Fact Page 11-12 Healthy Prison Summary Hp.01-Hp.46 13-22

REPORT ON A FULL ANNOUNCED INSPECTION

HM PRISON LEWES

10-14 MARCH 2003

HM CHIEF INSPECTOR OF PRISONS

INTRODUCTION

This is not only a report on a good local prison; it is also a report on a prison which has become significantly better, due to effective management and a committed staff group. This improvement was endorsed by many prisoners we spoke to, and by the Board of Visitors.

Lewes faces many difficulties. It is an old and poorly-maintained prison. It receives a high proportion of mentally disordered prisoners, many of them with a history of substance abuse, and this has been linked to the high rate of self-inflicted deaths (5 in the preceding year). It seeks to work as an effective local prison, preparing prisoners for release locally, but is frustrated in this by the fact that those prisoners are routinely moved further away from home after short periods, because of the pressure of prison overcrowding. Prison overcrowding has also forced the prison to hold some prisoners in cramped and unfit conditions, particularly on one wing.

It is therefore a tribute to the prison’s staff and managers that in many of the areas covered in this report, Lewes scores significantly higher than most local prisons. From the results of our prisoner survey, Lewes was considerably better than other local prisons in relation to reception and first night arrangements, perceptions of safety and respect, and access to telephones: often as much as 20-30% above the average. By comparison with other local prisons, hardly any prisoners complained about the way that staff spoke to them, and no prisoner alleged assaults by staff. More prisoners had personal officers than in most local prisons, and three-quarters of those who did found them helpful.

We found that this positive atmosphere was reflected throughout the prison. Staff felt valued by managers; and this was reflected in their relationship with prisoners. It was often staff who drew our attention to the unsatisfactory conditions in which prisoners were held: particularly on the vulnerable prisoner wing, where cells were far too small to hold two prisoners in any decency, particularly for disabled and elderly prisoners.

Lewes was also a prison that was aware of gaps and weaknesses and sought to remedy them; and which valued co-operation with local community organisations. The new healthcare management structure was designed to improve provision considerably, particularly in the critical area of mental health, and the Governor was personally driving co-operation with the local NHS economy. A safer custody co-ordinator had been appointed, to strengthen and bring together the safer custody agenda, and involve local community groups, in light of the recent suicides. The prison had recently appointed a diversity manager, from outside the Prison Service, with experience of race complaints investigation, to co-ordinate race relations and foreign nationals work.

There are two areas, however, where the prison needs to strengthen its work further. The first is in the provision of work skills and education. There were not enough work spaces, they were not appropriately allocated and the great majority of the work available was menial, repetitive and unskilled. Education provision also needed to be increased and broadened. The second area, as in many local prisons, was resettlement, where the prison needed to develop a coherent strategy, based upon assessed need, and including active assistance with housing and employment. These are two large and important areas, and the prison may need to strengthen its management structure in these areas to drive both forward.

There is, however, a key issue that the Prison Service needs to address. As in many of the prisons we inspect, vulnerable prisoners were essentially being parked in Lewes, with no provision for active work to address their offending behaviour; and a culture of denial was beginning to emerge. By contrast, those whom Lewes could have helped, and wanted to - its locally-resident short-term population - were being moved out to establishments at some distance from their homes and families. This makes no sense. It was scarcely surprising that the main source of adjudications was prisoners’ refusal to be transferred to a distant prison which could do less for them.

We would strongly recommend to local management that Lewes’s strengths – its positive engagement with prisoners and growing links with the community – are built on properly, by allowing it to use F wing to retain and resettle local men, rather than merely contain vulnerable prisoners.

Anne Owers April 2003 HM Chief Inspector of Prisons

CONTENTS

Paragraph Page INTRODUCTION 3-5 FACT PAGE 11-12 HEALTHY PRISON SUMMARY HP.01-HP.46 13-22

1 ARRIVAL IN CUSTODY 23-38 Courts and transfers 1.01-1.12 Reception, first night and induction 1.13-1.71 Legal rights 1.72-1.91

2 RESIDENTIAL UNITS 39-45 Accommodation and facilities 2.01-2.25 Clothing and possessions 2.26-2.34 Hygiene 2.34-2.42

3 DUTY OF CARE 47-68 Anti-bullying 3.01-3.18 Preventing self-harm and suicide 3.19-3.35 Race relations and foreign national prisoners 3.36-3.57 Substance use 3.58-3.94 Maintaining contact with family and friends 3.95-3.109 Applications, requests and complaints 3.110-3.117

4 HEALTHCARE 69-79 Introduction 4.01-4.03 Environment 4.04-4.12 Records 4.13-4.14 Staffing 4.15-4.25 Delivery of care 4.26-4.49 Recommendations 4.50-4.62

Paragraph Page 5 ACTIVITIES 81-94 Employment 5.01-5.12 Education and work skills training 5.13-5.34 Physical education 5.35-5.45 Faith and religious activity 5.46-5.62 Time out of cell 5.63-5.73

6 GOOD ORDER 95-106 Rules of the establishment and security 6.01-6.05 Prisoner disciplinary procedures 6.06-6.08 Use of force 6.09-6.12 Segregation unit 6.13-6.21 Vulnerable prisoners 6.22-6.27 Conclusion 6.28-6.31 Recommendations 6.32-6.36 Good practice 6.37-6.42 Incentives and earned privileges 6.43-6.49 Categorisation 6.50-6.57

7 RESETTLEMENT 107-113 Management of resettlement 7.01-7.02 Re-integration planning 7.03-7.11 Sentence planning 7.12-7.15 Offending behaviour work 7.16-7.17 Personal officers 7.18-7.21 Conclusion 7.22-7.23 Recommendations 7.24-7.27 Good practice 7.28

8 SERVICES 115-118 Catering 8.01-8.14 Prison shop 8.15-8.21

Paragraph Page 9. RECOMMENDATIONS AND GOOD PRACTICE 119-130 Main recommendations 9.01-9.05 To the Director General 9.06-9.08 To the Area Manager 9.09 To the Governor 9.10-9.90 Examples of good practice 9.91-9.103

APPENDICES I Inspection team II Prisoner population profile III Summary of prisoner questionnaires IV Adult Learning Inspectorate report

FACT PAGE

Role of the establishment HMP Lewes is a category B local prison.

Brief history Lewes was built in 1853 and designed on the radial system; it still maintains Victorian buildings as house blocks.

Area organisation Kent, Surrey and Sussex

Number held 5 March 2003: 497

Cost per place per annum £20,014

Cost per prisoner place £20,579 year to date; target £20,164

Certified normal accommodation 485

Operational capacity 523

Last inspection Full inspection: September 1997 Short unannounced inspection: March 2000

Description of residential units Lewes currently had five residential units; a further wing, B wing, was being used as a temporary healthcare centre while the healthcare building was closed for refurbishment.

A, C and F wings were the three large, main wings: A held primarily remand and trial adults, with some young adults awaiting remand or trial; C held convicted prisoners, awaiting allocation and serving short-term sentences prior to discharge; F was used as a vulnerable prisoner unit. A and C wings were refurbished three years ago and provided a good level of accommodation; F wing was in need of refurbishment and the establishment was awaiting the outcome of a bid for funding to carry this out.

K and G wings were separate units in the basement areas of A and C wings respectively: K was the first night centre and G was the induction unit.

HEALTHY PRISON SUMMARY

Introduction HP.01 The concept of the healthy prison was introduced in our thematic review, Suicide Is Everyone’s Concern, 1999. The four criteria for a healthy prison are:

Safety – all prisoners are held in safety. Respect – prisoners are treated with respect as individuals. Purposeful activity – prisoners are fully and purposefully occupied. Resettlement – prisoners are prepared for their release and resettlement into the community with the aim of reducing the likelihood of their re-offending.

HP.02 Lewes had, historically, received a large number of prisoners who had substance-related problems, many of whom also suffered from mental health problems. During 2002 there had been five deaths of prisoners, all of which had been self-inflicted.

HP.03 The Governor, who had been in post for two years, had set priorities for the prison, which involved establishing effective first night arrangements to support prisoners, re-organising and strengthening the healthcare provision, and implementing safer custody arrangements.

Safety HP.04 Despite a relatively high incidence of assaults and self-harm, both of which related to the troubled nature of the population, the prison was fundamentally safe. No tension was evident in the atmosphere, and prisoners did not report feeling unsafe. In our prisoner survey, 67% of respondents said that they had never felt unsafe in Lewes, compared with the average of 57% for local prisons.

HP.05 The reception building was a large, well maintained facility in which staff managed prisoners sensitively and efficiently. In our survey, 70% of respondents said that they had been well treated by reception staff, double the average response from

local prisons of 35%. Prisoners did not stay long in reception before moving on to K wing, the first night centre.

HP.06 The first night centre was managed by dedicated staff. They carried out a comprehensive series of interviews and processes, in the course of which urgent problems were identified, information on the prison was communicated, and the Prison Service cell sharing risk assessment was completed. The staff completed the whole process whatever time prisoners arrived on the unit, often leaving after their shift finishing time as a result.

HP.07 Prisoners moved on from the first night centre to the induction unit on G wing, where they received induction. Sessions provided relevant information that was well presented to small groups. The atmosphere was relaxed and prisoner orderlies were available to provide peer support to new arrivals.

HP.08 All prisoners were encouraged to go through the first night and induction procedures on these units, but some vulnerable prisoners felt unable to do so and were moved straight to F wing, the vulnerable prisoner unit. They were not able to benefit from the same level of information and support, and they were placed in shared cells in advance of the cell sharing risk assessments being completed the following morning. There was also no mechanism to inform staff on night duty of the prisoners on F wing who had arrived that day.

HP.09 The procedures to prevent suicide and self-harm were taken very seriously in the establishment. Monitoring booklets, F2052SH, were opened if there was any indication of a prisoner’s intent to self-harm, and reviews took place on schedule. Support plans largely focused on preventing immediate self-harm, as opposed to helping the prisoner develop coping skills, but the reviews and the routine entries in the booklets demonstrated the level of care and concern shown by staff. Night staff were aware of prisoners under monitoring, and were familiar with actions to be taken in the event of an emergency. Prisoner Listeners were used if a prisoner was acutely in need of support, but there was no suite for Listeners to spend the night with such prisoners.

HP.10 The reported incidence of bullying was very low, and the prisoner survey confirmed this. However, apart from F wing, there had been only one instance where a prisoner had been subject to anti-bullying arrangements, which indicated that some bullying could have gone unnoticed or unreported by staff. There were no prisoner representatives on the anti-bullying committee, and no intervention strategy to help bullies or their victims understand and modify their behaviour.

HP.11 The segregation unit was well maintained and managed. Staff knew the prisoners located there and did their best to support them. Some prisoners with severe mental health problems preferred to remain in the segregation unit: staff treated them with care and tried to persuade them to move to the healthcare centre. There was a range of locally produced documentation designed to increase the efficiency of the unit, ensure that prisoners were regularly checked, and provide them with the maximum information.

HP.12 Vulnerable prisoners were located on the least desirable wing in the prison, both because it lacked in-cell electricity and also because it housed the largest number of prisoners with the least space available for recreation. The majority of prisoners there were sharing cells that were designed, and only suitable, for single occupancy. There were shower curtains around the toilet, but these gave insufficient privacy. Despite this, the atmosphere in the wing was relaxed and it was maintained to a very high standard. It was clear that relationships were good and that prisoners had confidence in the staff. Prisoners were appropriately protected, but they were not excluded from the regime. They had their own workshops and education centre, received ample opportunity for physical education, and shared the visiting room with other prisoners.

HP.13 Despite the efforts of managers and staff, the vulnerable prisoner unit remained little more than an exercise in containment. There was no structured means of re-introducing prisoners into the mainstream prison, nor was there the facility to address offending behaviour or public protection issues.

HP.14 A range of measures had been introduced to reduce the incidence of substance misuse within the prison, and these had been supported by a very effective

detoxification programme. The reduction in the numbers of prisoners testing positive on mandatory drug testing, from 33% to 14%, bore testament to this approach.

Respect HP.15 Respect for one another was embedded in the running of Lewes, from senior management down. The relationships between managers and staff were based upon mutual regard, and it was apparent that staff were valued and empowered. This enabled staff to mirror managers’ behaviour in the way that they treated prisoners. A programme of training staff in pro-social modelling had recently begun (see paragraph 7.03). It was envisaged that all staff would ultimately be trained in this, enabling them to engage even more positively with prisoners and contribute more effectively to their resettlement needs.

HP.16 The fabric of the buildings was very poor, due to the age of the prison and to years of comparative neglect. Despite this, the living accommodation was kept in very good order, and the cleanliness reflected the effort and pride that staff and prisoners took in their environment. The use of single cells for two prisoners was disrespectful and unacceptable, but was due to overcrowding within the prison system and therefore beyond the control of local management.

HP.17 Prisoners had access to clean kit and bedding, and were routinely issued with the necessary toiletries for personal hygiene. With the exception of remand prisoners, all prisoners wore prison issue clothing. There were plans to offer prisoners the option of wearing their own clothing, but these had been delayed due to the absence of laundry facilities on F wing, and the justifiable reluctance of management to exclude vulnerable prisoners from the privilege of wearing their own clothes.

HP.18 Prisoners were interviewed by trained legal aid officers during their induction period, and were referred to the bail officer promptly if they had relevant needs.

HP.19 The prison shop carried a rather narrow range of products, particularly for minority ethnic prisoners, but products were reasonably priced. The meals provided also did not cater sufficiently for minority ethnic prisoners and were based on a fortnightly cycle, making them repetitive. The kitchen had suffered from staffing

shortages that had impeded development of the menu, but there was an awareness of the need for improvement. The breakfast meal was provided in packs, which were delivered with the previous day’s lunchtime meal. These included a bread roll which, in the unlikely event of a prisoner saving it through to the next day’s breakfast, would have become stale. There was potential for some out of cell dining, but this option had not been pursued.

HP.20 The incentives and earned privileges system was good, and was applied sensibly by staff. It was flexible so that, with some exceptions, prisoners could move easily between the levels without undue delay. It was also easily understood, transparent and included an appeal process in the event of prisoners’ dissatisfaction. There was, however, little differentiation between standard and enhanced levels, providing little incentive for prisoners to progress to enhanced.

HP.21 Race relations issues had been seriously neglected until the previous autumn, but had been given more attention since then. Regular meetings had begun to take place and some rudimentary ethnic monitoring had been initiated. The rate of reporting of racial incidents had risen dramatically, indicating prisoners’ increased confidence in the system and awareness of the heightened priority of racial matters. The practical needs of the foreign national prisoners were being met, but little more was being done to promote understanding and awareness of cultural issues. The prison had recently appointed a dedicated diversity officer who would have responsibility for the development of policy and links with community and other agencies.

HP.22 Historically, the prison had experienced difficulties with how healthcare was managed and served the needs of the establishment. This was particularly acute due to the level of mental health problems within the prisoner population. In recent months changes had been made to the management structure and much of the previous friction had been resolved. The healthcare staff were integrated into the establishment and shared the common goal of caring for some difficult and needy prisoners. In the prisoner survey, 43% of respondents rated the treatment they received from healthcare as good or very good, against an average of 30% for local prisons.

HP.23 There was a high level of commitment among healthcare staff, incorporating mental health nurses, an in-reach team and specific support for prisoners suffering withdrawal from drugs. There were severe staff shortages, but trained nurses had been supplemented with selected discipline officers who were much appreciated and provided significant support.

HP.24 Shortly prior to the inspection the healthcare function had been moved temporarily into B wing while the healthcare centre was refurbished. The location on B wing was less than ideal, with little space for interviews or for prisoners waiting to see medical personnel. In particular, the dentists’ room was inadequate for its purpose, and the whole setting did not lend itself to a therapeutic environment.

Activity HP.25 There were insufficient occupation places for the full prisoner population, and the places that were available were not always filled to capacity. On induction, prisoners were asked about their employment history and preferences, but subsequent allocation to activity was not systematic or related to individual need. Plans for a full labour board system, based on sentence plan targets, had been drawn up and were almost ready for implementation.

HP.26 The work available in workshops was mainly menial and did not provide prisoners with the opportunity to gain qualifications or marketable skills. In one area of work, which involved the refurbishment of computers, accreditation could have been gained but there were no systems for this. The only workplace where National Vocational Qualifications (NVQs) were offered was the kitchen, where only two prisoners were engaged in working towards NVQ level 1.

HP.27 The education department could provide classes for up to 50% of the population on a combination of full and part-time working. Courses were available in all six key skills, but the curriculum was narrow and did not cater for prisoners who wished to pursue higher education. The resources available for information technology were very limited and only allowed for delivery of CLAIT (Computer Literacy And Information Technology). The quality of teaching and learning was

good, however, and there was a mentor support programme to encourage prisoners to help their peers. There was parity of pay between education and other work, so that prisoners were not discouraged from taking education classes.

HP.28 The library was well stocked with large print books and texts in foreign languages, but access to it was very limited by the attendance of the professional librarian. It was open on one day for prisoners from F wing, who used it extensively, and one day for the remainder of the prison.

HP.29 The physical education department had, in the past, run courses leading to NVQs, but these had ceased due to staffing shortages. At the time of inspection it was providing only recreational PE, but this was varied, of good quality, and offered to all prisoners. Prisoners who wished to could go to the gym as often as six times a week.

Resettlement HP.30 The development of a resettlement strategy was in its early stages; the various initiatives in place were unco-ordinated and not systematically available to all prisoners. No needs assessment had been carried out, and planning for resettlement did not fully take into account that most prisoners from the local area were transferred out of Lewes to make space for prisoners coming in from the courts. Even prisoners serving short sentences and approaching release were likely to be transferred as far away as the Isle of Wight.

HP.31 There was some assessment of resettlement and re-integration needs during induction, but there were no formal means of following through any identified needs. Some opportunities to pursue employment options were available through the FOR (Focusing on Resettlement) a change and the job club initiatives, but these were not accessible to all prisoners and did not start early enough in the sentence. There was no housing advice service, even though nearly a third of prisoners released from Lewes were believed to have no fixed abode. Release on temporary licence was rarely used as part of resettlement planning, perhaps because prisoners did not remain in Lewes long enough, but home detention curfew (HDC) was well used. Of prisoners eligible for HDC, 56% were granted it, which was impressive for a local prison.

HP.32 The maintenance of family ties was severely impeded by the necessity to transfer prisoners away from their home area, but prisoners’ visitors were treated well. The visitors’ centre was very basic, but there was a determination among managers and staff to provide a better facility. Visitors reported no difficulty booking visits, and said that they were treated with respect by staff. The visitors’ toilet had been closed as part of the initiative to prevent drugs coming into the prison, so that visitors, including those with young children, had no reasonable access to toilet facilities during a visit. Despite the motive for the closure, this was unreasonable. There was a supervised crèche facility in the visiting room, and arrangements for children in care to be brought to the prison to visit their fathers.

HP.33 There was a personal officer system, and some prisoners knew, and were known by, their personal officers. For most, however, their personal officer was just a name and there was little direct contact or personal knowledge. Personal officers were unable, therefore, to support effective sentence planning.

HP.34 Sentence plans were generally being completed, although there was a significant backlog on F wing, for which the Area Manager had given a temporary derogation. The completion of the plans and the reviews was perfunctory, with prisoners playing little part in it. Although prisoners were informed of their sentence planning targets they did not necessarily agree with them, and there was no mechanism to help them complete their targets.

HP.35 The only accredited offending behaviour programme offered was enhanced thinking skills (ETS). The quality of delivery was good, but the programme was only available to prisoners on F wing. Even had it been available to them, prisoners on the other wings rarely spent long enough in Lewes to be able to complete the programme.

HP.36 The drugs strategy had improved considerably since the last inspection. A new detoxification regime had been introduced, based on the use of subutex, and community links had been developed with the local mental health trust. A range of counsellors was available, whose services were co-ordinated by healthcare, and the general approach to drug users was not punitive, but supportive. The voluntary drug

testing programme was functioning, but was not centred on a physical area of the prison, so that prisoners on a voluntary testing compact received little additional or specialist support. There was also no specific resource designated to meet the needs of crack-cocaine users.

