Hm Prison Bristol

REPORT ON

AN UNANNOUNCED FOLLOW-UP

INSPECTION OF

3 – 5 SEPTEMBER 2001

HM CHIEF INSPECTOR OF PRISONS

PREFACE

As far as Bristol prison itself is concerned, this is overall a very positive report. In all but one area, it records significant progress made since the last inspection report. More than that, it draws attention to the excellent and innovative work being carried out in resettlement, drugs and legal services: ‘We saw more work being done at Bristol to deal with the needs of resettlement and help prisoners to address offending behaviour than in any other local prison we have inspected. The Jade project and the drugs strategy were two key examples.’

This report does, however raise two important issues which are primarily matters for the Prison Service, and not for the prison.

The resettlement work that is going on in Bristol should be the rule, not the exception, in local prisons. They release hundreds of prisoners every month into the community, many of them short-term prisoners who are among the most prolific offenders, with the greatest resettlement needs and, at present, the lowest level of provision. Local prisons need to be specifically tasked with a resettlement role, as we recommend in this report and set out in detail in our recent thematic review, Through the Prison Gate. And innovative projects, like Bristol’s Jade project, need to be analysed and disseminated as good practice throughout the prison system.

Secondly, the part of the prison which caused us great concern was its healthcare centre. Staff shortages, sickness and recruitment problems had resulted in unacceptable and potentially unsafe conditions for patients. These are conditions that would not have been allowed to exist, or continue, in healthcare provision outside the Prison Service. Individual prisons cannot solve such problems on their own. Providing satisfactory healthcare, particularly in high-cost high-employment areas, is a critical issue for the Prison Service and the NHS as a whole. As a start, personnel recruitment policies should be sharpened up, with a more proactive strategy for

3 retention and recruitment and much faster security clearance for staff recruited. In the longer term, prison healthcare must become an integral part of national and regional healthcare, with the same quality standards and resource priorities.

ANNE OWERS HM Chief Inspector of Prisons December 2001

CONTENTS

Paragraph Page

PREFACE 3

INTRODUCTION 7

FACT PAGE 9

CHAPTER ONE PROGRESS SINCE THE 1999 REPORT 1.01-1.221 11

CHAPTER TWO TESTS OF A HEALTHY PRISON 2.01-2.26 57

CHAPTER THREE SUMMARY OF RECOMMENDATIONS AND EXAMPLES OF GOOD PRACTICE

Recommendations Director General 3.01-3.09 63 Area Manager 3.10-3.11 64 Governor 3.12-3.71 64

Examples of good practice 3.72-3.80 72

APPENDICES 1. Inspection Team 2. Daily routines 3. Prisoner population

INTRODUCTION

Short inspections have been developed to ensure that the Inspectorate visit and check establishments between full inspections. They are carried out by a small team, last two or three days and are usually unannounced. Clearly they cannot serve the functions of full inspections but we believe that they are important in highlighting issues of concern or praiseworthy areas relating to the treatment of prisoners. They are not intended to cover every aspect of the prison.

Three inspectors, Mr John Podmore, Mrs Fay Deadman and Mr Eddie Killoran carried out an unannounced short inspection of HMP Bristol from 3 to 5 September 2001. The inspection’s main purpose was to review progress on recommendations made after the last inspection in 1999. The team also monitored the treatment of prisoners using the model of the healthy prison described in ‘Expectations’ published by HM Chief Inspector of Prisons in his Annual Report 1999-2000. During their visit they met prisoners and staff and had discussions with the Governor and the Chairman of the Board of Visitors. They discussed their conclusions with the Governor and members of the senior management team before they left.

FACT PAGE

Task of the establishment HMP Bristol held adult male prisoners and serviced local courts in Bristol and Avon. It was also a Category A facility for the South West Region.

Area organisation South West

Number of prisoners: Total population 581 Certified Normal Accommodation (CNA) 486 Operational Capacity 603

Cost per place CNA – cost per place £32,200. (KPT target 2001/2002)

Last full announced inspection 12 – 21 April 1999

Last short unannounced inspection 14 – 16 October 1996

Description of residential units Three Victorian wings A, G & D. B and C wings dated from 1960; B wing has an electronic locking system to access sanitation. · A Wing is for remands · B Wing is a lifer/long-term wing · C Wing – drug free wing – convicted and remand · G wing – convicted

· D wing – Safe Custody Unit, consisting of previous Rule 45s and poor copers and prisoners with behavioural problems. · E wing – 11 standard cells and 2 unfurnished cells · Health Care – 20 beds

Brief History · HMP Bristol was a Victorian prison opened in 1883. · Major buildings works were completed to enable the establishment to fulfil its new role of holding Category A prisoners.

The prisoner population · 43.5% of the population was unsentenced · 21% of the sentenced population were serving life sentences · 40% were serving sentences of up to two years · 21% of prisoners were charged with drugs offences; 16% with driving offences; 13% with offences of theft and handling; and 12% with the offence of murder. · 55% of the population were aged between 21 – 29 years. · 25% of the prisoner population were from the Avon area; 19% were from Wales; 16% from Devon and 15% from Dorset · 21% of prisoners were from ethnic minorities · 49% of prisoners were of no stated religion; 25% were Church of England and 15.5% Roman Catholic; 5% were Muslim, 1% Buddhist and 1% Hindu.

CHAPTER ONE

PROGRESS SINCE THE LAST REPORT

Introduction 1.01 In order to examine the progress that had been achieved following our last inspection in April 1999, we have used the recommendations from that report as a framework for our examination of the establishment.

1.02 We have commented where we have found significant improvements and where we believe little or no progress had been made and work remained to be done. We have also highlighted additional information relating to work being undertaken. During this inspection we concentrated on aspects that directly affected the treatment and conditions for prisoners and therefore not all the recommendations from the last inspection were examined. The numbers in brackets at the end of each recommendation identify the paragraph where it appeared in the text of the last report.

To the Director General 1.03 Consideration should be given to making Bristol a regional induction centre for lifers. (2.27) Achieved, in that there had been a national review of those prisons taking lifers at all stages of the process, particularly in the context of Schedule 2 lifers. There had been no change in Bristol’s role in the lifer system.

1.04 Local prisons should be formally tasked with the resettlement of remand and short sentenced prisoners and provided with the practical guidance and support to effect this. (4.06) Not achieved. There had been some innovation from individual establishments and particularly so from Bristol in the form of the Jade project. There was still insufficient direction from Prison Service Headquarters. Specifically, the problems of ‘revolving door prisoners’ needed to be corporately acknowledged and addressed. We repeat the

11 recommendation. (See also thematic review of the Prison and Probation Inspectorates ‘Through the Prison Gate’ [2001]).

1.05 All psychologists working with lifers should be trained in the use of the dispersal assessment package. (4.22) Not achieved. The establishment were still awaiting instructions from Prison Service Headquarters regarding training in the use of the dispersal assessment package in the light of planned changes to the lifer system. We repeat the recommendation.

1.06 The single storey buildings and the portacabins should be demolished and replaced by multi-storey structures. (8.04) Not inspected.

1.07 The plenum heating system should be replaced with a wet pipe system having adequate zoning to ensure economic automatic temperature control. (8.05) Not inspected.

1.08 Falls and drainage from the whole north-east corner of the site should be revised to ensure that water does not reach the buildings. (8.09) Not inspected.

1.09 All flat roofs should be protected by superimposed lightweight pitched roofing. (8.10) Not inspected.

To the Area Manager 1.10 Resources should be allocated to provide prisoners on B Wing with access to toilet and washing facilities throughout the periods when they are located in their cells. (2.14) Achieved following a major refurbishment.

1.11 Resources should be provided to refurbish the toilet areas on B Wing. (2.15) Achieved following a major refurbishment.

1.12 The criteria for the transfer of sentenced prisoners to training prisons in the South West should be examined. (4.08) Achieved as part of an ongoing process.

1.13 A purpose built sports hall should be funded. (5.28) Not achieved. There were no funds available to build a purpose built sports hall, and we were informed that competing priorities made this increasingly less likely in the near future. An addition to the general physical education provision had been provided in the form of an occupational health centre. It was in the final stages of completion at the time of the inspection and it was intended that the facility would be available for staff as well as prisoners. We repeat the recommendation.

1.14 Funding should be provided to refurbish the chapel. (5.54) Achieved. A complete refurbishment of the chapel commenced shortly after the inspection.

1.15 Proper investment should be made to provide the correct accommodation and regime for vulnerable Category A prisoners rather than house them in the Segregation Unit. (7.08) Achieved. At the time of the inspection D Wing was undergoing complete refurbishment to provide a Safer Custody Unit for vulnerable prisoners. Category A vulnerable prisoners were to be located on a spur of this unit. All prisoners on this unit were to have access to a newly introduced therapeutic regime.

1.16 Boilers should be fitted on each landing. (2.20) Achieved.

1.17 The implementation of the cluster arrangements and the unified health care budget should be closely monitored. (6.01) The strategy of using Bristol’s Health Care as the central service for the local cluster of four prisons had not been substantially developed since our last visit. This had partially been due to external factors and the complexities in reaching agreement with

13 the local Health Authority on a combined needs assessment. It was clear however that the main delay was caused by the ongoing operational difficulties in Health Care, and that the Prison Service was in no position to proceed until these problems were resolved.

To the Governor

Reception 1.18 Medical rooms should not be left unattended. (1.04) Achieved. Medical rooms were secured on a separate locking suite.

1.19 Call systems should be installed in the two large holding rooms in reception. (1.05) Achieved.

1.20 The height of the partitions between the officers’ spaces along the counter in reception should be lowered. (1.05) Achieved. The structure in place meant that both staff and prisoners were required to stand throughout the process. Privacy remained an issue but from what we saw the staff dealt sensitively with prisoners.

1.21 A free telephone call to next of kin should be given on a prisoner’s first evening. (1.06) Not achieved. We accepted that staff would make a call on behalf of a prisoner if they perceived that there were particular circumstances requiring one. Prisoners were able to make calls the next day by using their own money to buy telephone cards or by means of an advance. We consider the matter to be sufficiently important in a local establishment for the recommendation to be repeated.

1.22 The shower in reception should be relocated. (1.06) Not achieved. Its location in the middle of a holding room meant that it was unlikely ever to be used. There was scope for improving access to the shower with minor

14 alterations. We recommend that adaptations be made to the shower in reception to provide better access to it.

1.23 All new receptions should have a shower in reception. (1.06) Not achieved. This remained an unrealistic option unless the recommendation in paragraph 2.22 above is implemented.

Additional Observations 1.24 We considered that the holding rooms were not large enough for the throughput of prisoners and were informed that prisoners could be held in vans in the yard whilst others were being seen through reception. This was unacceptable. We also considered that the arrangements for Category A prisoners were inappropriate given their cramped and insecure holding cells. We recommend that the reception area be refurbished in order to take account of prisoner numbers and the needs of Category A prisoners.

