Prisoners provide social care, governors admit

More than one-third of prison governors believe the quality of social care in their prison is below average or poor, research by Community Care has revealed.In a Prison Governors Association (PGA) survey, 40% of respondents also said prisoners provided social care in their prison.

By Vern Pitt on August 1, 2011 in Adults, Disability, Mental Health, Older people, Youth justice

More than one-third of prison governors believe the quality of social care in their prison is below average or poor, research by Community Care has revealed.

In a Prison Governors Association (PGA) survey, 40% of respondents said prisoners provided social care in their prison.

Half of prison governors said care was provided by prison staff who were not part of healthcare services, while just 4% said local authorities, which are not obliged to deliver social care in prisons, provided staff.

Although a quarter of the 96 respondents said care was good or excellent, the survey found a lack of specialist skills to deliver social care, with many prisons reliant on prisoners to provide it.

The findings come despite several reports over the past 10 years that have highlighted the poor state of social care in prisons (see timeline below) and a rising population of older inmates.

The number of sentenced over-50s in prison rose from 4,006 in 2000 to 7,452 last year.

“With a growing number of older people being put into prison and not being released we are going to have a crisis on our hands when it comes to the care of the elderly in prisons,” said Stuart Ware, director of older prisoners’ charity Restore.

Elizabeth Tysoe, head of health inspection at the prisons inspectorate, said she had encountered poor care on inspections, including equipment not being provided because of its cost or being taken away to save money. “It seems silly but it makes a real difference to people’s lives,” Tysoe said.

See our special report: social care behind bars – the challenge of delivering services in custodial settings.

Francesca Cooney, advice and information manager at the Prison Reform Trust, thought it unlikely that prisoners who provided care were receiving adequate training to do so.

Ware said the reliance on prisoners was the result of budget cuts. “Prisons don’t have enough staff on the wings to cover those who are absent,” he added.

However, the use of carer prisoners “may not be a bad thing”, said Brian Swann, director of Recoop, an organisation that promotes the care and rehabilitation of older ex-offenders. “Prison is a community too and in any community you will always find good neighbours,” he said.

PGA president Eoin McLennan-Murray said prisons had to make use of scarce resources and the inmates themselves had an important role to play in plugging the gap.

On the results as a whole, he said those working in a service were less likely to be satisfied with standards than other groups because they are always pushing to make things better. “I think that we are saying there is room for improvement,” he added.

The Department of Health said it was developing a strategy for the management of older prisoners.

FEEDBACK FROM THE GOVERNORS

● “It [social care] is very ad hoc and needs to be put on a statutory basis not only for those who are elderly but equally for those who have mental health issues or learning disabilities. We recently discharged a prisoner who had been in continuous custody since 1976 and his needs were many as a result of mild autism and moderate learning disability. The help he needed was not forthcoming. It was a truly sad reflection on our 35 years of planning this man’s release.”

● “Any additional resources would help. The increasing age of the population and their deteriorating health mean that we will consistently see prisoners who require more care than we can give.”

● “No-one is prepared to take ownership and responsibility for co-ordinating and delivering social care. We receive increasing numbers of elderly prisoners serving long sentences, of whom many will die in custody. In the community social services would take ownership but if the person is in prison then social services say it’s not their problem. The primary care trust says it’s not its problem either and the governor says he does not have any funding. ”

● “We hold focus groups with older prisoners to identify needs (such as dedicated gym sessions or more comfortable footwear) and seek to meet their needs using staff from healthcare professionals, through landing staff to other prisoners who buddy up with the older prisoners to provide assistance.”

● “Without dedicated units/prisons for older inmates, most staff who have contact with prisoners have to be involved in their social care.”

● “Social care provision in prison is a non-starter. No one wants to fund it. The healthcare providers have a duty to provide social care for 30 days, after discharge from hospital. This does not happen. The local authority is not willing to pick up the responsibility for funding social care; it is for the prisoner’s home area to pick up the bill. That does not happen. Plus, the Prison Service does not want to pay for it.”

● “The delivery of social care is becoming a problem, particularly in a healthcare setting. The NHS and the PCT are not willing to support this, despite comprehensive needs assessments being completed by public health specialists.”

HALF OF PRISONS WITHOUT A SOCIAL CARE CO-ORDINATOR

Nearly half of prisons have no appointed staff member to co-ordinate social care for prisoners, the survey revealed.

Just 35% of governors said their prison had appointed someone to co-ordinate social care, while 20% were not sure.

Eoin McLennan-Murray, president of the Prison Governors Association, said it could be difficult to find volunteers to fulfil specialist roles, on top of their usual job.

Prisons do not have to appoint a social care manager but they have previously had to appoint disability liaison officers, who ensured disabled people could participate in prison life.

Since April this year they have had to have someone to ensure legal equality duties are met, including those relating to age.

“Co-ordinated care means better outcomes for older offenders – real improvements to someone’s quality of life such as organised activities to foster mental and physical well-being,” said Brian Swann, director of Recoop, which promotes the care and rehabilitation of ex-offenders.

Francesca Cooney, advice and information manager at the Prison Reform Trust, said: “It’s good practice to have someone who is co-ordinating care for older people or disabled people.”

A lack of co-ordination of social care often left healthcare staff having to pick up the slack, said Elizabeth Tysoe, head of health inspection at the Prisons Inspectorate. But they seldom work evenings and weekends, leaving gaps in the week where need is unmet.