Report on Drugs Strategy; Implementation & the BME

Prison Population (HMP Wormwood Scrubs)

Abd Al-Rahman
Drugs and Diversity Advisor
HMPS (London Area)

December 2003
 Contents
Page

1 Introduction 1

2 Objectives 1

3 Key Targets 1–2

4 Methodology 2

5 Meetings with key Stakeholders 3

6 Wormwood Scrubs Drug Strategy Meeting 3

7 Healthcare 3

8 CARAT Service – HMP Wormwood Scrubs 4–6

9 Turning Point – HMP Wormwood Scrubs 6–7

10 Other drug related services 7

11 Detox – The Process 8 –9

12 Voluntary Testing Unit/Detox 9

13 Mapping of treatment pathways at 9 - 10

HMP Wormwood Scrubs

14 Wormwood Scrubs Prison Statistics 11

And Monitoring System

15 Race Relations and Foreign Nationals 11

16 Security 12

17 Workforce Planning issues in the 12 - 14

Substance Misuse sector in London

18 The RRAA 2000 and the BME Prison 14

Population in Wormwood Scrubs

19 Conclusion 15 – 16

20 Recommendations 17 – 20

References & Literature Review 21

Appendices 22 – 34

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1. Introduction

1.1 The Federation has been established as a national, membership body

actively supporting the needs of BME professionals in the drug and
alcohol field and their communities. The Federation also acts in a
consultant advisory capacity to central government, informing the
Updated Strategy (2002) from a culturally sensitive standpoint. The
Federation have established regional committees to support regional
government, other strategic partnerships and BME drugs & alcohol
professionals to address the aforementioned gaps and meet the targets
informed by the ten year drug strategy and updated strategy 2002, carried
forward through its key drivers (Drug Strategy Directorate, National
Treatment Agency, HM Prison Service, Drugs Action Teams, Crime
Reduction Partnerships etc). The Federation, through its regional
committees, will support the aforementioned stakeholders to deliver
joined up and inclusive services which meet the support needs of the
‘whole community’.

1.2 The regional structure is based on government models of best practice,

which allow for the step-organic model of change management as detailed
in the ‘Change Here’ booklet produced by the Audit Commission. The
Federation will ensure the drug and community safety related needs of
BME communities and wider communities are represented locally,
regionally and nationally.

2. Objectives

2.1 This report seeks to inform HM Prison Service (London Area) and The
Federation (London) Regional Management Committee (RMC) of the
contractual outcomes achieved to date. This report represents
performance of the Drugs and Diversity Advisor (London Area) in
relation to the contractual outcomes for the period October 2003 –
December 2003.

2.2 The Outcomes to date can be measured by the requirements of the Key
Targets agreed with between HMP (London Area) and The Federation, for
the period outlined above. 1

3. Key Targets

3.1 Key Target 2

Review Area and DSU data collection on BME use of drugs services.

1
See Key Targets and Work Programme (Appendix 0.01)

1
3.2 Key Targets 3.

Review and evaluate service diversity training for service, employed staff.
• Visit 6 named establishments; report on findings

3.3 Key Target 4.

Offer the contract drug services consultation and support their training
needs and operational considerations to assist complying with the prison
service duties and policies on diversity

• Produce and distribute letter of introduction to Service Managers of

contract agencies (1) explaining context of prison service work, rationale
and (2) offering Federation consultancy services2

• Make recommendations on any necessary systems improvements.

Highlight any indicated service shortfall or trends to be reviewed by
steering group.

• Equality Health Check Process Update3.

• Information gathered during the visit also pertains to the Prison service
Diversity training. This feedback will be included in a separate document
focusing on Prison Service Diversity training and training needs of
CARAT service providers after conducting a training needs analysis.

4. Methodology.

4.1 a). Meetings with key stakeholders to consider culturally sensitive service
provision4 in order to consider the service provision in relation to BME
prisoners in Wormwood scrubs. b ) . A mapping exercise to establish
existing pathways and services available to drug using inmates (i.e.
throughcare). c). Review of HMPS (London Area) prison statistics and
monitoring systems. d). Consideration of workforce planning issues across
the substance misuse sector; recruitment, retention and training of BME
professionals. e). Consideration of the implications of the Race Relations
Amendment Act (2000) in respect of the BME prison population in
Wormwood Scrubs. Culminating in a set of recommendations, which aim
to assist the process of developing equitable, and quality service provision
for BME inmates alongside the HMPS (London Area) Equality Health
Check process and findings from the national CARAT service review. The
CARAT Admin worker Dorothy Yesufu provided quantitative data and
support throughout this process.

2
See letter of introduction (Appendix 0.02)
3
See Equality Health Check Update
4
See list of meetings (Appendix 0.03)

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5. Meetings with Key Stakeholders

5.1 Informal meetings with key stakeholders were held during the 1st - 5th
December 2003. Discussions took place pertaining to the impact of the
drugs strategy and intervention in relation to BME prisoners in
Wormwood Scrubs. The meetings were made as informal as necessary to
facilitate the exchange of varied perspectives held by those concerned.