Induction 1.25 Prisoners should be provided with paper and writing implements when they undergo induction. (1.10) Achieved.

1.26 Sessions by Listeners and on harm reduction concerning the abuse of drugs and alcohol should be considered for incorporation into the Induction Programme. (1.10) Not achieved. Plans were underway to introduce a full multi-disciplinary induction programme and this we commend. These plans should be implemented as soon as possible.

1.27 All new prisoners to Bristol, regardless of their location, should be provided with a full induction. (1.11) Achieved. A good induction programme, soon to be further improved, was being operated by discipline staff in excellent surroundings.

Self Harm 1.28 Statistics kept on the use of Listeners should also include use of Listener suites. (1.14) Not achieved. This recommendation had initially been accepted and the Orderly Officer was responsible for keeping a log of all prisoners who made use of the Listener service, and the location used for the meeting. This system, however, had fallen away although it was intended to start collecting this information again as part of the data set of the prison’s new ‘Safer Custody’ strategy. We repeat the recommendation.

1.29 Procedures to identify staff who may need to be approached by the Care Team should be reviewed. (1.15) Achieved. This had been integrated into standard practice and a book was kept in the Orderly room recording full details of all those involved in any serious incidents. This was then reviewed by the Care Team to ensure that support was offered to all relevant individuals. The identification of staff to be approached by the Care Team was also an integral part of the establishment’s ‘Death in Custody’ policy.

1.30 Reviews for 2052SH’s should be chaired at Principal Officer level or above. (1.18) Achieved. This proposal had been accepted and reviews were normally chaired by a Governor or, in his absence, a Principal Officer.

1.31 The reviews on C Wing should be combined for all its prisoners. (1.18) This recommendation no longer applied, as all open F2052SHs were reviewed weekly at one unified meeting. We looked at a number of F2052SH files on the wing and were impressed by the quality of entries, which also clearly indicated that staff were positively interacting with the prisoners rather than simply observing them.

1.32 Staff should be alert to the location of all prisoners who were not out of cell and, in particular, to the location of those on an open F2052SH. (1.19) We were assured that this had improved since our last visit and that staff were fully aware of the location of all those who were believed to be at risk. Our observations, however, suggested that there were still delays in responding to cell bells.

Management should regularly test responses to cell bells and in particular to those from cells housing prisoners with an open F2052SH.

1.33 All staff, particularly those on night duty, should carry pouches containing scissors. (1.23) Achieved. Since our last visit considerable progress had been made in developing the establishment’s response to self-harm. This included taking a holistic approach to self- harm and related issues, as part of a wider ‘Safer Custody’ strategy. Central to this had been the appointment of a full time Safer Custody Manager who had the responsibility for monitoring and co-ordinating development.

Additional Observations 1.34 Recent initiatives had included the introduction of new forms to ensure that procedures were adhered to and the training of wing staff in ‘Mental Health Awareness’. Future plans included more specialised training for selected staff, a research project on the ‘triggers’ to self-harm and the development of a Safe Custody Unit on D Wing when it re-opened. We were encouraged by these developments and recognised that there was the potential for developing a model of good practice that could be adopted by other prisons.

Grievance Procedures 1.35 Prisoners requiring confidential access should be granted it. (1.25) Partially achieved. The last nine months saw 37 confidential access request complaints submitted, in comparison with six in the previous 12 months. The prisoners we met were not as fully aware of the system as they should have been. We recommend that steps be taken to more widely promulgate all avenues of redress open to prisoners as part of the IEP scheme.

1.36 Staff on the wings should be aware of the correct procedures for Requests and Complaints and be able to explain them sufficiently to prisoners to avoid confusion and delay. (1.29)

Partially achieved. Staff were aware of the procedures but there was insufficient advertising of the process to prisoners. We were further concerned about the quality of replies, some of which were barely legible and unclear as to who was the respondent.

Legal Services 1.37 Consideration should be given to making the Legal Services group separate to the visits group. (1.31) Achieved. A separate visits group of staff no longer existed. Staff were detailed from other groups, including legal services.

1.38 The NVQ for Legal Aid should be given full support. (1.32) Achieved. The range of training being undertaken by legal services was the best we have seen. We commend this approach as a model of best practice.

1.39 Urgent improvements should be undertaken to improve the ventilation in the legal services area. (1.33) Partially achieved. A programme to improve the ventilation was underway at the time of the inspection. The facility itself however remained cramped and, given the increasing expansion of the service, consideration should be given to improving the physical layout of the legal services area.

1.40 The video describing the video link process should be shown to all prisoners who have not used the video link before. (1.41) Achieved.

1.41 Consideration should be given to making the information leaflet for the video link available in a wider range of languages. (1.41) Not achieved. Versions of the information leaflet for the video link in languages other than English should be provided by Prison Service Headquarters.

A Wing 1.42 There should be a fuller regime on A Wing. (2.06) Not achieved. The regime remained relatively limited with association in particular being adversely affected by staff shortages. We were concerned about the prospect of even less association (effectively none in the evening), which in our view would be unacceptable. There had been no significant improvement in prisoner access to work or education on A wing. We repeat the recommendation.

1.43 A multi-disciplinary team on a weekly basis should review those prisoners being monitored for actively suicidal feelings. (2.07) Achieved. A multi-disciplinary team met every Tuesday chaired by a Principal Officer.

1.44 There should be more incentive for prisoners to aspire to an enhanced regime and more opportunities for remand prisoners to demonstrate their suitability. (2.08) Not achieved. There remained minimal variation between standard and enhanced regimes and although TVs were beginning to be introduced for enhanced prisoners there remained the problem of access to 240v in-cell electricity. Ironically, should TVs in cells be extended to prisoners on the standard regime, variations between different levels of the IEP scheme would be even further reduced. A more imaginative approach to the IEP scheme was needed to make it more effective.

B Wing 1.45 Staff should ensure that cell calls are carefully monitored and swiftly answered. (2.16) Achieved. As part of the wing refurbishment a new cell call system had been installed which gave a double check of officer responses. Problems remained on A and G Wings, however, where we witnessed staff ignoring cell bells for long periods. Managers should carry out regular spot checks on cell call responses. (See also para 1.32).

1.46 Consideration should be given to setting up a painting works party to improve the decorative state of the cells. (2.17) Not currently relevant. The wing had only just been reoccupied after major refurbishment. In the context of this refurbishment, however, we commend the provision of in cell TVs and kettles but recommend that further consideration of the design of the furniture in-cell is needed, given that the cells are particularly small.

1.47 The deficiencies in the servery area and the handling of food here should be addressed. (2.19) Achieved as part of the refurbishment.

1.48 Dining out should be considered. (2.21) Not achieved. We were told that some thought had been given to dining out of cell but that shift systems for staff would not allow for it. B Wing remained the ideal location for such an initiative and we repeat the recommendation.

1.49 The recording of information on prisoners’ history sheets should be improved. (2.22) Achieved. The examples we saw were of an acceptable standard.

1.50 A discrete lifer unit should be set up to meet the needs of the lifer population. (2.27) Achieved. The internal structure to deal with lifers was sound and the establishment had successfully and rightly resisted attempts to locate Lifers on B wing, other than those at the second stage of the system. We endorse this approach and share the view that newly sentenced lifers in general, and Schedule 2 lifers in particular, should not be located on B Wing.

1.51 An induction programme should be produced to help prepare remand prisoners for the implications of a life sentence. (2.27) Achieved. Two Officers now delivered a programme and an induction pack was being compiled to take account of recent changes to the system.

1.52 Arrangements should be put in place to allocate all newly sentenced lifers to the long-term wing. (2.27) See paragraph 1.50 above.

C Wing 1.53 The painting programme currently underway should be extended to the cells. (2.29) Partially achieved. The painting programme continued and some cells had been improved. The general fabric, however, remained in need of major refurbishment. A comprehensive refurbishment programme should be scheduled in the near future.

1.54 The gate at the entrance to the wing office should be locked back. (2.30) Achieved.

1.55 The personal officer scheme should be developed. (2.31) Achieved. There was a much better structure in place with appropriate documentation.

1.56 The level and quality of entries in the wing history sheets should be improved. (2.31) Achieved. The entries that we reviewed were of an acceptable standard.

1.57 The phone booking system should be revised to maximise use of phone time. (2.34) Not achieved although the prisoners to whom we spoke had no complaints about telephone access. However, the process should remain under review as part of the anti-bullying strategy.

1.58 A more objective method for selecting prisoners for enhanced status should be considered. (2.35) Partially achieved. The emphasis for selection was still primarily focused on time in the establishment and employment. Within this context, however, it was led too much by prisoners rather than by Personal Officers.

1.59 There should not be a limit to the number of prisoners on enhanced level. (2.36) Achieved.

1.60 Additional privileges for enhanced prisoners should be considered to ensure a more meaningful differentiation between them and those on the standard level. (2.37) See paragraph 1.44 above.

1.61 Regular case conferences should be held for prisoners on 2052SHs. (2.38) See paragraph 1.43 above.

1.62 The wing notice boards should be made more user friendly. (2.40) Partially achieved. Good, broadband headings were used to draw attention to items on notice boards but print size was often too small. We repeat the recommendation.

1.63 The wing roll board should be improved and the system for accounting for prisoners’ whereabouts reviewed. (2.41) Achieved.

1.64 A policy for voluntary drug testing should be in place. (2.42) Achieved. We were, however, very concerned to see a direct linkage between voluntary testing and the IEP scheme. The practice of linking voluntary drug testing with the IEP scheme should cease.

1.65 Consideration should be given to enhancing the use of the drug support officers by involving them more in the drug free aspects of the wing. They should receive appropriate training for this task. (2.44) See section on the drug strategy at paragraphs 1.73-1.86.

D Wing 1.66 Consideration should be given to the future use of D Wing, in particular the mix of prisoners housed there. (2.54) Achieved. We commend the plans to develop a day care centre and therapeutic regime on D Wing.

G Wing 1.67 A new personal officer scheme should be introduced as soon as possible. (2.58) Achieved although there was scope for the scheme to become more effective. Senior Officers using it as a tool of performance appraisal should lead the Personal Officer scheme.

1.68 Consideration should be given to allowing all prisoners to mix together during joint activities. (2.61) Achieved. Category A prisoners now mixed with prisoners of other categories.

Throughcare 1.69 The efforts of throughcare staff for custody planning should be supported. (4.12) Achieved. Throughcare staff felt well supported and encouraged to be innovative.

1.70 There should be active liaison with various other agencies and prompt and thorough assessment for the management of licence recalls or revokees. (4.19) Achieved. Locally there were active and constructive links. Problems remained however with the time taken for decisions from Lifer Management Unit at Prison Service headquarters.

1.71 Newly sentenced lifers should be formally inducted alongside other long-term prisoners beginning long sentences. (4.20) See paragraph 1.50 above.

1.72 The psychologist’s contributions in the Lifer Sentence Plan should be completed in all cases and updated at each review. (4.21) Achieved. There were also excellent links with Probation staff as part of a multi- disciplinary approach to reviews.

