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3. Summary of Inspections Undertaken 2008-2009
Establishments
HMP Dumfries
Full Inspection 28 April-2 May 2008
The basic necessities of life are provided and the quality of food is good. However, some living areas do not have natural light; some cells have unscreened toilets; arrangements for the provision of underwear are poor; and the timing of meals is poor. Some mattresses are also in a very poor condition and exercise is not provided in appropriate areas.
The prison is safe; relationships are good; prisoner escort arrangements are appropriate; and there have been no suicides since the last inspection.
Prisoners are treated with respect by prison staff.
There is good communication between the prison and the escort provider; vehicles are clean; and escort staff treat prisoners with respect.
Arrangements for maintaining family contact are reasonably good: the visits room is bright, airy and spacious; facilities for visitors are good; and supervision arrangements during visits are appropriate. However, the visits booking system was not working properly and there was very little information for visitors.
Disciplinary procedures and the handling of privileged mail are carried out appropriately. However, complaint forms are not readily available in all residential areas.
All prisoners have access to learning opportunities, including those on remand and those serving short-term sentences. Around one third of prisoners participate in Learning, Skills and Employability activities.
Waiting times to see the doctor are good, and the Health Centre is clean and tidy. The addiction service generally is good. However, the referral system to the Health Centre is poor, and no appointments for healthcare are provided. Access to the dentist was very poor due to refurbishment of the dentist's room. The timing of medicine distribution at weekends is inappropriate.
Arrangements for Integrated Case Management are good; some programmes to address offending behaviour are in place; a wide range of community based partner organisations operate within the prison; and there is a well structured pre-release programme in place for long-term prisoners. However, because the sex offenders being held deny their crimes they do not participate in the " SOTP" programme which is designed specifically to address sex offending behaviour.
HMP Peterhead
Focused Inspection 3-4 June 2008
The basic necessities of life are provided although the cellular accommodation is the worst in the SPS and a form of slopping out still exists.
There are very limited opportunities to engage in purposeful work or activities.
Some small improvements have been made to the visits facility and prisoners are often able to have visits over and above their statutory entitlement. However, the visits room itself is very small and cramped and the catering facilities for visitors are poor.
There is no formal ongoing training for visit staff on child protection.
The number of prisoners completing the ' SOTP' programme, designed specifically to tackle sex offending behaviour, has increased slightly. However, there are long waiting lists and demand is not being met. As a consequence high risk prisoners may be returned to the community on completion of their sentence without having addressed their sex offending behaviour.
Some improvements have been made to healthcare provision and the service available to prisoners is now much better. Addiction services have been introduced. However, there is no full time mental health or addictions nurse and the arrangements for administering some medications gives cause for concern.
The Open Estate
Focused Inspection 15-19 September 2008
Prisoners are not exposed to harm and they report feeling safe. However, the immediate post Extended Home Leave Act2Care risk assessment is inadequate.
The system in closed establishments for assessing suitability for the Open Estate is now much more robust and at the time of inspection there were proportionately fewer short-term prisoners and more long-term prisoners preparing for release being sent to the prison. This has improved the atmosphere and reduced tensions.
The processes connected to the risk assessment and risk management of prisoners have improved considerably.
Work, Vocational Training and Community Placements are all relevant to current labour market opportunities. However, the range of education courses available is limited and there are very few prisoners undertaking literacy programmes. Arrangements to engage prisoners with literacy and numeracy requirements are not sufficiently proactive.
Extended Home Leave and Community Work Placements are the main means of reintegrating prisoners into the community. The Community Placements Scheme is excellent, but there are few opportunities for families and prisoners to prepare, together, for Extended Home Leaves. There is a lack of accredited programmes to address offending behaviour, and no "top up" programmes. Sex offenders receive the worst preparation for release.