6. Wormwood Scrubs Drug Strategy Meeting

6.1 The DDA attended the Wormwood Scrubs Drug Strategy Meeting during
the initial visit on Thursday 20th November 2003 where the role of the
Drugs & Diversity Advisor was explained and findings from the focus
group conducted earlier in the year was tabled and discussed. Drug
Strategy was also discussed during the block visit with the Drug Strategy
Co-ordinator.

6.2 The Prison Drug Strategy Principles states that:

“We are committed to providing a range of quality services to assist those

prisoners who misuse, have misused or are at risk of misusing drugs or
substances whilst in custody, through training, support and encouragement of
those prisoners wishing to address their substance misuse problems.”

6.3 The subject of Diversity and how services can work more effectively
towards equitable service provision was not a tabled agenda item for the
meeting. However, minutes of previous meetings had made reference to
diversity in relation to the work being carried out by The Federation i.e.
Focus groups and action research. The DDA enquired how Wormwood
ensures representation of diversity on its agenda. As a consequence, it was
established that the Governor of C & E Wing sits on the LAO Diversity
Group and as such he is the lead for Diversity at the Drug Strategy
Meeting.

6.4 To date, there is no model that can be referred to in terms the components
that make up an effective drug treatment package in a prison setting. As a
result meetings are largely based on numerical data, service updates and
meeting KPT’s. This, coupled with the fact that many of those attending
drug strategy meetings are not drug treatment specialists means that there
is little in the way of identifying the developmental direction required in
order to establish a matrix of services are based on needs and

7. Healthcare

7.1 The DDA met with the Healthcare Lead to discuss the detox process, care
standards, general service provision and the diversity/race equality
agenda at Wormwood Scrubs.

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7.1 The current Healthcare Lead has been in post for 2 months and is
employed by the NHS to implement the “Dependence - Guidelines on
Clinical Management” as the framework for proposed changes

7.2 It was stated that at present the Healthcare Lead is in the process of
developing a strategy that considers all areas of need in relation to the
prison population; drugs just being one. The plan is to have a credible
audit trail and care package by this time next year, as at present this does
not exist.

7.3 A request was made for data on the uptake for BME inmates of the
healthcare services. I have been informed that these do not exist at
present.

7.4 Healthcare stated that an individually tailored package of care based on

inmate needs was required. It was added that there is not, at present a
seamless approach to service provision. Healthcare would be more
effectively supported if all inmates were to have equality of access to
structured, therapeutic groups, underpinned with harm minimisation,
that is accredited with quality standards in place for staff and for the
treatment programmes.

7.5 At present Crack users in the prison population do not have access to a
detox program but instead are sent directly onto the wings. With such a
high number of crack users present in the prison population (see point
11.4 below) and no specific provision this was considered to present
additional challenges; particularly in relation to BME inmates.

8. CARAT Service – Wormwood Scrubs

8.1 The DDA spent the equivalent of 1 day with CARAT team members,
including the admin worker. The following information is taken from
informal meetings and discussions held with CARAT staff

8.2 It was stated that the CARAT service has been short staffed for a number
of months with 3 staff members servicing the entire establishment. During
this period A and B wings have been provided with a “skeletal service”.
However, an additional staff member started on the 2nd December and a
full team is expected to be in place by January 2004.

8.3 Fig.1 shows the breakdown of 2002 – 2003 CARAT assessments. This
information was gained from the CARAT admin worker. It can be seen
that the team conduct assessments with a significant number of BME
inmates.

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 Fig. 1

Ethnic breakdown of CARAT assessments 2002 - 2003

Asian (A1, A2, A9) 197 (13.95%)
Black (B1, B2, B9) 470 (33.39%)
Chinese (O1) 2 (0.12)
Mixed (M1, M2, M9) 77 (5.45%)
White (W1, W2, W9) 666 (47.16%)
Total assessments 1412
Total BME assessments 746 (52.8%)

8.3 It was found that the staff compliment at Wormwood Scrubs comprises of
an all female team of which (with the exception of one Asian worker) none
were from BME communities. This was discussed at length during a
meeting with CARAT staff. Anecdotal feedback suggests this was not a
concern to most of the team members as they believed the expectation was
that ‘inmates would benefit if they were motivated for change’. A CARAT
worker stated that the current staffing situation results from ‘a lack of
Black workers coming forward for interviews’.

8.4 The recent development of a Detox unit was said to have generated many
clients for the team. This unit has 1 CARAT worker based within it.
Relapse prevention sessions have been on hold for some time due to low
staff levels. However, plans are in place to re-start these groups in the
new-year.

8.5 Questions put to staff regarding the diversity related needs of the prison
population were not addressed directly. Within discussions it became
evident that the issue of working with BME inmates focused on the
peripheral and the wider implications are not well understood. For
example, religious rights, language issues and the like were addressed but
seeking to effectively deal with perceptions from inmates that stopped
them from accessing services in the first place were not well addressed. It
was stated that this situation is not helped by an over focus on
quantitative requirements (assessment focused work) to the detriment of
the qualitative (time allocated for counselling, groups, etc).