Drugs Strategy 1.73 The budget governing drugs used during the detoxification process should be reviewed. (4.28) Achieved. We were told that the budget for drugs was sufficient to meet the needs of the prisoners and that the detoxification service in the establishment met the requirements of PSO 3550, which sets out the new standard ‘Clinical Services for Substance Misusers’.

1.74 Prisoners undergoing detoxification should be isolated from the rest of the population. (4.29) Not achieved. Prisoners undergoing detoxification were scattered throughout the prison’s residential units, which exposed them to pressure from other prisoners. It also caused resource problems in that drugs had to be dispensed several times daily from different locations under close supervision. Management should review the housing of prisoners undergoing detoxification and, given the practical constraints, separate them from the general population.

1.75 All prisoners undergoing a medical detox should be housed in the same area and offered a programme, which will be both supportive and motivate them. (4.30) Not achieved. This recommendation had been accepted as appropriate but the difficulties in housing those undergoing detoxification in the same area had meant it was not implemented. It was intended to provide a level of individual support from the detox nurses but a combination of staff absences, regime restrictions and volume of work had meant that even this was not happening. We repeat our recommendation that prisoners undergoing detoxification should have access to motivational and supportive services.

1.76 A discipline officer should be seconded full time to the programme provided for prisoners on F Wing. (4.31) Achieved. Since our last visit there had been major changes in the nature of the funding and staffing of the drug services in the prison. In particular the introduction of the Counselling, Assessment, Referral, Advice/Information and Throughcare scheme (CARATs) and further funding from CSR monies had provided sufficient staffing to ensure that the programme on F Wing was adequately staffed.

1.77 Daily exercise should be provided for prisoners on F Wing. (4.32) Achieved. This recommendation had been accepted and implemented.

1.78 Structural issues surrounding the staffing of the nursing staff on F Wing should be resolved. (4.33) Partially achieved. The concerns around the management and use of the four detox nurse posts had been partially resolved. Two of the posts had been integrated into Health Care and were directly involved in the assessment and management of those who needed a medical detoxification. The other two posts had been attached to the CARATs team and were providing general health-care input. We were told that it was intended that one of these posts would be transferred back to Health Care to support the detox programme while the remaining post would be fully integrated into the CARATs team. This proposal appeared to have the support of all those involved and should be implemented as soon as is practical.

1.79 The probation officer on C Wing should be given the necessary back-up staff to implement the full programme for the drug free wing. (4.34) Achieved. The programme ‘Choices’, on C Wing, was being co-ordinated on a full time basis by an Officer who was supported as necessary by another trained Officer. This appeared to be functioning well, offering relapse prevention, harm minimisation and pre-release information on a daily rolling programme.

1.80 The part-time worker provided by the Bristol Drugs Project should be provided full-time and as a service and not just an individual. (4.37) Achieved. The role of the Bristol Drugs Project workers had been altered since our last visit. Instead of being based within the prison, they were attending official visits to see individual prisoners by appointment. The contract for this post ended at the end of March 2002 and it was likely that the service specification would be radically modified to more accurately reflect the resettlement needs of prisoners from the Bristol area.

1.81 Co-ordination and collaboration between Programmes and Health Care needs to be improved. (4.38) Achieved. The appointment of a full-time Drug Strategy Co-ordinator seemed to have considerably eased the tension between Programmes and Health Care staff and there were clear examples of good co-working practice between them.

1.82 Consideration should be given to providing more suitable accommodation to the drugs based programmes within the prison. (4.38) Not achieved. There were plans to undertake work on F Wing to alter the living accommodation from dormitories to double cells, which would greatly improve the living environment for participants. More suitable accommodation should be provided as soon as possible for the drugs based programmes within the prison.

Additional Observations 1.83 The Drug Strategy at Bristol had continued to develop since our last visit and was offering a range of responses tailored to individual need. Staff shortages, particularly in Health Care, had caused a level of disruption to services, but the Drug Strategy Co-ordinator was addressing this.

1.84 Unfortunately the Primary Intervention Programme was not in operation at the time of our inspection due to the closure of D Wing, although we were told that it had been running successfully up to this point. It had been extended from three-weeks to four, and was still aimed at supporting those prisoners who wished to tackle their drug related offending. We were concerned that in the near future this programme might

26 find its existence under threat as it did not fit the Prison Service’s criteria for accreditation. The Prison Service’s Drug Strategy Unit (DSU) should commission independent research into the outcomes of the Primary Intervention Programme, to evaluate whether it is an effective brief intervention model.

1.85 Since our last visit the prison had developed a Voluntary Drug Testing (VDT) programme and C Wing was now a Voluntary Testing Unit. This had given those who wished to participate the opportunity to provide some evidence to suggest that they were staying drug free. We were concerned, however, that the VDT and IEP schemes had become inter-linked and that a prisoner was unlikely to gain enhanced status unless he agreed to be ‘voluntarily’ tested. It also appeared that a VDT failure meant automatic removal from C Wing, contrary to the advice in PSO 3620. The Drug Strategy Co-ordinator should review the operation of the VDT scheme to ensure that it meets the principles laid out in PSO 3620.

1.86 We were also concerned at the way in which the prison was reporting its Mandatory Drug Testing (MDT) results. It was including those that were “consistent with medication” and those of prisoners who had been in the establishment for less than 30 days as positives. It was unclear if the Drug Strategy Unit was amending these figures, but at local level they were giving a totally misleading impression. For example in July 2001 there had been nine positive results out of a total of 28 tests, a 25% failure rate. However, three of these were consistent with medication, quite possibly that which was being prescribed for detoxification purposes, and one was a prisoner who had been there less than 30 days. The confusion around MDT figures throws into doubt their reliability as an indicator of drug use within prisons. The Prison Service Drug Strategy Unit should set clear guidelines for recording and ensure that all prisons apply them in the same way.

Education 1.87 A specific detailed section in the education contract relating to Bristol should be drawn up to ensure quality and development can be monitored and evaluated. (5.01)

Not achieved. The education contract was with Stroud College. It was in standard contract format, since it was designed to cover general themes shared by the other prison establishments that also had a contract with Stroud College. The contract did not set out the specific requirements of HMP Bristol relevant to the assessed educational needs of their prisoner population. We repeat the original recommendation that a specific detailed section relating to HMP Bristol should be drawn up and added to the education contract.

Additional Observations 1.88 We were told that the department had conducted a prisoner education needs analysis involving prisoners themselves and that it was intended that this should take place annually. We commend this initiative. This analysis, together with the BSA screening results, could be used to inform additions to the education contract, which could be in the form of an appendix, referring to specific requirements. This would transform the contract into a specific working document for HMP Bristol.

1.89 The Education Department had introduced monthly education contract monitoring meetings that included discussions regarding programme delivery, class sizes and attendance, student recruitment and development and staff development. This was very good practice. The effectiveness of this meeting would be enhanced by the recommended addition to the contract, which should then be continuously monitored and evaluated.

1.90 There should be an individual and confidential interview as early as possible with a skilled guidance or education worker. (5.09) Partially achieved. This recommendation had been interpreted by the Education Department as a need to provide individual information and guidance to prisoners who had themselves expressed an interest in accessing some form of education during their time at HMP Bristol. To this end such prisoners were individually assessed and provided with information and guidance to assist them to access the most suitable education provision to meet their needs.

Additional Observations 1.91 However, underpinning this recommendation was an acknowledgement that there was a need to make early contact with many adult prisoners, who have had previous poor experiences of education, to outline the opportunities that the education department had to offer, thus increasing their motivation to consider applying for a course. We were told that levels of staffing were insufficient to introduce a system of individual education interviews for all new receptions.

1.92 We acknowledge that the wing-based work carried out by the peripatetic teacher (see 1.99 below) would result in a number of prisoners who did not actively seek out educational opportunities, meeting education staff as a matter of course and having the opportunity to discuss individual needs via this informal route.

1.93 Additionally, the liaison between the education department and the physical education department relating to the basic skills work provided another point of contact with the education department (see 1.114).

1.94 We were satisfied that the education department had an ethos of proactively promoting educational opportunities whenever the occasion presented itself. However, in order to ensure that prisoners make fully informed and relevant choices as to the type of purposeful activity they will undertake during their time at Bristol, educational opportunities should be discussed at the induction stage.

1.95 If individual education interviews are not possible during induction, due to insufficient staffing levels, then a member of the education department should deliver a session during the induction programme, setting out educational opportunities available at Bristol, as a motivational exercise. Thereafter individual interviews should be offered to those prisoners who wish to avail themselves of such opportunities. This would be an acceptable compromise.

1.96 We were also informed that prisoners who attended education received a considerably lower rate of pay compared with those on other forms of purposeful activity. The differentials between the choices of purposeful activity should be

29 examined to ensure that they do not represent a disincentive to those prisoners who might otherwise be motivated to take part in education.

1.97 The current curriculum should be reviewed to ensure it meets the needs of all students. (5.20) Achieved in as much as a review of the curriculum had taken place, but at the time of the inspection not all of the actions agreed upon as a consequence of the review had been implemented. Additionally some of the options outlined in the review had yet to be considered.

Additional Observations 1.98 The core curriculum comprised of a range of courses, all accredited by national awarding bodies or the Open College Network, with the exception of the Art course, which was awaiting accreditation. Students spoke highly of the education provision within the establishment, as well as praising individual teachers. Relationships with teaching staff were good and several students said that they would choose to speak to a member of the education department about a personal difficulty, not related to education, in preference to a member of the prison staff. The classroom environments were relaxed but industrious and purposeful and comparable with any typical community based adult learning resource. We observed an English class of mixed ability working well, in which a lesser able student was being supported, not only by the classroom teacher, but also by more able fellow students.

1.99 The education department also offered a peripatetic or outreach wing-based service. The wing-based work targeted those prisoners who were unable or unwilling to attend classes in the education block for a variety of reasons. Two sessions of two hours duration were on offer to the Health Care Centre each week. CSR funding had been granted to provide additional peripatetic hours to enable key skills to be delivered in the workshops. Integration between the workshops and the physical education department was good.

1.100 There was little provision for Rule 45 prisoners who were basically offered the choice of English, Mathematics or Art on three morning sessions per week. There had previously been a computer course on offer but this had been closed due to Officer shortages.

1.101 Our main concern with regard to education was that it was not accessible to a greater number of prisoners. At the time of the inspection there were 40 full-time places available to prisoners and 24 part-time wing based places. This was wholly inadequate for the prisoner population of 534. The waiting list of prisoners who had applied for education stood at 94 on the first day of the inspection. On average 13- 15% of the prison population accessed the services of the education department in some form.

