The Nelson Mandela Rules
Anyone detained in, working in or visiting a prison has the absolute right to safety, respect and decency. This is set out in Rule One of the United Nations Standard Minimum Rules for the Treatment of Prisoners adopted by the UN General Assembly in December 2015 – known as the Nelson Mandela Rules. That is why anyone inspecting or reporting on a prison looks at how it treats its prisoners in terms of safety, respect and decency – and it is how and why have always done the same in The Prisons Handbook and why we will do the same in our Prison Entries on this web site.
“Rule 1. All prisoners shall be treated with the respect due to their inherent dignity and value as human beings. No prisoner shall be subjected to, and all prisoners shall be protected from, torture and other cruel, inhuman or degrading treatment or punishment, for which no circumstances whatsoever may be invoked as a justification. The safety and security of prisoners, staff, service providers and visitors shall be ensured at all times.”
Prisoners, particularly the most vulnerable, are held safely.
Prisoners transferring to and from prison are safe and treated decently. On arrival prisoners are safe and treated with respect. Risks are identified and addressed at reception. Prisoners are supported on their first night. Induction is comprehensive.
Prisoners live in a safe, well ordered and motivational environment where their positive behaviour is promoted and rewarded. Unacceptable conduct is dealt with in an objective, fair, proportionate and consistent manner.
Security and good order are maintained through an attention to physical and procedural matters, including effective security intelligence and positive staff-prisoner relationships. Prisoners are safe from exposure to substance misuse and effective drug supply reduction measures are in place.
The prison provides a safe environment which reduces the risk of self-harm and suicide. Prisoners at risk of self-harm or suicide are identified and given appropriate care and support. All vulnerable adults at risk are identified, protected from harm and neglect and receive effective care and support.
Expectations:Safety: Prisoners, particularly the most vulnerable, are held safely.
Respect: Prisoners are treated with respect for their human dignity.
Purposeful activity: Prisoners are able, and expected, to engage in activity that is likely to benefit them.
Rehabilitation and Release Planning: Prisoners are supported to maintain and develop relationships with their family and friends. Prisoners are helped to reduce their likelihood of reoffending and their risk of harm is managed effectively. Prisoners are prepared for their release into the community.
Levels of violence and self-harm rise and fall, decreased between July 2017 and April 2018 although there was a brief spike in September when Altcourse became a smoke free establishment.
The introduction of PAT (Pets as Therapy) dogs helped with the downward trend in self-harm. May saw a sharp upturn with 45 violent incidents recorded which fell to 35 in June. There were 109 instances of self-harm in June which was the highest number since October 2016. These included multiple incidents carried out by a small number of individuals.
• There were 3 deaths in custody during the reporting year. Two were apparently self-inflicted and one from natural causes.
• The ACCT process has been reviewed resulting in an increase in assessors and key workers. There is a first night watch for all new admissions. Numbers of open ACCT books rose to 95 in May. There has been a reduction in incidents for those on an open ACCT reflecting the effectiveness of the system.
• Safer Altcourse and Use of Force meetings have been introduced weekly. The IMB are invited to attend. The former discusses prisoners of interest together with intensive intervention plans. The latter scrutinises any incidents which have required the use of force. This was considered a model of good practice by HMCIP. The wearing of Balaclavas by staff during cell extractions have been banned.
• The Admissions area has been repainted, showers refurbished and there are two new interview rooms. Large posters display training and employment opportunities. A choice of microwave meals is available so prisoners are now able to have a hot meal on arrival. Peer supporters act as greeters. The new First Night leaflet gives clear practical information. Prisoners comment at IMB induction about the positive experience at Admissions.
• However, late arrivals from the courts and increased paperwork requirements for Healthcare have, at times, resulted in prisoners spending prolonged periods of time in Admissions. This peaked in the third week of April when it took between 5 to 8 hours to process new arrivals. Healthcare now allocate additional staff to carry out the initial screening.
• Bechers Green, the vulnerable prisoner (VP) unit, holds a challenging and demanding mix of offenders. When the unit is full VPs are housed elsewhere but are brought over for association. These prisoners have reported feelings of intimidation although we note that managers have identified and are addressing the underlying issues.