Conclusion HP.37 The current management had recognised that there was considerable room for improvement in the operation of HMP Lewes, and had set priorities for the work to be done. Initial priorities were predominantly in the areas of safety and respect, and this was reflected in the running of the prison. It was fundamentally safe, and respect was embedded in relationships throughout the establishment. The practice of allocating two prisoners to cells designed for one was, however, disrespectful particularly in the cramped conditions of F wing. Vulnerable prisoners were well protected, but there were very few facilities to meet their offending behaviour needs.

HP.38 There was insufficient activity available for all the prisoners, and too little of what was offered was purposeful. The personal officer system was not effectively established across the prison, and sentence planning was not being used as a tool to prepare prisoners for release. The resettlement strategy was unco-ordinated and not reaching all prisoners, but was also adversely affected by overcrowding drafts which resulted in most prisoners being transferred away from their home area. Managers acknowledged most of the shortcomings and were, in some instances, actively engaged in planning to overcome them.

Main recommendations HP.39 A fully furnished care suite should be provided for Listeners to stay overnight with prisoners at risk of self-harm.

HP.40 The future of the vulnerable prisoner unit should be reviewed to determine whether HMP Lewes can provide appropriately for the offending behaviour needs of these prisoners.

HP.41 Consideration should be given to the use of F wing as a training wing for prisoners from the local area.

HP.42 Cells designed for one person should not be used for two.

HP.43 The healthcare facility should be moved from its unsuitable temporary accommodation as soon as possible.

HP.44 Every effort should be made to provide prisoners with more employment and accreditation of work skills.

HP.45 There should be an assessment of prisoner needs to inform future resettlement planning and the provision of offending behaviour programmes.

HP.46 All prisoners should have practical, and agreed, sentence or custody plans that prepare them for release, drive through the sentence and deal with issues of accommodation and employment.

CHAPTER ONE

ARRIVAL IN CUSTODY

Courts and transfers Expected outcomes The expected outcomes for courts and transfers procedures are: • Safety: Prisoners travel in safe conditions to and from court and between establishments • Safety: Prisoners are safe in crown court cells and other holding areas • Respect: Prisoners are held in decent conditions in escort vehicles and at court • Respect: Prisoners are provided with opportunities for refreshment, toilet and washing facilities at reasonable time intervals • Respect: The individual needs of prisoners during escort and while at court are given proper attention

1.01 Premier Prison Services dealt with all movements of prisoners between the establishment and the courts. The transfer of prisoners to and from other establishments was managed by other escort contractors, most usually Group 4.

1.02 The establishment was a local prison in that it received prisoners sentenced to a period of custody and also those remanded by the courts. In the week prior to the inspection 74 prisoners had been taken to appear in court, and it was estimated that an average of 35 prisoners moved in and out of the reception area daily.

1.03 The relationships between the prison and the main escort contractor were effective, and representatives from Premier Prison Services attended regular meetings with prison managers. During the inspection we were present in reception when a manager from the escort contractor visited the area to ask staff if the systems in place were satisfactory.

1.04 The escort vehicles were clean and appeared to be well maintained. Prisoners were safely escorted to and from court, with the relevant documentation. Prisoners subject to the procedures of self-harm and suicide watch were brought to the attention of all of the staff involved. Escort staff were aware of prisoners who were vulnerable, perhaps due to the nature of their offence, and such individuals were kept segregated from other prisoners during transportation, and moved from the vehicles prior to the other prisoners.

1.05 Prisoners were moved quickly into the reception area upon arrival and were not kept waiting in the escort vehicle, although there were sometimes delays when a vehicle arrived between 12.30pm and 1.30pm, when the reception was closed for lunch.

1.06 There was adequate storage space on the vehicles for prisoners’ property. We were told that there had been occasions when prisoners’ property had not been properly recorded by escort staff, but this had been noted by the escort contractor and the necessary action taken.

1.07 We spoke to some prisoners who had been transferred into Lewes from other establishments; some had travelled for up to four hours in the escort vehicle with no break in the journey.

1.08 A protocol had been developed between Premier Prison Services and the establishment. This set out the details of the 11 courts involved, the time that the escort vehicle was expected to arrive at Lewes, and the time it was expected to leave. All movements to court were expected to arrive at their destination by 9.30am.

1.09 Reception staff noted the time of arrival of the escort vehicle at the reception area and its time of leaving. The reasons for any delays were noted daily. In January 2003, records showed that there had been 295 movements to court, of which 141 (48%) had arrived on time, and 154 (52%) had not. Some of the late arrivals had been due to circumstances outside the control of escort and prison staff, such as traffic and/or road conditions.

1.10 The prison managers and representatives from the court escort provider met regularly to monitor and review the protocol. At the time of the inspection staff commenced work in the reception area at 7.15am, and the first escort vehicle was expected to arrive at 7.30am and leave at 8.15am. New work patterns were due to start in April, and it had been agreed that staff would be available in the reception area from 6.30am to enable the first escort movements to begin at 7.00am.

Conclusion 1.11 The relationship between the prison and the escort contractor was mutually supportive. Prisoners were transferred in safety, although those travelling some distances did not always receive the necessary toilet breaks.

Recommendation 1.12 On long journeys, escorts should break the journey to allow prisoners to use the toilet.

Reception, first night and induction Expected outcomes The expected outcomes for arrival in custody procedures (reception, first night and induction) are: • Safety: Everything reasonable is done to help prisoners feel safe on their reception into prison; prisoners’ needs are identified, including physical and mental healthcare, in order that they may be cared for and supported by competent trained staff • Respect: The way in which entry procedures are conducted and the approach of competent staff preserves the personal identity of prisoners, respects their privacy and dignity and is responsive to their individual needs • Respect: Prisoners are made aware of prison routines, how to access available services and cope with imprisonment • Purposeful activity: Prisoners are constructively occupied during their first days in prison, preferably as part of a comprehensive induction programme • Resettlement and reducing re-offending: Prisoners’ welfare needs are identified and appropriate help offered to deal with them

Reception 1.13 The reception area was exceptionally spacious, and it was clean and well managed. It was staffed by a senior officer, plus three officers. All of the officers were detailed to the area and knew the systems and procedures in operation. Staff knew in advance the names and number of prisoners due to be received into the establishment, and also if any were in need of segregation from other prisoners.

1.14 Upon arrival escort staff brought the documentation and prisoners’ possessions into the reception area. The paperwork was quickly checked to ascertain that the necessary documentation was included and, once this was completed, the prisoners were escorted one by one from the vehicles into the reception area.

1.15 Movements out of the establishment were similarly well organised. Prisoners leaving the establishment to court were strip searched by reception staff, and also received a rub-down search by escort staff prior to being placed in the escort vehicle.

1.16 Upon entering the reception area, each prisoner was seen immediately by the senior officer on duty, who verbally checked the prisoner’s personal details and, if necessary, asked if he understood why he was being held in custody. The senior officer checked the details recorded in the booklet of any prisoner who was subject to an F2052SH (self-harm monitoring form). The cell sharing risk assessment form was not completed by reception staff, but by staff in the first night unit. In our prisoner survey, 65% of respondents said that reception staff asked them if this was their first time in prison; this compared with the local prison average of 47%.

1.17 After completion of these procedures, each prisoner was moved to a holding room; there were three. Sight lines were good; staff in the main reception office could view CCTV coverage of the three rooms and the main corridor through which they were accessed.

1.18 The initial holding room (room one) was large, with bench seating and access to a toilet and a sink. Two notice boards displayed a variety of information, including the race relations, anti-bullying and suicide and self-harm policies. Information was

also available about the Board of Visitors, the drug strategy, the Criminal Cases Review Commission, the Prisons Ombudsman, and the CARAT (counselling, assessment, referral, advice and throughcare) services. Notices on the Listener scheme, visits information, and information for life sentenced prisoners were also displayed. All of the information was protected by a plastic screen to prevent damage; it was all in English only.

1.19 Printed copies of the Prison Information Book, translated into 30 languages, were available in the reception office, as were cassette tapes of reception questions in 10 languages. A Prison Service poster on religion displayed in room one was in a variety of languages; the poster invited the prisoner to point to the language and religion of his choice, so that the necessary support could be made available to him.

1.20 Holding rooms two and three also contained bench seating, and had access to a toilet. No information was displayed about local or national support agencies, and the rooms were bare. Nothing was provided in these holding rooms – such as newspapers or a television – to enable prisoners to pass the time. Drug and racist graffiti was scribbled on the wall of holding room three.

1.21 Although all of the holding rooms displayed no smoking signs, we observed prisoners smoking in them.

1.22 There were nine small, individual holding cubicles where any individual who had to be segregated from other prisoners in the area could be locked. A group of vulnerable prisoners could be kept separate in one of the three holding rooms.

1.23 Prisoners were called from the initial holding room to a large search area, which was suitably screened from the view of others in the reception. Each prisoner was strip searched. After searching, the prisoner’s property would be recorded onto the appropriate property sheets, and he was issued with one set of prison clothing; additional clothing was available on the wings. Remanded prisoners could wear their own clothing if they wished. Each prisoner also received bedding and one towel. Each new prisoner had his photograph taken for inclusion onto an identity card and his records.

1.24 On completion of the search and receipt of clothing prisoners moved to a second holding room (room two), where they waited to be escorted to their allocated wing. Prisoners did not remain long in the reception area. In our prisoner questionnaire, 42% of respondents said they moved from the area in under than one hour, and 43% in one to two hours. The local prison average for prisoners in reception for less than two hours was 43%, compared with 85% at Lewes.

1.25 A nurse did not automatically see prisoners in reception, as all new prisoners were seen during the evening of their arrival on the first night unit. However, reception staff would call a nurse to the area if they felt a prisoner was in need of such attention.

1.26 Prisoners were not given a telephone call in reception, as they would have access to this on their accommodation wing. Showers were available in reception, but we were told that these were used only rarely.

1.27 There was a staff kitchen in reception, but no hot refreshments were available to prisoners. Staff gave water if requested. Prisoners going to the first night unit would receive a hot meal on that unit.

1.28 A plentiful supply of sandwiches was sent to the reception every afternoon. These were given to prisoners returning from a court appearance, who were too late to receive their evening meal on their accommodation wing. We noted that one prisoner was involved in a lengthy trial that demanded his daily attendance at court. To avoid him living on an evening meal of sandwiches for some weeks, the establishment had organised for the escort contractor to return him to the prison by 5.00pm each afternoon to enable him to have a hot meal on his wing.

1.29 There were no orderlies or Listeners working in reception. We were told that staff cleaned the area, and a cleaner worked there every Saturday.

1.30 In our prisoner survey, 70% of respondents at Lewes reported that they were treated ‘well’ or ‘very well’ on reception, double the average of 35% for local prisons.

1.31 The reception area also contained a video conferencing suite and a room known as the ‘flat visits’, which accommodated visits for prisoners or visitors who were unable to access the visit hall.

1.32 A large property room was accessible in reception. Every prisoner was allocated a property box, although the storage space available meant that property did not have to be forwarded to the Prison Service store at Branston. The area was secure and only accessed by prison officers. Access to property was by application, and usually dealt with at weekends.

First night 1.33 The establishment had developed a self-contained first night centre on K wing, containing 11 cells. A senior officer and two officers staffed the unit, and both the first night centre and the induction wing on G wing were staffed by a dedicated group of officers who were interchangeable between these two wings.

1.34 The first night centre could accommodate up to 22 prisoners in shared cells. Each cell contained a television and a toilet. Two prisoners were orderlies who lived on the unit in a shared cell. One of these was a trained Listener, and both orderlies undertook cleaning duties on the wing, as well as offering information and peer support to prisoners there.

1.35 One cell could be occupied by one prisoner if necessary, for instance if he was a young person, or subject to a self-harm and suicide watch. If a cell was occupied by a single prisoner, the total capacity of the wing was reduced accordingly. Two of the cells contained CCTV that enabled staff to view the activity there from the wing office.

1.36 Prisoners who were new to custody, transferred in from other establishments, or returned to the prison from court subject to a change of status (such as being sentenced to custody after a period of remand) were accommodated on the first night centre.

1.37 Prisoners who were classed as vulnerable in some way – or who might acquire this status, perhaps through the nature of their offence – also spent their first night on K wing whenever possible. Groups of vulnerable prisoners transferred in from other establishments went directly to the F wing, the vulnerable prisoner unit.

1.38 Prisoners going directly to F wing were not risk assessed using the cell sharing risk assessment form, but were assessed by officers on the wing using the information contained in their documentation and through talking directly to the prisoner. An officer from the first night centre interviewed each prisoner on F wing and completed the cell sharing risk assessment the morning following their reception into the establishment. The first night centre officer also undertook the required interviews with prisoners on F wing.

1.39 All prisoners arriving on the first night centre received individual attention from a unit officer. A member of the healthcare centre saw each one, and a hot meal was available, irrespective of the time of arrival. It was not uncommon for officers working on the unit to remain there until very late in the evening.

1.40 A cell sharing risk assessment was completed during the evening of arrival for every prisoner admitted onto the first night centre. We looked at a random selection of 23 wing history records across three wings, and all but two of them contained a completed risk assessment.

1.41 A day one interview was undertaken with every prisoner upon arrival. This short interview recorded the prisoner’s personal details, his current offence and legal status, and any outstanding court appearances. The names and ages of any victims were also recorded, if appropriate.

1.42 The interviewer asked the prisoner if he was expecting to be received into custody, if this was his first time, and if he had any concerns. If appropriate, he was asked if he would be applying for bail, if he had ever attempted self-harm and how he was now feeling. The interview also noted if the prisoner had a substance misuse problem, had ever suffered or been treated for depression, and if he had any disabilities.

1.43 The interview ended by asking the prisoner if there were any immediate concerns, such as contact with family, situation of pets, or security of accommodation. There was space for the interviewing officer to record comment and detail of the interview. The various prison compacts were also explained and signed.

1.44 Prisoners were given toiletries, a reception letter, a tea pack and an information booklet. The booklet contained a wide range of appropriate information, but it was only available in English.

1.45 A form was completed detailing the telephone numbers of the prisoner, and he was given a £1.00 advance to enable him to use the telephone on the wing during the evening. In our prisoner survey, 67% of respondents told us that they had been given the opportunity to use the telephone on the day of their reception, compared with the local prison average of 44%.

1.46 Each prisoner was given an advance of £2.50 which he could use to order items from the prison shop, which would be made available the following day.

1.47 A record of the induction process was kept for each prisoner. Instructions in the booklet reminded staff of the importance of the risk assessment, and stated that: ‘All new receptions MUST be given the first night interview upon arrival at the first night centre. There are no exceptions to this rule’. It also advised that: ‘If a problem occurs DON’T just write it down and forget it, make sure you deal with and rectify it’.

1.48 A first night report was also included in the induction record booklet. The night duty officer completed this if anything of importance occurred during the night.

1.49 The morning following reception onto the first night centre, prisoners were offered exercise and were seen by a prison doctor. A chaplain saw each prisoner, as did a legal aid officer or the bail information officer. These procedures also applied to prisoners on F wing.

1.50 Every prisoner undertook a day two interview with an officer. This referred to, and built upon, the information gathered the previous day during the cell sharing risk assessment and the day one interview. It asked questions in more depth on drug use, accommodation, vulnerability, work experience and, if the prisoner had any children, their whereabouts and their care. It also recorded if the prisoner was a foreign national or immigration detainee.

1.51 The officer had to note if he or she felt that there was any concerns regarding the prisoner’s location (for instance, if there was any sexual offences, racist attitude, self-harm issues, or if he was a ‘poor coper’). He also noted the prisoner’s disposition during the interview (such as, ‘cheerful, confused, indifferent, quiet, aggressive’).

1.52 Any other concerns or worries that the prisoner had were noted, as was any action that could be taken to address these. Any referrals made to services within the establishment, such as the Samaritans, probation or the substance misuse nurse, were recorded.

1.53 We observed three of these interviews, none of which were rushed. The officers concerned undertook all of them with patience, humour and empathy.

1.54 The interview sheet was kept in prisoners’ wing history sheets. A copy was also kept by the probation team who noted the name of any home probation officer, or if the prisoner was a schedule 1 offender or subject to Prison Service order 4400 procedures.

1.55 Prisoners generally stayed one night on the first night centre and moved onto the induction unit the day following their reception into custody. However, it was not unusual for prisoners to be known to wing staff, and if both prisoner and staff agreed that there was little to be gained from moving to the induction wing, the prisoner could move directly onto one of the main wings.

1.56 In our prisoner survey, 67% of respondents told us that they were given written or spoken information about what was going to happen to them on their first

night/day – more than double the local prison average of 33%. When asked if they felt confident that they knew what was going to happen to them on their first night/day, 82% of respondents at Lewes said that they felt confident, compared with the average of 56%.

Induction 1.57 G wing contained the establishment’s induction wing. It consisted of 12 cells, all of which were shared apart from one, which was occupied by the induction orderly who lived on the wing; the orderly was a trained Listener. All cells contained a toilet, screened by a curtain. Prisoners generally spent two to three days on the induction wing, although this was often dependent on available spaces on A and C wings.

1.58 In our prisoner survey, 66% of respondents told us that they had attended an induction course at the prison, compared with the local prison average of 55%. Of those who said that they had attended an induction course, 66% said that it had been useful.

1.59 On the morning after arrival onto the induction wing, prisoners could clean their cells and undertake exercise. During the morning they attended the education unit for an education assessment and an introduction to the library.

1.60 An introduction to the gym took place every Monday; however, a member of the gym department visited each new prisoner personally to tell him about the facilities available, and to ask if he was interested in using these.

1.61 A Listener gave a verbal presentation of his work, including the support available to prisoners from both Listeners and the Samaritans. An officer who worked regularly with life sentenced prisoners visited the wing to speak specifically to prisoners who were already sentenced, or who were facing a prospective life sentence.

1.62 An induction officer delivered a verbal presentation to each group of induction prisoners. The information was based on that in the induction information booklet given on the first night centre. The presentation was carried out in the induction area,

was not rushed, and was informal and relaxed. Prisoners could ask questions and make comments on the subject areas.

1.63 There were no presentations from other areas of the establishment, and no media utilised other than the spoken word. A wide range of information was given and discussed. However information about anti-bullying, suicide and self-harm and race relations was not addressed in any great depth.

1.64 No information was made available about coping with custody or ways of dealing with stress or maintaining good mental health.

Conclusion 1.65 The reception area was clean and well managed. The staff there used appropriate and effective routines, and responded to prisoners professionally with respect and humour. Prisoners were appropriately supervised at all times, and the area was generally calm. The first night centre offered individual support to prisoners from a dedicated staff team who could empathise and engage with them. The atmosphere was relaxed and well supervised. The small, manageable group of prisoners on the induction wing meant that information could be given in a relaxed and focused way. The atmosphere was harmonious, and staff responded to, and engaged well, with prisoners.

Recommendations 1.66 A Listener should be employed as a reception orderly to offer a hot drink and peer support to newly arriving prisoners. He could also undertake work in the area, as appropriate.

1.67 The cell sharing risk assessment should be completed on the evening of arrival for prisoners on F wing.

1.68 Consideration should be given to using a variety of media for the delivery of induction information, and to involving individuals with specialist knowledge in some areas of presentation.

1.69 Items such as reading matter should be provided in holding rooms to enable prisoners to pass the time there.

1.70 Graffiti should be removed from the holding room walls, and there should be no smoking in areas designated as smoke-free.

Good practice 1.71 The development of the induction unit, along with the first night centre, contributed to the overall safety of prisoners at Lewes, offering specific, individual support from a dedicated and empathic staff team.