1.102 The Regime Review undertaken by the programmes group in July 2001 considered the impact that the poor state of repair of the education buildings had in terms of restricting the curriculum. It also outlined some costly proposals to build a new education block on three levels. In a structural survey undertaken in 1998 it was recommended that the existing building be demolished, as it was uneconomic to undertake remedial repairs. The Deputy Director General of the Prison Service commented on a recent visit that the facilities were probably the worst he had seen. We repeat the recommendation made following the previous inspection that the single storey buildings should be demolished and replaced by multi-storey structures. In the case of the education department, this has the potential to provide the physical space for an additional 60 full-time students in addition to the current 40 full-time places.

1.103 Consideration should be given to providing adequate resources to provide a wider and more varied curriculum. (5.20) Partially achieved. Funding had been made available to recruit an additional full- time teacher. This had enabled the curriculum to be broadened to include general education topics such as Life-skills, Creative Writing and Parenting. Prisoners expressed the view that there was insufficient recreationally based education activity. They said they would like to study topics such as music, pottery, general craftwork and

31 cookery. These recreational pursuits have an intrinsic educational value and serve to motivate and interest those who might not achieve through the traditional academic route. We recommend that some recreationally based education activity be introduced to the curriculum.

1.104 There should be more professional development opportunities for staff with others outside the prison. (5.22) Achieved. There had been an agreement in principle that the professional development of education staff within the establishment was crucial. All staff had recently attended a jail-craft course, including part-time staff that had been paid at the full-time rate to enable them to attend the course. In addition to training for their core business, which included basic and key skills, curriculum planning and lesson observations, education staff had recently been released to attend mental health awareness training. The Education Contract Monitoring group had begun to agree a programme of visits to other establishments with a view to sharing and learning from best practice.

1.105 Efforts should be made to improve the balance between the number of male and female staff. (5.23) Achieved. The staff gender split in the education department had been 12 women and two men. The department had recently recruited one new male full-time tutor and a male full-time clerk. There were two male part-time tutors waiting for clearance prior to taking up appointments. However, it was felt that the education posts within HMP Bristol were probably more attractive to women rather than men because of their part- time nature, and this is a common situation in respect of teaching posts within the Prison Service.

1.106 IT equipment should be updated and improved. (5.24) Not achieved. The establishment was awaiting the long overdue report from QUANTUM before giving any consideration to major expenditure on IT equipment. However, equipment in the education department had been upgraded by way of installing sound cards and speakers. The IT class was very popular and well attended. Prisoners were achieving accreditations in computer literacy (CLAIT). A pilot course

32 had commenced for the European Computer Driving Licence, which is a modular course enabling prisoners to have the option of continuing with it upon release. We repeat the recommendation that IT equipment needs to be updated and improved to meet prisoner need.

1.107 Consideration should be given to a careers education and guidance section in the library. (5.25) Achieved. There was a careers education and guidance section containing an interesting range of books. There was also a display table and an interest topic stand that changed subject matter each week. At the time of the inspection the topic happened to be careers and it was proving to be a good way of attracting the interest of prisoners.

Additional Observations 1.108 The library employed six prisoners who were all seen to be carrying out their duties very professionally. There was an intention to pilot NVQs for two of the workers in the library later on in the year and this initiative should be developed. Prisoners who were visiting the library and required help were dealt with courteously and efficiently. Prisoners we met said that the library service was valued. A frequent prisoner complaint was that there was a long wait for any book that needed to be ordered from the central library. The librarian explained that this was because she had to visit the central library weekly in order to process her requests. Provision of a computer link from the prison to the central library would afford a direct ordering service. Consideration should be given to funding the provision of a computer link to the central library.

1.109 Appropriate provision should be made for those prisoners who cannot attend the library on their set days. (5.27) Achieved. The library timetable had been changed to include three sessions for supplementary applications to cater for prisoners who had missed their library session for a valid reason. We also saw evidence of a flexible spontaneous approach being taken for prisoners who had missed their library session and had requested to visit the library before the supplementary application session. This was a good example of

33 being responsive to individual prisoner need. Generally prisoners were able to use the library at least once a week. They were permitted to borrow a maximum of six books as well as two music cassettes and two talking books at any one time.

Physical Education 1.110 Every prisoner should have a proper physical assessment before being allowed to join in the PE (physical education programme) programme. (5.31) Achieved. The medical screening given to every prisoner on reception had been expanded to include an assessment of fitness for physical education (PE). Prisoners were categorised either as being fit for normal PE, having remedial needs or having severe difficulty. The PE staff utilised this initial screening as an indicator for further assessment and ongoing needs analysis. In this way, those prisoners who had been categorised as remedial, or having severe difficulty, underwent a more detailed assessment through activity to ensure that they could undertake the activity safely and that their designated PE programme met their individual needs. Individual needs analysis would be further enhanced when the almost completed occupational health centre was fully operational and available for the use of prisoners.

1.111 The involvement of the PE department in offending behaviour and drugs work and in sentence planning should be encouraged. (5.32) Achieved. The PE department had devised its own contribution form to sentence planning, which provided a comprehensive picture of the work that the prisoner was involved in, including achievements, as well as describing behaviour and commitment. We were told that PE staff attended sentence planning boards when they could and made attendance at Lifer Boards a priority. There was a clear acknowledgement of the relevance of PE activity to sentence planning and a holistic approach to what constituted offending behaviour work.

Additional Observations 1.112 The PE department was also well integrated with the drugs strategy, supporting the detoxification programme, undertaking relapse prevention work on F Wing and

34 generally proactively promoting self-esteem through sport. A poor sleepers course had been introduced as an alternative therapy to assist those prisoners who were reliant upon medication.

1.113 PE instructors were allocated individual responsibility for certain wings and this appeared to increase effectiveness in a number of areas, notably encouraging prisoner participation and involvement in other regime activities as described above. A more structured approach to increasing prisoner participation should be considered by identifying prisoners who do not participate in PE activity from the LIDS system and adopting a proactive approach to encourage their attendance.

1.114 Between 56-60% of the prison population accessed the services of the PE department and there were very good working relationships between staff and prisoners. Through PE, prisoners were able to address identified basic skills needs and gain sporting awards in performance, coaching, officiating and vocationally related courses. The Community Sports Leadership Award (CSLA) was integrated with basic skills provision and the liaison between the PE department and the education department was excellent. We were particularly pleased to be told of the relatively recent introduction of NVQs to the PE department. Although there were only two prisoners working on NVQs at the time of the inspection, the staff had the enthusiasm to develop it and the establishment should ensure that this initiative is encouraged and supported.

1.115 Overall, we were impressed with the work carried out by the PE department within the limited provision available. Whilst the new occupational health centre would enhance existing provision, the main gym hall remained too small to adequately accommodate all of the activity required to meet the needs of the population of HMP Bristol. We repeat the recommendation that a purpose-built sports hall should be funded to provide proper facilities for physical recreation.

Employment 1.116 The organisation of work places should be reviewed to maximise every employment opportunity. (5.34) Partially achieved. The Programmes Group had undertaken a comprehensive Regime Review in July 2001. At the time of the inspection the report of the review was only available in draft form. The Programmes Group had taken the innovative step of seeking the consultancy services of a Principal Officer from HMP Wormwood Scrubs, who had undertaken a similar exercise at his own establishment. The review included the need to reflect the changes that had taken place within the establishment and within the community, as well as the need to examine existing systems of allocating prisoners to activities and the overall monitoring of the regime.

Additional Observations 1.117 The review exposed a significant shortfall in the total number of employment spaces available against the operational capacity of the prison. Snapshot figures compiled on the 10 July 2001 during the regime review showed 311 activity places available to a prison population of 534. There were 245 prisoners included in an activity indicating that 66 activity places were unfilled. Consequently 289 prisoners had no purposeful activity.

1.118 Prisoners non-attendance at the workshops, as with education, was high, and it was not uncommon for numbers as high as six or more prisoners to fail to report for their activity. This had begun to be addressed by way of the compilation of a monthly monitoring report outlining a record of individual prisoner attendance at their required activity on a daily basis. This was overseen by the Principal Officer responsible for programmes, who reported directly to the Programmes Group; this was good practice. We examined a sample of the attendance sheets which indicated that failure to attend an activity was not always attributable to prisoners, as there were accounts of Officers failing to unlock. Prisoners, workshop instructors and teachers in the education department, who also complained that prisoners were frequently brought over to their activities late, corroborated this. During our inspection, prisoners were taken back to their cells from their activity early without any explanation being given to prisoners or to the staff responsible for the activity. The activity attendance

36 monitoring system should be adapted to include reports of late arrival and early departure from classes, so that action may be taken to address misconduct.

1.119 The reasons for the lack of work and unfilled vacancies were fully explored in the regime review and a number of options and recommendations aimed at addressing the issues had been outlined in the draft report. The options included some proposals that had already been implemented, for example the redeployment of an instructor from the woodshed to the textiles workshop in order to maximise the total number of activity places available between the two, which in effect instantly increased the workplace numbers by four. Another option that had already been acted upon was the submission of a bid to fund the expansion of the existing Jade project, which would create an additional 25-30 places.

1.120 The options also included more radical proposals, for example the demolition and rebuild of three of the main workshops, the rebuild of Workshops One and Two to create a ‘super workshop’ and the installation of a Call-Centre Training Unit.

1.121 Overall, we were impressed with the way in which the employment review had been carried out. It had effectively challenged traditional perceptions of what could and could not be achieved at HMP Bristol. However, the draft review document did not include any plans to consider the options put forward and we were unable to ascertain whether there was a strategy or timetable to formally complete the review by way of action planning. The Regime Review, which was in draft form, should be completed and an action plan drawn up to consider and implement agreed options and recommendations.

1.122 The appointment of an Industrial Manager should be funded. (5.35) Not achieved. Following the regime review, the appointment of an Industrial Manager was not considered to be a priority. In part some of the efficiencies outlined in the regime review, including the new system for direct allocation of labour rather than through prisoner application, will go some way toward addressing the issues for which an Industrial Manager would have been responsible. Consequently, completion of the regime review as outlined above is essential.

1.123 The decision about employing another instructor in Workshop One should be pursued. (5.37) Achieved in as much as a decision had been made not to employ another instructor in Workshop One. In the light of the staffing situation and reduction programme that we were informed of at Bristol at the time of the inspection, the appointment of any additional instructors in any of the workshops was unlikely in the foreseeable future.

1.124 A no smoking rule should be introduced into Workshop Three. (5.39) Not achieved. Whilst we were assured that a no smoking rule had been introduced to all of the workshops, we discovered two prisoners smoking whilst they were working in the woodworking workshop and a member of staff who was smoking in the tailoring workshop. The establishment should take action to enforce its own no smoking rules.

1.125 The workshop expansion scheme should be reviewed to include vocational training as the main aim of the employment strategy. (5.41) Partially achieved. The Regime Review, which could have formed the basis of a fully revised employment strategy, was still only in draft form. There was no specific reference to consideration of vocational training in the review report. Consequently we did not consider that the establishment had fully agreed upon a revised employment strategy to include vocational training as the main aim. We repeat the recommendation.