Extended Home Leaves give prisoners significant periods of time with their families and friends. However, families are not involved in the arrangements for these. Visiting arrangements within the two sites are very good and staff are courteous, polite and helpful. There is no formal family strategy in place which encourages family involvement at induction, in addictions, or at other stages of the prisoner's stay in the Open Estate.
There has been a significant drop in the level of illegal drug taking across both sites.
The range of healthcare services is very good at both sites. However, the times at which prisoners can access these services is more restricted at Noranside than at Castle Huntly.
Whilst methadone throughcare is excellent on both sites the administration of this at Noranside falls outside recommended standards.
Relationships are in general good.
HMP Aberdeen
Full Inspection 6-10 October 2008
Prisoners report feeling safe and initial risk assessments are carried out appropriately. However, the prison is very overcrowded and there is a shortage of staff. The facilities in reception are poor.
Prisoners are treated well by Reliance Custodial Services' staff when under escort. However, the conditions in the holding rooms at Aberdeen Sheriff Court are unacceptable.
Cell windows are in a poor condition; protection prisoners have limited access to exercise; the food is poor; and prisoners do not get the same prison issue clothing (including underwear) back which they handed in to the laundry. There are often shortages of prison kit.
Prisoners are treated with respect by prison staff and relationships are good. Multicultural issues are dealt with appropriately.
The visits room is inadequate and there are no facilities for visitors or children; visits are difficult to book; there is no family policy; and the visits area is not wheelchair friendly.
Complaints forms are readily available and privileged mail is handled appropriately.
All prisoners have access to very good learning opportunities, including those on remand. High numbers participate in the education programme. However, prisoners do not have sufficient access to opportunities to work or gain work-related qualifications.
Healthcare is good, particularly in the context of the complex prisoner mix and high levels of overcrowding. However, the provision of dentistry and mental health support is inadequate, and the addiction service is struggling to meet the demands caused by overcrowding and a lack of staff. The health centre is not fit for purpose.
The prison has developed good relations with a wide range of community agencies. There are very good links with Jobcentre Plus and community employers. A good pre-release programme is in place.
HMP Edinburgh
Full Unannounced Inspection 12-21 January 2009
The new buildings provide excellent living conditions. The new reception facility is excellent and canteen provision is very good. The food is good at the point of cooking although it deteriorates when being transported to the halls. Prisoners are able to have their clothes washed every day during the week and there are good opportunities for exercise.
The prison is safe; levels of serious violence are low; there have been no escapes since the last inspection.
Relationships between prisoners and staff are very good; but there was little evidence of informal contact in prisoner areas of halls.
Prisoners are treated well by escort staff. Conditions in Edinburgh Sheriff Court are good. Conditions in Linlithgow Sheriff Court are poor.
The visits room is spacious and bright; prisoners book the visits; a number of family initiatives are in place and the Visitors Centre is a very good facility. However, there are no facilities for children in the visits room and the system for getting visitors from the Visitors Centre to the visits room is inadequate.
There are few opportunities for out-of-cell activities for remand prisoners, their accommodation is the least good, and their recreation facilities are poor.
Disciplinary procedures are fair and open. Conditions in the segregation unit are good. Complaints forms are not readily available throughout the prison.
Chaplaincy services are well developed, active, and integrated into the prison regime.
Very few prisoners go to work: the workshops are often empty.
There is very little available to prisoners at weekends.
Learning, Skills and Employability provision is good. Prisoners have good access to a wide range of learning opportunities, and receive high quality teaching and support.
The provision of healthcare is good: facilities are excellent, although underused, and there is a developing mental health service. The referral system to see the doctor is not working effectively.
The prison has developed excellent links with community-based organisations.
Other Reports
Out of Sight: Severe and Enduring Mental Health Problems in Scotland's Prisons
Thematic Inspection 2008
The main focus was as follows:
This was a thematic inspection focusing on "severe and enduring" mental health problems of prisoners in Scotland. This includes prisoners with a formal diagnosis of a severe and enduring mental health problem, and those who have not been diagnosed, but whose behaviour indicates that they experience such problems, or who suffer substantial disability as a result of their problems.