• Overall prisoners tell us they feel safer at Altcourse than at other establishments.
• A new 20 bedded enhanced support unit (SEEDS) has opened targeted at prisoners who require an enhanced level of support. This can be due to learning disabilities, autism, those suffering from heightened levels of stress or trauma, or who have difficulty coping on normal location. The intention is to offer a range of therapeutic activities and ‘Manchester Survivors’ will provide an input, addressing issues of trauma. Four dedicated prisoner mentors have been identified and trained to work on the unit along with other specialist staff. The IMB welcomes this initiative.
• The prison has commissioned the services of ‘Manchester Survivors’ to offer a service to individuals and groups of prisoners who have experienced past trauma. The prison is also undertaking the use of PAT (Pets as Therapy) dogs for prisoners who are socially isolated, prolific self-harmers or who have mental health issues.
The healthcare provision at Altcourse has been seriously affected by a lack of GP coverage. The IMB report that a new GP contract has just been agreed which they hope will ultimately reduce the eight week waiting list to see a doctor.
“We understand the delays are caused because the current contract stipulates that each new prisoner must be seen by a doctor on admission. We do not consider eight weeks to be an acceptable waiting period.
• All new prisoners are encouraged to attend the nurse led ‘Well Man Clinic’ which allows more time for detailed discussion about any healthcare concerns.
• A new system has been introduced whereby community GPs are followed up more proactively when the prison needs information regarding prescribed medication.
• The waiting room for vulnerable prisoners is still not fit for purpose. It is airless and cramped, can only seat four prisoners and there is no access to water, toilet or a buzzer to attract staff in an emergency. Prisoners often have to wait there for several hours before they are returned to residential units. We understand there are now plans to rectify this situation.
• Prisoners can now book appointments on CMS and can therefore take more responsibility for their own health.
• The Board is now receiving statistics regarding healthcare complaints. These have reduced quite dramatically over recent months, which suggest that prisoners are generally more satisfied with the healthcare they receive. In addition, the healthcare forum now meets regularly and provides an opportunity for prisoners to raise concerns.
• The 12 bedded in-patient unit continues to house challenging individuals including an increasing number of frail elderly patients and those receiving palliative care. There have also been a number of mentally unwell patients on the unit whose behaviour was, at times, unsettling for the other patients, impacting on their sleep. Patients have little meaningful activity to occupy their time, spending long periods in bed and watching TV. A number of these prisoners express anxiety about their release into the community and the lack of suitable supportive accommodation. Professional cleaners are now employed on the unit to supplement the cleaning undertaken by dedicated prisoner orderlies. Prisoners are always complimentary about their care and treatment on the unit.
• There has been considerable health promotion/prevention activity this reporting year including stress awareness, HIV, blood pressure, autism awareness, ‘dry blood spot testing’ and ‘Time to Talk’(mental health awareness) sessions. In addition, bowel cancer screening has been introduced. Mental Health
• The prison has no psychological service and the counselling service has a long waiting list, with only 1 full time counsellor. The two additional part time staff are on long term absence. This is a serious concern for the Board as many prisoners’ needs for psychological help are unmet.
• The Integrated Mental Health Team, which combines In Reach and Primary Care, works well, providing a seamless service with improved communication and joint working.
• A new clinical mental health lead has been appointed to offer help and advice and develop the team.”
Drug Strategy & Security
- MDT failure rates have fluctuated but have exceeded the target of 12%. The use of psychoactive substances has dipped and cannabis has increased. The Security department continues to work to reduce the presence of illegal items.
- Prisoners are well supported by the Substance Misuse Team which offers a range of interventions and provides structure and support from the drug recovery and stabilisation units on Furlong. A Community Connector works with focused individuals and meets them on release.
- The prison now uses a paper scanner to detect the presence of illicit substances on incoming mail. The prison has also had the temporary use of a body scanner as part of a national trial. This has proved effective both in detection and as a deterrent.
EQUALITY AND FAIRNESS
- Reported incidents of discrimination remain low. The BME (Black & Minority Ethnic) Prisoners Focus Group does not believe that there is a culture of racism at Altcourse.