Additional Observations 1.126 At the time of the inspection there were four workshops, including textiles, tailoring, woodwork and packing. In addition to the workshops, wing based activity tended to be in the main domestic employment (wing cleaners and painters). Rule 45 prisoners on C Wing were undertaking contract work for ‘Specsavers’ employing 15 prisoners. The proposed move to D Wing, following final completion of the refurbishment, will increase the capacity to employ an additional ten prisoners on this contract work.

1.127 Much of the work, and certainly all of the workshops, offered potential for delivering NVQs. There were staff within the workshops who had undergone training to become accredited assessors and internal verifiers; yet no prisoner had been through the accreditation process within any of the workshops for the past two years. This was a very disappointing waste of potential.

1.128 We had been made aware of some activity areas, such as PE and library, where NVQs were beginning to be delivered, but clearly consideration of vocational training was not part of the culture at Bristol. The Regime Review had concluded that “the variety of work on offer in the workshops is limited and it is questionable whether it meets local employment needs”. We were pleased to learn that this was beginning to be addressed in a number of ways, including the examination of the local employment market and an impending Job Fair to which 100 local employers had been invited. Completion of the Regime Review should incorporate a revised employment strategy to include vocational training as the main aim.

Visits 1.129 The plan to put all official visits bookings through to the main visits booking line should be reconsidered. (5.43) Not achieved. The plan to put all official visits bookings on the same line as for domestic visits had not been implemented. Our concerns about this on our last inspection were that due to the difficulty domestic visitors had in getting through on the line, the situation would be exacerbated if official visitors were attempting to use the same number as well. On our latest visit we telephoned the domestic visits number eight times without being able to get through. On six occasions the line was engaged and twice there was no answer. This suggested that the problem visitors had in accessing the booking system still existed. Management should review the booking system to ensure that visitors are able to book visits without excessive difficulty.

1.130 Consideration should be given to removing the raised divider on the tables in the Category A visiting room. (5.45) Not achieved. This recommendation had been rejected on the grounds that the Security Group had determined the layout of the Category A visiting room. However,

39 neither we, nor the staff to whom we spoke, saw any enhancement of security by retaining the dividers and we repeat our recommendation that their removal should be considered.

1.131 Posters, magazines or a television should be provided in the prisoners’ waiting rooms. (5.47) Not achieved. The waiting rooms were still extremely basic with nothing offered to occupy the prisoners’ time. We repeat our recommendation that posters, magazines or a television should be provided in the prisoners’ waiting rooms.

1.132 The facilities and limitations in place for feeding babies should be reviewed. (5.47) Not achieved. This recommendation had been rejected on the grounds that bottle- feeding babies in the visit room could compromise security. While the reality of this concern is debatable, we are aware that other prisons have overcome this problem by supplying bottles themselves. The establishment should review other available options, rather than requiring the visitor to leave the visits area to bottle-feed their baby.

1.133 Regular arrangements for the supervision of young children should be made. (5.47) Partially achieved. Although on the day we inspected, the play area in the visits room was not open we were assured that it was usually staffed by volunteers and well used. The supervision of the play area should be kept under review to ensure that this facility is consistently available.

Prison Visitors 1.134 Official guidance should be provided for prison visitors to assist them in their work. (5.57) Achieved. The training and support of prison visitors had been made the responsibility of the chaplaincy who were expected to provide them with clear guidance on their role.

Catering 1.135 The time taken to do repair work in the kitchen should be addressed. (5.59) Not achieved. There were still problems in the time it was taking to get basic maintenance work done. In terms of the equipment, the main problem was that service agreements had not been arranged with the manufacturers when items had been purchased. This meant that the prison had ongoing problems in calling engineers out when machinery broke down. The servicing of kitchen equipment should be taken into account when any new purchases are made.

1.136 The deficiencies in the kitchen regarding storage and internal alarms in the walk-in fridges should be addressed. (5.60) Achieved. The general condition and tidiness of the kitchen had been improved and a new alarm system had been fitted in the walk-in fridges.

1.137 The menu should be reviewed and include prisoner preferences and a greater variety of dishes. (5.61) Achieved. The menu had improved markedly since the previous inspection. Catering staff conducted surveys amongst the population and attended the ‘lifer’ meetings to get feedback from prisoners. There were a greater variety of dishes offered including daily halal, vegetarian and healthy eating options.

1.138 The choices of dishes available at each meal should be increased. (5.61) Achieved. There were choices available at each meal including breakfast, with options of yoghurt and fresh fruit as part of the main meals.

1.139 The intervals between meals should be altered. (5.62) Not achieved. The timing of meals had been marginally improved but was still not meeting catering standards with a gap of fourteen and a half hours between the serving of the evening meal and breakfast. We repeat the recommendation.

1.140 The management of the catering department should be reviewed. (5.63) Achieved. The standards on the serveries had improved since our last inspection and we observed the correct health, hygiene and safety measures being carried out. We

41 were concerned, however, that the physical conditions in some areas were poor, particularly A and G serveries where there was insufficient space in the heated cupboards for all the hot food. The overall quality of the food being served was good and we received no complaints from prisoners about it. We were satisfied that the catering department was well managed and provided a good service despite the constraints within which it operated.

Prison Shop 1.141 Due to the unavailability of the Shop Manager this area was not directly inspected.

1.142 Fresh fruit should be sold in the shop. (5.68) Not achieved. We were told that it was not possible to sell fresh fruit in the shop, as there were problems regarding storage. However fruit was now available daily as part of the dinner menu.

1.143 The range of products available for ethnic minorities should be increased. (5.69) Partially achieved. Special orders to suit the needs of ethnic minorities could be placed for items not carried by the shop.

1.144 Dated price lists should be displayed on every wing and consideration be given to putting canteen prices on the actual order form. (5.70) Achieved.

Race Relations 1.145 The psychology department should be provided with a LIDS terminal. (5.72) Achieved. Because of the delays caused by the development of QUANTUM, no LIDS terminal had been provided for the psychologists. They had, however, acquired a link via one of their PCs and were able to access most of the information they required.

1.146 The current method of ethnic monitoring should be expanded and reviewed. (5.73) Achieved. The information being supplied had been considerably expanded to cover most areas of activity within the prison. This allowed the Race Relations Management Team (RRMT) to take a more pro-active role in ensuring that any trends that might suggest bias or discrimination were tackled.

1.147 Consideration should be given to making a member of the Senior Management Team the chairman of the RRMT. (5.74) Achieved. The RRMT was now chaired at governor level.

Health Care 1.148 The skills mix of the nurses, particularly those with mental health training, should be addressed. (6.06) Achieved. This recommendation had been accepted and the recruitment of mental health nurses was an ongoing priority for Health Care.

1.149 The work of the administrative staff supporting clinical activity should be reviewed. (6.08) Partially achieved. The Health Care Centre (HCC) had been given more administration time and an improved administration system was being set up.

1.150 All the nurses should be part of a single professional management structure, have clinical supervision and take part in continuing professional development. (6.09) Achieved. All those nurses involved in the provision of clinical services to patients, including detoxification, were now managed and supervised through Health Care.

1.151 A formal audit programme should be established and reviewed annually. (6.11) Achieved. An audit programme was now in place and eight different areas of clinical practice had been audited during the previous twelve months.

1.152 The constitution, terms of reference and membership of the recently commissioned Health Care review should be reassessed to ensure they meet the new Ministerial requirements. (6.12) Achieved. The reassessment had taken place, in as much as the Health Needs Assessment highlighted the level of need to be met in order to reach the required standard set out in Ministerial conditions. In particular the involvement of the local Health Authority was integral to it. An interim report had been issued in February 2001, but there had been little progress in meeting the recommendations.

1.153 The proposed development of a day care unit for mentally disordered prisoners should be considered by the review committee to ensure it will meet the needs of the prisoners at Bristol. (6.13) Not achieved. The Health Care review had considered the proposed day care unit for mentally disordered prisoners and had supported it as an appropriate and innovative initiative. However, as no resources had been found to run it there had been no progress in its development since our last inspection and the concept had been largely abandoned. We repeat the recommendation.

1.154 The review should also consider the management structure. (6.14) Achieved. The review had considered the management structure and had recommended the recruitment of an I Grade nurse as a manager for the service. An appropriate appointment had been made, but unfortunately the post-holder was on long-term sick leave at the time of our visit.

1.155 The state of repair and cleanliness in the Health Care Centre should be addressed as a matter of urgency. (6.15) Achieved. The state of repair and cleanliness of the Health Care Centre had significantly improved since our last inspection.

1.156 Consideration should be given to converting the unfurnished rooms in the Health Care Centre to normal furnishing. (6.16) Not achieved. Plans had been agreed to convert the empty rooms in the Health Care Centre and we were told that work was scheduled to start on them in December 2001.

We were told also, that significant finance was likely to be agreed to undertake a total renovation of the Health Care premises in the near future.

1.157 A more therapeutic exercise area should be provided. (6.18) Not achieved. Although the establishment had accepted this recommendation, there had been no improvements made to the exercise area. We repeat the recommendation.

1.158 The need for more time and clearer protocols for the triage system of seeing patients should be considered. (6.19) Not achieved. This had been accepted as an improvement to clinical practice but the ongoing shortages of staff had meant that no progress had been made in this area. We repeat the recommendation.

1.159 All upgrading work to the locations providing primary care should take account of the relevant HCSs (standards). (6.20) Achieved. All actual and planned improvements to primary care locations were incorporating HCSs as central to work specifications.

1.160 Surgeries should be centralised in the HCC, ensuring the provision of a single well-equipped doctor’s surgery. (6.20) Achieved. This had been accepted and accomplished.

1.161 The beds in the Health Care Centre should not be counted in the prison’s CNA. (6.22) Not achieved. This recommendation had been rejected as it remained Prison Service policy to include Health Care beds in the CNA of an establishment. We reiterate our previous recommendation and urge the Prison Service to reconsider its policy of including health care beds in the CNA figure.

1.162 Prisoners should only be admitted to the HCC beds if they need 24 hour nursing care. (6.22) Not achieved. Prisoners were still being admitted to HCC beds for a variety of expedient reasons, unconnected with a need for 24-hour nursing care. We repeat our previous recommendation that prisoners should only be admitted to the HCC beds if they need 24 hour nursing care.

1.163 The regime for in-patients should be reviewed and as a minimum meet HCS 2.2 and 4.2. (6.24) Not achieved. Due to staff shortages the regime remained impoverished and did not meet HCS 2.2. The regime for in-patients should be reviewed and as a minimum meet HCS 2.2 and 4.2.

1.164 The night medical staffing levels should be reviewed. (6.25) Not achieved. Due to staff shortages night medical cover remained at the same level as at our last inspection, which we considered to be wholly insufficient. We repeat our previous recommendation that the night medical staffing levels should be reviewed.

1.165 A protocol to guide staff in emergency intervention at night should be developed. (6.25) Achieved. A written protocol on emergency interventions at night was now available.

