some Reception processes owing to their late arrival or disruptive behaviour, and those whose status and demeanour may change after a court appearance via video link.

HMP Bedford will introduce a system whereby all identified high profile cases (including prisoners that attract a high media attention in the community) will be brought to the attention of the Senior Management Team meeting at the earliest opportunity and a case management team identified. The outcomes will be recorded in the prisoner’s case notes on Prison-NOMIS (Prison National Offender Management Information System), which is a single national database of offender information that allows information to be shared throughout the prison system. PSI 74/2011 ‘Early Days’ contains guidance for prisons on managing prisoners during their ‘early days’ stages of prisoners’ time in custody – first reception into prison, the first night spent in prison custody , and induction into prison life generally and the establishment where they are located. The prisoner’s risk of self-harm or harm to others by the prisoner, or harm from others will be risk assessed following examination of the PER and other available documents and an interview with the prisoner. For prisoners who are new to prison custody, or new to the current establishment, they will spend their first night in the establishment in the First Night Unit, or other accommodation, such as the Segregation Unit or Healthcare, as necessary. If a prisoner is identified as being at risk of self-harm (whether they are high profile or not), consideration will be given to the most appropriate place to locate them within the prison.

Staff at a local level will determine the frequency of checks of prisoners in the holding room based on their vulnerabilities at the time. HMP Bedford have advised that prisoners that are considered or identified as being at risk of self-harm, are fast tracked and prioritised through the reception process and located onto a residential area as soon as possible.

There are too many variables to make a simple, easy to follow algorithm for staff. The decision making around categorisation is already well-documented and it is not considered that further changes are required. HMP Bedford has a procedure in place as part of their local security strategy. Any decision to hold a Potential Category ‘A’ board and the outcome will be recorded on the security IT system.

HMP Bedford has confirmed that this is completed as part of the prisoner no longer being treated as a Potential Category ‘A’.

NOMS has in place several policies that include the requirement to obtain next of kin details from prisoners during their early time in prison custody. PSI 74/2011 ‘Early Days’ requires that details of all newly arriving prisoners must be recorded in their personal record, known as the F2050, and on Prison-NOMIS. The information recorded must include the name and contact details of the prisoner’s next of kin or nominated contact. Additionally PSI 64/2011 Safer Custody contains a section regarding family engagement. It requires that prisons must record a next of kin or nominated person to contact for each prisoner during the reception/early days process. This information must be kept up to date. HMP Bedford agrees in principle to the recommendation but highlights that foreign nationals are sometimes reluctant to disclose this information for other reasons.

How cells are allocated is a matter for the Governing Governor to determine at a local level. It is not considered that a national policy is necessary at this time. For prisoners who have an ACCT plan open, PSI 64/2011 ‘Safer Custody’ requires case managers and case review teams to consider the type/place of location, including cell sharing, safer cell when completing the CAREMAP. The CAREMAP records actions that are tailored to meet the individual needs of the prisoner and are aimed at reducing the risk of harm to them. It is reviewed at each case review. The case managers and case review teams must base their decision on where to locate an at risk prisoner against the risk they present to themselves and others and the benefits the location may afford them. There is also a policy for the cell sharing risk assessment (CSRA) PSI 9/2011, which is an essential tool in the identification of prisoners who may pose a risk of assaulting or killing a cell mate in a locked cell. Whilst this is not the focus of your recommendation, it will have an impact on the allocation of a prisoner to a cell type. HMP Bedford has advised that all prisoners are allocated accommodation according to their individual risk factors and any medical concerns that have been identified as part of their cell sharing risk assessment and the reception screening process. A multi-disciplinary team will decide the appropriate location for prisoners that are subject to ACCT monitoring.

HMP Bedford has advised that it would be impractical for managers to countersign all internal cell moves. It is however expected that staff should make entries onto Prison-NOMIS regarding any concerns for the safety and wellbeing of a prisoner and this may lead to a cell move. Such concerns may also be recorded in the ongoing record that forms part of the ACCT plan and/or the wing observation book.

PSI 09/2011 ‘Cell Sharing Risk Assessment’ (CSRA) requires that all CSRA assessments and review decisions must be entered on Prison-NOMIS in addition to completing the paper form. The paper form is kept in the prisoner’s core records (the F2050). The CSRA PSI states that it will be necessary to review all high risk assessments, either when risk factors change or when offender management reviews take place. The timing for these reviews is determined by the nature of the risk. Additionally, it sets out that it will also be necessary to review standard risk assessments where new or additional information becomes known which indicates increased risk. All reviews must be carried out by, or subsequently approved by, a multi-disciplinary team to ensure a balanced and reasonable risk decision is taken. Duty governors or managers can authorise urgent review decisions pending confirmation by the multi-disciplinary team.

PSI 64/2011 ‘Safer Custody’ is not prescriptive regarding case management, however, ACCT Case Manager Training highlights the benefits of operating a consistent Case Manager approach, which can be achieved in a number of ways. Multi-disciplinary working is also important. PSI 64/2011 ‘Safer Custody’ is not specific about the role of the Case Manager. It is for the Governor to determine how the case management process will operate. Continuity of care is only one way of delivering effective case management. HMP Bedford confirms that every effort is made at the prison to ensure continuity of case managers throughout the ACCT process.