Legal rights Expected outcomes The expected outcomes for legal rights procedures are: • Safety Prisoners are safe from repercussions or recrimination in making any application, request or complaint • Respect: Prisoners are told their rights of access to due process in relation to bail, legal aid, legal representation and appeals and can exercise those rights while in prison • Respect: Unconvicted prisoners are treated as innocent, unsentenced as not having a custodial sentence, and both are given the same opportunities and activities as convicted or sentenced prisoners • Purposeful activity: The regime provides reasonable opportunity to seek release on bail and prepare for trial • Resettlement and reducing re-offending: The regime provides reasonable opportunity to preserve accommodation and employment and to pursue legitimate business and social interests

1.72 Upon arrival in both the reception area and the first night centre, all prisoners were asked about their legal status, and if they understood what had happened to them in court.

1.73 A bail information service was provided by a trained and experienced probation officer employed by East Sussex Probation Service.

1.74 A print-out was produced every morning, using the information on the local inmate database system, of all of the prisoner arrivals into the establishment the previous day. The bail information officer identified those who had been remanded into custody, and personally visited each prisoner on their wing. Each prisoner was asked if he wished to apply for bail at his next court appearance and, if so, the necessary information was discussed with him.

1.75 The officer also met prisoners who were convicted but as yet unsentenced to discuss the opportunities available to them if bail had been granted in principle at the court hearing.

1.76 All prisoners were seen within 24 hours of their arrival into the establishment. Records were kept of every contact, and the bail information officer had good links with the various bail hostels. He could discuss the meaning of bail decisions and the details of the conditions attached to them.

1.77 The bail information officer had access to a national solicitors’ directory and the use of an answerphone, fax machine and an administrator who typed the necessary reports for court.

1.78 In the absence of the bail information officer there was no other trained individual to offer bail services, although his colleagues in the probation team undertook as much work as possible.

1.79 The establishment had five trained legal service officers. As with the bail information officer, they had a list of the previous day’s admissions and a legal service officer saw each of these the morning following their reception into custody.

1.80 Each prisoner was asked if he needed assistance in any way. Every sentenced prisoner was told of his right to appeal against his conviction and/or sentence. The officers concerned took a selection of the most frequently requested forms to each

interview – such as a request for a change of solicitor, or information about the appeals procedure itself.

1.81 The legal service officer would assist prisoners who had difficulty reading and writing to complete forms, when necessary.

1.82 Various solicitors’ directories were available in the legal service office, as were a variety of legal information books (for example, Archbold) that were accessible to prisoners on 24-hour loan. The necessary forms were available in the legal service office, and a record was kept of all action taken.

1.83 Each record confirmed the date that a legal service officer had seen the prisoner. It recorded if he was legally represented, by whom and their telephone number. It noted if he intended to appeal, if there were any outstanding fines or further charges. The record noted if the services of the legal services department were required, and it was signed and dated.

1.84 A stock of booklets was available in the legal service office, although these were not displayed for prisoners’ perusal. These were a series of 24 titles published by the Legal Services Commission, giving information and advice on a variety of specific subjects. These were available in English only.

1.85 The legal service staff were aware of prisoners involved in the appeals process, as correspondence was routed to them from the court of appeal.

1.86 Prisoners could complete an application form to see both the bail information officer and a legal service officer if wished. The legal service office was staffed during the core day, and staff had access to necessary equipment, such as an answerphone and fax machine.

1.87 The library also contained a large stock of appropriate information books and copies of relevant Prison Service orders. A CD-ROM was also available in the library from which prisoners could print information that interested them.

1.88 Legal visits were available every morning and were booked via the telephone, on a number separate from the domestic visit booking number. Facilities were available to play a tape recorder, or view video evidence.

1.89 The establishment also had a video link area in the reception, which enabled a number of prisoners to give evidence in court without the need to be there in person.

Conclusion 1.90 Prisoners had access to an excellent source of information and support from both the legal service officers and the bail information officer. All of the staff concerned were knowledgeable and keen to provide a thorough service to prisoners.

Recommendation 1.91 Trained back up staff should be available in the absence of the bail information officer.

CHAPTER TWO

RESIDENTIAL UNITS

Expected outcomes The expected outcomes for accommodation and facilities, clothing and possessions, and hygiene are: • Safety: Prisoners live in a safe and hygienic environment • Safety: Prisoners are risk and needs assessed before being placed with other prisoners in shared cells • Respect: Prisoners have their dignity and privacy of life respected while in prison • Respect: Prisoners are encouraged, enabled and expected to maintain an acceptable level of personal hygiene in appropriate, decent residential accommodation • Purposeful activity: Suitable space and facilities on residential units are available and used to permit association activities that meet prisoners’ needs

Accommodation and facilities 2.01 The establishment was very old and was in need of refurbishment and improvement. However despite its age, the accommodation was clean and generally well maintained. All of the wings, apart from F wing, radiated off a central area.

2.02 A wing accommodated mainly remanded prisoners and consisted of 67 cells on four landings. The wing held a population of 117 during the inspection, although its certified normal accommodation (CNA) and operational capacity was 134. All of the cells were double occupancy, and were adjoined by a separate small room, which contained a toilet and sink. The wing was provided with in-cell electricity and each cell had a television.

2.03 Apart from the small, lower ground floor landing, there was a staff office on each landing. The three main landings had a recess containing showers, sinks, a screened toilet, a urinal and a sluice sink for the disposal of dirty water.

2.04 Prisoners had access to two telephones per landing, each having a metal privacy hood. The ground floor contained two pool tables and a table football for use during association.

2.05 The CARAT (counselling, assessment, referral, advice and throughcare) office was based on this unit, and a small number of interview rooms were available.

2.06 B wing was closed for refurbishment, but was temporarily occupied by healthcare at the time of the inspection (see chapter four).

2.07 C wing mainly accommodated convicted prisoners, and contained 81 cells on three landings. There was a population of 157 at the time of the inspection, and the CNA was 149, and operational capacity was 161.

2.08 Some of the cells were designed to hold two prisoners and, similar to A wing, had access to a small room containing a toilet and sink. Other cells did not have this separate area but had an in-cell toilet screened by a curtain. All prisoners ate meals in their cells – the situation for those who did not have a separate toilet area was unhygienic and undignified.

2.09 Each cell in the wing had in-cell electricity and was equipped with a television.

2.10 Each landing was equipped with two telephones. Table tennis equipment, table football and a pool table were available on the ground floor. The landing areas were spacious and an additional pool table and table tennis were available on the fours landing.

2.11 Most cells on all wings were equipped with a kettle, or were provided with flasks in which to keep hot water.

2.12 There was staff accommodation on each landing, and a number of treatment and interview rooms. C wing housed the job point information room.

2.13 F wing had originally been built to hold female prisoners, with windows only looking away from the main prison. It accommodated vulnerable prisoners in 86 cells, mostly shared, on three landings. Its CNA was 87 and the operational capacity 157. This wing was the smallest of the wings in area, but held one of the largest populations.

2.14 There were 12 single cells on the wing. One of these was reserved as a medical single, for which an approval by the doctor had to be granted, and three cells were used as ‘high risk’ single occupancy cells for prisoners who, for various reasons, could not share accommodation.

2.15 The ground floor contained the main office accommodation, and there was a small office on each landing. The wing did not have full access to in-cell electricity, and only 12 of the cells had this facility and were provided with a television. There was a communal lounge on the ground floor: this contained a large number of easy chairs, and a television and video, but its walls were blank, and it was not personalised in any way. Two pool tables and a table football on the ground floor were available for use by prisoners.

2.16 All cells contained a toilet, screened by a curtain. Each landing had a recess containing showers, sinks and a toilet.

2.17 The wing accommodated a number of sex offenders and we were concerned to note some displays of women in suggestive poses.

2.18 F1 was the segregation area (see paragraphs 6.13-6.19)

2.19 G wing was the induction unit, accessible from C wing. It contained 12 cells, all shared apart from one. Each cell contained a screened toilet. The wing area was small but adequate for the wing population, containing easy chairs, two coffee tables, a pool table and bookcases with a selection of books. There was a recess with showers, a toilet and sinks.

2.20 K wing was the first night centre, accessed from A wing. It contained 11 cells which could accommodate 22 prisoners. The cells had access to a small area containing a toilet and sink. Activity in two of the cells could be observed by CCTV. There was a recess on the wing containing three showers, sinks, a toilet and a sluice sink for the disposal of dirty water.

2.21 Apart from prisoners on F wing, the cell sharing risk assessment of prisoners was undertaken on the evening of arrival, prior to them being located in shared accommodation.

2.22 Prisoners with a mobility disability were accommodated in cells on the ground floor, although none of the facilities had been specifically adapted, for example, to accommodate a wheelchair user. During the inspection, staff were particularly concerned about one disabled prisoner, who had arrived from HMP Parkhurst without his wheelchair, had to be carried to the wing and frequently fell over in his cell because there was not adequate space for his Zimmer frame. Staff rightly felt that this was degrading.

2.23 Each wing contained its own servery and hot water boilers from which prisoners could obtain hot water, and had appropriate storage room for cleaning materials. There was a small laundry on each wing, apart from F wing. A, C and F wings contained their own small wing shop and clothing exchange stores.

2.24 A fixed bed or bunk bed was provided in each cell, as was a table(s) and chair(s), and a cupboard(s). Some cells had a lockable cupboard. Many cells were provided with notice boards for prisoners to display photographs etc, although we also noted that toothpaste had been used to adhere articles to the walls in many cells.

2.25 All wings contained notice boards displaying a variety of pertinent information. These were tidily displayed and offered useful information, albeit in English only.

Clothing and possessions 2.26 Most prisoners wore prison issue clothing, although remanded prisoners could wear their own.

2.27 Prison clothing, bedding and towels were issued upon arrival in the reception area, and additional items were given on the accommodation wings. Clothing and bedding was changed weekly, and there was no shortage of these items.

2.28 The establishment had made plans to allow all prisoners to wear their own clothing if desired, and this was due to be introduced once F wing was provided with the necessary laundry facilities.

2.29 Prisoners could wear their own underwear if they wished. Laundry facilities were available on each wing, apart from F wing, but many prisoners told us that they washed their clothing in the sinks in their cells and dried them on the radiators. It was an unhygienic practice to allow prisoners to wash their teeth, hands and clothing in their cell sink. Ironing facilities were freely available on all wings.

2.30 A facilities list was published. This clearly stated the articles that prisoners could have in their possession and how each could be obtained. Items linked to the incentives and earned privileges scheme were specific. Enhanced and standard prisoners located in cells without electricity were allowed to spend an additional £2.50 a week on batteries.

2.31 Prisoners had access to items held in the reception area by means of an application that was dealt with by reception staff during the weekend.

2.32 Prisoners could purchase various items through the Argos catalogue. Applications to purchase from this source were available on each wing. The prisoner completed the application accordingly and it was forwarded to the finance department to confirm that he had the necessary amount in his account. The cost of the item was removed and the order forwarded.

2.33 When the item was received into the prison, it was dealt with either by the post room, if a small item, or via the reception area if large. Each item was searched and logged onto the appropriate property record held in the reception area. Although an x- ray machine was available in the reception area this was unused, and all parcels had to be searched by hand.

2.34 The prisoner would be called to the reception area to retrieve the item, or alternatively it might be collected by a staff member while in the reception area and taken to the prisoner on his wing. It could also be delivered to the individual concerned by post room staff. The prisoner signed for receipt of the item.

Hygiene 2.35 Ample supplies of toiletries necessary for personal hygiene were freely available on the wings for prisoners’ use. Prisoners could also purchase both branded and generic toiletries from the prison shop. Cleaning materials for cells were also easily available, and prisoners were encouraged to maintain their cells to a good standard of cleanliness.

2.36 Prisoners could access showering facilities daily with little difficulty. There were showers in the gymnasium, which prisoners were free to use before leaving. Most cells had separate toilets which prisoners could use in reasonable privacy. However, some cells had a flimsy shower curtain screening the toilet, and a small number had no screen at all.

2.37 Both beds and mattresses were in reasonable condition and prisoners could regularly obtain clean sheets and blankets as needed. Communal areas such as toilets and shower rooms, as well as the main wings, were maintained to a good standard of cleanliness and repair.

Conclusion 2.38 Accommodation was well maintained and cared for. There were adequate association facilities, and good access to the telephones. Prisoners’ clothing was clean and well maintained. There was no shortage of clothing, and items were regularly laundered. Good standards of hygiene applied overall across the prison, and

both staff and officers took a pride in ensuring clean living conditions. Where toilets were situated in cells, they were inadequately screened, and some cells were too small for sharing.

Recommendations 2.39 In-cell toilets should be screened more appropriately and effectively than by a curtain.

2.40 Inappropriate displays of pictures on cell walls should be removed.

2.41 Plastic bowls should be provided for prisoners to wash items of clothing in their cells.

2.42 The x-ray machine in the reception area should be utilised.

CHAPTER THREE

DUTY OF CARE

Anti-bullying Expected outcomes The expected outcomes for creating an environment safe from bullying are: • Safety: Prisoners are as safe as possible from bullying behaviour and bullied prisoners are always given full support in any bullying incident • Respect: Neither staff nor prisoner uses their position or power to bully others • Respect: Bullying and bullied prisoners are treated fairly and are aware of the systems that operate to prevent bullying behaviour • Purposeful activity: Activities take place to develop self-esteem within an environment which discourages bullying and assists those who are or might be bullied • Resettlement and reducing re-offending: Street and prison cultures are challenged through effective anti-bullying measures and programmes for all who are involved

3.01 A clear message about the establishment’s stand against bullying began in reception, where the policy was clearly displayed. This message was reinforced on induction where all new receptions received an anti-bullying talk, although this did not identify the various forms that bullying takes, or encourage prisoners to consider how such behaviour can be made to be seen as unacceptable.

3.02 The definition of bullying, how to deal with bullies and how to support victims was clearly stated in the prison’s local policy. The policy development was influenced by a biennial prisoner survey, which highlighted areas of concern for prisoners.

3.03 There was some evidence of early intervention in combating bullying. There were entries in a number of wing records alerting staff to the possibility of an

individual suspected of bullying. However, in the three-month period preceding the inspection all prisoners subjected to anti-bullying measures were from F wing (with the exception of one case on C wing). Although it was possible that there had been no incidents of bullying on the other wings, it was more likely that some instances had gone undetected or had been managed informally.

3.04 Staff set a good example to prisoners in their relationships with each other. The atmosphere was relaxed and staff communicated with each other in a respectful manner.

3.05 In our prisoner survey, 88% of respondents said they felt safe on their first night in custody; this compared favourably with the local prison average response of 74%. This feeling of safety was further confirmed in our discussions with prisoners.

3.06 When asked about the presence of bullying, 6% of respondents told us that bullying took place, just below the 7% average for local prisons.

3.07 Staff were unable to provide evidence, other than anecdotal, when asked where bullying was most likely to take place in the establishment; bullying was not monitored for trends.

3.08 We were told by managers that prisoners on F wing were more likely to report incidents of bullying than in other areas of the prison. We were also told that there were plans to introduce an ‘informant system’ in the near future, and this was expected to improve the level of reporting on the wings.

3.09 Prisoners were encouraged to contribute to the development of the anti- bullying strategy, and their views were sought via a discharge questionnaire. However, prisoners were not directly represented on the anti-bullying committee and could not, therefore, contribute directly to its day-to-day management. We were aware that the establishment had previously held anti-bullying prisoner meetings that linked into the anti-bullying committee, and that it was considering re-commencing these.

3.10 All prisoners had unhindered access to Listeners, whom they used regularly. Listeners were also used to help measure the extent of bullying throughout the establishment. If families or friends brought an incident of bullying to staff’s attention then action would be taken. However, there were no mechanisms to actively seek out the views of family and friends about bullying in the prison.

3.11 Where possible, both the bully and the victim remained on normal location, although this often proved difficult as there was a culture of ‘no grassing’ (informing on fellow prisoners) among prisoners.

3.12 Lewes had not designed any specific interventions to counter individuals who were either a bully or a victim of bullying. Identified bullies were placed on a waiting list for an anger management course. There were no interventions to help victims develop coping mechanisms.

Conclusion 3.13 Although there were areas in which Lewes could do more to counteract bullying and its effects, bullying did not appear to be extensive throughout the prison. Even so, it appeared likely that some bullying was not being reported. There were no strategies to help bullies modify their behaviour or to help victims develop coping skills.

Recommendations 3.14 The establishment should develop effective interventions to challenge and support both bullies and victims.

3.15 There should be prisoner representation on the anti-bullying committee, and the anti-bullying prisoner meetings should re-commence.

3.16 A survey of bullying should be conducted and the results used to assist staff in identifying and confronting bullying behaviour.

3.17 Staff should pay particular attention to ensure that incidents of bullying do not go undetected.

3.18 The establishment should consider how to involve families as an active part of the anti-bullying strategy.

Preventing self-harm and suicide Expected outcomes The expected outcomes for preventing self-harm and suicide are: • Safety: Prisoners are held in an environment in which all reasonable steps are taken to protect prisoners from self-harm and suicide honouring the prison’s duty of care to every prisoner • Safety: Significant information about individual prisoners at risk of self-harm or suicide is communicated effectively by those who hold it to those who need it and integrated into the support plan • Respect: Prisoners know where to find help and access it in times of crisis or need • Respect: Raising and maintaining prisoners’ self-esteem, especially in times of transition or change, should be inherent in the prison’s culture, management, regimes and activity • Respect: The treatment of those at risk of self-harm or suicide shall always maintain confidentiality, preserve or enhance the dignity of the prisoner and shall not itself be dehumanising • Purposeful activity: Those prisoners at risk of self-harm or suicide are encouraged to participate in appropriate purposeful activities including specific programmes for their needs in this respect

3.19 Lewes gave self-harm and suicide prevention a high profile. There had been a number of deaths in the past year, and every effort was being made to prevent any reoccurrence.

3.20 The newly appointed safer custody manager was due to head the self-harm and suicide prevention committee, and both the self-harm and suicide prevention co-

ordinator and the healthcare manager managed the day-to-day oversight of this area. Both these staff had a sound knowledge of the issues and the clinical implications.

3.21 The self-harm and suicide prevention committee consisted of staff representing most areas of the prison, as well as community in-reach and the escorting service provider. A Listener also attended.

3.22 With the exception of some prisoners who were located directly onto F wing, all prisoners spent their first night in the first night centre on K wing. Staff could observe new receptions in their cells via CCTV, when necessary.

3.23 There was further investigation of a prisoner’s personal circumstances and the completion of cell sharing risk assessments in the first night centre. That process was conducted in a manner conducive to obtaining accurate and sometimes sensitive information. However, during a night visit we discovered that the night officer on F wing did not necessarily know about the newly arrived prisoners located there, to facilitate closer supervision.

3.24 Lewes had previously had problems training staff in self-harm and suicide awareness, but this had been addressed and over 80% of daytime staff had received the necessary training at the time of the inspection; 50% of the night staff had also been trained in self-harm and suicide awareness.

3.25 The establishment had recently commissioned two ‘safer cells’, which were located in F1. Our observation suggested that they were well designed and suitable for observing prisoners who may wish to self-harm. However, these cells were adjacent to the segregation unit, with no physical separation between the two. Prisoners accommodated in the safer cells would, therefore, be within hearing of any activities in the segregation area.

3.26 Experienced and trained healthcare staff saw all new prisoners on the day of their arrival. Prisoners were encouraged to express any thoughts of self-harm and suicide, and Listeners were readily available to respond where appropriate. Listeners

were actively used in combating incidents of self-harm. However, the Listeners’ suite did not allow for overnight stays and had no sleeping facilities.

3.27 A total of 116 F2052SH (prisoners at risk) forms had been opened in the previous four months. At the time of the inspection, F2052SH documents were active for 18 prisoners, half of whom were located in the healthcare centre. The self-harm and suicide prevention co-ordinator ensured that all reviews were conducted within the recommended timescale, and that there was a multi-disciplinary approach to each case. The documents were quality-checked regularly by both the co-ordinator and a governor. Statistics were checked and trends monitored. Entries in F2052SH booklets were meaningful and frequent.