1.166 Episodes of seclusion should be correctly recorded, monitored and audited. (6.26) Achieved.

1.167 Ways of meeting the Health Care Standards for care of those patients with mental health problems should be considered during the proposed review of the health care services. (6.27) Not achieved. The prison was still experiencing difficulties in meeting these standards. Until recently there had been regular visits from a local Health Service psychiatrist, who had been able to provide support where patients had mental health

46 problems. However, she had moved on to a new post and the levels of support had reduced and were now crisis orientated. Ways of meeting the Health Care Standards for care of those patients with mental health problems should be considered during the proposed review of the health care services

1.168 There should be discussions with South West regional office of the NHS with a view to limiting any delays in transfers of mentally disordered patients to secure beds in the NHS. (6.28) Not achieved. This was still an ongoing problem and was part of the overall Health Needs Assessment review. As part of the overall Health Needs Assessment review, there should be discussions with the South West regional office of the NHS with a view to limiting any delays in transfers of mentally disordered patients to secure beds in the NHS.

1.169 Both medical rooms in reception should meet HCS 1.3. (6.30) Not achieved. The medical rooms were still inadequate for their purpose and we repeat our recommendation that they should meet HCS 1.3.

1.170 The reception process should allow adequate time for health assessment. (6.30) Not achieved. Staffing issues had overshadowed this recommendation and the amount of time Health Care itself was able to commit to the reception process was the significant issue. Problems with Health Care staffing need to be resolved to allow adequate time for health assessment as part of the reception process.

Pharmacy 1.171 The old bottles of galenicals should be safely disposed of. (6.33) Achieved. The bottles of galenicals had been disposed of safely, as recommended.

1.172 The refrigerator in the hospital treatment room should only contain medicinal items and separate arrangements should be made for the storage of body fluids. (6.35) Achieved.

1.173 A maximum/minimum thermometer should be provided for this refrigerator and those on the wings and daily temperature records kept. (6.35) (6.36) Achieved. The refrigerators on the wings were no longer in use for clinical purposes. The refrigerator in the hospital had a thermometer and daily temperature records were being kept.

1.174 A restraining chain should be put round the oxygen cylinders and securely bolted to the wall. (6.35) Achieved. This work had been carried out.

1.175 Steps should be taken to contact the Medicines Control Agency to request regular mailing as and when drug recalls occur. (6.37) Not achieved. There had been no action on this recommendation. We repeat the recommendation.

1.176 Controlled drugs should only be supplied for specific patients after receipt of the fully written prescription. (6.48) Achieved. We were told that this recommendation was being fully complied with.

Additional Observations 1.177 While there had been a number of improvements in some aspects of the Health Care service since our last visit, our overall impression was that there had been a significant deterioration in the level of care to patients and the morale of staff. There were a number of reasons for this, the major one being that with vacancies and illness the staff complement was reduced by about 50%. We were also told that a number of staff were resistant to change and inflexible in their working practices. In addition the rigidity of the daily routine militated against making the best use of staff time and undermined clinical practice.

1.178 The general difficulties in recruiting suitable health care staff in the south-west was further compounded by the inordinate length of time it was taking for the Prison

Service to give security clearance for them to be employed in the prison. We were told that in some instances it was taking several months, by which time applicants had taken up other positions.

1.179 There had been an attempt to restructure Health Care through the employment of an experienced Nurse Manager from the Health Service. However, it was clear from internal correspondence that she had been finding it a struggle to bring things up to an acceptable professional standard before, unfortunately, she herself went off on long-term sickness.

1.180 It was clear that the prison was unable to provide the level of care required by a Type 3 service and that remedial action needed to be taken immediately. Health Care staff, the Governor and Area Manager shared our view that the situation was unacceptable. Management should take immediate and direct action to resolve the structural and staffing issues in the Health Care Centre and ensure that the treatment of patients meets the Prison Service’s Health Care Standards.

Dental Services 1.181 The new dentist should contribute to revising the procedures governing the management of the dental waiting list. (6.51) Partially achieved. Although the dentist’s sessions had been increased to three times per week, there was still a waiting list of approximately a hundred prisoners. Demand was also likely to remain high, as many prisoners were drug users who had neglected the care of their teeth over a long period. The Health Care Manager should meet with the dentist to agree upon a strategy to keep the waiting list down to a reasonable level.

1.182 The following equipment should be obtained; Emergency drugs kit, Mercury spillage kit, disposable paper towels, refilling of positive pressure oxygen cylinder and developing facilities for radiographs. (6.52)

Partially achieved. The recommended equipment had been obtained with the exception of the developing facilities for radiographs. We repeat our recommendation that developing facilities for radiographs should be obtained for the dental suite.

Good Order 1.183 The reasons for the proportionately higher use of C&R in the hospital should be enquired into. (7.02) Achieved. The establishment monitored monthly analysis of the locations in which control and restraint (C and R), the legitimate use of force by staff was used. In the year 2000 there had been 43 incidents where the use of force was used and in 2001, during the first eight months prior to the inspection, the use of force had been used on 39 occasions, indicating an increase on the previous year. Examination of the records did not reveal any location as being disproportionately represented.

Segregation Unit 1.184 The practice of placing all prisoners who come into the Segregation Unit on basic regime should be changed. (7.04) Achieved. This practice had ceased.

1.185 Privileges should not be removed unless as part of prescribed disciplinary procedures. (7.04) Achieved. We examined revised disciplinary procedures indicating that privileges could not be withdrawn unless the criteria laid down within the procedures were met.

1.186 A telephone should be installed within the Segregation Unit. (7.05) Achieved. A telephone had been installed in the Segregation Unit.

1.187 Special cells should not be used for those at risk of self-harm. (7.07) Achieved. Prisoners at risk of self-harm were appropriately located in recently refurbished observation cells within the Health Care Centre. The Health Care Centre

50 also provided double cell accommodation and a Listener suite and prisoners deemed to be at risk of self-harm were located within the Health Care Centre according to the level of support required.

Anti-bullying 1.188 The previous inspection report referred to “an extremely enthusiastic and dedicated group of staff at the centre of the anti-bullying strategy, who had clear and sensible plans for the future”. A number of those staff had since moved on and the consequence appeared to have been the stagnation of the development or full implementation of the anti-bullying strategy.

1.189 Many of the recommendations following the previous inspection related to the function and operation of the anti-bullying unit, as well as the delivery of the anti- bullying programme that was being piloted at the time. There was no longer a dedicated anti-bullying unit, and identified bullies were managed on normal wing locations. Although the anti-bullying programme had been reviewed and revised, it was not being delivered at the time of the inspection, and we were given no information to suggest that it would be reintroduced in the near future. Consequently, there was little that remained relevant to the situation we found at HMP Bristol arising from the recommendations.

1.190 Consideration should be given to staffing the anti-bullying unit from a dedicated group of officers. (7.14) Not achieved. This recommendation was no longer applicable since there was no longer an anti-bullying unit.

1.191 X Wing should be used for the purpose it was intended, holding those prisoners who have been identified as bullies, and a suitable regime should be developed. (7.14) Not achieved. Similarly, this recommendation was no longer applicable.

1.192 The temperature in the cells on X Wing should be addressed. (7.15) Not achieved. This recommendation was no longer applicable, as above.

1.193 The anti-bullying programme should be extended. (7.16) Not achieved. The anti-bullying programme had run once as a pilot, and had not operated since that time. The original programme had been reviewed and revised taking into consideration the evaluation of the pilot. We recommend that resources be identified to deliver the revised programme. Tackling bullying behaviour through programmes that confront bullies is likely to be more effective in the long term than taking action that relies solely upon monitoring and the implementation of sanctions.

1.194 Adequate resources and support should be provided for the running of the anti- bullying wing and programme. (7.17) Not achieved. Neither the anti-bullying wing nor the anti-bullying programme was operational.

1.195 The dormitory cell on X Wing should be converted for use as a group room. (7.17) Not achieved. As above.

1.196 More use should be made of the anti-bullying booklets to monitor both victims and perpetrators of bullying. (7.18) Partially achieved. There had been an increase in the use of the anti-bullying observation booklets by staff. This may have been attributable to an increase in the incidences of bullying, or an increase in the level of reporting or a combination of these two factors. There was still inconsistency in the level of reporting between wings. The anti-bullying booklets, which monitor both victims and perpetrators of bullying, should be used to provide a better understanding of the reasons for the inconsistency in the level of reporting between wings.

Additional Observations 1.197 The anti-bullying committee had observed that there was no correlation being made between the summary of the security incident reports (SIR)s, where an element of bullying had been involved, and the anti-bullying observation booklets. There was a view that this constituted evidence supporting the perception of under-reporting. The

52 anti-bullying committee published ‘league tables’ in respect of the numbers of anti- bullying observation booklets received, indicating the wings from which they had originated. Low numbers were not interpreted as low incidences of bullying, for the reasons outlined above, consequently we felt that the publication of the ‘league tables’ was a good initiative designed to encourage reporting of bullying behaviour.

1.198 Residential Governors should regularly monitor the completion of anti- bullying observation booklets.

1.199 Staff on the wings need to be trained in the use of the anti-bullying booklets. (7.18) Not achieved. Staff had not been specifically trained to complete the anti-bullying observation booklets since their original inception. We repeat the recommendation and add that staff should receive training to enable them to become familiar with the establishment’s anti-bullying strategy and their role within it, and in particular the completion of the anti-bullying observation booklets.

1.200 The anti-bullying committee should be supported and assisted in their efforts to raise the profile of bullying at Bristol. (7.20) Partially achieved. The establishment had agreed a proposal to merge the Anti- Bullying Committee with the Suicide Prevention Committee to become one Safer Custody Group in order to bring it more in line with the national Safer Custody agenda. Whilst this initiative has the potential to raise the profile of anti-bullying within HMP Bristol, as was the intention, there was also the possibility that it might become further marginalized unless both strategies were acknowledged individually as well as collectively. It will be essential to ensure that the enormous potential evident in the anti-bullying strategy is not lost. A possible method to achieve this might be to re-launch the anti-bullying strategy. In any event, the anti-bullying strategy should be revised. The 1999 document was out of date, referring to the anti-bullying unit that was not operational, the anti-bullying programme that had ceased to run and people who no longer had responsibility for anti-bullying.

1.201 Research to measure the extent of bullying in the prison should be carried out as soon as possible. (7.21) Achieved. A questionnaire had been circulated to all prisoners within HMP Bristol regarding all aspects of bullying and/or intimidatory behaviour. There had been a detailed analysis of the survey. It identified problematic areas that could be used to develop the anti-bullying strategy further. Information provided by prisoners indicated that there was significant under-reporting of bullying by both staff and prisoners. It also suggested that staff were frequently the perpetrators of bullying behaviour.

Additional Observations 1.202 The documentation that we examined relating to anti-bullying was impressive. The strategy itself, the anti-bullying observation booklets, the revised anti-bullying programme and the analysis of the survey carried out the previous year into bullying behaviour at Bristol were all excellent examples of working documents relevant to tackling bullying behaviour. However, anti-bullying work must be more than a paper exercise and the anti-bullying strategy must be owned and supported by all staff.