8.6 It was stated that as a consequence, the number of services conducting

assessments was seen as ‘tedious’ by many of its recipients and gave the
impression of ‘workload’ while the quality side of work at times suffered or
was poorly recorded.

8.7 Concerns were expressed for inmates at the exit stage. Housing was
identified as the number one issue. There was also a difficulty in tracking
what happened to inmates between when they left and when they came
back to prison, a cycle that many go through.

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8.8 Concerns were expressed with regard to release plans and appointments
in the community for inmates. This was seen as problematic particular for
those inmates who were involved in violent offences, as many services in
the community would refuse access due to their own access criteria. This
was seen as problematic for inmates generally as different localities had
varying levels and types of service provision. As BME inmates make up
65% of Wormwood Scrubs this issue probably impacts on a significant,
though unknown, number of them.

9. Turning Point- Wormwood Scrubs

9.1 The DDA met with the Turning Point Manager and in addition gathered
information through the Drug Strategy Meeting detailed herein.

9.2 Turning Point provide a training programme that has been described as
‘provisionally accredited’. It is described as broader than simply drug
awareness. The programme is 10 weeks long and there is provision of 5
groups per year. As well as this there is a pre-admission course once a
week for 4 weeks. All pre-admissions go on a compact before access to the
course. After completing the course there is a 6 weeks after-care
programme once a week that is run by a mixture of outside agencies such
as Adfam, various rehabs, NA and the like. The 10-week course is a closed
group that inmates cannot access beyond the 1st week. As a result there
can be a waiting list of up to 10 weeks.

9.3 It was stated that within the last 6 to 8 months there has been an increase
in the number of inmates referring themselves to the course. Those that
come through this route now outnumber those referred from the CARAT
service. Although self-referrals are always sent for a CARAT assessment it
is done through an informal process without referral forms.

9.4 The course programme structured and is made up of sessions that will be
familiar to anyone who has worked within a therapeutic setting.
Observations and taking into account the views of those who have fully
attended the course are crucial in assessing how effective it is in assisting a
process of self-change. It is also difficult for those on remand or on short
sentences to access the course.

9.5 Complimentary to the training course health specialists run sessions on

Tai-Chi, Chi-Gong, breathing exercises and so on. Information on take-up
of these sessions was not known.

9.6 Turning Point has a KPT of 60 people starting the course per year. The
figures indicate that Turning Point are particularly successful at attracting
and engaging inmates from BME communities. The ethnic breakdown of
the last course was 2 White, 2 Asian and 8 Black. However, feedback
within the Drug Strategy Meeting showed that high attrition rates are

6
 present on these courses. It was pointed out that next year there will be a
KPT added that would track attrition rates.

9.7 Applicants on the course are required to complete a questionnaire,

however there is no robust system present to evaluate qualitative
information in relation to the work carried out to illustrate the impact of
the programme upon those who have successfully completed. The
benefits of post evaluation were discussed and suggestions for inmate
feedback, both verbal and written were given along with staff debriefing
at the end of each session to assist the process of continuous
improvement.

9.8 When asked if Turning Point services were sensitive to cultural

needs/differences the answer came after a long silence, “not sure, I hope
so”. Added to was that ‘differences are respected but the overriding
emphasis was on working with individuals’. Diversity training was an
aspect of Turning Point’s internal staff training package but there was an
inability to demonstrate an understanding of diversity in the context of a
drug service and to explain how this learning filtered through to practice.
Prison service Diversity training facilitated by officers and psychologists
was said to be more theory than practical, focusing on “language and
understanding diversity”. This training was said to be considered
inadequate and few T.P. staff attended.

9.9 Turning Point identified staffing as an issue. The service has all female
staff except the Team Leader. One female worker is Asian. The example
was given by the Team Leader of an all male team working in a Women’s
prison and the issues that would be thrown up as a result of this.

10. Other services – Wormwood Scrubs

10.1 Earlier in the year the Blenheim Project supplied a worker, David
Lawrence from June 2002 – January 2003, to provide crack specific groups
but this came to an end. The Drug Strategy Co-ordinator stated that the
work taken forward by the Blenheim Project worker was beneficial to
inmates. Anecdotal information suggests that the lack of a crack specific
group, or other interventions specific to this user group means that crack
users are greatly disadvantaged within Wormwood Scrubs. The worker
was not replaced and to date there are no crack specific groups within a
prison where 49% of reception tests show positive for crack use (see point
11.4 below). Numbers alone cannot measure the impact of this on inmates.
A recent Home Office report (2003) states that:

“Treatment programmes for crack cocaine should be a primary focus for ethnic
minority men”. P.6

10.2 These programmes need to be provided by highly skilled facilitators who

are able to gain the respect of inmates and engage with them in an

7
 effective manner. Alcoholics Anonymous and Narcotics Anonymous
meetings are available. It was suggested that BME inmates don’t access
these groups in any significant number.