3.28 The support plans contained with the F2052SH appeared to be primarily designed to prevent incidents of self-harm, but the plans often neglected to address the reasons for the prisoner self-harming. There was little evidence of planned progression, or interventions designed to address the individual’s reason for self- harming, as well as looking to prevent future self-harm. We were told of the establishment’s plan to introduce a self-harm support group as one possible way of addressing these areas.

3.29 The self-harm and suicide prevention committee was implementing recommendations received from previous death in custody investigation reports. These had highlighted issues around healthcare responses and communication issues for foreign national prisoners. Both these areas were in the process of being addressed. A coded radio message system had been introduced, which graded the seriousness of incident, and the prison had recently become a member of the National Register of Public Services Interpreters. The prison had also recently conducted a prison-wide audit of possible ligature points.

3.30 All night staff carried ligature shears and were aware of, and had access to, the emergency response kits. They were all aware of emergency procedures and orders, and indicated a sensible level of response if confronted by an instance of self-harm.

Conclusion 3.31 Five deaths in custody in 2002 had focused the establishment on self-harm and suicide prevention. Discussions with both staff and prisoners left us in no doubt that everyone in the prison took the issue very seriously. Excellent systems were in place, although there was scope for further development of support plans.

Recommendations 3.32 All staff should be made aware of new receptions into the prison, irrespective of the wing on which they are located.

3.33 Case reviews on prisoners on F2052SH (at risk forms) should attempt to identify the individual’s reasons for self-harming, and set targets in the support plan which help the prisoner to develop coping strategies.

3.34 The establishment should continue to develop its proposal to introduce a prisoners’ self-harm support group.

Good practice 3.35 Listeners were represented on the self-harm and suicide prevention committee.

Race relations Expected outcomes The expected outcomes for race relations are: • Safety: Prisoners live in an environment in which they are safe from physical, verbal or emotional abuse, intimidation or victimisation or any discrimination on the grounds of race or culture • Respect: Prisoners experience a culture that values diversity and actively promotes, maintains and monitors good practice in race relations • Respect: Foreign nationals and those for whom English is not their first language are enabled to understand and communicate successfully • Respect: Prisoners, regardless of their ethnic cultural background, have equal access to all appropriate facilities and activities within the establishment. Eligibility for benefits and privileges, e.g. risk assessments, are made without regard for race, ethnicity or culture • Purposeful activity: Prisoners and staff are able to recognise and acknowledge the cultural diversity of the prison population

3.36 Overall responsibility for race relations lay with the deputy governor, who was the chair of the race relations management team (RRMT). Prior to him taking over management control in September 2002, the area had been seriously neglected for some months.

3.37 The race relations liaison officer (RRLO) now received the mandatory minimum eight hours a week facility time, although he was without a dedicated office, which made issues of confidentiality a concern.

3.38 It was evident that the issue of race relations was taking priority, and an action plan had been drawn up to review and drive forward the necessary changes. Lewes had carried out diversity training for 150 of its staff, and this training was ongoing. The establishment had recruited a new diversity manager, who had commenced employment during the week of the inspection; she brought with her community expertise and a sound knowledge of investigation procedures.

3.39 The RRMT, which had prisoner representation, had met three times since November 2002 to address outstanding issues; it planned to meet quarterly. Minority ethnic and foreign national prisoners were given the opportunity to comment on issues pertinent to them in the discharge questionnaire.

3.40 There was no community representation on the RRMT. The establishment displayed a list of six community contacts from which it could co-opt assistance – however, at least one of these had no current relevance to the establishment. The list appeared to be useful for audit purposes only.

3.41 The identities of both the RRMT chair and the RRLO were displayed throughout the establishment, as were the local and national policies. There was a little evidence of diversity in posters displayed around the prison, although these were confined to messages concerning race relations.

3.42 The establishment had celebrated Black History Month in 2002. This had been seen as a great success, but appeared to have been a one-off event rather than part of the prison’s year-round approach to inclusion and celebration of diversity.

3.43 Ethnic monitoring was severely deficient at the time of the inspection. Figures were available for the two preceding months. However these were difficult to understand as they lacked any baseline against which to measure them.

3.44 Racial incident reporting forms were available in many areas of the prison, including visits. Prisoners could access them without having to ask a staff member, and they could be posted confidentially on all wings.

3.45 Lewes had an average black and minority ethnic population of approximately 16%. Our prisoner survey indicated that it was not a prison steeped in racism, with only 2% of respondents stating they had been victimised because of their race or ethnic background, compared with the average local prison response of 6%.

3.46 We received few complaints from prisoners concerning racism within the prison. However, in discussion with prisoners it was apparent that, knowing they were

in a rural town, some had resigned themselves to expect a certain amount of racial ignorance within the regime.

3.47 The number of racial incidents reported throughout the prison had increased dramatically (300%) over the past two to three years, although the actual numbers remained relatively low (29 in the previous 12 months). The increase was probably indicative of an increased confidence by both staff and prisoners in reporting such incidents. However, without effective monitoring, it was difficult to identify and assess the main causes of any change.

Foreign national prisoners 3.48 At the time of this inspection there were 61 registered foreign national prisoners at the establishment – 12% of the total prisoner population.

3.49 Issues of concern for foreign national prisoners were raised in the RRMT meetings, although these were brought on an ad-hoc basis as no appropriate needs analysis had been carried out. There was no dedicated policy or strategy to assist in meeting the needs of this part of the population.

3.50 A foreign national prisoners’ coordinator had recently been appointed who was considering the introduction of a structure similar to the comprehensive model used in HMP Wandsworth.

3.51 Foreign national prisoners often feel isolated and may have difficulties understanding exactly what processes are in place to assist them. This can lead to considerable frustration and unhappiness. Due to previous deaths in custody investigations at Lewes, staff responsible for preventing suicide and self-harm were going some way to ensuring that the communication needs of foreign national prisoners were met, but no consideration had been given to needs such as resettlement, diet, peer or community support.

Conclusion 3.52 The establishment was making real efforts to address the previous neglect of race relations. However monitoring systems were in disarray and required urgent

attention. It was difficult to identify, measure and assess detailed gaps in provision for foreign national prisoners, as no needs analysis had been undertaken.

Recommendations 3.53 A recognised ethnic monitoring system should commence as a matter of urgency.

3.54 Efforts should be made to develop effective, relevant and ongoing contact with appropriate individuals and organisations in the nearby minority ethnic communities.

3.55 The prison should carry out a fact-finding and needs analysis of its foreign national prisoners as a matter of urgency, and use this to inform policy development.

3.56 Images displayed throughout the establishment should reflect the diversity of the population, and the prison should celebrate diversity as a mainstream issue.

Good practice 3.57 The discharge questionnaire used to solicit the views of all prisoners being discharged from Lewes asked for specific comment on issues of importance to minority ethnic and foreign national prisoners.

Substance use Expected outcomes The expected outcomes regarding substance use are: • Safety: All prisoners are as safe as possible from exposure to and the effects of substance use while in custody • Respect: Prisoners with substance related needs are identified at reception and throughout their time in custody • Purposeful activity: All prisoners receive effective drug and alcohol education interventions to meet their needs • Resettlement and reducing re-offending: Prisoners, according to their individually assessed needs, are provided with the necessary support and treatment both in prison and after release to maintain healthy lifestyles and avoid the harmful effects of drug use

3.58 The main elements of the establishment’s drug strategy consisted of a new detoxification programme, the provision of a specialist substance misuse nurse, CARAT (counselling, assessment, referral, advice and throughcare) services, voluntary drug testing (VDT), and a range of security measures to prevent drugs from entering the prison.

3.59 The prison’s multi-disciplinary substance misuse committee met monthly and was chaired temporarily by the healthcare manager, until the new safer custody manager was in post.

3.60 It was clear that the drug strategy had a high profile within the establishment. It was managed by a principal officer, an experienced trainer with knowledge of safer custody work, who was keen to develop the existing strategy.

3.61 The 2002-03 drug reduction strategy and business plan was a comprehensive document containing detailed action plans, including targets which were referenced with occupational and quality standards. The various costs involved and a SWOT (strengths, weaknesses, opportunities and threats) analysis were also included.

3.62 In our prisoner survey, 47% of respondents said they had had drug problems in the past or when they were received into custody; this compared with the local prison average of 38%.

3.63 Key staff from the substance misuse committee were members of the local DAT (drug action team) drug-related deaths steering committee. A training package for staff focusing on harm minimisation and overdose was being developed. Specialist accredited drug training had been provided for four officers, two of whom were on the CARAT team, but drug awareness training had not been made available for staff generally.

3.64 A member of healthcare staff saw all prisoners on their arrival onto the first night centre. Those with opiate dependency were identified and were given clear and comprehensive drug treatment information. If necessary, prescribed symptom relief was made available, and the specialist substance misuse nurse would complete a full assessment the following morning. Some prisoners told us that, despite this medication, they felt uncomfortable and restless during their first night.

3.65 Following the assessment by the substance misuse nurse, a prescribing regime was agreed, a care plan drawn up, and a referral was made to the CARAT team. There were, however, no written service level protocols between the substance misuse nurse and the CARAT team.

3.66 The establishment had introduced a new detoxification programme in November 2002. Since then, 150 opiate users had been detoxified using the drug subutex.

3.67 Prisoners who had been maintained on methadone in the community could continue their treatment while on remand in the prison, and undertake a reduction programme once sentenced.

3.68 Prisoners with complex physical or mental health needs could be detoxified in the healthcare unit. The substance misuse nurse worked closely with the mental health in-reach team on the care of dual-diagnosis patients.

3.69 Of the respondents to our questionnaire who felt that their drug use had been a problem, 55% said they had received help, and 45% of these identified the subutex treatment as the source of this. We were told that a dedicated 27-place detoxification facility was to be developed on B wing, once the healthcare department had moved from there back to its refurbished unit.

3.70 The substance misuse nurse dispensed medication on the wings and supervised consumption. He conducted hepatitis C and HIV pre-test counselling, undertook the testing involved, and liaised with the local haematologist and GPs. If identified as necessary, a prisoner could start an accelerated regime of hepatitis B vaccinations. The substance misuse nurse also liaised with drug treatment clinics in East and West Sussex on the completion of detoxification regimes and follow-up support for short- term prisoners.

3.71 The substance misuse nurse was a specialist post, jointly funded by the local NHS trust’s substance misuse service, the primary care trust and the prison. Much of the effectiveness of the detoxification regime depended on the sole expertise and availability of the substance misuse nurse. In his absence, an alternative substance misuse nurse was not automatically made available, although the substance misuse service provided nurse cover. We were told that there were negotiations for an additional substance misuse nurse.

3.72 CARAT services were provided by the Crime Reduction Initiative. Prisoners told us that there was ease of access to the CARAT team, which consisted of a team leader and four workers, two specially trained prison officers, and an outreach worker for Brighton and Hove. This latter post was charity-funded. Administration support was provided by a part-time worker, but was insufficient to meet the needs of the team.

3.73 The CARAT team was meeting its required target of initial assessments and carried an active caseload of 130 clients. Its remit had recently been extended to cover work with problematic alcohol users, although no additional resources had been made available to deal with the increased workload.

3.74 The CARAT team had reviewed its groupwork practice, and from April 2003 planned to deliver a six-week cognitive behavioural course consisting of two sessions per week. These sessions would be offered to prisoners on A and C wings separately, although the necessary groupwork space had yet to be identified. A groupwork programme was also being developed to offer a range of interventions – such as harm reduction advice and auricular acupuncture – to support the 40% of CARAT clients who described crack-cocaine as their primary drug of choice.

3.75 The CARAT team contributed to prisoners’ sentence plans, as well as transfer plans for those prisoners requiring structured rehabilitation. However due to issues such as population pressures, the needs of substance misusers were not always given high priority; transfers of prisoners to prisons with a suitable rehabilitation programme often came secondary to more immediate Prison Service considerations.

3.76 Approximately 50% of prisoners known to the CARAT team had taken up treatment or supported housing options upon release, and the outreach worker could offer two months’ follow-up to newly released prisoners. The outreach worker also liaised closely with the substance misuse nurse to fast-track released prisoners into the treatment programme of Brighton NHS Trust’s substance misuse service, which had 40 places specifically allocated for ex-prisoners.

3.77 Other members of the CARAT team provided throughcare for prisoners released to areas such as Eastbourne and Hastings. We were told that, although workers liaised with a wide range of community projects in these areas, prisoners often failed to attend the appointments that had been organised for them; it was apparent that additional support was needed for prisoners at the point of release and just after.

3.78 A range of specialist counselling services was available to assist prisoners to deal with issues such as bereavement and sexual abuse. Mankind (a charity providing sexual abuse counselling) operated an on-call service which prisoners could access. These services were co-ordinated by a community psychiatric nurse in the healthcare department, and provided a valuable source of support.

3.79 The establishment had exceeded its target in the number of compacts for voluntary drug testing (VDT), but fell below its target for the number of tests carried out. VDT testing facilities were available on A, C, and F wings.

3.80 The percentage of prisoners testing positive under mandatory drug testing (MDT) had dropped from 33% to 14% during the last year. This improvement was attributed to a number of factors, ranging from improved security procedures to a rise in referrals to the CARAT team. A prisoner testing positive would automatically be referred to the team. MDT testing took place in a new MDT suite, which was spacious, clean and well laid out.

3.81 The establishment met its random MDT target of 5%, but not the target for weekend testing. Additional staff had recently been trained to carry out this work, and an MDT co-ordinator was due to be appointed to support the work of the MDT team.

Conclusion 3.82 The establishment had effective and pro-active substance misuse policy and procedures. We were impressed by the culture of support rather than punishment, the dedication of staff, and the introduction of a flexible detoxification programme. There were good relationships between the NHS specialist service and community agencies. Prisoners gave positive feedback about the subutex regime and their daily contact with the substance misuse nurse.

Recommendations 3.83 Additional substance misuse nurse input should be provided.

3.84 Written procedures between substance misuse treatment providers should be developed and co-ordination improved.

3.85 The establishment should develop an alcohol strategy and allocate resources according to the identified need.

3.86 Voluntary drug testing areas of the prison should be identified for prisoners requiring post-detoxification support.

3.87 The establishment should ensure that the planned CARAT (counselling, assessment, referral, advice and throughcare) groupwork is delivered, and appropriate groupwork space is made available.

3.88 Administrative support for the CARAT team should be reviewed.

3.89 First night symptom relief medication should be reviewed.

3.90 Community in-reach services should be developed in partnership with drug action teams.

3.91 The planning of the dedicated detoxification unit should start as soon as possible.

Good practice 3.92 A flexible detoxification programme had been developed, and a range of specialist counselling services was available through the healthcare department.

3.93 An outreach worker could refer and follow up CARAT (counselling, assessment, referral, advice and throughcare) clients who returned to Brighton or Hove, and released prisoners were fast-tracked into the local NHS trust’s substance misuse service.

3.94 Drug strategy staff attended the drug action team’s drug-related deaths steering committee, and planned harm-reduction training.

Maintaining contact with family and friends Expected outcomes The expected outcomes on maintaining contact with family and friends are: • Safety: Prisoners and visitors feel safe in their time together and visitors feel safe within the establishment • Respect: The rights of prisoners to maintain contact with family and friends are upheld and practical arrangements are in place to provide for them with special consideration being given to children and partners • Respect: Visitors are welcome to the establishment, supported within the prison and recognised as free members of society in order that they may contribute positively to the prisoners’ progress • Resettlement and reducing re-offending: Prisoners are encouraged to build and maintain family and social networks and relationships that contribute to their well- being and help reintegrate them into the community

Mail and telephone 3.95 All prisoners received a free letter on arrival at the prison and every week thereafter. They could also purchase additional letters and postage stamps from the prison shop. Prisoners were given a £1.00 advance to enable them to use the telephone during the evening of their arrival on the first night centre, and additional telephone units – available the following day – could be purchased from the prison shop.

3.96 Ordinary letters were opened by the postal staff to check for enclosures, but parcels, legal letters and those sent by special delivery were taken onto the wings and opened in front of prisoners to allow for verification of their contents. Larger parcels were taken to reception and the prisoners called down to confirm the contents.

3.97 At the time of our inspection the postal staff were struggling to manage the volume of mail that they were required to process in and out of the prison. In particular, there had been problems in getting visitors orders posted out within reasonable time limits. We were told that there had recently been delays of up to a

week in sending them out to visitors and this was beginning to cause problems in arranging visits.

3.98 There were sufficient telephones located on all wings and we received no complaints about access to them. This was supported by the results of our prisoner questionnaire, in which only 15% of respondents claimed that they had difficulty in gaining access; this compared very favourably to the local prison average of 38%.

Visits 3.99 Standard social and domestic visits took place every afternoon, with one session on Monday to Friday and split sessions at the weekend. Uptake was high and most sessions were running at capacity. There were plans to introduce visits in the evening and on weekend mornings to deal with the high level of demand.

3.100 All visits had to be booked by telephone on a specific visits line, which appeared to operate well and could deal with the number of visitors who used it. Visitors received full information about prison visits printed on the visiting order that was sent to them by the post staff.

3.101 Vulnerable prisoners shared the same visiting times and visits room as other prisoners. They were normally placed at specific tables so that staff could ensure their safety, but we were told that, in practice, there were no significant problems in integrating them into the visit system.

3.102 The prison was prepared to make special arrangements when sensitive news needed to be communicated to a prisoner. One option was that they could be seen in the visit room, either in the open hall or in the more private circumstances of legal visits. It was also possible to arrange special visits via the chaplaincy, which were held in their accommodation. The prison chaplaincy also managed, supported and supervised the prison visitors’ scheme, which was well used by prisoners.

3.103 The prison was flexible in accommodating the needs of visitors and was happy to make special arrangements where appropriate. This included allowing children in care accompanied by their social worker to visit their fathers in the morning. As other

domestic visits took place only in the afternoons this allowed for greater contact and the opportunity for children to play in the visit room crèche.

3.104 In our prisoner questionnaire, 48% of respondents said that they and their visitors were treated ‘well’ or ‘very well‘, compared with the local prison average of 40%. Only 9% of respondents thought that they had been treated badly. These findings were reflected by the visitors to whom we spoke, who described staff as being polite and helpful.

3.105 The one major criticism we received from visitors was that no toilet facilities were available for them in the prison. There had been toilets in both the visit waiting room and the visit room, but they had been closed as part of the strategy to prevent the smuggling of drugs into the prison. We were told that visitors would be given access to toilets in some cases, but this did not appear to be known to those who complained to us. Given that some visitors had travelled long distances, and many were accompanied by children, the lack of toilet facilities was unacceptable.

3.106 The prison had an external visitors’ centre based in a small portakabin. This had a snack bar and toilet facilities, but appeared to offer little in terms of advice or support for visitors. There were plans to move the visitors’ centre into more suitable premises currently occupied by the staff mess, which would hopefully allow for the provision of more relevant services.

Conclusion 3.107 The establishment made some effort to make visitors feel comfortable and enjoy their visit. There was a need, however, to ensure that security measures employed justifiably to stop the trafficking of drugs did not have a negative effect on the visitor’s experience.

Recommendations 3.108 The prison should ensure that toilet facilities are available to visitors who genuinely need them, and that its security systems can cope with this.

3.109 Management should ensure that delays in sending out visiting orders are resolved and that all mail is processed as rapidly as possible.

Applications, requests and complaints Expected outcomes The expected outcomes for applications, requests and complaints are: • Safety: Prisoners are safe from repercussions or recrimination in making any application or request or complaint • Respect: Prisoners know and are given appropriate help to exercise their right of access both to applications, and requests and complaints; they receive a prompt, courteous and fair response from staff • Resettlement and reducing re-offending: Sentence plans are normally implemented without a prisoner needing to use applications or request and complaints

3.110 The good relationships between staff and prisoners meant that many issues were dealt with on an informal basis. We noted numerous examples of officers dealing with problems and queries directly and helpfully. Staff took a pride in this and saw the need for prisoners to go through formal procedures as a last resort, rather than the norm.