1.203 The anti-bullying strategy clearly identified individual as well as collective responsibility. It was motivational, gave guidance for wing based liaison officers as well as governors, and also covered the needs of victims. It extended to monitoring and evaluation.

1.204 The Senior Management team should reinforce the message to all staff that anti-bullying and the safety of prisoners is as important as security. We were told that wing staff who acted as anti-bullying liaison officers, who would become safer custody liaison officers with the new proposals, rarely attended the monthly meetings. Consequently there was no flow of essential information to and from the staff who needed to use it on a daily basis. The Senior Management Team should take action to ensure that anti-bullying liaison officers, or safer custody liaison officers, attend the anti-bullying strategy meetings and are generally more involved and accountable.

The Estate 1.205 The rooflight in the induction room should be fitted with a high-level coil and either the cabin moved or the heating amended. (8.06) Not inspected.

1.206 Responsibility for the old patch shop should be clarified. (8.07) Not inspected.

1.207 Works staff should not be used for regular general prison duties (8.08) Not inspected.

1.208 The separate bars and windows should be replaced over time by the more modern design. (8.11) Not inspected.

1.209 The battery maintained lighting should be checked after dark and any deficiencies made good. (8.12) Not inspected.

1.210 A lift should be fitted to serve the Administration Department. (8.13) Not inspected.

1.211 Adequate facilities for the disabled should be provided throughout the prison. (8.13) Not inspected.

1.212 The repairs specified in paragraph 8.14 should be rectified. (8.14) Not inspected.

Health and Safety 1.213 The works department should be responsible for providing a Radiological Protection Supervisor for the whole prison. (8.17) Not inspected.

1.214 Cold room safety equipment should be checked regularly and kept in full working order. Door catches should not be defeated by hasps and staples. (8.18) Not inspected.

Fire Precautions 1.215 More emphasis should be given to fire precautions in the prison and the Fire Inspectorate report dealt with as a matter of urgency. (8.19) Not inspected.

1.216 Training needs should be addressed. (8.20) Not inspected.

1.217 The signposting of escape routes should be checked. (8.21) Not inspected.

1.218 Responsibility for opening and closing the meter bypass valve should be very clearly allocated, included in the contingency plan and tested during exercises with the fire brigade. (8.22) Not inspected.

1.219 Evacuation exercises should also be carried out after dark. (8.23) Not inspected.

1.220 Smoke clearance ventilators should be fitted to D Wing. (8.24) Not inspected.

1.221 Inundation points should be fitted to all cell doors. (8.25) Not inspected.

CHAPTER TWO

TESTS OF A HEALTHY PRISON

2.01 Bristol had a lot to be proud of particularly in the way the establishment had encouraged and facilitated innovation.

2.02 Much has already been spoken and written of the Jade Project and we were happy in this inspection to commend it yet again. In order to help it move forward, we recommend that a detailed analysis of its effectiveness be carried out. We also recommend that the scheme be expanded, such that it is available to more prisoners and that its principles, at least, are rolled out formally across the prison estate. We were disappointed to hear that even now the establishment receives ad hoc enquiries from Governors of other establishments who have merely ‘heard about it’.

2.03 Bristol had established an excellent drug strategy which was commended in the last full inspection and which continued. We welcomed the new role of a Drug Strategy Co-ordinator, and the way the strategy was moving forward not least in the plans for D Wing as a therapeutic unit and day centre. It was unfortunate that at the time of this inspection the drug strategy was being undermined by problems with Health Care.

2.04 Legal services at Bristol remained some of the best we have seen, particularly in the context of the video links and the excellent commitment to staff training through which prisoners will have access to very well qualified legal services staff.

2.05 The PE department continued to provide good services for prisoners and we particularly commend its links with education and involvement with basic skills education.

2.06 The self-harm strategy was well developed with staff now receiving training in mental health awareness. A large number of F2052SHs (self-harm monitoring 57 documentation) were open at the time of the inspection but regular reviews were taking place and the quality of the documentation was good.

2.07 Our most serious concern was, as already indicated, the situation in the Health Care Centre. The management issues identified in our last report remained unresolved, despite the highly appropriate appointment of a Health Care manager from the NHS. Unfortunately at the time of this inspection she was on sick leave, but it was clear from documentation available to us that some very drastic managerial intervention was still required. There were significant staffing shortfalls, which emanated from a rapid turnover of staff, sickness, suspensions and recruitment problems made worse by the amount of time it was taking to complete security checks on potential recruits.

2.08 The net result of all these problems was that the treatment of patients was well below the standard they should expect. Patients were rarely getting out of their cells, there was little in terms of therapy and the detox programme was suffering badly. It was the view of the Senior Medical Officer that her patients were at increasing risk. The Governor informed us that he had discussed the closure of the hospital as well as designating it as ‘red’ in the context of the traffic light system describing the state of health care across the prison estate. The Area Manager in the report of his visit in July described a situation that ‘could not continue’.

2.09 The situation had, in our view, continued for far too long and we see three possible courses of action: § the hospital is closed § the hospital is re-designated such that it is required to deliver drastically reduced services § immediate and drastic interventions are put in place to correct the regime, staffing and management problems. We saw evidence of numerous strategies, plans and reviews both locally and with the NHS but saw no evidence of more positive outcomes for prisoners

2.10 We had further serious concerns about regime reductions which had taken place and seemed likely to continue. We were told that the very limited evening

58 association currently in place was in danger of being lost completely. We see this as unacceptable. Our concerns were exacerbated by the failure of the establishment to make full use of existing activity places. At the time of the inspection we saw one workshop closed for a day to allow instructors to receive drug awareness training. Given the amount of contact time prisoners and instructors have in any week we felt there was plenty of opportunity for such training outside the core prisoner day. We were also told that workshops were rarely full. The establishment’s own monitoring listed reasons for non-attendance at activities. These included ‘sleeping’, ‘dentist’, ‘haircut’, ‘gym’, ‘library’ and ‘no unlock’ which we were told meant that staff omitted to unlock the prisoner. We fully acknowledged that in the context of activities, education funding had not been cut, but felt that this activity in particular warranted expansion given the size of the establishment and the needs of its population.

2.11 We did not have, in the context of a short inspection, sufficient time to fully examine the levels of bullying across the establishment. There was anecdotal evidence of bullying in the context of prescribed medication, which was mostly in tablet form in order to keep costs down. We recommend that that there should be more managerial impetus behind the anti-bullying strategy, which although sound on paper was neither fully implemented nor up to date. Furthermore it was not widely supported by middle managers, in that Wing Officers routinely did not attend meetings. Consequently we felt that incidents of bullying were under-reported.

2.12 In terms of where the establishment needed to go in the future, we firmly believed that the Governor’s priorities and initiatives were right.

2.13 Health Care and the Drug strategy were fundamental to the establishment and mutually dependent. Health Care was in crisis and undermining the drug strategy. As already indicated urgent action was required.

2.14 The regime review was sound but at an early stage in its development. The sooner it is translated into action, the better it will be for prisoners and the health of the establishment.

2.15 That the establishment knew in which direction it needed to go as a local prison was not in doubt, but that it will be able to do so was more problematic.

2.16 Because Bristol was designated as a core local with all the implications of that in terms of Category A prisoners and investment as part of the Woodcock review, the establishment had necessarily focused heavily on security.

2.17 The wider population of prisoners at Bristol did not differ substantially from that of HMP Lewes, Canterbury, Dorchester or Winchester yet the regime and culture had to concentrate on a tiny minority who ironically themselves did not receive a full regime.

2.18 Bristol had made more attempts than we have seen in many other locals to identify and meet the needs of its local prisoner population. Indeed it could be said that it had done more than most to develop as a community prison. Its current dual role can only continue to hinder such developments.

Four Tests of a Healthy Prison 2.19 We include in our inspection reports an appraisal of an establishment’s performance against the model of the healthy prison as described in ‘Expectations’ published by HM Chief Inspector of Prisons in his Annual Report 1999-2000. In a short unannounced inspection such as this, opportunities for checking outcomes with prisoners themselves are more limited than during a full inspection. However, from our discussions with prisoners, staff, managers of the establishment and the Board of Visitors, we are confident of the following conclusions.

Test 1 – All prisoners are held in safety 2.20 Although safety and security do not necessarily go hand in hand, the Category A security meant that the establishment was very tightly controlled and under close supervision. Fortunately this had not impinged on the very positive staff prisoner relationships that we frequently observed. A number of prisoners approached us in an unsolicited way to give testimony to how they felt in the establishment and to say how

60 well treated they were by staff. The excellent self-harm strategy underpinned this atmosphere of support, as did the environment in education and workshops.

2.21 We were still concerned, however, at the response to cell call bells which, although greatly improved via a new system in the refurbished B Wing, remained poor in A and G Wings. The anti-bullying strategy was crucial for future prisoner safety and should receive urgent managerial support.

2.22 Our greatest concern in the context of prisoner safety was undoubtedly Health Care, as previously discussed.

Test 2 – Prisoners are treated with respect as fellow human beings 2.23 We saw no active signs of disrespect for prisoners; indeed the positive staff prisoner relationships, already referred to, reflected very well in this context. The way in which the establishment had made extensive community links also underpinned what we saw as a wish to identify and meet the needs of individuals and acknowledge wider community responsibility. It was therefore a pity to see the establishment having to record the fact that one reason why prisoners sometimes did not get to work was because staff had omitted to unlock them.

Test 3 - Prisoners are expected to improve themselves and are given the opportunity to engage in purposeful activities 2.24 There were far too few prisoners engaged in constructive activity and the problems identified in the last report continued. We were particularly disappointed at the lack of opportunity for prisoners to gain accredited qualifications and at the possibility that the regime may become even more impoverished in the future. We received conflicting information as to the budgetary situation in future years at Bristol. We simply express our concern that the regime should expand rather than contract. This includes the regime for the Category A prisoners, which in all other ways so dominated the establishment.

Test 4 - Prisoners are helped to resettle in society and reduce the likelihood of re- offending 2.25 We saw more work being done at Bristol to deal with the needs of resettlement and help prisoners address offending behaviour than in any other local prison we have inspected. The Jade project and the drug strategy were two key examples.

2.26 The new role of a Director of Prison and Probation Initiatives was an interesting and wholly commendable development, and we look forward to seeing the outcomes. We were also made aware of a forthcoming job fair and proposals under the auspices of the drug strategy for staged housing for prisoners on release. Both of these initiatives represented a fresh approach to the role of a local prison, which is very much reflected in this report.