11. Detox – The Process

11.1 It was stated that Healthcare services are provided by the NHS and are the
first point of contact for all new inmates. All new inmates are given a
health screen. For some this represents the first check-up for many years if
ever. Medical staff within the first night centre conduct this. Those with a
history of drug use are identified and decisions are made according to the
drug used, the level of use and the state of the inmate. Here they also
receive information on various services operating within the prison. This
is available in various languages. ‘Listeners’ and a number of multi-
lingual inmates also provide interpretation wherever necessary in a wide
variety of languages. At this point inmates access the detox which is part
of Healthcare (Triage system in operation; 11 beds are available), are
referred to the CARAT team or go onto the wings.

11.2 It was stated that DF118’s are often used as treatment for those accessing
the detox. However, due to protocols around the use of DF118’s this
means that inmates must stay for 21 days and this means that others are
delayed in accessing the service. As a result, changes will be made to use
DF118’s less and, instead, utilise Subutex and methadone. Those who use
crack go straight onto the wings and have no specific provision.

11.3 It was stated that, at 8am each morning a P.O. and an S.O. screen new
inmates (about 20 per day) for drug use. A one-paged form is used for
this. If they say they use cannabis there is no referral to the CARAT. If
they use any other drugs they are asked whether or not they want to see a
CARAT worker, if so then a referral is made.

11.4 It was highlighted that a large proportion of Crack users are identified at
reception along with a growing number of new inmates with abscesses
from ‘speedballing’ (injecting heroin and crack). Crack users, identified
from total reception testing, currently stands at 49%. THC and Morphine
positives are at 37% and 45% respectively. A major problem exists due to a
lack of specific intervention for crack users.

11.5 It was stated that The Blenheim Project, had in the past, supplied a
resource to run crack specific groups. However, at present there was not a
dedicated worker for crack users or the availability of crack specific
groups. The DDA was informed by an officer that African Caribbean
inmates made up the majority of crack users in the prison while most

8
 Asian drug users used heroin or heroin and crack. It was also stated that
most of them did not want to engage with drug services and that, “Heroin
users on reception tend to admit use but crack users don’t.”

12. Voluntary testing unit/Detox

12.1 November figures for inmates resident in a VTU show 68% BME inmates.
Caribbean constitute 49%.

12.2 That same month in the detox unit (for drug, poly drug and alcohol detox)
there were 0 Black, 4 Asian, 2 Mixed (M1, M2) and 50 White inmates (W1,
W2, W9).
12.3 Detox on the wings 7 Black, 18 Asian, 7 Mixed and 36 White. There was
also a large number of ‘not stated’.

12.4 Points 12.1, 12.2 and 12.3 demonstrates that in one month there were
10.7% BME inmates in the Detox unit (with zero Black inmates), 47% of
detox’s on the wings were BME while the VTU had 68% BME inmates.
This illustrates the process of crack users being made up of largely BME
inmates and going straight onto the wings (inc. VTU). It also illustrates an
inequality in service provision as there is no structured programme on the
VTU.

12.5 The above figures suggest various possibilities that cannot be confirmed
without more extensive work. For example, Detox focuses on other than
users of Crack alone. So whereas Alcohol/Heroin/Poly-drug users can
receive a detox those who use only crack, reported by an S.O. to be a high
number of Black inmates who don’t declare their use at reception, are
without Crack specific intervention. See also the number of Black CARAT
assessments in 6.6. Also note the number of Asians in detox’s and
compare with the ‘epidemic’ of heroin use in the community amongst this
group.

13. Mapping of Treatment Pathways at HMP Wormwood Scrubs

13.1 Figure 2 below was put together from discussions with the Drug Strategy
Co-ordinator, CARAT Manager and Turning Point Team Leader.
Mapping services and the process in this way allows for ease in
understanding what is available, to what level, for whom it is available
and for ease in assessing where problems areas occur/are likely to occur.
For example, Where in Figure 2 is the structured Relapse Prevention
element?

13.2 Apart from detox drug treatment in the prison is low threshold. If this was
all that was available to drug users in the community it would not be
enough to bring about the change desired. The addition of a structured
treatment programme that incorporates the elements common to a good

9
 treatment in the community, perhaps run within a VTU will, along with
other recommendations, enhance drug treatment in the prison. Crack
specific/Relapse Prevention groups could run for those awaiting entry
into the programme.

13.3

Fig. 2

Drug Strategy
George Baker – Head of Meetings Dave Sherwood – Drug Strategy
Drug Strategy Co-ordinator

Referral to Reception
CARAT Team
Assessment/ P.O. and S.O. First Night
Careplan Conduct drug Centre. Health
specific Screen.
Forward to screening Voluntary
Wings drug test.
Palliative
Care, i.e.
Referral to AA, NA, etc. DF118’s etc.
services Full
Assessment –
Detox Team
Sentenced 1 to 4 years
with a minimum of
4mths to serve referred Detox Unit –
to Turning Point Prescribing.

Referral to 2nd Stage.

Turning Point. CARAT Team Connibere
Assessment/ unit
Inmate self referral. Careplan
Still given CARAT
assessment. Most
inmates now come Forward to
through this route. Wings

Mandatory Visitor Checks Voluntary

Drug Testing Passive/activeDogs Drug testing

10
14. Wormwood Scrubs Prison Statistics and Monitoring Systems

14.1 Wormwood Scrubs utilises ethnic monitoring system codes that are in line
with the last census. The system used, termed the ‘traffic light system’
allows disproportional representation in all areas of prison work to be
highlighted for action, as such this system is effective.

