Prison Cat B training prison Key Concerns Identified Positive Findings

Swaleside

IMB Annual Report 2022 · Published 19 July 2022

HMP Swaleside experienced a challenging year (May 2021 - April 2022), marked by severe staff shortages, a restricted regime due to Covid-19, and a high number of deaths in custody and self-harm incidents. The Board highlighted significant concerns regarding staffing, the impact of new prisoner allocations, and the lack of essential equipment like body-worn cameras. Positive developments included excellent education provision, effective outreach services, and improvements in discrimination incident reporting, though overall challenges to prisoner welfare and safety persist.
Population
1,038
CNA (Designed For)
1,111
93% occupancy
Deaths in Custody
7
Self-harm Incidents
860
ACCT Cases Opened
449
Drug Finds
339
Positive Findings
The Board was impressed by the staff and governors' efforts to implement worthwhile regimes despite Covid-19 and severe staff shortages. Education provision by Milton Keynes College and the Swaleside outreach service (SoS) were excellent. The in-cell technology installation has commenced, and the kitchen maintained an impressive service. The equalities manager successfully cleared a backlog of discrimination incident reports, and the CSRU is generally well-run with a stable staffing group and high standards of treatment. The Sycamore Tree victim awareness course is a unique and valuable offering.
Key Concerns
Staffing Repeated
The Board is extremely concerned at the continuing low numbers of staff and the seeming inability to recruit. The inequality of pay and conditions when compared to other government agencies is certainly a factor in the cause of this issue together with the accessibility of the geographical area in which the prison is situated. The low numbers of staff severely impact the mental health and well-being of prisoners. Urgent action is needed to remedy this situation.
Safety
The Board shares the concerns expressed by the Senior Management Team regarding the number of deaths in custody during the year and appreciates that much investigation is being conducted by the LTHSE into the root causes of these. However, a national investigation is perhaps required to establish either commonality of cause irrespective of prison type or to highlight specific issues relating to particular establishments.
Segregation Repeated
The length of time spent in the CSRU by a number of prisoners is far too long and far exceeds normal recommendations. An effective means of reducing this time should be sought as a matter of urgency.
Regime/Time Out of Cell
The Board is concerned at the detrimental aspects of the recently introduced prisoner flow and allocation system such that Swaleside, a category B trainer within the LTHSE, is receiving young (21-24), shorter sentenced (as little as four weeks) prisoners to the detrimental effect of the well-being of older, long sentenced prisoners. This change should be re-examined and the benefit examined against its detrimental impact.
Safety
Prison staff should ALL have access to up-to-date body-worn cameras as issued to police and other services. Current equipment is inadequate and inappropriate and should be replaced urgently to support the reduced number of staff.
Food/Catering Repeated
The continued reliance of HMP Standford Hill on the kitchen at Swaleside for the preparation of its food continues to cause major issues, as has been stated for several years. The stalled installation of kitchens at HMP Standford Hill should be restarted urgently and be completed without further delay.
Staffing
The Board has seen examples of inadequacy of apprentice officer training and believes that training must at least result in those staff knowing what to expect when they arrive at their establishment. Shortage of trained staff exacerbates failings in this respect.
Equality/Diversity Repeated
The inequality of opportunity for men convicted of sexual offences (MCOSO) and vulnerable prisoners still needs to be addressed, despite progress made in that direction.
Mental Health