The main findings were as follows:
A very large proportion of prisoners have some form of mental health problem. Of these, only a small proportion have severe and enduring mental health problems. At least 315 prisoners with severe and enduring mental health issues were identified by prisons (not counting Polmont where psychiatrists do not diagnose young people). A further eight prisoners were identified who were, at the time, undergoing assessment in a hospital facility. Excluding Polmont, this represents around 4.5% of all prisoners. This is a much higher proportion than in the population as a whole.
The number of prisoners with severe and enduring mental health problems appears to be rising, although it was not clear if the numbers themselves are increasing, or if the visibility of mental health problems is increasing.
The most common types of severe and enduring mental health problems in Scottish prisons are schizophrenia and bi-polar affective disorder. There is also a significant number of prisoners with a personality disorder. The majority of prisoners with mental health problems also have substance misuse issues.
Prisoners with severe and enduring mental health problems have an impact on the general running of an establishment, with this group seen as being both resource-intensive and a cause of disruption. There is also an impact on prison staff, in terms of the physical and emotional demands of being required to manage difficult behaviour and respond to complex needs.
The impact on other prisoners is general disruption; disproportionate use of staff time; less access to facilities; and a charged atmosphere.
The fact and nature of imprisonment itself does real harm to people with severe and enduring mental health problems.
These impacts are exacerbated by overcrowding.
Reception and induction processes can provide the first opportunity to identify mental health needs. During a sentence, the main ways of identifying mental health problems are through observation by prison staff, other workers, prisoners, and through self-referral.
There are a number of gaps in the identification of mental health problems and needs. These include: problems with the transfer of information from courts and the community; difficulties for prisoners in disclosing issues; problems with processes and operational issues; and problems with staff being able to identify issues. These difficulties can mean that some prisoners with severe and enduring mental health problems may not access assessment and referral.
Once prisoners have been identified as having severe and enduring mental health problems which do not require transfer to hospital, the treatment which they receive in prisons generally includes: medication; access to a psychiatrist; and input from a mental health nurse.
Segregation units and separate cells are used at times, with difficulties faced in making distinctions between mental health and behavioural or management problems. The use of segregation as a response to mental illness is wrong.
The provision of advocacy support varies. In some prisons, there was no provision, or it was virtually non-existent. Prisoners generally had no awareness of their right to access advocacy support under the Mental Health (Care and Treatment) (Scotland) Act 2003.
A number of concerns were expressed with aspects of existing provision including variations and gaps in practice and treatment; issues with medication; issues with the use of segregation; a lack of an holistic approach; a lack of day care facilities; a lack of "talking treatments"; the removal of in-patient facilities; and issues relating to overcrowding, staffing, information and other resources.
Prisoners diagnosed with severe and enduring mental illness and requiring transfer to hospital may wait longer than similar people in the community.
The referral, assessment and transfer processes are generally appropriate.
In most hospitals, the number of prisoners forms a very small proportion of the total number of patients, although this is larger in the medium and high secure facilities. These patients have access to a range of treatment, interventions and support, which are generally the same as that available to any other patient, but in the main are not available in prisons.
Unlike prison, advocacy is available in all of the hospitals visited, and some hospitals have an advocacy service on-site.
Prisoners face a range of issues prior to release, and accessing support is very important. Some work is being carried out in prisons to assist prisoners in preparing for their release and in accessing support, but the nature of this varies, particularly in relation to the level of formalised planning undertaken. A more systematic, formal, process for making arrangements to prepare people for return to the community and to ensure that their care continues is in place in hospitals.
In many cases, prisoners being released from prison have to approach organisations in the community at their own instigation, with limited external support available. Some prisoners with severe and enduring mental health problems are released from prison with few if any links to continuing support in the community, and without any arrangements for the continuation of any work which had started in prison.