There is no requirement for prison establishments to offer a Personal Officer Scheme. However, PSI 75/2011 ‘Residential Services’ highlights the importance of staff in residential units building good relationships with prisoners, interacting with them regularly and providing positive role models. Governors will decide the best way of achieving this locally. Additionally, PSI 64/2011 ‘Safer Custody’ recognises that good staff/prisoner relationships are fundamental to the management of safe and decent prisoners. Although it does not require specific staff to be allocated to individual prisoners, it includes reference to inviting a member of staff who knows the prisoner, e.g. wing officer to the first case review. Thereafter the ACCT case manager will determine who should be invited to attend/input into future case reviews. Every effort is made at HMP Bedford to ensure continuity of case managers throughout the ACCT process.

NOMS recognises the benefit of inviting those staff that may provide helpful input at an ACCT review. PSI 64/2011 ‘Safer Custody’ states that the first case review should be attended and chaired by the Residential Manager, or equivalent and/or the Case Manager (if different), the Assessor, whenever possible, a member of staff who knows the prisoner e.g. wing officer, the person who raised the initial concern, healthcare, and any other member of staff who has or will have contact with the at-risk prisoner and who can contribute to their support and care e.g. staff from Probation, Education, CARATS, psychology, etc. This review should be timely and not unduly delayed to ensure full attendance. It also states that if invited participants cannot attend in person, exceptionally, they can provide a written account of their input. Subsequent case reviews should be multi-disciplinary where possible. The PSI recognises that the ACCT process will operate more effectively if there is continuity in the attendance of staff from relevant departments/services. For example, if education is seen as a relevant department to attend the review, then every effort should be made to ensure the same member of staff attends the reviews. HMP Bedford has confirmed that individual agencies within the prison are invited to attend the next case review as part of the ACCT process, where considered appropriate.

PSI 64/2011 ‘Safer Custody’ states that the person named against each of the actions required in the CAREMAP must complete their actions within the timescale given. Additionally ACCT case manager training covers this issue and the CAREMAP form itself includes a prompt that actions are allocated to a specific person and timescale. HMP Bedford will issue an instruction to case managers to remind them that action point in the CAREMAP should be time bound. Senior Managers will be tasked to ensure compliance.

PSI 64/2011 ‘Safer Custody’ includes a chapter that identifies a number of potential triggers which may increase risk of harm to self or others. It states that where these triggers are identified as being relevant to a prisoner, appropriate action must be taken. In addition PSI 64/2011 states all staff that have contact with prisoners must be aware of the triggers that may increase the risk of suicide, self harm or violence and take appropriate action. PSI 64/2011 also recognises that not all triggers are identifiable and predictable, such as anniversaries.

ACCT Case Managers receive training on the broader management of risk management rather than focussing on the trigger points. The process seeks to address the reasons for the prisoner’s crisis, including any potential triggers, and to address them by means of structured intervention. PSI 64/2011 states that the trained ACCT Assessor must make every effort to engage with the prisoner being assessed during his ACCT assessment interview. However, if a prisoner refuses to be interviewed or is unable to participate in the interview, the ACCT assessor must undertake the assessment based on all the available information. The first ACCT case review should be attended by the ACCT Assessor, wherever possible. If the ACCT Assessor cannot attend then they must meet with the Residential /Case Manager prior to the first case review and give a detailed summary of the assessment discussions and key issues. PSI 64/2011 ACCT Assessor Training includes sections on dealing with prisoners who are non responsive or for whom English is not a first language. Where prisoners do not speak English, ACCT assessments must be undertaken with the assistance or involvement of an interpreter, or appropriate translation service. Furthermore, whilst an ACCT plan is open, staff must engage with the prisoner, encouraging him/her to talk and participate in activities where appropriate.

Prisons have systems in place for the sharing of information. Whilst the views of cellmates would not be proactively sought when a prisoner’s level of risk is being assessed. Any prisoner is able to report concerns about another prisoner to staff. Whenever any member of staff is made aware that a prisoner may be at risk of suicide or self harm they are required to consider opening an ACCT document. PSI 64/2011 ‘Safer Custody’ recognises that staff may receive information from various sources, including from family members or external agencies. If this information indicates a risk of suicide/self harm then they must consider opening an ACCT plan.

Whilst it is accepted that research of this type may assist NOMS to identify a particular risk factor for a select group of prisoners, NOMS does not propose to take this recommendation forward at this time of scarce resources. All prisons have Chaplains and Chaplaincy teams in place to meet the needs and reflect the faith make up of the prison population. Additionally, there is a provision in PSI 51/2011 ‘Faith and Pastoral Care for Prisoners’ for a Chaplain to be appointed on a temporary basis to meet particular needs of prisoners with regard to denomination, language or culture. Each prison has a Co-ordinating Chaplain who leads on Chaplaincy strategy and development. At HMP Bedford the Co-ordinating Chaplain has the opportunity to input into local policies and strategies for foreign national prisoners, where appropriate, as they are part of the Senior Management Team. Furthermore, each prison will agree a programme setting out the details of the Chaplaincy educational classes and cultural activities. The programme should make provision for religious education and nurture within each faith group.

NOMS has recently adopted a policy of concentrating foreign nationals in fewer prisons. This means that staff in those prisons develop a greater understanding of their needs. All prisons have Chaplains and Chaplaincy teams in place to meet the needs and reflect the faith make up of the prison population. Where a prisoner’s faith is not represented, arrangements are made for them to have access to a Minister of their own faith. This may be achieved by appointing on a temporary basis to meet particular needs of prisoners with regard to denomination, language or culture. The Chaplaincy will also maintain and develop links with the wider faith community, where necessary.