The Board has concerns regarding the mental health of prisoners who have suffered long-term lockdown as evidenced by the high number of assessment, care in custody and teamwork (ACCTs) cases, self-harm cases and general violent incidents. The necessity for increased psychology and psychiatric services should be assessed.
Healthcare Repeated
The continued occupancy of the life limited room in healthcare by one paraplegic prisoner whose needs are different, whilst there are a number of other prisoners who qualify for the use of this room requires urgent resolution.
Safety
A solution should be found for the lack of external gate security (EGS) staff as a matter of urgency.
Safety
Wellbeing checks for all prisoners must be increased and maintained regularly to prevent self-harm.
Mental Health
The Board believes that more could be done to avoid self-seclusion by prisoners and wonders whether more help should be sought from psychological services.
Food/Catering Repeated
The Board is again concerned at the lack of discipline and cleanliness at wing serveries and believes that this should receive immediate attention. This approach should insist on the use of temperature probes and ‘whites’ to avoid a health risk to prisoners.
Staffing
Training on the use of Planet FM should be given to senior officers (SOs) and above to ensure a correct interface is maintained with GFSL.
Other Repeated
The number of adjudications dismissed or ‘not proceeded with’ has continued at a high level. Further staff training is required to remedy this situation.
Substance Misuse
Adjudication awards should be re-examined to ensure that appropriate disincentives for prisoners are available. This seems particularly pertinent for prisoners producing hooch or distilled liquor.
Safety
Challenge, support and intervention plan (CSIP) should receive more attention from custody managers (CMs) as evidenced by minutes from the weekly safety intervention meetings (SIMs).
Estate/Conditions
GFSL should be tasked with improving the rate at which out of action cells are brought back into use.
Estate/Conditions Repeated
The installation of showers throughout the establishment should be completed. The identified faults with recently installed showers should be remedied urgently.
Safety
The IMB is concerned at the occasional failure to be invited to serious incidents and planned moves to the CSRU and would appreciate the necessity for this to be reiterated to all senior staff.
Board Commentary
Staffing
Swaleside faces an unprecedented period of staff shortage, with only 160 uniformed staff available out of an agreed complement of 261, severely impacting prisoner and staff well-being and regime provision. Over 35% of uniformed staff have less than two years’ experience, and the prison struggles to recruit due to its isolated location and uncompetitive pay compared to other government agencies. This shortage has led to the almost total withdrawal of the key worker scheme, causing frustration and worry for prisoners.
Healthcare
Healthcare services transferred from IC24 to Oxleas Healthcare Trust on 1 April 2022, with early indications being encouraging despite continuing staff shortages. A long-term issue persists with a paraplegic prisoner who requires specialist care remaining in the healthcare unit's disabled cell, making it unavailable for others. Despite agreement at the highest levels, no transfer has occurred, a situation the Board deplores. Missed outside specialist appointments continue, often due to a lack of escort staff.
Regime & Daily Life
The reporting year was challenging due to Covid-19 restrictions and severe staff shortages, which at one point limited time out of cells to just 30 minutes per day. This resulted in a restricted regime for most of the year, with limited prisoner working and the closure of all 'self-cook' facilities, contributing to increased self-harm and boredom. The lack of meaningful activity for the majority of prisoners, outside of two wings, remains a significant concern, with little prospect of normal activities resuming until staffing improves.
Applications to the IMB