14.2 Contained in Fig.3 is information gained from the Race Relations Liaison
Officer and represents figures for one day at the end of November 2003.
There is no particular significance of the specific date used for the figures
aside from the fact that the Race Relations Liaison Officer was seen on that
day and it was said that the figures are representative of the usual
breakdown.

Fig.3.

Total Wormwood Scrubs prison 1168 inmates

population
BME prison Population 767
BME as a % of the Total population
65%
Breakdown Total Black: 47.86%; Total Asian
10.27%; Total White 34.33%; Other
7.53%
E wing BME population 81%
Asian prisoners accessing a drug Approximately 2%
service
Jamaican Nationals 25% of all Foreign Nationals.

15. Race Relations and Foreign Nationals

15.1 It was stated that the highest number of foreign nationals are from
Jamaica. They make up 41% of the total. There are also increasing
numbers of inmates from Eastern Europe. Most foreign nationals who
import drugs don’t use but some become users as a coping mechanism.
They are spread throughout the prison but E wing has the highest
proportion, 81%. The overriding issue for them is immigration and mental
health issues brought on by anxiety.

15.2 Wormwood Scrubs has had 207 recorded racial incidents between January
2002 and October 2003 (HMP Wormwood Scrubs Race Relations Report).
That’s 18.8 per month. This suggests racism in the Prison environment
may significantly increase, if measures are not put in place to redress the
balance.

11
16. Security

16.1 In relation to the implementation of the drugs strategy; the general

perception gathered was that tightening of security = less drugs = general
instability, fighting and higher prices. 12 – 15% of visitors indicate for
drugs through the use of sniffer dogs.

16.2 It was stated that mandatory drug testing indicates that it is particularly
effective in identifying cannabis than heroin or crack due to the length of
time the drug stays in the system. It was said that this leads to many
inmates switching to heroin and crack use. Inmates, drug workers and a
variety of prison staff have stated these examples and it appears these
factors are also considered outside of prison within the wider community.

“We conclude that this [relative or actual shift from use of cannabis to harder
drugs] has arisen from a variety of different factors, of which the MDT
programme is only one5.”

17. Workforce Planning Issues in the Substance Misuse Sector in London

17.1 Much of the information gathered throughout the process of this visit
suggests that workforce developmental issues, present a significant
challenge to Wormwood Scrubs in relation to the successful
implementation of its drugs strategy. As a consequence of this exercise, it
has been established that HMP Wormwood Scrubs should not consider
the implications of equitable drugs treatment and service provision in
isolation, but within the broader context of challenges faced across the
substance misuse sector as a whole within the capital. Health Works UK’s6
findings regarding the recruitment and retention of staff in the substance
misuse field also supports this view they describe the issue of recruitment
and retention as,

“A national problem, largely due to overall shortages across the health and social
care professions…the rapid development of the drug treatment sector – with new
criminal justice interventions developing alongside the expansion of drugs
commissioning and policy – has exasperated these pressures. Many agencies
reported difficulties retaining staff due to new opportunities elsewhere. Such
pressures are unlikely to diminish… Estimates suggest that the number of drug
treatment specialists will need to increase by up to 50 per cent in the next five
years to meet demand7”

5
Drugs and Prisons Report by The Select Committee on Home Affairs stated (2000)
6
Health Works (UK) is a National Training Organisation for the health sector. They are currently
developing national occupational standards for people working in the drug and alcohol sector.
7
Audit Commission – Changing Habits (2002)

12
17.2 It should be noted that London demonstrates consistently higher rates of
drug use than any other region in the U.K8 The Mayor for London
established the Greater London Drug and Alcohol Alliance (GLADA)9
who in 2001 agreed that the crisis in recruitment, retention, training and
workforce planning faced by the sector in London should be addressed as
a matter of priority. As a first step, GLADA commissioned the Cranfield
School of Management to undertake a systematic assessment of workforce
requirements. The information generated by the assessment is being
utilised to develop a human resource action plan for the specialist drug
and alcohol sector in London. The Federation are members of GLADA.

17.3 London and the South East of England have long been “hotspots” for
recruitment difficulties and for pressures on all aspects of employment.
Therefore, an important aspect of the research programme was to form an
overall demographic profile of the sector in London. The Training Needs
Analysis has generated a reliable profile of age, gender and ethnicity for
different areas of the workforce population, its findings are as follows.