3.111 Application forms were freely available on the wings and were administered by the landing officers. However, the only applications that were recorded were those that were directed to the duty governor. Where the application was the responsibility of another department it was sent directly to them, which meant that system could not be monitored. This system did not allow the progress of applications to be reviewed, and chased if necessary.

3.112 There were sealed complaints boxes on all the wings and plentiful supplies of the various forms were available. The boxes were opened by a senior officer each morning and all forms were recorded before a decision was made on whether they should be dealt with on the wing or be sent to the request and complaints clerk. While this practice allowed issues to be dealt with at the appropriate level, it meant that

those forms which were kept on the wings were not part of the central monitoring process.

3.113 The prison had a target of answering 95% of complaints/requests within three days and was achieving 84% at the time of our inspection. We were told that it was unlikely to achieve its target because, where the complaint involved another prison or the area office, the speed of response was out of its hands. All replies were typed and were checked by a senior manager to ensure that they met quality standards. The areas of complaint were monitored to establish whether there were any discernible trends, but at the time of our inspection there were no specific issues.

3.114 In our prisoner questionnaire, 60% of respondents said they were not satisfied with the complaints system. Their dissatisfaction was mainly around the length of time it took to get a complaint resolved, although it was also claimed that forms were thrown away or left in the office. This claim reinforced the need for all forms to be subjected to central monitoring.

Conclusion 3.115 The prison provided prisoners with appropriate access to the applications and complaints system, while trying to assure that any problems were resolved without the need to resort to formal procedures. There was no indication that prisoners were being dissuaded from complaining, or that pressure was put on them to withdraw complaints.

Recommendations 3.116 All applications should be recorded systematically to allow both the procedure and responses to be monitored.

3.117 All submitted complaint forms should be recorded centrally and be subject to the same monitoring process.

CHAPTER FOUR

HEALTHCARE

Expected outcomes Inspectors will make judgements about healthcare against the following outcomes: • Prisoners receive a full range of primary healthcare, health promotion and disease prevention services in an environment that is clean, safe and conforms with the standards that operate in the NHS • NHS and prisoner records are available to those responsible for the care of the patient • Prisoners receive healthcare from appropriately trained staff and support and care in meeting their health needs from all prison staff. Their right to refuse treatment is recognised • Prisoners with physical or mental health problems are identified and assessed promptly, receive appropriate treatment and care and, where appropriate, are referred without delay to appropriate secondary care providers • Prisoners’ access to health promotion in primary care is equivalent to that in the community • Prisoners are encouraged to maintain healthy lifestyles while in prison and on release and are linked to community services including GPs prior to release • Prisoners receive inpatient healthcare that meets NHS standards in an environment that is clean, safe and meets NHS standards • Inpatients receive opportunities for purposeful, therapeutic occupation according to their assessed needs and care plan • Patients requiring specialist healthcare are identified promptly and referred to visiting specialists or the NHS • Continuity of treatment and care is not impeded by transfer between prison and the NHS or by inappropriate security precautions

Introduction 4.01 At the time of our inspection there was evidence of good partnership working between HMP Lewes and the local health economy, but this now needed to be grounded in a formal agreement. Negotiations were in progress with two local primary care trusts (commissioners of healthcare) to ensure that a full range of clinical services would be available to prisoners from April 2003 – when the funding for prison healthcare transferred to the NHS. The results of the health needs assessment and the soon to be completed case note analysis should inform these discussions.

4.02 As over 90% of the prison population came from the Brighton and Hove area and East and West Sussex, good partnership arrangements were crucial to provide continuity of care both in the prison and on release.

4.03 Lewes was rated ‘amber’ under the traffic light system used to rate prison healthcare.

Environment 4.04 The establishment had a type-3 healthcare centre providing 24-hour nursing care with an inpatient capacity of up to 25 beds.

4.05 At the time of the inspection the healthcare centre was closed for a total refurbishment. The estimated completion date was late 2003. There was concern that there might be some slippage to the timescale as another financial bid had to be submitted to provide further in-cell electricity, ligature-free doors and windows and a safer environment.

4.06 During the refurbishment, healthcare services were being provided on two floors on B wing, a modified residential unit. These temporary arrangements, though necessary, were far from ideal and further interim alterations were needed to improve the facilities.

4.07 Despite the difficulties and current unsuitability, the healthcare centre was very clean, light and airy although very cramped, with rooms used for a variety of activities. The lack of space meant that there were few rooms suitable for staff offices,

and insufficient consulting rooms for visiting specialists or for patients to have confidential discussions with staff.

4.08 There was no physical barrier between the inpatient unit on the first floor and the outpatients on the ground floor. As the servery and the hot water boiler were located downstairs, there was constant movement between the two floors. The three healthcare cleaners lived on the ground floor.

4.09 The waiting room, a converted cell with an en-suite toilet facility, was only big enough for about six patients at a time. This meant that a lot of time was wasted in collecting patients on the days when the dentist was in the prison and GP surgeries and treatment clinics were in progress.

4.10 The dental surgery had also been temporarily relocated in B wing. The dental unit and chair, the upholstery of which was torn in several places, appeared to have come to the end of their useful life. Neither conformed to modern standards and, along with the autoclave used for sterilisation of instruments, raised health and safety concerns, including cross-infection control. The room had very limited work surface available to the clinical staff, and although the flooring met current standards it was not particularly clean.

4.11 Most inpatients were located on the first floor, mainly in double rooms. This was proving to be difficult as many patients needed to be managed on their own.

4.12 The pharmacy, a large dispensary, was within a gated area with an alarm. At the time of the inspection it was cluttered, generally untidy and in need of some redecoration.

Records 4.13 There was no space to keep patient records confidentially in the general office. Consequently they were stored in cabinets in the main corridor. Scrutiny of a sample of individual medical records and care plans showed that they were mostly in order. In many instances the signatures and writing were difficult to decipher. The care plans were reasonably completed. They would benefit from greater attention to detail, such

as reviews of the results of original clinical interventions and documentation of changes in the plan of care.

4.14 A computerised patient medication (PMR) system was used and, with the exception of special sick remedies, it recorded all items dispensed to patients.

Staffing 4.15 The healthcare manager was an I grade nurse with forensic psychiatric experience. She was also a member of the prison senior management team and directly accountable to the Governor. A senior officer managed all the administration and business areas. An acting senior officer, who was nurse-qualified, managed the outpatient area.

4.16 A G grade registered mental nurse (RMN) was the clinical nurse manager for the inpatient area, with an F grade RMN as the deputy and five full-time staff nurses; two were on permanent night duty.

4.17 There were two healthcare officers (HCO) without nursing qualifications, and an additional five discipline officers were in post to deal with domestic issues such as the prison shop, visits and discipline matters. These officers were either in the process of undertaking the NVQ (National Vocational Qualification) in custodial health care or were on the waiting list to do so. Agency nurses, bank staff or existing nurses doing overtime covered vacant posts.

4.18 In addition, student nurses came to the prison on placement from Brighton University, which had a dedicated web page about the healthcare centre at HMP Lewes on its website.

4.19 Medical cover was undertaken by locum staff seven days a week. A team of three doctors provided out of hours cover on a rota basis.

4.20 The dentist attended for two sessions per week. There were no arrangements for the treatment of out of hours emergencies or for cover during the dentist's annual/sick leave.

4.21 A part-time pharmacist (25 hours a week) provided the pharmaceutical services, which included ordering dressings and medical equipment for the prison. A part-time pharmacy technician had been recruited, but had not yet taken up post.

4.22 A consultant general psychiatrist provides three sessions per week on a locum basis.

4.23 A radiographer visited the prison twice a week to take x-rays, which were then assessed by the local consultant radiologist.

4.24 The optician visited bi-monthly.

4.25 A full-time secretary was responsible for administration and the management of appointments.

Delivery of care 4.26 Nurses completed the reception screening documentation when new receptions were transferred to the first night centre. These prisoners were seen by the doctor the following morning. This meant that any prisoners requiring medication for withdrawal from drugs received only symptom control overnight. The list of agreed medication was two years out of date, and signed by a doctor no longer employed in the prison.

4.27 A previous audit of medical records showed that 72% of prisoners in the establishment had a history of drug misuse, and 30% had used heroin. Drug users were offered a subutex programme. This increased the workload of the nursing staff, but was instrumental in tackling the drug culture of the prison, as was the introduction of a benzodiazepine protocol.

4.28 In the previous 10 months four staff had left and six had joined. This resulted in a staff group that was inexperienced in prison work, although enthusiastic and committed. A two-week induction programme had been introduced, which would be enhanced by the introduction of a named mentor for an agreed period as part of the clinical supervision policy. Nevertheless, the nursing establishment remained

inadequate to provide a safe clinical environment and deliver the range of healthcare services required in a busy local prison.

4.29 Nursing staff tried hard to provide acceptable standards of care, but this was further compromised on occasion by the need to deliver tasks as required by the whole of the prison. When time and staffing permitted, full assessments of patients’ immediate needs were carried out and referrals made to other services. The nurses were not able to run specialist chronic disease management clinics, and health promotion advice and support was delivered on a one-to-one basis.

4.30 Prisoners reported sick at the same time that medication was given out in the morning. There was no triage system or practice nurse clinic, but there was an appointments system and prisoners were usually seen by a doctor within two days of a request. Approximately 30 prisoners were seen in each GP surgery, held from Monday through to Saturday, from 9.00am until 12.00 noon. Patients attended from different wings on designated days. At the same time, nurses saw patients requiring injections, dressings and other treatments. Wing officers brought patients to the healthcare centre if they were seeing the doctor, but healthcare staff managed all other patient movements. An earlier attempt to hold wing-based surgeries had proved very unsuccessful and had been suspended for the time being.

4.31 During our inspection there was some confusion about the medical on-call arrangements, which resulted in a patient who required suturing having to be escorted to hospital. All the medical arrangements were made with locum doctors, as the prison had had little success in recruiting GPs locally following the retirement of the full- time medical officer. A resolution of the locum medical arrangements was seen as a priority in the current discussions with the primary care trusts.

4.32 The dentist was carrying out her first clinical session in the temporary surgery on the morning of the inspection. Dental care was provided under the National Health Service (General Dental Services) regulations. It was understood that a full range of treatment was offered under these regulations. Many appointments were cancelled due to a lack of escorts or because of equipment failure – 17 sessions had been cancelled since the end of 2002. This contributed to the long waiting list and some patients,

described as emergencies, were not seen for two months. The procedures for patients to apply for dental treatment, and their subsequent inclusion on a day list for treatment, was not satisfactory as the dentist had little input into the prioritisation for dental care.

4.33 Patients we spoke to complained of having toothache and having to wait a long time to see the dentist. In our prisoner survey, 77% of respondents said that it was not easy to see the dentist, and only 32% thought it was good service.

4.34 The pharmacy was open from 11.00am until approximately 5.00pm, Monday to Friday. Medication was mainly dispensed in possession, either daily or weekly, and given out once daily, between 7.45am and 9.00am. This meant that the queues were long, and some prisoners complained that they had to choose between exercise or attending for their medication. We were told that even night sedation medication was given out in the morning: while acceptable in the community setting, there were problems with this in the prison setting – it could be used as ‘currency’ as prisoners did not have a safe place to keep their medication. During the inspection there were 222 prisoners taking medication, including 17 taking subutex.

4.35 A significant quantity of the stock medicines in the pharmacy was date- expired, and stock did not appear to have been rotated properly. Despite the provision of purpose-built steel, lockable medicine cabinets, some medicines were left out on worktops and a number of the cupboards were left unlocked.

4.36 Appropriately labelled medicines were supplied to prisoners in plastic Henley bags, amber tablet bottles or pre-packed blister packs.

4.37 There was a list of medicines that could be supplied without reference to a doctor, but this had not been reviewed since1995-96. Medication supplied to prisoners reporting special sick was not always recorded on the treatment chart.

4.38 The storage of controlled drugs in the pharmacy was in accordance with the requirements of the Misuse of Drugs Act 1971 and, although an old register was in use, running balances were only sporadically recorded.

4.39 Despite the regular attendance of an optician, some 74% of prisoners surveyed said it was difficult to obtain an appointment. Eight patients were seen at each session, which resulted in a waiting list of at least six weeks.

4.40 Only one of the three visiting consultant psychiatrists had access to local beds, although this had eased the past problems of transferring patients to the NHS. The consultants completed court reports and initial assessments, and continued their care with follow-up appointments and discussion with staff members. They also assumed an ongoing responsibility for their patients when admitted to the inpatient unit. A very simple way of identifying the responsible doctor had been introduced by flagging up the medical notes for each doctor, which was good practice in the absence of a permanent psychiatrist on the staff.

4.41 It was apparent that the current psychiatric cover needed improvement. The appointment of a lead mental health clinician who could devote more time in the prison would benefit the situation. Such a postholder would improve the overall quality of mental healthcare by facilitating multi-disciplinary meetings, improving the management of prisoners who persistently self-harmed, and participating in the suicide prevention strategy.

4.42 More mental health nurses had been recruited in the last few months, which meant that inpatients with a mental health problem had an appropriate care plan. An in-reach team had been recruited which consisted of an experienced social worker (senior practitioner) and two psychiatric nurses, one of whom was part-time. The physical location of the team was challenging, as it had to share a room with a part- time doctor and the radiographer – and all shared a telephone line with the pharmacist.

4.43 The team took referrals from other colleagues, including wing-based officers and healthcare staff, and worked closely with a locum psychiatrist. There had been some teething problems with differing professional expectations since the team started. It was hoped that a two-day team building exercise would resolve areas of conflict, such as caseload management and joint working arrangements. There were

also plans to develop ways of working with local community mental health teams to secure ongoing care and support for patients on release from prison.

4.44 The occupancy of healthcare beds was high, with most occupied most of the time. At the time of the inspection there were 17 inpatients, three with physical and 14 with mental health problems.

4.45 Discipline staff made sure that patients had showers, exercise and association, as often there were no more than two qualified nurses to carry out clinical work. Staffing levels on the inpatient landing were commonly eroded by the need to staff other activities, such as outpatients and dealing with visiting specialists.

4.46 The addition of five discipline officers to work in healthcare had improved the situation but, because their duty rota was the same as the rest of the prison, there were occasions when there were only two staff on duty. This precluded patients being unlocked, as there was a requirement for three staff to be on duty to do so. The number of staff was insufficient to maintain a safe level of nursing care directed by a first level nurse over a 24-hour period.

4.47 There was always a qualified nurse on duty at night, with an officer support grade present should the nurse be called away to the main part of the prison.

4.48 There were good working links with segregation unit as some prisoners there were quite violent, which could be a sign of mental illness. Some patients moved between the two departments and had shared care plans.

Conclusion 4.49 Implementation of some of the previous inspection recommendations was well underway with the total refurbishment of the healthcare centre. Despite the problems of staff shortages, prisoners valued their care and treatment: 43% of the prisoners surveyed thought the quality of healthcare was ‘good’ or ‘very good’, which compared well with the 30% average for local prisons. We were pleased to see the beginnings of a high quality mental health service, which should become even better established with the greater integration of prison healthcare with the local NHS. The

same level of nurse recruitment was required in prison primary care to provide the range of services needed.

Recommendations 4.50 The Governor and the healthcare manager should review the temporary location of healthcare services in B wing in light of the proposed timescale for refurbishment of the healthcare centre, and take account of: • safety aspects of the living space, including observation of patients and use of rooms for single occupancy • the level of clinical activity and outpatient clinic management • the shortage of space for interviewing patients in a confidential setting • additional equipment, such as a fax machine and additional telephones.

4.51 The Governor and the healthcare manager, in conjunction with the Regional Prison Health Development Team and their NHS partners, should, as a matter of urgency, formally agree a health promotion strategy and the clinical services required in the prison (including general practice and psychiatry input), as described in the HMIP action plan. An agreed timescale for implementation should be set.

4.52 The healthcare manager should review skill mix and staffing levels to ensure the best quality patient care, identify any skills deficit, and recruit additional staff who are suitably qualified and competent.

4.53 The Governor, the healthcare manager, the Regional Prison Health Development Team and the dental advisor from the local primary care trust should identify the funding required and appraise the use of the current dental surgery facilities to: • reduce the present waiting list and improve access to dental care • provide an out of hours emergency treatment service • introduce a dental health promotion strategy.

4.54 The clinical governance forum should re-constitute the drugs and therapeutics committee to: • review, agree and implement policies for in possession, stock management, out of hours supply and nurse prescribing, and develop a prescribing formulary as agreed with the local pharmacy advisory group • agree the criteria for a pharmacy-led clinic.

4.55 The dental surgery floor should be cleaned thoroughly after every clinical session.

4.56 Up-to-date copies of pharmacy reference materials (Martindale and British National Formulary) should be available.

4.57 The pharmacist should ensure that patient information leaflets are supplied, or a notice displayed at the treatment rooms, to ensure that prisoners are aware of the availability of the relevant leaflets for them to consult.

4.58 The pharmacist should ensure that all medicines and devices are stored in their original containers and that checks are made of stock levels and expiry dates. The date of each check should be recorded.

4.59 All refrigerators should contain a maximum/minimum thermometer, and temperatures monitored within the 2-8 degrees Celsius and recorded on a daily basis.

4.60 The pharmacy fridge should be kept tidy and clean, and milk should not be stored there.

4.61 Control drugs registers should be used to record use of these drugs.

4.62 Where drugs require fridge storage (for example, insulin), a drug refrigerator should be provided in the wing treatment room.

CHAPTER FIVE

ACTIVITIES Employment The expected outcomes for prisoner employment are: • Safety: Prisoners work in a safe, suitable environment • Respect: The range, type and availability of work activity meets the needs of the prison population and prisoners are treated fairly in all aspects of their work, its allocation and pay • Purposeful activity: Prisoners are engaged in well-organised employment; work programmes are integrated fully with residential units and other departments • Resettlement and reducing re-offending: Prisoners are occupied in realistic work that prepares them for employment on release and helps to reduce re-offending

5.01 Prisoners were asked about any previous work experience during their interview on the first night centre. In induction they were told that work was available, but there was scant information on the opportunities for this.

5.02 Work opportunities ranged from cleaning to laundry work, with two workshops for prisoners from F wing, and one for other wings. Prisoners could attend some education classes and one session of gym during the working week.

5.03 Prisoners were not allocated to employment following any assessment of needs and skills. The establishment had not yet introduced a labour board, so allocation to work was not informed by individual sentence plans (see paragraph 7.16). Work allocation was co-ordinated by an officer responsible for labour allocation and it was allotted on availability rather than identified need. There was insufficient employment for all prisoners.

5.04 The largest of the workshops, workshop one, employed prisoners packing plastic cutlery into bundles. The work was contracted to a variety of companies and employed 40 prisoners from F wing. During the week of the inspection this workshop

had also undertaken some piecework, which involved the assembly of plastic guttering.

5.05 Prisoners from F wing also worked in workshop two, where they were involved in contract work, assembling and packing small plumbing items. Approximately 12 prisoners worked here full-time, and 10 part-time.

5.06 Workshop three employed 15 prisoners, mainly from C wing, in the trimming of excess rubber from light domes (cat’s eyes). This was also contracted to an outside firm.

5.07 Other forms of work were available in the kitchen and on the wings, for example, as cleaners, servery and laundry workers and various orderlies.

5.08 Wages were generally the same for all prisoners and did not disadvantage those attending part-time education.

5.09 The work in the workshops was repetitive and unskilled and bore little relevance to opportunities upon release. No nationally recognised qualifications were offered in the workshops or in forms of employment other than education. While the work gave ample opportunities for social and personal development, these activities were not accredited for basic and/or key skills.

5.10 The establishment had identified additional electrical assembly work contracts, which should offer good employment-related training, but at the time of the inspection this had yet to be formalised. While the senior management was committed to improving production work, there were severe restrictions on space to accommodate new work.