Prisoners can apply to their IMB about any aspect of their treatment. This table shows application counts by category.

Category Current Previous Change
Accommodation (including transfers) 129 100
Discipline 128 155
General treatment 179 185
Healthcare 105 104
Information 119 120
Other/unknown 163 115
Property 196 185
TOTAL 1,019 964
Recommendations (21)
HMPPS: 9 Ministry of Justice: 1 Governor / Director: 11 8 repeated
Recommendation 1 Repeated
The Board is extremely concerned at the continuing low numbers of staff and the seeming inability to recruit. The inequality of pay and conditions when compared to other government agencies is certainly a factor in the cause of this issue together with the accessibility of the geographical area in which the prison is situated. The low numbers of staff severely impact the mental health and well-being of prisoners. Urgent action is needed to remedy this situation.
HMPPS Staffing
Recommendation 2
The Board shares the concerns expressed by the Senior Management Team regarding the number of deaths in custody during the year and appreciates that much investigation is being conducted by the LTHSE into the root causes of these. However, a national investigation is perhaps required to establish either commonality of cause irrespective of prison type or to highlight specific issues relating to particular establishments.
Ministry of Justice Safety
Recommendation 3 Repeated
The length of time spent in the CSRU by a number of prisoners is far too long and far exceeds normal recommendations. An effective means of reducing this time should be sought as a matter of urgency.
HMPPS Segregation
Recommendation 4
The Board is concerned at the detrimental aspects of the recently introduced prisoner flow and allocation system such that Swaleside, a category B trainer within the LTHSE, is receiving young (21-24), shorter sentenced (as little as four weeks) prisoners to the detrimental effect of the well-being of older, long sentenced prisoners. This change should be re-examined and the benefit examined against its detrimental impact.
HMPPS Regime
Recommendation 5
Prison staff should ALL have access to up-to-date body-worn cameras as issued to police and other services. Current equipment is inadequate and inappropriate and should be replaced urgently to support the reduced number of staff.
HMPPS Safety
Recommendation 6 Repeated Prev. unaddressed
The continued reliance of HMP Standford Hill on the kitchen at Swaleside for the preparation of its food continues to cause major issues, as has been stated for several years. The stalled installation of kitchens at HMP Standford Hill should be restarted urgently and be completed without further delay.
HMPPS Food
Recommendation 7
The Board has seen examples of inadequacy of apprentice officer training and believes that training must at least result in those staff knowing what to expect when they arrive at their establishment. Shortage of trained staff exacerbates failings in this respect.
HMPPS Staffing
Recommendation 8 Repeated
The inequality of opportunity for men convicted of sexual offences (MCOSO) and vulnerable prisoners still needs to be addressed, despite progress made in that direction.
HMPPS Equality
Recommendation 9
The Board has concerns regarding the mental health of prisoners who have suffered long-term lockdown as evidenced by the high number of assessment, care in custody and teamwork (ACCTs) cases, self-harm cases and general violent incidents. The necessity for increased psychology and psychiatric services should be assessed.
HMPPS Mental Health
Recommendation 10 Repeated Prev. unaddressed
The continued occupancy of the life limited room in healthcare by one paraplegic prisoner whose needs are different, whilst there are a number of other prisoners who qualify for the use of this room requires urgent resolution.
HMPPS Healthcare
Recommendation 11
A solution should be found for the lack of external gate security (EGS) staff as a matter of urgency.
Governor / Director Safety
Recommendation 12
Wellbeing checks for all prisoners must be increased and maintained regularly to prevent self-harm.
Governor / Director Safety
Recommendation 13
The Board believes that more could be done to avoid self-seclusion by prisoners and wonders whether more help should be sought from psychological services.
Governor / Director Mental Health
Recommendation 14 Repeated Prev. unaddressed
The Board is again concerned at the lack of discipline and cleanliness at wing serveries and believes that this should receive immediate attention. This approach should insist on the use of temperature probes and ‘whites’ to avoid a health risk to prisoners.
Governor / Director Food
Recommendation 15
Training on the use of Planet FM should be given to senior officers (SOs) and above to ensure a correct interface is maintained with GFSL.
Governor / Director Staffing
Recommendation 16 Repeated
The number of adjudications dismissed or ‘not proceeded with’ has continued at a high level. Further staff training is required to remedy this situation.
Governor / Director Other
Recommendation 17
Adjudication awards should be re-examined to ensure that appropriate disincentives for prisoners are available. This seems particularly pertinent for prisoners producing hooch or distilled liquor.
Governor / Director Substance Misuse
Recommendation 18
Challenge, support and intervention plan (CSIP) should receive more attention from custody managers (CMs) as evidenced by minutes from the weekly safety intervention meetings (SIMs).
Governor / Director Safety
Recommendation 19
GFSL should be tasked with improving the rate at which out of action cells are brought back into use.
Governor / Director Estate
Recommendation 20 Repeated Prev. unaddressed
The installation of showers throughout the establishment should be completed. The identified faults with recently installed showers should be remedied urgently.
Governor / Director Estate
Recommendation 21
The IMB is concerned at the occasional failure to be invited to serious incidents and planned moves to the CSRU and would appreciate the necessity for this to be reiterated to all senior staff.
Governor / Director Safety
Other IMB Reports for Swaleside
2025 Published 14 Oct 2025 922
2024 Published 30 Aug 2024 900
2023 Published 8 Sep 2023 828
2021 Published 3 Sep 2021 989
2020 Published 5 Aug 2020 1,083
HMIP Inspections

Recent inspections by HM Inspectorate of Prisons for this establishment.

15 Dec 2025 Urgent Notification
11 Sep 2023 Announced
Safety: 2 Respect: 2 Activity: 2 Release: 2
PPO Fatal Incidents

Prisons and Probation Ombudsman fatal incident investigations for this establishment.

Thomas Ruggiero
Self-inflicted · Report published
Peter Turner
6 Feb 2025 · Natural causes · Report published
Tony King
18 Jun 2024 · Natural causes · Report published
Prevention of Future Deaths Reports

Coroner PFD reports issued to this establishment.

Thomas Ruggiero
24 Mar 2026 · State Custody related deaths
Sean Davies
8 Aug 2024 · Suicide (from 2015)
Idris Habib
24 Jan 2022 · State Custody related deaths | Mental Health related deaths
Douglas Birch
13 Jul 2015 · State Custody related deaths