In the area of service delivery (TNA A) the population breaks down

broadly as:

• 69% White, 16% Black and 7% Asian

• For managers (TNA B) the same three broad groups break down as
75% White, 13% Black and 7% Asian
• There is a small disparity between the practitioner ratio and
manager ratio that implies ethnic minority workers, particularly
from a black background, may have more difficulty progressing to
management levels
• Ethnicity profiles for commissioners indicate an entirely White
sample
• The community care assessors profile is 78% White
• Gender profiles for practitioners reveal a majority of Female
workers, the ratio being 61% Female and 39% male
• In the managers sample there are 45% Male and 55% Female

17.4 The National Treatment Agency has committed to recruiting an extra 3000
practitioners into the drugs treatment workforce, a significant number of
which will be recruited from BME communities. Between 1991 and 1993 a
much smaller increase in BME employees in the drugs field led to a 30%
increase in disciplinaries involving BME staff. It is generally recognised
that the majority of services have not developed the polices, processes,

8
Changing Habits (p.8)
9
GLADA is a London based partnership alliance established to provide a mechanism to tackle London
wide problems and to promote better co-ordination of policy and commissioning of drug and alcohol
services

13
 structures and professional competencies to deal with the challenges that
will come with an increasingly diverse workforce10 and the communities
within which they serve.

18. The Race Relations Amendment Act (RRAA2000) & the BME prison
population in Wormwood Scrubs

18.1 ‘Institutional racism consists of the collective failure of an organisation to provide

appropriate and professional service to people because of their colour, culture or
ethnic origin. It can be seen or detected in processes attitudes and behaviours
which amount to discrimination through unwitting prejudice, ignorance,
thoughtlessness and racist stereotyping which disadvantage minority ethnic
people’. MacPherson

18.2 The Task Force Review Report, NTA HR Strategy; Developing Careers,
Updated Drug Strategy (2002), and National Scoping Study11; Delivering
Drug Services to Black and Minority Ethnic Communities (Home Office),
state clearly that the drug related needs of BME communities and BME
professionals in the drugs field have not been met by drugs service
commissioners and drug service providers.

18.3 Lack of cultural competence (absence of culturally sensitive treatment

modalities, lack of competent management support and developmental
opportunities for BME staff), ineffective needs assessment/consultation
with BME communities, inadequate HR/Performance Management
Frames, inadequate data collection systems (ethnic monitoring is
particularly poor), research gaps in relation to the specific needs of BME
drug users and inadequately trained staff, particularly in relation to
diversity, have been sighted as key areas in need of development if BME
communities are to experience equitable access to drugs services and
equal opportunity in the appointment to and development in professional
roles within the drugs field12.

18.4 The Federation Equality Health Check currently being carried out on
behalf of London Area will recommend any necessary training, policy
and/or procedural development that is required including a full race
equality specific training needs analysis. The EHC uses an assessment tool
that is DANOS and QuADS compliant and designed to compliment the
RRAA(2000) related audit tools developed by local authorities, PCT’s and
Criminal Justice Services across the country. The findings will be
consolidated in a confidential report to HMP London Area.

10
Federation Equality Health Check (2002)
11
Sangster D, Shiner M, Patel K and Sheikh N (2002)
12
Ahmun V, 2000

14
19. Conclusion

19.1 HMP Wormwood Scrubs has a good basis from which to build a more
effective drug strategy. There is good work taking place in some areas and
one aspect of drug related intervention, Healthcare, is focused on change
in regard to standards and clinical management. The CARAT service
conducts a large number of BME assessments and the team are on track
with their KPT’s although there have been staff shortages in the past. As
well as this Turning Point is able to attract a significant number of BME
inmates to their programme. The need for crack specific intervention was
addressed over a year ago when the Blenheim project commenced group-
work. Although these groups are no longer running it shows that some
efforts were made to cater for the high number of crack users after the
need was highlighted.

19.2 However, the information gathered suggests that drug treatment services
within Wormwood Scrubs, despite effort, lacks the required culturally
sensitive approach to meeting effectively the drug treatment needs of its
BME prison population.

19.3 Findings suggest the nature and level of provision does not provide the
BME prison population with an effective response, particularly with
regard to stimulant users and remand prisoners. In addition, treatment
staff was found to not reflect the diverse prison population they seek to
serve. Anecdotal information from BME prisoners suggests that this is an
issue that seriously hinders effective delivery of the drugs strategy at a
grassroots level. These concerns were also echoed by some CARAT
workers.

19.4 The HM Prison Service and in particular CARAT providers should

encourage greater levels of diversity in teams. Diversity is a gateway to
being more effective. Belbin (1981)13 talks about balance in a team,
ensuring that a whole range of individual differences in areas such as
skills, attitudes, attributes and personality is taken into account.4 The more
diverse the team is in terms of shared interests, attitudes and
backgrounds, the more potential for increased productivity and practice;
thus fostering a more cohesive force.

19.5 Recruitment, retention and training of appropriately skilled staff and in

particular professionals from BME communities are workforce challenges
currently reflected in the wider community. For example, the Audit
Commission’s review of the sector; Changing Habits (2002) states that
workers in the sector experiencing problems with delivery of treatment
may be doing so as a consequence of “low levels of staff training and
expertise…as staff in the sector are drawn from a wide variety of
professional backgrounds”.