Conclusion 5.11 While the management of employment opportunities was generally effective, there were inadequate arrangements for the allocation of places, which was based on spaces available rather than identified need. The production work was menial and

provided little employment-related skill accreditation. There were insufficient places to meet the needs of all prisoners.

Recommendations 5.12 The plan for a labour board should be implemented, and prisoners should be allocated to work according to an assessment of their needs, and as part of ongoing sentence planning.

Education and work skills training Expected outcomes The expected outcomes for education are: • Safety: Prisoners receive education and work skills training in a safe, suitable environment in which they are enabled to participate fully • Respect: Prisoners are offered opportunities in education and work skills training that meet their identified needs and different levels of ability, and promote and respect personal responsibility; education is facilitated and valued by the establishment and reflects a sensitivity to equality of opportunities issues • Purposeful activity: Prisoners have the opportunity to engage in a range of education and work skills training that provides constructive and meaningful activity and potential for self-expression • Resettlement and reducing re-offending: Prisoners are involved in education and work skills training specifically to enhance their employment opportunities

Education 5.13 Education provision was contracted to South Downs College of Further Education and offered 8,400 hours annually. Education was available full and part- time to approximately 50% of the prison population, but this met the needs of those requiring it and waiting lists were in single figures.

5.14 The department offered a narrow core programme of, for example, art and craft, basic and key skills and life skills. English for speakers of other languages (ESOL) and information and communications technology were also available. ESOL

provision was included in the basic skills classes when required, and there were good resources in the library to support ESOL needs.

5.15 There was one full-time education manager and sufficient other staff to cover the curriculum on offer. All staff were appropriately qualified. Some staff worked towards basic skills qualifications, and there was good support for staff development from senior management of the prison.

5.16 Most prisoners received a standard national Basic Skills Agency assessment upon entering the prison, although some 20% had not been assessed. The establishment estimated that approximately 60% of its population had basic skills needs.

5.17 There was an insufficient range of courses to meet the needs of those learners who wanted to learn for leisure; opportunities for progression to higher awards were limited, mainly due to the capacity of the computer equipment.

5.18 The curriculum was also limited for those on F wing; however, the ICT equipment was of a much higher standard and could support additional ICT courses. Education for this unit was provided in an annexe of the wing.

5.19 Part of the education contract included a workshop dedicated to the refurbishment and restoration of computer equipment on behalf of charity organisations. This only took place on two days per week, and the workshop was unsuitable and not fit for the purpose. On the other three days computer technology classes were held in the same workshop.

5.20 Access to some education courses was restricted for those with mobility difficulties as much of the education in the main department was on the first floor with no wheelchair access. The education staff provided some outreach courses in the healthcare centre; however, there was inadequate space for group or individual work.

5.21 There were no evening classes available in the prison. Prisoners were encouraged to do work in their cells, and this was welcomed by many. There was

good support by the education department for this mode of learning, and there was strong use of peer mentors.

5.22 Prisoners attending the classes rated the provision as good. In our prisoner survey, 87% of respondents told us that education was ‘good’ or ‘very good’, compared with the average of 79% for similar establishments. There were examples of good work in all areas, and we rated 92% of teaching as satisfactory or better, with 75% rated as good or better.

5.23 The prison had excellent working relationships with the college and used its quality assurance systems effectively, including the analyses of formal lesson observations by college staff to monitor the quality of education. There was an established quality improvement group, and good links between the education staff in the prison and the main college.

5.24 The prison had achieved good results for key skills targets, meeting or exceeding many of them, and there were effective systems to record and monitor learner progress. The transfer of achievement and learning information between prisons was good.

Work skills training 5.25 Training activities were severely restricted, with the kitchen providing the only national vocational qualifications (NVQs), although NVQs had previously been offered in the physical education department. This provision had ceased due to staff shortages; however, staff recruitment was due to take place the week following the inspection.

5.26 The kitchen NVQ programme was managed by the kitchen manager. The college was the accredited centre for the NVQ. This meant that the external verifier was not required to visit the prison to ascertain the resources available.

5.27 The management of the NVQ was unstructured and relied heavily on the commitment of staff and the support of the deputy governor. There was little specialist assistance for the programme. Information about prisoners’ basic skills

assessment and prior learning and experience was not routinely passed to training staff in the kitchen-training environment. Thus support for basic skills was limited to the commitment of staff, and was not structured or managed effectively by the education department.

5.28 There were only two prisoners on the NVQ programme; however, it was well delivered and standards of work were high. There was good retention and achievement of the award. Resources for practical training were very good, and staff were well experienced and qualified.

Library 5.29 The library was located on the ground floor, close to the education centre. It was open only on two weekdays from 9.00am to 4.00pm. One day was allocated to prisoners on F wing, and the other to the remainder of the population. There was no access during evenings or weekends, due to staff shortages. The main users of the facility were the prisoners from F wing, where in-cell television was limited.

5.30 Although stock loss was high at 50%, the library was well stocked with some 6,000 books, including legal reference books and a good range of large print books, many in different languages. Withdrawn books were placed on wings for prisoners’ personal use. A range of newspapers was available for prisoners to order through a local newsagent.

5.31 Prison staff encouraged prisoners to use the library, and many officers went out of their way to visit the workshops to encourage prisoners to use the library when it was open. The prison had plans to improve the library resources and its opening hours and accessibility.

Conclusion 5.32 The management of the education and training provided was satisfactory; however, there were insufficient opportunities for vocational awards and the curriculum lacked variety. Teaching and learning were good, and in some cases very good, but the flow of information from the initial assessment to teaching staff was

spasmodic, particularly in the kitchen training. No formal training and no recognised qualifications were offered in the workshops.

Recommendations 5.33 The educational curriculum should be broadened to include other subjects and interests, and enable progression to higher awards beyond basic and key skills.

5.34 The use of the computer refurbishment workshop should be evaluated, and its value as an activity considered.

Physical education Expected outcomes The expected outcomes for physical education are: • Safety: Prisoners are safe during physical education activities • Respect: The range, type and availability of physical education activities meet the needs of the prison population; prisoners are treated fairly in all aspects of physical education • Respect: Physical education is part of the provision of a healthy lifestyle in promoting personal health, fitness and co-operative and team skills • Purposeful activity: Prisoners are engaged in suitable physical education programmes that are fully integrated with other purposeful activities

5.35 The physical education department prided itself on ensuring that all prisoners – including those in healthcare, on the vulnerable prisoner unit and on remand – were able to access its services and the facilities of the gym. It had developed a timetable which allowed most prisoners, including those who worked, to attend PE up to six times a week.

5.36 The prison had two large sports halls, which meant it could offer a variety of sports, including team games. While the fabric of the buildings was in poor condition they offered a good and flexible space in which to undertake a variety of activities. There was an outside sports pitch, but drainage and maintenance costs meant that it could only be used during the summer. There were plans, yet to be confirmed, to

develop both the buildings and the sports pitch to improve facilities and maximise their use.

5.37 There were adequate showering facilities in the gym, which prisoners could use at the end of each PE session. However, the changing rooms were in extremely poor condition, with major damp damage, and were also in urgent need of decoration. Clean kit was issued to prisoners on each visit to the gym.

5.38 There was an impressive range of exercise machinery and weights, as well as the necessary equipment for team games. Staff supervised the day-to-day condition of equipment and made a thorough monthly check. The prison also had a contract with an outside firm to conduct an annual inspection and provide a maintenance service. There was a costed replacement schedule for all the major equipment, which meant that staff could ensure that nothing was kept past its useful life.

5.39 PE staff saw all new prisoners as part of the induction package. Those who were interested in using the PE facilities were brought to the gym the following Monday and given a thorough induction. This included training on manual lifting, the handling of equipment, and health and safety rules. In addition prisoners were required to sign a compact that clearly laid out the rules and expected standards of behaviour for those using the PE facilities.

5.40 Due to staff shortages, the PE department was not offering accredited programmes at the time of our inspection. It had chosen to concentrate on offering recreational sport, remedial courses and fitness training until it had enough staff to provide adequate supervision. It was, however, continuing to allow two disadvantaged community groups into the prison weekly to use the facilities with the support of prisoner volunteers.

5.41 Several of the PE staff were trained in first aid, and all incidents were recorded in the unit accident book. This was monitored by the senior officer, and the figures were also collated by the administration department for the information of management. However, there were relatively few incidents in PE and staff were alert to safety issues. We were told that there was little bullying in the gym and, where

there was an incident, it would be directly confronted and reported to the anti-bullying co-ordinator.

5.42 The PE department was fully involved in sentence planning and contributed to over 300 sentence plans a year. Staff also attended any meetings to which they could usefully contribute, and were keen to develop programmes for specific groups. Prisoners subject to an F2052SH (at risk form) brought the document with them to the gym, and staff made a written contribution at the end of the session.

Conclusion 5.43 The gym offered an excellent and accessible service to prisoners, including a variety of recreational, vocational and remedial courses appropriate to their needs. It was unfortunate that there were no opportunities for prisoners to achieve awards or qualifications, and this needed to be remedied as soon as the staffing vacancies were filled. While it was to be expected that the prison would not want to invest too much into the fabric of the buildings until the potential redevelopment had been decided, the state of the changing rooms was unacceptable and needed urgent remedy.

Recommendations 5.44 The gym changing rooms should be refurbished and brought up to an acceptable condition for use.

5.45 The opportunity for prisoners to gain awards and qualifications in physical education should be pursued and developed.

Faith and religious activity Expected outcomes The expected outcomes for faith and religious activity are: Safety: Prisoners can safely take part in spiritual activities Respect: Prisoners of all faiths are able to practise their faith in suitable accommodation with sufficient appropriate facilities Purposeful activity: Prisoners have ready access to a range of appropriate spiritual activities Resettlement and reducing re-offending: Prisoners and groups of prisoners are able to be involved with their faith ministers from the community

5.46 There were six faith ministers in the establishment – four Christian, one Buddhist and one Muslim. There was also access to three other ministers (Sikh, Hindu and Jewish) if required. Prisoners were informed that they could request other ministers if necessary.

5.47 A member of the chaplaincy team saw all new prisoners within 24 hours of their arrival. The chaplaincy accessed the prison computer system to ascertain names and locations in the prison. Contact was maintained via application (where appropriate), through meetings held with prisoners, either in their cells, in a wing office or in the chapel.

5.48 Apart from those on F wing, prisoners requesting to attend the Sunday Christian services did so on the day prior to the service, although it was not clear why they could not request to attend on the Sunday morning.

5.49 F wing prisoners had a service on the wing. Prisoners located in the segregation unit could not attend the standard Saturday/Sunday services, but were seen by the chaplaincy at appropriate times and individual services were provided when required.

5.50 There were two areas dedicated for worship, a chapel (with seating for 50 prisoners) and a multi-faith room. No ablution facilities were available in the vicinity of the multi-faith room.

5.51 Muslim prayers did not take place communally on a Friday, as the Imam was not available to attend the prison on that day; he saw Muslim prisoners individually on a Monday or Tuesday.

5.52 All prisoners were informed of the start times of services via a leaflet issued from the chaplaincy staff. We noted that Sunday’s Church of England service commenced at 10.30am for a duration of one hour, and this clashed with access to the gymnasium which took place at 11.00am.

5.53 The chaplaincy was making sound attempts to ensure that the content of services was appropriate to the congregation. Services varied from contemporary to traditional from week to week. Services were supervised by uniformed staff, who were respectful and maintained an appropriate level of discipline. The Anglican chaplain took the lead responsibility for maintaining the appropriate level of discipline.

5.54 All chaplains contributed to sentence planning where ongoing contact with the prisoner had been maintained. They were also called upon to relay sensitive news, such as bereavement or family illness, and actively involved in issues such as race relations, suicide awareness, substance use and anti-bullying.

5.55 The chaplaincy was responsible for co-ordinating the prisoner visitor scheme, which had access to a total of 17 visitors – although none of these visitors was from a black or minority ethnic group.

Conclusion 5.56 The chaplaincy team in Lewes was well integrated into the work of the prison. It provided spiritual and pastoral care for both prisoners and staff, and the team was readily accessible to prisoners and actively sort to engage with them whenever possible.

Recommendations 5.57 Religious services should not clash with other regime activities.

5.58 An Imam, or suitable prisoner, should facilitate a Muslim congregation for Friday prayers.

5.59 Effort should be made to co-opt prison visitors from black or minority ethnic communities.

5.60 Prisoners should be able to register for their relevant service on Sunday morning.

5.61 Consideration should be given to conducting risk assessments on prisoners located in the segregation unit who apply to attend services, to facilitate their attendance wherever possible.

5.62 Consideration should be given to locating washing facilities in the vicinity of the multi-faith room.

Time out of cell Expected outcomes The expected outcomes for time out of cell, including hours unlocked, association and exercise, are: Safety: Prisoners are safe when participating in out of cell activities Respect: All prisoners have fair access to out of cell activities, opportunities for which meet the needs of the prison population Purposeful activity: Varied and appropriate activities are supported by well-run wing routines and staff involvement

5.63 The establishment published a regime indicating that prisoners would be unlocked for a total of nine hours per day on four days a week. At weekends the unlock total was six hours per day. However, this total did not account for the short

times during the day when prisoners were also locked in their cells, such as prior to receiving a lunch or tea meal.

5.64 The published regime did not accurately reflect the daily operation of the wings. For example, it showed that lunch was to be served at 12.00 noon, finishing at 12.25pm; however, this meal was often served between 11.40am and 12.00 noon. Prisoners were often locked in their cells by 12.15pm.

5.65 Some prisoners also complained that they missed morning exercise when they needed to access medical treatment, which took place at the same time. Prisoners in receipt of medication often had to choose between the two.

5.66 There were association areas on each wing, with items such as table tennis, table football and pool tables. Prisoners received regular association, although there were occasions when this had to be cancelled due to staffing difficulties. At such times, association was cancelled on a rota basis between the wings, and prisoners clearly knew in advance. Since the introduction of TVs in cells, fewer prisoners made use of the association facilities available.

5.67 Prisoners who were unemployed remained in their cells through most of the day, but staff took every opportunity to unlock them to use the telephone, take showers or clean their cells.

5.68 Exercise in the open air took place each morning between 8.00am and 8.30am. All prisoners could access this, but it did clash with other parts of the regime such as showering and the dispensing of treatments. Prisoners were allowed to return to the wing if they so wished, and the number of prisoners choosing to take exercise varied greatly, with as few as two taking exercise from one wing on one particular day. There were no exercise activities, with exercise simply constituting a walk around the yard.

5.69 All prisoners were required to eat their meals in their cells, although no adequate reason was given for this. The association area on each landing was not large

enough to accommodate all prisoners should they wish to dine in association, but could have accommodated a smaller number.

Conclusion 5.70 Morning exercise took place routinely, although it clashed with the time that medication was administered. Association was occasionally cancelled due to staffing shortages, but this was done in advance on a rota system. There was some slippage against the published times of regime activities. Unemployed prisoners spent considerable time in their cells, although staff unlocked them whenever possible. There was no dining in association.

Recommendations 5.71 The actual regime and in particular the serving of meals should accurately reflect the published regime.

5.72 The dispensing of medication should not clash with other activities.

5.73 Consideration should be given to allowing prisoners to dine in association, for example, on a rota basis.

CHAPTER SIX

GOOD ORDER

Expected outcomes The expected outcomes for good order are: • Safety: Prisoners’ safety is protected by clear rules necessary for the maintenance of good order and discipline and enforced by the properly exercised authority of prison staff • Respect: Prisoners understand the rules of the establishment and are treated fairly; they are able to appeal against decisions • Respect: Segregation, the use of force and application of category and status are used for their proper purposes and not as punishments • Respect: Every opportunity is taken to encourage good behaviour even when enforcing boundaries of control • Purposeful activity: Good order is supported through activities for prisoners which are challenging and well-organised

Rules of the establishment and security 6.01 The role of security was well understood and integrated into the establishment. Security managers routinely visited all parts of the prison and ensured that security measures were properly enforced. The elements of dynamic security were in place, staff had a good knowledge of the prisoners in their care, and the level of security information reports (SIRs) indicated that intelligence was being routinely collected and passed on to the security department. SIRs were submitted from all grades of staff and averaged 50 per month. The number had risen from 365 in 2001 to 626 in 2002 and the majority related to drug use. Every SIR submitted was acknowledged.

6.02 The security committee met every month and was chaired by the head of security or the deputy governor. It was well attended and included representatives from the residential units, the Board of Visitors, the escort contractors and the police liaison officer. A monthly security bulletin was compiled and provided details of

information received, incidents, searches completed and prisoners whose behaviour warranted special attention.

6.03 The security department compiled monthly wing diaries for all areas of the prison. These incorporated a matrix for cell searching, which wing staff completed as they conducted cell searches, and a section for completion by the searching officers, detailing any illicit items found. Diaries also included sections for tool checks, cell fabric checks, movements on and off the wing, any prisoners on F2052SH (at risk forms) and the daily exercise record. At the end of each month the diaries were returned to security where they were filed, constituting an auditable record of procedures carried out.

6.04 Searching was conducted on a three-monthly cycle, and targets were being met. The residential senior officers were responsible for the quality control of searches, and security managers were expected to observe occasional searches, although this was not formally systematised. There were relatively few finds of illicit articles and most of these were related to drugs or hooch.

6.05 The rules of the prison were explained to prisoners on induction and they were given a comprehensive information pack that contained details of the prison routine and the rules relating to prisoners’ behaviour. There were no individual wing rules, and the prison rules were not displayed on wing notice boards. Prisoners stated that they were aware of the rules and that all members of staff consistently applied them.

Prisoner disciplinary procedures 6.06 Adjudications took place in a dedicated room in the segregation unit. The room was large, bright and suitable for its purpose. The seating arrangements for staff ensured that the prisoner did not feel intimidated in any way. Those adjudications that we observed were carried out fairly and gave the prisoner ample opportunity to present his case. There was a tendency for the proceedings to become somewhat laborious as adjudicators took pains to consider and discuss every point that the prisoner made. Of the two adjudicating governors observed, one sought permission from prisoners to address them by their first names, and the other used title and surname.

6.07 Standardisation meetings had taken place and a separate sheet had been prepared for each paragraph in the adjudication manual. This sheet set out the agreed range for punishments, issues for the adjudicator to consider when assessing the seriousness of the offence and possible mitigating circumstances. The senior officer provided the adjudicating governor with the appropriate sheet for the charge; it was expected that this would be completed and form part of the case file in the event that it was needed to inform an appeal. Unfortunately, not all of these sheets had been completed in the completed adjudications which we scrutinised. Before leaving the adjudication room each prisoner was given a sheet of paper that informed him of his punishment and set out the appeal process.

6.08 Our examination of completed adjudications confirmed that they were properly investigated and that the prisoners’ responses were recorded. Witnesses were called as necessary and the documentation was properly completed. A very large proportion of charges in recent weeks had concerned refusals to transfer out of Lewes. These prisoners were all given suspended awards of cellular confinement and loss of privileges. Most of the prisoners presumably obeyed the order when it was next given, but those who continued to refuse to move away from their home area were ultimately punished harshly.

Use of force 6.09 Force had been used 100 times in 2002 and seven times in January and six times in February 2003. Some of these instances involved a number of prisoners on whom force was applied. For example, the January 2003 figure included five prisoners involved in a barricade. Use of force forms were, quite correctly, completed when any member of staff had reason to lay hands on a prisoner. In some instances, therefore, control and restraint techniques were not deployed.

6.10 The areas where force had been used most were the segregation unit and the healthcare centre. Other instances were randomly distributed across the wings.

6.11 Use of force documentation was completed, attached to the report of injury to a prisoner form, F213, and filed securely in the security office. On some forms the

name of the authorising officer was not completed, but the word ‘spontaneous’ was written in the space. Where the use of force was authorised, it was often certified by the same officer.