- Regular meetings now take place for all ‘protected’ groups.
- Members of the Board undertake regular sampling of prisoner complaints (Comp1s) in order to check that response times are adhered to and that the complaint has been answered appropriately. The findings are that complaints are dealt with promptly, fairly and proportionately.
- Foreign Nationals make up approximately 4% of the prison population with the Immigration Enforcement Unit conducting regular visits. The Library maintains Prisoner Information Files in 14 languages providing information relating to HMP Altcourse.
- A system is in place in Admissions for identifying men from protected groups with a process now in place to record Travellers. Peer mentors refer anyone with specific needs to the Equality Officer.
- Although a high proportion of prisoners declare ‘Nil Religion’ on admission the Chaplaincy has a very positive impact on the prison. The ‘Sycamore Tree’ victim awareness programme, run by the Chaplaincy, has recently been completed with prisoners, victims and members of the local community attending the final session.
- Enhanced prisoners clearly enjoy the Family Days when they are given the opportunity to spend the afternoon with their families in the Visits Hall. Catering is provided and activities include face painting, iPads, reading groups and birds of prey demonstrations. The seating arrangements and facilities, including a private baby changing room, have been improved, making the visits hall more welcoming. The long waiting times for visitors are still proving to be an issue, particularly when families travel a long distance and arrive before the external Visits Centre is open.
- There is one prisoner who is wheelchair dependent and his support and treatment have been appropriate.
- Although Vulnerable Prisoners do not constitute a protected group, some have expressed concerns about their limited opportunities for education, employment and offence focused work.
- SEGREGATION/CARE AND SEPARATION UNIT
- The CSU capacity is twenty -wo and for the last twelve months occupancy has averaged at around fifty/sixty percent. This is a reduction on previous years and on occasions has been as low as twenty percent.
- The unit’s condition is basic but it is kept clean and tidy by the unit’s cleaners. The two shower units have been refurbished. There are three exercise yards, all weather clothing is available and a fitness programme is painted on the yard walls. Visits to the main gym are facilitated as appropriate. There is access to education and regular visits from the Education Department staff take place. A selection of library books is also now kept on the unit.
- There are two experienced managers and a staff team who have to deal with some very challenging prisoners. During the reporting year, staff have been required to manage one extremely disruptive prisoner with a physical health condition and have done so with compassion and resilience.
- Review Boards are held three times a week and IMB members monitor the vast majority. The Board is pleased to note an increased emphasis on forward planning and the timely reintegration of prisoners back to normal location which is reflected in the much reduced occupancy of the unit.
- Members also visit each prisoner weekly, affording an opportunity to speak freely and raise any concerns. Particular attention is paid if a prisoner is on an ACCT and IMB are notified if any prisoner is placed in Special Accommodation.
- IMB monitor prisoners held ‘behind their doors’ on basic regime on normal location.
Internal & External Adjudications
- Internal Adjudications are held six times each week and Board members regularly attend. The Board is satisfied that prisoners are given an opportunity to give their accounts and that decisions are fair and appropriate.
- An external adjudicator (a local District Judge) attends on a three week cycle to hear the more serious cases and IMB also monitor these sessions.
7 ACCOMMODATION (INCLUDING COMMUNICATION)
- The PEC (Prisoner Engagement Council) is well attended by prisoners as a forum to discuss issues with managers.
- The prison became smoke free during the reporting year and although there was a heightened risk of violence and disorder at the time of the changeover, the process went smoothly owing to the excellent preparation, good support and communication with prisoners. Unfortunately, it has created another form of contraband within the prison.
- There has been an issue with vulnerable prisoners housed in Reynolds town being required to walk past residential units where they have been verbally abused by other prisoners. This issue has been raised with the Director on a number of occasions and steps have now been taken to tackle this.
- Prisoners report rodent problems on some units and in the Aramark shop. However we are satisfied that the prison is taking steps to address this issue.
- The CMS kiosks on units are popular and widely accepted by prisoners as a good medium for communication. Although the delivery of canteen from the Aramark shop has reduced to once a week, the majority of prisoners state that the service is efficient.