There is a number of perceived difficulties in securing access to services upon release, such as GP services, hospital services, housing services, and issues for some specific groups. There are difficulties in gaining access to an in-patient bed when this is required. There are also issues relating to geographical variations and capacity of services, as well as a lack of communication between agencies.
The level and nature of healthcare staff, and particularly mental health specialist staff varies widely across prisons. Generally, nursing teams are available on a weekly basis, although there is little or no mental health nursing cover on-site overnight or at weekends. Most prisons have access to a psychiatrist, although for a relatively small number of hours.
There is concern about the level of specialist staffing resources available, the number of competing priorities, and the extent to which existing arrangements have sufficient resilience to cope with, for example, a member of staff leaving, or periods of sickness.
In all prisons, residential and operational staff have a less well-defined, but still important, and increasing role, to play in relation to prisoners with severe and enduring mental health problems. A number of concerns were raised that staff: lack specific training; may lack confidence; may feel that they have not had sufficient guidance; may have insufficient time to interact with prisoners; and may lack information about the prisoners' problems and the impact of any steps they take in working with them.
Healthcare beds have been phased out in virtually all prisons, which has given rise to concerns both within prisons, and among NHS staff. This means that more prisoners who might have been located in these beds are now located in halls.
There is some positive work taking place with prisoners with severe and enduring mental health problems, despite some of the difficulties and constraints. There have been developments to the services available in prisons, in terms of the basic care provided, the overall approach to mental health, and conditions for prisoners. There have also been changes in local and regional secure mental health facilities, in terms of the composition of the overall forensic estate.
Progress has been made in terms of throughcare, and in the development of improved communication with external organisations.
The level of understanding of mental health issues in prisons has increased, and the knowledge and awareness amongst some officers has also increased.
The stigma associated with mental health problems has reduced, both inside and outside prison, but it still remains a major problem.
The main conclusion was as follows:
Prison is not the most appropriate environment for people with severe and enduring mental health problems. Their primary need is their mental health and the appropriate place to address this is in a hospital.
Young Offenders in Adult Establishments
Inspection November 2008
This was an inspection of the conditions in which young offenders are held and the treatment they receive in Friarton Hall in HMP Perth, Darroch Hall in HMP Greenock and Bruce House in HMP Cornton Vale.
Young offenders in all three locations are safe and suicide risk management is handled well.
Relationships between staff and young offenders are generally good.
The conditions in Friarton Hall are good although Darroch Hall needs to be refurbished. The conditions in Bruce House are poor.
Access to toilets during certain parts of the evening in Bruce House is unacceptable.
The young offenders in Friarton and Darroch have a much more useful, stimulating and productive day than the YOs in Cornton Vale, and indeed than the YOs in Polmont.
The arrangements for catering are very good in Friarton and excellent in Darroch, but are very poor in Bruce. The experience of eating in Friarton and Darroch is very pleasant, but most unpleasant in Bruce.
Arrangements for maintaining family contact are good and there is evidence that this is particularly enhanced in Darroch as a result of the young offenders being located closer to their families.
Work opportunities are excellent in Friarton and in Darroch, but poor in Bruce. A number of prisoners in Friarton are also participating in community work placements which is good preparation for release. There are very few other out of cell activities available in Bruce House.
A wide range of learning opportunities in all three locations is focused appropriately on needs. High numbers participate in education in Darroch and Friarton.
The provision of healthcare in Darroch and Bruce is as good as that received by adult prisoners. The lack of an onsite and timebound service in Friarton gives cause for concern. Young offenders in Friarton do not have access to supervised medication.
All three locations have established excellent links with community organisations who contribute greatly to the reintegration process. There are no YO specific offending behaviour programmes.
When staff are focused on, and have an interest in, a particular group, then that group is better off - particularly if it is in a smaller unit close to families.
The experience of female young offenders in Cornton Vale is not good. There is very little for them to do and they consistently mix with adult prisoners in various circumstances.
A smaller unit, specifically for women under 21 years of age should be considered.
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