CHAPTER THREE

SUMMARY OF RECOMMENDATIONS

To the Director General

3.01 Local prisons should be formally tasked with the resettlement of remand and short sentenced prisoners and provided with the practical guidance and support to effect this. (1.04)

3.02 All psychologists working with lifers should be trained in the use of the dispersal assessment package. (1.05)

3.03 A purpose built sports hall should be funded to provide proper facilities for physical recreation. (1.13, 1.115)

3.04 Versions of the information leaflet for the video link in languages other than English should be provided by Prison Service Headquarters. (1.41)

3.05 The Prison Service’s Drug Strategy Unit (DSU) should commission independent research into the outcomes of the Primary Intervention Programme, to evaluate whether it is an effective brief intervention model. (1.84)

3.06 The confusion around MDT figures throws into doubt their reliability as an indicator of drug use within prisons. The Prison Service Drug Strategy Unit should set clear guidelines for recording and ensure that all prisons apply them in the same way. (1.86)

3.07 The single storey buildings should be demolished and replaced by multi-storey structures. (1.102)

3.08 The Prison Service should reconsider its policy of including health care beds in the CNA figure. (1.161)

3.09 In order to help it move forward a detailed analysis of the effectiveness of the JADE project should be carried out. If found to be effective the scheme should be expanded, such that it is available to more prisoners and its principles, at least, are rolled out formally across the prison estate. (2.02)

To the Area Manager

3.10 A comprehensive refurbishment programme should be scheduled in the near future. (1.53)

3.11 Immediate and direct action should be taken to resolve the structural and staffing issues in the Health Care Centre and ensure that the treatment of patients meets the Prison Service’s Health Care Standards. (1.180)

To the Governor

Reception 3.12 A free telephone call to next of kin should be given on a prisoner’s first evening. (1.21)

3.13 Adaptations should be made to the shower in reception to provide better access. (1.22)

3.14 The reception area should be refurbished in order to take account of prisoner numbers and the needs of Category A prisoners. (1.24)

3.15 Plans for a multi-disciplinary induction programme should be implemented as soon as possible and should include sessions by Listeners and sessions on harm reduction concerning the abuse of drugs and alcohol. (1.26)

Self Harm 3.16 Statistics kept on the use of Listeners should also include use of Listener suites. (1.28)

3.17 Management should regularly test responses to cell bells and in particular to those from cells housing prisoners with an open F2052SH. (1.32)

Grievance Procedures 3.18 Steps should be taken to more widely advertise all avenues of redress open to prisoners as part of the IEP scheme. (1.35)

Legal Services 3.19 Consideration should be given to improving the physical layout of the legal services area. (1.39)

A Wing 3.20 There should be a fuller regime on A Wing. (1.42)

3.21 A more imaginative approach to the IEP scheme is needed to make it more effective. This should include greater incentive for prisoners to aspire to an enhanced regime and more opportunities for remand prisoners to demonstrate their suitability. (1.44)

3.22 Managers should carry out regular spot checks on cell call responses, and on A and G Wings in particular. (1.45)

B Wing 3.23 Further consideration of the design of the furniture in-cell is needed, given that the cells are particularly small. (1.46)

3.24 Dining out should be considered. (1.48)

3.25 Further improvements are needed to the wing notice boards to make them more user friendly. (1.62)

3.26 The practice of linking voluntary drug testing with the IEP scheme should cease. (1.64)

D Wing 3.27 Management should review the housing of prisoners undergoing detoxification and, given the practical constraints, separate them from the general population. (1.74)

3.28 Prisoners undergoing detoxification should have access to motivational and supportive services. (1.75)

3.29 The proposal that one of the detox nurse posts should be transferred back to Health Care to support the detox programme and another post should be fully integrated into the CARATs team should be implemented as soon as is practical. (1.78)

3.30 More suitable accommodation should be provided as soon as possible for the drugs based programmes within the prison. (1.82)

3.31 The Drug Strategy Co-ordinator should review the operation of the VDT scheme to ensure that it meets the principles laid out in PSO 3620. (1.85)

Education 3.32 A specific detailed section relating to HMP Bristol should be drawn up and added to the education contract to ensure quality and development can be monitored and evaluated. (1.87)

3.33 A member of the education department should deliver a session during the induction programme, setting out educational opportunities available at Bristol, as a motivational exercise. Thereafter individual interviews should be offered to those prisoners who wish to avail themselves of such opportunities. (1.95)

3.34 The differentials between the choices of purposeful activity should be examined to ensure that they do not represent a disincentive to those prisoners who might otherwise be motivated to participate in education. (1.96)

3.35 Some recreationally based educational activity should be introduced to the curriculum. (1.103)

3.36 IT equipment should be updated and improved to meet prisoner need. (1.106)

3.37 The initiative to pilot NVQs for two of the workers in the library should be developed. (1.108)

3.38 Consideration should be given to funding the provision of a computer link to the central library. (1.108)

Physical Education 3.39 A more structured approach to increasing prisoner participation should be considered by identifying prisoners who do not participate in PE activity from the LIDS system and adopting a proactive approach to encourage their attendance. (1.113)

3.40 The establishment should ensure that the initiative to develop the number of prisoners working on NVQs should be encouraged and supported. (1.114)

Employment 3.41 The activity attendance monitoring system should be adapted to include reports of late arrival and early departure from classes, so that action may be taken to address misconduct. (1.118)

3.42 The Regime Review, now in draft form, should be completed and an action plan drawn up to consider and implement agreed options and recommendations. (1.121)

3.43 The establishment should take action to enforce its own no smoking rules. (1.124)

3.44 The workshop expansion scheme should be reviewed to include vocational training as the main aim of the employment strategy. (1.125)

3.45 Completion of the Regime Review should incorporate a revised employment strategy to include vocational training as the main aim. (1.128)

Visits 3.46 Management should review the booking system to ensure that visitors are able to book visits without excessive difficulty. (1.129)

3.47 The removal of the dividers on the tables in the Category A visiting room should be considered. (1.130)

3.48 Posters, magazines or a television should be provided in the prisoners’ waiting rooms. (1.131)

3.49 The establishment should review other available options, rather than requiring the visitor to leave the visit area to bottle-feed their baby. (1.132)

3.50 The supervision of the play area should be kept under review to ensure that this facility is consistently available. (1.133)

Catering 3.51 The servicing of kitchen equipment should be taken into account when any new purchases are made. (1.135)

3.52 The intervals between meals should be altered, especially between the serving of the evening meal and breakfast. (1.139)

Health Care 3.53 The proposed development of a day care unit for mentally disordered prisoners should be considered by the review committee to ensure that it will meet the needs of the prisoners at Bristol. (1.153)

3.54 A more therapeutic exercise area should be provided. (1.157)

3.55 The need for more time and clearer protocols for the triage system of seeing patients should be considered. (1.158)

3.56 Prisoners should only be admitted to the HCC beds if they need 24 hour nursing care. (1.162)

3.57 The regime for in-patients should be reviewed and, as a minimum, meet HCS 2.2 and 4.2. (1.163)

3.58 The night medical staffing levels should be reviewed. (1.164)

3.59 Ways of meeting the Health Care Standards for care of those patients with mental health problems should be considered during the proposed review of the health care services. (1.167)

3.60 As part of the overall Health Needs Assessment review, there should be discussions with the South West regional office of the NHS with a view to limiting any delays in transfers of mentally disordered patients to secure beds in the NHS. (1.168)

3.61 Both medical rooms in reception should meet HCS 1.3. (1.169)

3.62 Problems with Health Care staffing need to be resolved to allow adequate time for health assessment as part of the reception process. (1.170)

3.63 Steps should be taken to contact the Medicines Control Agency to request regular mailing as and when drug recalls occur. (1.175)

3.64 The Health Care Manager should meet with the dentist to agree upon a strategy to keep the waiting list down to a reasonable level. (1.181)

Dental Care 3.65 Developing facilities for radiographs should be obtained for the dental suite. (1.182)

Anti-bullying 3.66 Resources should be identified to deliver the revised anti-bullying programme. Tackling bullying behaviour through programmes that confront bullies is likely to be more effective in the long term than taking action that relies solely upon monitoring and the implementation of sanctions. (1.193)

3.67 The anti-bullying booklets, which monitor both victims and perpetrators of bullying, should be used to provide a better understanding of the reasons for the inconsistency in the level of reporting between wings and their completion should be regularly monitored by Residential Governors. (1.196, 1.198)

3.68 Staff should receive training to enable them to become familiar with the establishment’s anti-bullying strategy and their role within it, and in particular the completion of the anti-bullying observation booklets. (1.199)

3.69 The anti-bullying strategy should be revised. The 1999 document was out of date, referring to the anti-bullying unit that was not operational, the anti- bullying programme that had ceased to run and people who no longer had responsibility for anti-bullying. (1.200)

3.70 Anti-bullying liaison officers, or safer custody liaison officers, should attend the anti-bullying strategy meetings and be generally more involved and accountable. (1.204)

3.71 There should be more managerial impetus behind the anti-bullying strategy which although sound on paper, was neither fully implemented nor up to date. (2.11)

EXAMPLES OF GOOD PRACTICE

3.72 Recent self-harm initiatives had included the introduction of new forms to ensure that procedures were adhered to and the training of wing staff in ‘Mental Health Awareness’. Future plans included more specialised training for selected staff, a research project on the ‘triggers’ to self-harm and the development of a Safe Custody Unit on D Wing when it re-opened. We were encouraged by these developments and felt that there was the potential for developing a model of good practice that could be adopted by other prisons. (1.34)

3.73 The range of training being undertaken by legal services was the best we have seen. We commend this approach as a model of best practice. (1.38)

3.74 The education department had conducted a prisoner education needs analysis involving prisoners and intended to do this annually, which we commend. (1.88)

3.75 The Education Department had introduced monthly education contract monitoring meetings that included discussions regarding programme delivery, class sizes and attendance, student recruitment and development and staff development. (1.89)

3.76 Prisoners non-attendance at workshops had begun to be addressed by way of the compilation of a monthly monitoring report outlining a record of individual prisoner attendance at their required activity on a daily basis. This was overseen by the Principal Officer responsible for programmes, who reported directly to the Programmes Group. (1.118)

3.77 We were pleased to learn that the degree to which the variety of work on offer in the workshops met local employment needs was beginning to be addressed in a number of ways, including the examination of the local employment market and an impending Job Fair to which 100 local employers had been invited. (1.128)

3.78 The anti-bullying committee published ‘league tables’ in respect of the numbers of anti-bullying observation booklets received, indicating the wings from which they had originated. Low numbers were not interpreted as low incidences of bullying and consequently we felt that the publication of the ‘league tables’ was a good initiative designed to encourage reporting of bullying behaviour. (1.197)

3.79 The documentation that we examined relating to anti-bullying was impressive. The strategy itself, the anti-bullying observation booklets, the revised anti- bullying programme and the analysis of the survey carried out the previous year into bullying behaviour at Bristol were all excellent examples of working documents relevant to tackling bullying behaviour. (1.202)

3.80 We saw more work being done at Bristol to deal with the needs of resettlement and help prisoners address offending behaviour than in any other local prison we have inspected. The Jade project and the drug strategy were two key examples. (2.25)