6.12 Since January 2003 a new committee had been established specifically to discuss use of force. It was chaired by the deputy governor and included a number of standing agenda items, one of which was quality checks of completed use of force forms.

Segregation unit 6.13 The segregation unit was situated on the ground floor of F wing. Only part of the landing was designated as the segregation unit. The other part, designated F1, was accessed through a locked gate and was not in use as cellular accommodation, but contained two safe cells and a cell used as a Listener suite.

6.14 There were eight normal cells and two special cells in the segregation unit. The normal cells were all fitted with a bed and mattress, stainless steel sink and screened toilet, and cardboard table and chair. Staff told us that they had been furnished with wooden tables and chairs, but that these had been smashed up and they were awaiting replacements. All the cells, and the other areas in the unit, were clean and well maintained. Shower and toilet areas were also clean and properly screened. A PIN telephone was available for the use of residents, and there were two bookcases containing a selection of books.

6.15 Six prisoners were resident in the unit at the start of the inspection. All were seen by inspectors and confirmed that they knew why they were in segregation and had no complaints. They also confirmed that they could take exercise and a shower every day if they so chose. Two of the residents were suffering from mental health problems and were temporarily in segregation of their own choice while awaiting a more suitable allocation.

6.16 Staff knew and related well to all of the prisoners, and worked particularly hard with the more difficult and needy of their charges. We observed one prisoner being relocated under constraint. He was extremely distressed, but was dealt with

compassionately by segregation staff, who managed to get him into the healthcare centre later that day. In the process of being admitted to the segregation unit he was strip searched, and the principal officer in charge confirmed that all receptions to segregation were strip searched.

6.17 Prisoners on good order and discipline rule were reviewed each week by the deputy governor and segregation staff. A pro-forma was used to compile an action plan to return the prisoner to normal location, and the prisoner was given a copy of this when it was completed.

6.18 The segregation wing diary incorporated full details of showers, exercise and telephone calls made by prisoners, and also included records of cell searches, movements and cell fabric checks. It listed all visitors to the unit, and showed that the medical officer, chaplain, duty governor and Board of Visitors visited regularly. Records of prisoners segregated under good order and discipline were properly kept, and a Board of Visitors member completed these as necessary.

6.19 Records of the use of the special cells were kept in the security department. These showed that the special cells were not used often and that, when they were, prisoners did not remain in them for long. It was rarely necessary for the Board of Visitors to authorise continuation.

6.20 A range of locally devised forms was in use in the segregation unit, generally to increase the efficiency of the unit and ensure that all members of staff knew the procedures. One such form had been devised to record the monitoring of prisoners serving periods of cellular confinement. It required regular checks by staff to be signed, and incorporated space for the duty governor, chaplain, medical officer and nurse to append their comments on a daily basis.

6.21 All prisoners coming into the segregation unit were provided with an information pack that explained the rules and routines of the unit, and informed them why they were there and when they would return to their own unit.

Vulnerable prisoners 6.22 F wing accommodated the prison’s vulnerable prisoner population. Approximately 65% of the prisoners on the wing were sex offenders, while the remainder were judged to be at risk for various other reasons. The wing was separate from the others and provided its prisoners with the necessary protection.

6.23 Compared to the other wings, F wing offered the least landing and recreational space to its prisoners, and most cells were shared. The cells had originally been built for single occupancy and did not accommodate two prisoners comfortably. Since the majority of prisoners on the wing were sex offenders, it was not uncommon for two sex offenders to share a single cell, even before details of their offence and their proclivities were known.

6.24 The atmosphere on the wing was relaxed and comfortable. Staff maintained control and were aware of their prisoner group. Relationships between prisoners and staff were good, and it was noticeable that staff did not refer to prisoners as ‘VPs’, or use other language that differentiated them from other prisoners.

6.25 Prisoners on F wing enjoyed the same regime opportunities as those elsewhere. They had access to education and religious services, and attended the visits hall with prisoners from other wings. They had a broader opportunity for employment in the workshops than prisoners from the other wings.

6.26 Prisoners could attend an enhanced thinking skills course run on the wing, which accommodated 10-12 prisoners at any one time (see paragraph 7.17). Prisoners wishing to attend a sex offender treatment programme were transferred to an appropriate establishment as necessary.

6.27 There was little movement of prisoners from F wing to the other wings, and there was little impetus to achieve this. There was a lack of planned work to challenge the sex offenders accommodated on the wing, and there was evidence of a growing culture of denial.

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Conclusion 6.28 Appropriate security measures were in place and enforced across the prison. Dynamic security was being applied and intelligence was forwarded to the security department. The searching of cells was on target, but there were few finds, which suggested that searching could have been more thorough. The rules of the prison were not published on wings, but all prisoners were given copies of them and stated that they understood them.

6.29 Disciplinary proceedings were carried out fairly and thorough enquiries were made into each case. The documentation was properly completed, with the exception of the locally devised standardisation sheet. Forms were completed whenever any form of force was used. They were correctly filed and routinely monitored by a specially convened use of force meeting.

6.30 The segregation unit was well managed and all prisoners located there were properly cared for by staff. However, there was routine strip- searching of those admitted to the unit. Prisoners seldom spent long in a special cell, and prisoners segregated under good order and discipline were regularly reviewed.

6.31 Vulnerable prisoners on F wing were not discriminated against in any significant way and were well protected on the wing. However, the focus on the wing appeared to be on simply ‘holding’ vulnerable prisoners, and the lack of planned offence and/or behaviour-focused work with sex offenders was an area of concern.

Recommendations 6.32 Use of force forms should be certified by an officer who was not responsible for authorising the use of force, so that an independent check takes place.

6.33 Prisoners entering the segregation unit should not be strip searched automatically; such a search should be based on a judgement of the circumstances.

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6.34 The establishment should formalise the arrangements for security managers and senior managers to observe a sample of cell searches for quality checks.

6.35 The locally devised standardisation sheet should be completed by the adjudicating governor in all cases.

6.36 The name of the authorising officer should always be recorded when force is used, even when the need to deploy force is spontaneous.

Good practice 6.37 The monthly wing diaries, which contained written records of all the basic procedures carried out that month, provided a useful record.

6.38 The standardisation sheet ensured that all adjudicators were aware of the agreed range of awards and took into account all salient issues before deciding on the punishment.

6.39 The sheet of paper given to the prisoner at the end of the adjudication ensured that he knew what punishment he had been given, and was aware of the appeal process.

6.40 The introduction of a use of force meeting allowed all aspects of the process to be regularly reviewed, and any shortcomings in the recording process to be identified.

6.41 The locally devised form for checking prisoners serving cellular confinement ensured that all staff and visiting personnel saw the prisoner regularly, and signed to that effect.

6.42 The segregation unit booklet describing rules, routines and reasons for segregation and date for return to the wing provided prisoners with a good range of useful information.

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Incentives and earned privileges Expected outcomes The expected outcomes for incentives and earned privileges are: • Respect: Prisoners understand the rules of the establishment and are treated fairly; they are able to appeal against decisions • Respect: Every opportunity is taken to encourage good behaviour even when enforcing boundaries of control

6.43 The incentives and earned privileges (IEP) scheme was well publicised throughout the prison, and an explanation of it was an integral part of the induction process. Prisoners were clear about its operation and staff were extremely positive about its impact on improving behaviour.

6.44 The system was subject to a monthly audit, which included a check of history sheets to ensure that there were weekly entries. All stages were transparent, allowed for a contribution by the prisoner, and included a review of decisions by line management. The main responsibility for the scheme lay with senior officers and fully involved personal officers in the process.

6.45 Prisoners who were likely to be downgraded were, if possible, seen by a senior officer and warned about their behaviour prior to action being taken. If a prisoner was being considered for downgrading, the case went to an IEP board chaired by a senior officer and normally including the personal officer. When a decision was made to downgrade a prisoner to the basic regime, the case was required to be reviewed and endorsed by a principal officer.

6.46 All decisions were recorded and prisoners were kept fully informed at all stages of the IEP process. If a prisoner was dissatisfied with a decision, he had the right to appeal to the principal officer and, ultimately, the head of residence. Prisoners were further entitled to use the formal complaints system, including the confidential access option. Where a prisoner was placed on the basic regime, he was given clear targets which he needed to achieve to progress back to the standard level.

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6.47 The prison was struggling to make a clear distinction between prisoners on the standard level and those on enhanced. This was particularly problematic for prisoners on remand, for whom there was very little difference in privileges between the two levels.

Conclusion 6.48 The prison’s incentives and earned privileges scheme operated effectively and had a significant effect on improving the behaviour of prisoners. The system was transparent, and was operated sensibly and fairly by staff, but did not provide significant differences in the privileges available to standard and enhanced prisoners. We were aware that the prison was planning to review its IEP scheme in the near future.

Recommendation 6.49 The development of extra incentives for enhanced status prisoners should be prioritised.

Categorisation Expected outcomes The expected outcomes for categorisation are: • Safety: Prisoners are held in accommodation which is appropriate for their own and others’ safety • Respect: Prisoners are located in an establishment that is as close to home as possible and able to meet their identified needs • Respect: Criteria for determining security categorisation and allocation procedures are clear, open and fair, and rules governing transfer arrangements are fairly and consistently applied without discrimination • Purposeful activity: Security conditions do not unnecessarily restrict prisoners’ access to purposeful activity

6.50 Categorisation and allocation came under the responsibility of the prison officers who made up the resettlement group. This group was also responsible for: visits; video link; observation; legal aid; offending behaviour programmes; sentence

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planning; and pro-social modelling training. Some of these officers shared an office with probation staff, enabling open exchange and sharing of information.

6.51 One officer per main shift was designated to categorisation and allocation work; this mainly involved initial categorisation and the arrangement of inter-prison transfers. We were told that Lewes received between 20 and 30 newly sentenced prisoners each week.

6.52 Problems in obtaining previous convictions were leading to delays in categorisation, and in some instances in the processing of home detention curfew assessments. Staff and managers told us that prisoners regularly arrived from court without a copy of their previous convictions. Lewes did have a terminal for the Police National Computer, but this was a resource for other prisons in the area and only one clerk was trained and authorised to use it.

6.53 All prisoners were interviewed and their security category explained to them. In February 2003, Lewes held 93 category B prisoners, 177 category C and two category D prisoners; 195 prisoners were awaiting transfer to another prison, and 77 were being retained at Lewes, usually for medical reasons or to enable them to complete a programme.

6.54 We received no complaints from prisoners about the categorisation process. A pro forma was being introduced which notified the prisoner of his categorisation and allowed him to volunteer for a move to another prison. However, many prisoners wished to remain at Lewes, and staff told us that they did not always see the alternatives on offer as attractive, usually because of the distance from home. We were aware of a large number of adjudications resulting from prisoners’ refusal to transfer out, usually to category C establishments in the area. Lewes did operate a positive policy on ‘local release’ transfers; this meant that prisoners transferred to training prisons or to complete specific programmes could apply to return to Lewes prior to their release.

6.55 Re-categorisation reviews occurred either as part of the sentence planning process or in response to a prisoner’s application. Sentence planning staff told us that

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recategorisation was rarely granted as most prisoners were unable to demonstrate sufficient change in risk factor, and the prison adopted a cautious approach.

Conclusion 6.56 A significant number of prisoners arrived at Lewes without copies of their previous convictions. Categorisation took place promptly and was carried out by trained and experienced staff. Lewes was not able to meet all demand from prisoners to remain located close to home and, with large numbers of prisoners ineligible for transfer, there was often little or no choice about who would be transferred out.

Recommendations 6.57 A copy of a prisoner’s previous convictions should be available on their day of reception.

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CHAPTER SEVEN

RESETTLEMENT

Expected outcomes The expected outcomes for resettlement are: • Safety: Prisoners are able to trust staff to deal with details of their offending and personal circumstances responsibly • Respect: Sentence planning, offending behaviour and substance misuse programmes and re-integration planning are effective and meet prisoners’ assessed needs • Respect: The approach of all staff encourages responsible behaviour and supports prisoners working on their offending, substance misuse and other problems and preparing for release • Purposeful activity: Access and allocation to purposeful activity is linked to prisoners’ assessed needs and their planned targets • Resettlement and reducing re-offending: Prisoners address their offending behaviour and related problems and prepare for release while in custody

Management of resettlement 7.01 The resettlement policy committee was chaired by the head of resettlement and had wide representation from departments throughout the prison; it met once every two months. The minutes of the meetings reflected a strong emphasis on information-sharing between departments, and reporting progress on new and emerging projects. The committee was actively engaged in establishing the core facilities and systems necessary to support effective resettlement work. In our discussion with various members it was evident that, by adopting a sufficient hands on approach to this work, managers had not been able to pay attention to strategic planning and management. Consequently, the prison had no resettlement policy or strategy.

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7.02 There were various systems within departments for the storage of relevant information and the production of monitoring statistics. However, this data was not brought together routinely, and the committee was not reviewing or using it to identify trends, check performance or inform decision-making. We found much anecdotal evidence about the prisoner population, and commendable levels of knowledge about individual prisoners. However, managers found it hard to provide the overview of the population, its characteristics and resettlement needs that could result from the systematic analysis of readily available information.

Re-integration planning 7.03 This area of work was still being developed at the time of our inspection. Although certain key elements had been put in place, they were not well co-ordinated and did not serve all prisoners. Following successful bids for Custody to Work funding, managers planned to appoint a housing advice worker and to identify three prison officers to work as resettlement officers.

7.04 During induction, prisoners were asked about housing and benefit issues, and some limited advice and support was available to those needing help. A job club, set up on C wing in August 2002, aimed to help prisoners to find work through computer links with Jobcentres. We were told there had been problems with the computer link since October 2002, and only one of the two kiosks was working at the time of our visit.

7.05 Except for vulnerable prisoners located on F wing, all prisoners serving up to four years could attend the focusing on resettlement (FOR) programme in the last three months of their sentence. This brief 13-session cognitive motivation course included a monthly community forum which brought outside agencies into the prison, allowing prisoners to make contact with them before release. Once released, prisoners could have contact with a programme tutor for up to three months. Funding for this course was due to end in August 2003.

7.06 The prison could not readily provide a breakdown of the prisoner population based on home area. Our survey indicated that 58% of prisoners were less than 50 miles from their home area. Staff and managers estimated that 70% of normal

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location prisoners and 30% of vulnerable prisoners would be released into the Sussex area. However, the majority of these prisoners, including those approaching discharge, were not able to remain at Lewes, but were transferred out to other prisons in order to make space in Lewes for new arrivals from the courts.

7.07 In the six-week period following the inspection, 52 sentenced prisoners were due to be released; over two thirds of these were serving sentences of 12 months or less and would not be subject to any statutory supervision by the probation service on release. In our prisoners’ survey, 46% of those due for release in the next 6 months stated that they would be homeless on release, indicating a serious need to address basic re-integration issues.

7.08 There were clear procedures for identifying and assessing those prisoners eligible for home detention curfew (HDC). The HDC clerk produced a monthly monitoring sheet detailing all aspects of the process, from eligibility to recall and appeal. Monitoring for the four-month period prior to the inspection showed that 170 prisoners were eligible for HDC; assessments were completed for 61(36%), and 51(30%) were released. A further 14% of eligible prisoners were transferred to other prisons before the assessment could be completed.

7.09 Although notice boards throughout the prison detailed the procedures for applying for release on temporary licence (ROTL), this form of early release was rarely used at Lewes. In 2002, there had been seven applications for ROTL, of which two had been approved.

7.10 A principal officer was responsible for the management of child and public protection procedures in the prison; at the time of our visit 77 prisoners were subject to some monitoring or restriction under Prison Service order 4400, which deals mainly with those convicted of offences against children or harassment. The senior probation officer acted as the link between the prison and community in respect of those prisoners who remained at risk of harmful re-offending on release. Multi-agency risk assessment meetings were not held in the prison, but information was passed on to the probation and police services for action. Since October 2002, five prisoners

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due to be released with no requirement of supervision had been notified to the Home Office Dangerous Offenders’ Unit.

7.11 The procedures for managing those prisoners who fell into high risk of harm categories were rigorous and comprehensive. However, many of the staff dealing directly with prisoners were not aware of their risk status. This could mean that valuable intelligence went unnoticed or unreported, or that inappropriate behaviour by the prisoner went unchallenged.

Sentence planning 7.12 Specially trained staff working as part of the resettlement group completed sentence plans on all prisoners serving over 12 months. The sentence planning clerk compiled a folder for each prisoner, and these were picked up daily by the duty sentence planning officer. Staff from other departments provided written contributions and the plan was drawn up by the sentence planning officer and the prisoner; formal sentence planning boards were not held.

7.13 The systems for managing and monitoring the progress of sentence plans were thorough and ensured most plans were completed on time. With the knowledge and support of the Governor and Area Manager, sentence planning staff had been working hard to clear a backlog of some 120 cases. Most of these were vulnerable prisoners who had been transferred from other prisons without a completed or up-to-date sentence plan. We were told the current backlog stood at around 30. We sampled a number of sentence plans and found them to contain detailed entries. All were quality controlled by a senior officer.

7.14 Once completed, a copy of the targets was held on the prisoner’s wing history sheet. The prisoner could request his own copy. In our prisoner survey, 65% of respondents said they had a sentence plan; this compared favourably with the average for local prisons of 41%. However, a lower than average percentage of prisoners knew what their targets were or agreed with those targets.

7.15 In contrast to the efforts made to complete the sentence plan documentation, little attention was subsequently given to implementing the plan. The prison had not

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yet introduced labour boards, so allocation to work was not informed by the sentence plan. Indeed, we found little evidence of the sentence plan impacting to any degree on the prisoner or his management while at Lewes. With the exception of referral to the enhanced thinking skills programme, most other targets became the prisoner’s responsibility to pursue. This seemed to place an over-reliance on the knowledge, ability and motivation of prisoners.

Offending behaviour work 7.16 Following the designation of F wing as a vulnerable prisoner unit, the enhanced thinking skills programme had been introduced to provide some structured intervention for this prisoner group. Despite being staffed by only one psychologist and one officer tutor, and facing the same accommodation difficulties that beset many departments, the programme had recently received a 95% implementation quality rating at its annual audit. A further tutor officer had been identified, and the prison planned to run six groups during 2003-04 to meet the target of 48 completions of the programme. It was probable that some of the groups would be offered to prisoners on other wings in order to meet this target. In practice, however, few prisoners on the other wings remained in Lewes long enough to complete the programme.

7.17 There were no waiting lists for the offending behaviour programmes, and once on a programme the prisoner would be retained at Lewes until it was completed. We heard some concerns from staff that, as sex offenders were transferred out to other establishments to undertake sex offender treatment programmes, Lewes was likely to hold a higher proportion of those who were in denial or not prepared to address their offending behaviour.

Personal officers 7.18 A personal officer scheme had been introduced during the previous year, mainly to support other developments in prisoner safety and decency. The focus was, therefore, on the personal officer supporting the prisoner and helping him cope with the experience of prison rather than on providing more structured interventions or taking responsibility for aspects of sentence management or resettlement. No formal job description or role requirements had been published nor had officers received any specific training.

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7.19 The scheme was landing-based, with each officer responsible for prisoners in a number of cells. Each prisoner was allocated a personal officer and a back-up officer. These officers were expected to make entries at least weekly in the prisoner’s wing history sheet; the wing senior officer sampled 10% of the history sheets each week. We read a number of history sheets and saw that, in general, regular entries were being made. Some staff still tended to concentrate on reporting only poor behaviour.

7.20 We spoke to a number of personal officers; while most knew the prisoners for whom they were responsible, the level of knowledge varied, particularly on wings that experienced a high turnover of prisoners.

7.21 Our prisoner survey showed a fairly positive experience of the personal officer scheme: 54% of respondents knew that they had a personal officer, compared with the local prison average of 35%. Although over a half of prisoners said their personal officer never came to find out how they were getting on, over a third (37%) were seen by their personal officer at least once a week. Seventy three per cent of respondents felt the personal officer was there when they needed them, and 75% described the personal officer as helpful. This seemed to provide a strong foundation on which to develop and enhance the role of the personal officer.