13
Organisational Behaviour P.96

15
19.6 Whilst this report acknowledges it is still early day in the life of the HMPS
drugs strategy more can be achieved by utilising examples of best practice
as they exist within the wider community i.e. Nafas, the Federation,
Blenheim Project etc. These can be adapted and tailored to suit the
changing needs of the prison environment. Thus, supporting HMP
Wormwood Scrub’s aim to more provide more equitable service provision
in relation to drugs treatment and intervention for those from BME and
marginalised communities.

16
 Recommendations________________________________________________

1 Drugs Strategy

1.1 Mainstreaming of issues specific to BME drug users within the Prison
through inclusion on the agenda within Drug Strategy meetings as a
standing agenda item &/or within service updates to be evidenced within
minutes.

1.2 The Federation should be consulted in order to develop a strategy that

would successfully counter the poor expectations that BME inmates have
towards treatment services

1.3 Voluntary Testing Unit needs to incorporate a programme that is able to

effectively engage with BME inmates and which is modelled along the
lines of a rehabilitation service/day programme out in the community. At
HMP Wandsworth such a programme already exists run by the
Rehabilitation for Addicted Prisoners Trust (RAPt) with excellent results.

1.4 Within Drug Strategy Meetings services need to address the question:
“How might services evolve in order to meet the needs of BME inmates,
Crack users and polydrug users utilising independent consultants who
have expertise in this area to assist the process wherever necessary.

2. Workforce & Cultural Competence

2.1 There is a need for experienced drug workers who have the ability to
effectively engage and relate with BME inmates at the reception stage
allowing inmates to familiarise themselves with providers and to become
motivated to seek further assistance. This earlier contact with drug
services will aim to lower the number of drug users, in particular crack
users, refusing to see the CARAT team. Also, this will help to rectify what
was highlighted within the focus group earlier in the year re: confusion in
regard to how the CARAT team is accessed and the process through
which the team accesses inmates.

2.2 There is a need for crack specific workers – 49% of reception tests are
positive for crack. Crack users also benefit from structured talk therapy
and groups – this is a gap that needs to be filled if the Prison is to make
significant progress in treating BME inmates and inmates as a whole and
preparing inmates for life outside.

2.3 Services as a whole would benefit from a survey as well as ongoing

feedback groups that allow inmates to express what they want from a
drug service and their perceptions of current services. As well as
informing the evolution of provision this would include inmates in the
change process. The Audit Commission states that:

17
 “Without knowing anything about the people who use your service, how can
you begin to understand their needs? Without hearing what they want from
you, how can you focus on the areas that really matter to them? Without an
accurate picture of their experiences, how can you be sure that you fully
understand what works and what needs fixing, especially where your
contribution is part of an extended process involving other agencies as well as
your own?” p.64

2.4 The Drug Strategy needs to, as part of its vision, map out what constitutes
a service matrix that will ensure the most effective equality based
treatment provision. This could be drawn up on the back of consultation
with inmates and with assistance from specialists in the drug treatment
field.

2.5 Drug related information (Harm Reduction, Information on dangers

associated with various drugs, changing from one drug to another to try
and avoid MDT positive results, etc.) in various languages would be
beneficial for those at reception and within services on the wings.

3. CARAT Services

3.1 Contingency plans need to be in place to ensure that counselling/groups

(the only treatment available to crack users) are not disrupted due to staff
shortages.

3.2 Home Office guidance The Development and Practice Report, states, “Further
developments in CARAT teams should concentrate on (1) increasing the
number of places on therapeutic programmes and (2) pre-release planning
to address employment and housing needs, and (3) to establish ongoing
contact with services outside prison”. p.6. Employment and housing are
said to be the most pressing issues for inmates, particularly from BME
communities, leaving prison. Closer working ties with services outside of
the prison need to be established in order to work more effectively,
realistically and to document the specific areas of difficulty and need.

3.3 CARAT recruitment and retention policies need to be reviewed to ensure

recruitment process and procedures for CARAT’s are designed to appeal
to a wider audience and therefore are able to successfully attract
professionals from BME communities. The NTA states that: “There is clear
evidence that issues of anti-discriminatory practice in employment and
issues of equity in service provision for diverse communities are, and
should be considered as, related and not as separate issues”. p.7

3.4 Steps need to be taken to ensure that the CARAT team along with other
services within Wormwood Scrubs operate as one service with elements
managed by contractors. At present there is no uniformity in terms of care
standards, no equity in service provision for various drug usage and no

18
 robust qualitative evaluation process for counselling sessions or group-
work.

3.5 The Federation should support HMP Wormwood Scrubs to develop

specific means by which the needs of BME inmates can be adequately
explored in terms of the way in which services are delivered and
congruence in relation to references used during therapeutic interactions.

3.6 At present assessing the work of CARATs revolves around numbers.

These numbers need defining and definitions need to be made clear so
that interpretation can occur accurately. For example, CARAT counselling
sessions in one month can be as high as 140, but how many individuals (as
opposed to sessions) does this correspond to and what constitutes a
‘counselling session’ in terms of time and setting?

4. Turning Point

4.1 Turning Point should look into the possibility of having a rolling
programme alongside or instead of the existing closed process as well as
becoming more flexible particularly in light of recent high attrition rates.