- The Brook Unit (Bechers Blue) was established for prisoners who have been involved in violent and anti-social behaviour, to complete a four week programme to address their behavior before returning to normal location. This unit was commended by HMIP. However, the Board has noted the reluctance of some prisoners to relocate after the four week period. Equally some Unit Managers do not always want challenging prisoners returning to their unit.
- There are constant complaints to the Board regarding food. The Board concurs with the findings of last years’ HMIP inspection in that the food is bland and at times very unappetising.
- Broken kitchen equipment has impacted on the quality and choice of menus. Special diets appear to cause particular problems and this issue does not appear to be given sufficient priority by Aramark, the catering contractors.
- A major cause of concern for the IMB and prison staff is the constant issue of food shortages which cause anger and frustration for the prisoners and prison staff alike. It has not been established why this problem occurs so frequently. There are issues with trolleys not being locked, and keys have gone missing. A report commissioned by Aramark’s Director of Catering has been presented to the Prison Director.
- Servery practice is an ongoing concern for the Board. Staff supervision of servery workers is crucial but variable on some units, impacting on portion control and the wearing of whites and gloves. It is concerning to note that some staff seem reluctant to challenge prisoners about this.
HEALTHCARE (including mental health and social care)
Healthcare Provider: G4S Forensic and Medical Services (UK) Limited
- At the beginning of the reporting year GP provision was by locums resulting in patchy cover, inconsistent prescribing and delays in prisoners receiving medication. On at least two occasions there was no GP on site. A new GP contract has just been agreed and we hope that this will ultimately reduce the eight week waiting list to see a doctor. We understand the delays are caused because the current contract stipulates that each new prisoner must be seen by a doctor on admission. We do not consider eight weeks to be an acceptable waiting period.
- All new prisoners are encouraged to attend the nurse led ‘Well Man Clinic’ which allows more time for detailed discussion about any healthcare concerns.
- A new system has been introduced whereby community GPs are followed up more pro-actively when the prison needs information regarding prescribed medication.
- The waiting room for vulnerable prisoners is still not fit for purpose. It is airless and cramped, can only seat four prisoners and there is no access to water, toilet or a buzzer to attract staff in an emergency. Prisoners often have to wait there for several hours before they are returned to residential units. We understand there are now plans to rectify this situation.
- Prisoners can now book appointments on CMS and can therefore take more responsibility for their own health.
- The Board is now receiving statistics regarding healthcare complaints. These have reduced quite dramatically over recent months, which suggest that prisoners are generally more satisfied with the healthcare they receive. In addition, the healthcare forum now meets regularly and provides an opportunity for prisoners to raise concerns.
- The 12 bedded in-patient unit continues to house challenging individuals including an increasing number of frail elderly patients and those receiving palliative care. There have also been a number of mentally unwell patients on the unit whose behaviour was, at times, unsettling for the other patients, impacting on their sleep. Patients have little meaningful activity to occupy their time, spending long periods in bed and watching TV. A number of these prisoners express anxiety about their release into the community and the lack of suitable supportive accommodation. Professional cleaners are now employed on the unit to supplement the cleaning undertaken by dedicated prisoner orderlies. Prisoners are always complimentary about their care and treatment on the unit.
- There has been considerable health promotion/prevention activity this reporting year including stress awareness, HIV, blood pressure, autism awareness, ‘dry blood spot testing’ and ‘Time to Talk’ (mental health awareness) sessions. In addition, bowel cancer screening has been introduced.
- The prison has no psychological service and the counselling service has a long waiting list, with only 1 full time counsellor. The two additional part time staff are on long term absence. This is a serious concern for the Board as many prisoners’ needs for psychological help are unmet.
- The Integrated Mental Health Team, which combines In Reach and Primary Care, works well, providing a seamless service with improved communication and joint working.
- A new clinical mental health lead has been appointed to offer help and advice and develop the team.
- The manager of the SEEDS unit also acts as the social care lead. His role is to undertake an initial screening of prisoners who are flagged up at admission or who self-refer. A referral is then made to Liverpool City Council for an assessment and development of a care package. Only one prisoner has such a package in place but assessments are undertaken promptly. A need for occupational therapy assessment for prisoners has been identified.