Conclusion 7.22 Significant work was in progress to provide an appropriate and effective range of resettlement services. While many of the necessary components were in place or due to arrive, Lewes could not yet claim to have a systematic and comprehensive approach to assessing and addressing prisoner resettlement needs and much depended on prisoners themselves taking the initiative. Efforts to provide appropriate resettlement services were impeded by routine overcrowding transfers of prisoners from the local area to prisons in other parts of the country.

7.23 As part of a regional initiative introduced by the area manager, all staff at Lewes were to receive training in pro-social modelling. This approach emphasises the importance of demonstrating respect for others, for example, by being reliable, courteous and honest; by using appropriate language and behaviour, individuals can

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influence the response they receive from others. The potential benefit is not limited, therefore, to relationships between staff and prisoners but can help to enhance effective communication and improve all relationships. The commitment to this initiative was reflected in the fact that 90 staff had completed the training since January 2003.

Recommendations 7.24 All prisoners should be provided with advice and assistance in relation to accommodation, debts, benefits and employment on release.

7.25 There should be more pro-active management of the use of release on temporary licence as part of a staged preparation of prisoners for release.

7.26 Sentence plans should specify who is responsible for taking action on each target, and action should be monitored.

7.27 A full list of duties of personal officers should be devised and published so that staff and prisoners know what is expected of the post-holder.

Good practice 7.28 The delivery of training in pro-social modelling for all staff could help them to become proper and positive role models for prisoners, and support and reinforce programme work to change prisoners’ attitudes and behaviour.

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CHAPTER EIGHT

SERVICES Catering Expected outcomes The expected outcomes for catering are: • Safety: Prisoners’ food is prepared and served safely in accordance with environmental health regulations and religious requirements • Respect: Prisoners receive a fair portion of healthy, balanced, nutritious and varied meals to meet their physical, gender, health, religious, ethnic and medical needs • Respect: Prisoners have a choice and are encouraged to eat healthily to help them create and maintain healthy lifestyles

8.01 The establishment’s catering operation was managed by a senior officer with a team of four caterers. Another manager had also been recruited (and was undergoing training) to provide more comprehensive and consistent supervision of the kitchen. Because of its location the prison had experienced major difficulties in recruiting caterers, and unfilled vacancies had impacted on its ability to provide quality meals. Managers had, therefore, made the decision to train staff themselves, and two of the current team were new recruits undergoing a training programme.

8.02 Because of the staff shortages there was a heavy dependence on the prisoners who worked in the kitchen. Fourteen prisoners were working there at the time of our inspection, engaged at all levels in the production of meals.

8.03 The kitchen was adequate in size and, although in need of redecoration, was clean and generally well maintained. There were, however, some areas of the structure and floor which were in need of remedial work. The equipment was appropriate for use and was maintained in good working order. Health and safety systems were well managed, and food was appropriately stored and served. However,

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the victualling store contained a large quantity of broken and unwanted equipment, which was inappropriate and detracted from the health and hygiene standards.

8.04 The servery areas were kept extremely clean and the prisoners working there had been given basic training and were appropriately clothed for the handling of food. Food was probed before serving and a temperature record kept. While there was inadequate space for the increased number of options served at each meal, the serving of food was efficient and adequately supervised by staff. There were no communal dining areas, and all meals were consumed in-cell.

8.05 The menu was multi-choice and pre-select, with three options for lunch and five or six for the evening meal. Menus operated over a two-week cycle and a number of options were repeated – for example, steamed chicken was on the menu eight times in the fortnight. In our prisoner questionnaire, 19% of respondents thought the food was good, close to the 20% average for local prisons. However, we did receive a significant number of complaints from prisoners during the inspection; in our survey 37% of respondents said the food was bad.

8.06 An attempt had been made to cater for the needs of black and minority ethnic and foreign national prisoners, although again variety was limited and some meals were less than authentic.

8.07 The breakfast meal was bought in pre-packed, and was handed out to prisoners at lunch time with a bread roll. This was unacceptable and resulted in most prisoners consuming their breakfast during the day, and going without food from their evening meal until the following lunch time. This was exacerbated on the main wings when the evening meal was served early on rotation.

Conclusion 8.08 The development of the catering operation to meet the requirements of Prison Service order 5000, which laid out catering standards, had been negatively affected by difficulties in recruiting skilled staff. This had been remedied to some extent by the establishment’s decision to train its own staff, and there was a clear intention to develop and improve upon the existing service.

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Recommendations 8.09 The catering department should move to a four-week menu cycle as soon as possible and develop a greater variety of meals.

8.10 Foreign national and black and minority ethnic prisoners should be consulted in the development of appropriate meal options.

8.11 The breakfast packs should not be given out to prisoners at lunchtime.

8.12 The prison should seek the advice of a dietician to ensure that prisoners are receiving an appropriate diet, and that the timing of meals is conducive to a healthy lifestyle.

8.13 The necessary redecoration and remedial work should be carried out in the kitchen.

8.14 Immediate action should be taken to remove all broken and unwanted items from the victualling store.

Prison shop Expected outcomes The expected outcomes for the prison shop are: Safety: Arrangements to enable prisoners to purchase goods minimise opportunities for bullying Safety: Items held in the prison shop and store are stored and served according to the requirements of food safety, hygiene, religion and security Respect: Prisoners have a suitable range of affordable goods available for purchase at reasonable prices to meet their ethnic, cultural and gender needs

8.15 The prison shop was an in-house operation managed by directly employed staff. The three main wings had their own premises, which opened in rotation and were accessed by prisoners on free-flow movement. Prisoners from the main wings

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made their choice while at the shop; elsewhere goods were pre-ordered and delivered directly to prisoners.

8.16 There were plans to develop a bagging system for the whole prison. This would entail all prisoners having to pre-order their goods and then collect them already packed in transparent, sealed bags. It was felt that this would be a far more efficient process, freeing up staff time and streamlining the system.

8.17 The range of goods on sale, while not extensive, was adequate for most prisoners. In our prisoner questionnaire, 66% of respondents thought the range was wide enough, comparing well to the 46% average for local prisons. There were, however, few goods directly aimed at black and minority ethnic prisoners, and there appeared to have been little consultation about their specific needs.

8.18 New prisoners could make purchases direct from the shop on the day after their arrival. If they had no money they were given an advance of £2.50 to purchase their basic requirements. Prices were reasonable and half the profit made on sales was used for the establishment’s general purposes fund, which paid for various amenities for prisoners.

Conclusion 8.19 The prison shop provided an adequate service to prisoners, offering most items that were in popular demand. There was a need, however, to develop consultation processes with all sections of the population to ensure that any significant needs were met.

Recommendations 8.20 The prison should consult with black and minority ethnic and foreign national prisoners to determine the selection of goods that should be provided for them in the prison shop.

8.21 Any bagging system developed for the prison shop should be regularly reviewed to ensure that the service to prisoners is not negatively affected.

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CHAPTER NINE

RECOMMENDATIONS AND GOOD PRACTICE

(Numbers in brackets refer to paragraph in main report)

Main recommendations 9.01 A fully furnished care suite should be provided for Listeners to stay overnight with prisoners at risk of self-harm. (HP.39)

9.02 The healthcare facility should be moved from its unsuitable temporary accommodation as soon as possible. (HP.43)

9.03 Every effort should be made to provide prisoners with more employment and accreditation of work skills. (HP.44)

9.04 There should be an assessment of prisoner needs to inform future resettlement planning and the provision of offending behaviour programmes. (HP.45)

9.05 All prisoners should have practical, and agreed, sentence or custody plans that prepare them for release, drive through the sentence and deal with issues of accommodation and employment. (HP.46)

To the Director-General 9.06 The future of the vulnerable prisoner unit should be reviewed to determine whether HMP Lewes can provide appropriately for the offending behaviour needs of these prisoners. (HP.40)

9.07 Consideration should be given to the use of F wing as a training wing for prisoners from the local area. (HP.41)

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9.08 On long journeys, escorts should break the journey to allow prisoners to use the toilet. (1.12)

To the Area Manager 9.09 Cells designed for one person should not be used for two. (HP.42)

To the Governor

Arrival in custody 9.10 A Listener should be employed as a reception orderly to offer a hot drink and peer support to newly arriving prisoners. He could also undertake work in the area, as appropriate. (1.66)

9.11 The cell sharing risk assessment should be completed on the evening of arrival for prisoners on F wing. (1.67)

9.12 Consideration should be given to using a variety of media for the delivery of induction information, and to involving individuals with specialist knowledge in some areas of presentation. (1.68)

9.13 Items such as reading matter should be provided in holding rooms to enable prisoners to pass the time there. (1.69)

9.14 Graffiti should be removed from the holding room walls, and there should be no smoking in areas designated as smoke-free. (1.70)

9.15 Trained back up staff should be available in the absence of the bail information officer. (1.91)

Residential units 9.16 In-cell toilets should be screened more appropriately and effectively than by a curtain. (2.39)

9.17 Inappropriate displays of pictures on cell walls should be removed. (2.40)

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9.18 Plastic bowls should be provided for prisoners to wash items of clothing in their cells. (2.41)

9.19 The x-ray machine in the reception area should be utilised. (2.42)

Duty of care 9.20 The establishment should develop effective interventions to challenge and support both bullies and victims. (3.14)

9.21 There should be prisoner representation on the anti-bullying committee, and the anti-bullying prisoner meetings should re-commence. (3.15)

9.22 A survey of bullying should be conducted and the results used to assist staff in identifying and confronting bullying behaviour. (3.16)

9.23 Staff should pay particular attention to ensure that incidents of bullying do not go undetected. (3.17)

9.24 The establishment should consider how to involve families as an active part of the anti-bullying strategy. (3.18)

9.25 All staff should be made aware of new receptions into the prison, irrespective of the wing on which they are located. (3.32)

9.26 Case reviews on prisoners on F2052SH (at risk forms) should attempt to identify the individual’s reasons for self-harming, and set targets in the support plan which help the prisoner to develop coping strategies. (3.33)

9.27 The establishment should continue to develop its proposal to introduce a prisoners’ self-harm support group. (3.34)

9.28 A recognised ethnic monitoring system should commence as a matter of urgency. (3.53)

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9.29 Efforts should be made to develop effective, relevant and ongoing contact with appropriate individuals and organisations in the nearby minority ethnic communities. (3.54)

9.30 The prison should carry out a fact-finding and needs analysis of its foreign national prisoners as a matter of urgency, and use this to inform policy development. (3.55)

9.31 Images displayed throughout the establishment should reflect the diversity of the population, and the prison should celebrate diversity as a mainstream issue. (3.56)

9.32 Additional substance misuse nurse input should be provided. (3.83)

9.33 Written procedures between substance misuse treatment providers should be developed and co-ordination improved. (3.84)

9.34 The establishment should develop an alcohol strategy and allocate resources according to the identified need. (3.85)

9.35 Voluntary drug testing areas of the prison should be identified for prisoners requiring post-detoxification support. (3.86)

9.36 The establishment should ensure that the planned CARAT (counselling, assessment, referral, advice and throughcare) groupwork is delivered, and appropriate groupwork space is made available. (3.87)

9.37 Administrative support for the CARAT team should be reviewed. (3.88)

9.38 First night symptom relief medication should be reviewed. (3.89)

9.39 Community in-reach services should be developed in partnership with drug action teams. (3.90)

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9.40 The planning of the dedicated detoxification unit should start as soon as possible. (3.91)

9.41 The prison should ensure that toilet facilities are available to visitors who genuinely need them, and that its security systems can cope with this. (3.108)

9.42 Management should ensure that delays in sending out visiting orders are resolved and that all mail is processed as rapidly as possible. (3.109)

9.43 All applications should be recorded systematically to allow both the procedure and responses to be monitored. (3.116)

9.44 All submitted complaint forms should be recorded centrally and be subject to the same monitoring process. (3.117)

Healthcare 9.45 The Governor and the healthcare manager should review the temporary location of healthcare services in B wing in light of the proposed timescale for refurbishment of the healthcare centre, and take account of: • safety aspects of the living space, including observation of patients and use of rooms for single occupancy • the level of clinical activity and outpatient clinic management • the shortage of space for interviewing patients in a confidential setting • additional equipment, such as a fax machine and additional telephones. (4.50)

9.46 The Governor and the healthcare manager, in conjunction with the Regional Prison Health Development Team and their NHS partners, should, as a matter of urgency, formally agree a health promotion strategy and the clinical services required in the prison (including general practice and psychiatry input), as described in the HMIP action plan. An agreed timescale for implementation should be set. (4.51)

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9.47 The healthcare manager should review skill mix and staffing levels to ensure the best quality patient care, identify any skills deficit, and recruit additional staff who are suitably qualified and competent. (4.52)

9.48 The Governor, the healthcare manager, the Regional Prison Health Development Team and the dental advisor from the local primary care trust should identify the funding required and appraise the use of the current dental surgery facilities to: • reduce the present waiting list and improve access to dental care • provide an out of hours emergency treatment service • introduce a dental health promotion strategy. (4.53)

9.49 The clinical governance forum should re-constitute the drugs and therapeutics committee to: • review, agree and implement policies for in possession, stock management, out of hours supply and nurse prescribing, and develop a prescribing formulary as agreed with the local pharmacy advisory group • agree the criteria for a pharmacy-led clinic. (4.54)

9.50 The dental surgery floor should be cleaned thoroughly after every clinical session. (4.55)

9.51 Up-to-date copies of pharmacy reference materials (Martindale and British National Formulary) should be available. (4.56)

9.52 The pharmacist should ensure that patient information leaflets are supplied, or a notice displayed at the treatment rooms, to ensure that prisoners are aware of the availability of the relevant leaflets for them to consult. (4.57)

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9.53 The pharmacist should ensure that all medicines and devices are stored in their original containers and that checks are made of stock levels and expiry dates. The date of each check should be recorded. (4.58)

9.54 All refrigerators should contain a maximum/minimum thermometer, and temperatures monitored within the 2-8 degrees Celsius and recorded on a daily basis. (4.59)

9.55 The pharmacy fridge should be kept tidy and clean, and milk should not be stored there. (4.60)

9.56 Control drugs registers should be used to record use of these drugs. (4.61)

9.57 Where drugs require fridge storage (for example, insulin), a drug refrigerator should be provided in the wing treatment room. (4.62)

Activities 9.58 The plan for a labour board should be implemented, and prisoners should be allocated to work according to an assessment of their needs, and as part of ongoing sentence planning. (5.12)

9.59 The educational curriculum should be broadened to include other subjects and interests, and enable progression to higher awards beyond basic and key skills. (5.33)

9.60 The use of the computer refurbishment workshop should be evaluated, and its value as an activity considered. (5.34)

9.61 The gym changing rooms should be refurbished and brought up to an acceptable condition for use. (5.44)

9.62 The opportunity for prisoners to gain awards and qualifications in physical education should be pursued and developed. (5.45)

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9.63 Religious services should not clash with other regime activities. (5.57)

9.64 An Imam, or suitable prisoner, should facilitate a Muslim congregation for Friday prayers. (5.58)

9.65 Effort should be made to co-opt prison visitors from black or minority ethnic communities. (5.59)

9.66 Prisoners should be able to register for their relevant service on Sunday morning. (5.60)

9.67 Consideration should be given to conducting risk assessments on prisoners located in the segregation unit who apply to attend services, to facilitate their attendance wherever possible. (5.61)

9.68 Consideration should be given to locating washing facilities in the vicinity of the multi-faith room. (5.62)

9.69 The actual regime and in particular the serving of meals should accurately reflect the published regime. (5.71)

9.70 The dispensing of medication should not clash with other activities. (5.72)

9.71 Consideration should be given to allowing prisoners to dine in association, for example, on a rota basis. (5.73)

Good order 9.72 Use of force forms should be certified by an officer who was not responsible for authorising the use of force, so that an independent check takes place. (6.32)

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9.73 Prisoners entering the segregation unit should not be strip searched automatically; such a search should be based on a judgement of the circumstances. (6.33)

Good order 9.74 The establishment should formalise the arrangements for security managers and senior managers to observe a sample of cell searches for quality checks. (6.34)

9.75 The locally devised standardisation sheet should be completed by the adjudicating governor in all cases. (6.35)

9.76 The name of the authorising officer should always be recorded when force is used, even when the need to deploy force is spontaneous. (6.36)

9.77 The development of extra incentives for enhanced status prisoners should be prioritised. (6.49)

9.78 A copy of a prisoner’s previous convictions should be available on their day of reception. (6.57)

Resettlement 9.79 All prisoners should be provided with advice and assistance in relation to accommodation, debts, benefits and employment on release. (7.24)

9.80 There should be more pro-active management of the use of release on temporary licence as part of a staged preparation of prisoners for release. (7.25)

9.81 Sentence plans should specify who is responsible for taking action on each target, and action should be monitored. (7.26)

9.82 A full list of duties of personal officers should be devised and published so that staff and prisoners know what is expected of the post-holder. (7.27)

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Services 9.83 The catering department should move to a four-week menu cycle as soon as possible and develop a greater variety of meals. (8.09)

9.84 Foreign national and black and minority ethnic prisoners should be consulted in the development of appropriate meal options. (8.10)

9.85 The breakfast packs should not be given out to prisoners at lunchtime. (8.11)

9.86 The prison should seek the advice of a dietician to ensure that prisoners are receiving an appropriate diet, and that the timing of meals is conducive to a healthy lifestyle. (8.12)

9.87 The necessary redecoration and remedial work should be carried out in the kitchen. (8.13)

9.88 Immediate action should be taken to remove all broken and unwanted items from the victualling store. (8.14)

9.89 The prison should consult with black and minority ethnic and foreign national prisoners to determine the selection of goods that should be provided for them in the prison shop. (8.20)

9.90 Any bagging system developed for the prison shop should be regularly reviewed to ensure that the service to prisoners is not negatively affected. (8.21)

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EXAMPLES OF GOOD PRACTICE

9.91 The development of the induction unit, along with the first night centre, contributed to the overall safety of prisoners at Lewes, offering specific, individual support from a dedicated and empathic staff team. (1.71)

9.92 Listeners were represented on the self-harm and suicide prevention committee. (3.35)

9.93 The discharge questionnaire used to solicit the views of all prisoners being discharged from Lewes asked for specific comment on issues of importance to minority ethnic and foreign national prisoners. (3.57)

9.94 A flexible detoxification programme had been developed, and a range of specialist counselling services was available through the healthcare department. (3.92)

9.95 An outreach worker could refer and follow up CARAT (counselling, assessment, referral, advice and throughcare) clients who returned to Brighton or Hove, and released prisoners were fast-tracked into the local NHS trust’s substance misuse service. (3.93)

9.96 Drug strategy staff attended the drug action team’s drug-related deaths steering committee, and planned harm-reduction training. (3.94)

9.97 The monthly wing diaries, which contained written records of all the basic procedures carried out that month, provided a useful record. (6.37)

9.98 The standardisation sheet ensured that all adjudicators were aware of the agreed range of awards and took into account all salient issues before deciding on the punishment. (6.38)

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9.99 The sheet of paper given to the prisoner at the end of the adjudication ensured that he knew what punishment he had been given, and was aware of the appeal process. (6.39)

9.100 The introduction of a use of force meeting allowed all aspects of the process to be regularly reviewed, and any shortcomings in the recording process to be identified. (6.40)

9.101 The locally devised form for checking prisoners serving cellular confinement ensured that all staff and visiting personnel saw the prisoner regularly, and signed to that effect. (6.41)

9.102 The segregation unit booklet describing rules, routines and reasons for segregation and date for return to the wing provided prisoners with a good range of useful information. (6.42)

9.103 The delivery of training in pro-social modelling for all staff could help them to become proper and positive role models for prisoners, and support and reinforce programme work to change prisoners’ attitudes and behaviour. (7.28)

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