EDUCATION AND PURPOSEFUL ACTIVITY
- Following the HMIP Report, an Action Plan has been produced. The plan addresses issues regarding education and purposeful activity. It is pleasing to note that actions relating to library access, pay policy for prisoners, health and safety in workshops and vocational training have all been completed. The remaining targets are due for completion by November 2018.
- A good range of educational and vocational training courses and work opportunities continue to attract prisoners.
- Basic Skills courses encourage prisoners to develop before moving on to other purposeful activity.
- ESOL classes are always well attended and are valued by prisoners.
- Art and ICT classes continue to be popular and prisoners see the need and relevance of computer skills for employment.
- It is pleasing to note that clear welcome signage in several languages has been introduced into the library which is well used.
- An accredited Personal Training course (Level 3) has been introduced with the first cohort of 10-12 prisoners on the 12-week course. A sports massage qualification has been introduced – part of a full master practitioner programme.
- The prison has responded to the shifting age demographic. Gym sessions for prisoners aged 40 plus are now offered but uptake is slow. Bowls for over 55s started this year. Exercise referral for weight management has been introduced and staff are trained to deliver relevant programmes for prisoners referred by the GP.
- Football sessions for ex-military prisoners are proving to be popular.
- Although there was a shortfall of teaching hours against target this was far less than last year.
- The birds of prey continue to be popular and prisoners gain insight from caring for them. It is good to note the involvement of the birds on family days.
Areas of concern
- There are occasions when there are no staff available to escort vulnerable prisoners to the library which limits their access.
- More library resources in a variety of languages are required.
- Prisoners value their access to the Sports Hall but too often broken electronic equipment takes a long time to be fixed.
- Attendance at lessons has improved this year but consistency is lacking. Staff are not always able to explain absences. More rigorous monitoring is required. During some IMB visits to Education numbers were low. Prisoners have been allowed to leave the Education unit too easily but the appointment of a ‘Regime Chaser’ is a positive development in managing this issue.
WORK,VOCATIONAL TRAINING and EMPLOYMENT
- Purposeful activity within the prison has been maintained with levels very similar to the previous year and there are sufficient places for prisoners to work or learn new skills.
- Most prisoners are enthusiastic about gaining qualifications but more information could be provided prior to starting a course, explaining the possible job opportunities on release.
- Vocational workshops standards are considered high when compared to outside college courses.
- There is a healthy waiting list for most vocational workshops.
- Two academy schemes are in operation, with ‘Recycling Lives’ producing and repairing skips and Bloc ‘n’ Mesh for making metal components for fencing. Both afford employment opportunities for prisoners on release. Conversation with several prisoners in the workshop revealed that the possibilities opened up by these initiatives were regarded very positively by them.
- There is limited communication with prisoners after release but it is pleasing to learn that several prisoners have set up their own joinery business in the community.
- The construction of fence panels continues to be very productive with commendations being received from customers on the quality of work.
- The car workshop is no longer operating. This is unfortunate as it provided a good route to potential work and it was popular with prisoners.
- There are a number of interesting new initiatives in which prisoners can become involved, including the production of a video to show to children who may be anxious about visiting prison and the relaunching of the prison band.
- Resettlement is led by the OMU (Offender Management Unit) and Shelter. The primary role of Shelter is finding appropriate accommodation on release but financial, employment and educational needs are also addressed. Shelter report that finding accommodation in North Wales and Cheshire is more of a problem than in Merseyside.
- There is a Reduction in Re-Offending strategy group that meets bi-monthly.
- Although the relationship between OMU and Shelter works well it can be confusing to prisoners. This has been heightened by the introduction of new HDC (Home Detention Curfew) arrangements under which another department, the Bail Team, now have responsibility for finding accommodation. The boundaries between roles and responsibilities of these three departments are confusing to prisoners and indeed IMB members. If resettlement is not a more coordinated process and easily understood by prisoners, there is a risk that their preparation for release may not be as effective as it could be.