4.2 Extensive focus on long-term inmates occurs to the detriment of Short-

term/remand inmates who are all too often excluded from provision. An
alternative would be to put in place group-work that is specific to the
needs of those who will very soon be out in the community. The Drugs
and Prisons Report by The Select Committee on Home Affairs stated back
in 2000:

59 “Drug treatment in prisons has focused on longer-term prisoners. The

same attention needs to be paid to remand and short-term prisoners. They
are more likely to be in prison for drug-motivated crime and treatment is
more urgent because they will be released sooner. They are the greatest
challenge if the cycle of addiction, crime and imprisonment are to be broken.
We recommend that the Prison Service should make more drug
rehabilitation programmes available to remand and short-term prisoners
beyond what is currently envisaged under the CARAT service.”

4.3 Turning Point recruitment and retention policies need to be reviewed and
made live to ensure recruitment process and procedures for staff are
designed to appeal to a wider audience and therefore are able to
successfully attract professionals from BME communities. The NTA states
that:

“There is clear evidence that issues of anti-discriminatory practice in

employment and issues of equity in service provision for diverse communities
are, and should be considered as, related and not as separate issues”. p.7

19
4.4 Programme evaluation and inmate feedback processes need to be put in
place in order to make better sense of high attrition rates and to assist
Turning Point in meeting the diverse needs of inmates.

4.5 The KPT’s need to include information from inmate evaluations as well as
attrition rates. This will give some indication of the extent to which
inmates benefit from the programmes. Without this information it will not
be possible to assess in real terms how effective the Turning Point
programme is. The NTA states in Models of Care:

“There is an increasing central imperative to monitor the activity, cost

and outcomes of substance misuse treatment and care services. Structured
community and specialist substance misuse service providers are now
expected to report at least some information about how effective they are at
helping people who present for treatment. This reflects a desire to gauge
the return on natonal investment in treatment services and to ensure that
resources are directed to treatments that are effective.” P.196

5. Other Services

5.1 The Federation, Blenheim project or other organisation with a track record
of working with BME communities needs to be approached with the view
to developing a crack specific programme as part of overall service
provision open to those on short and longer sentences as well as on
remand.

5.2 Consultation should take place across the board in order to develop a
culturally sensitive model of working suited to the prison service.

6. Voluntary Testing Unit/Detox

6.1 Interpretation of figures needs to occur whole-istically on a regular basis

to draw out the underlying issues that cannot be seen so readily by
looking at pieces of individual information. see point 12.5 above.

6.2 See also recommendations under 1. Drug Strategy

7. Race Relations and Foreign Nationals

7.1 The lack of drug related information in a variety of languages has been an
ongoing issue within the substance misuse field in general. Although this
was not raised within the focus groups and given that the overall prison
population of foreign nationals is over 11% and rising the provision of
drugs and various other information in languages other than English
needs to occur.

20
8. Security

8.1 Leaflets about specific issues raised by inmates, i.e. MDT and moving
from one drug to another that has less days for detection could be
provided as a way seeking to prevent such cases.

8.2 The relationships between levels of security, drug supply and the
availability of treatment needs to be explored in order to identify the full
nature of interaction.

9. Workforce Planning

9.1 Carry out Equality Health Check to consider implications for Prison
Service, BME professionals and Communities.

9.2 Work with the Federation to develop diversity strategy; which defines
what diversity means for the prison service (particularly in relation to race
– common understanding that is flexible enough to accommodate the
providers varying ways of working with BME inmates).

9.3 Work with Federation to develop Diversity Manual – ‘Identity &

Difference’ for bespoke diversity training programme for service staff and
providers.

9.4 Provision of leadership and management training for service staff and
providers working with BME communities.

21
References & Literature Review

NTA for Substance Misuse – a) RRAA 2000 – Implementing good practice

b) Models of Care (2002)

Home Office - development and practice Report – ‘The Substance misuse treatment needs of minority
prisoner groups: Women, young offenders and ethnic minorities’ (2003)

DOH - ‘Drug Misuse and Dependence – Guidelines on Clinical Management’ (1999)

Audit Commission – ‘Change Here!’ (2001)

Select Committee on Home Affairs Second Special Report - ‘Drugs and Prisons’ (2000)
http://www.publication

The MacPherson Report

Belbin – ‘Organisational Behaviour’ p.96 (1981)

1) Home Office – ‘Findings 186. Prisoners’ drug use and treatment: seven studies’
2) Home Office – ‘Prison Population Brief’
3) Home Office online report 33/03 – ‘Differential substance misuse treatment
needs of women, ethnic minorities and young offenders in prison: prevalence of
substance misuse and treatment needs’.
4) Home Office DSD – Updated Drug Strategy 2002
5) Home Office – ‘Tackling Crack – A National Plan’
6) NTA/COCA – ‘Treating crack and cocaine misuse - A resource pack for
treatment providers’
7) NTA – ‘Models of Care’.
8) CRE – ‘Race equality in prisons’ (2003).
9) CRE – ‘The duty to promote race equality. Performance guidelines
10) CRE – ‘Public procurement and race equality’.
11) CRE/HM Prison Service – ‘Implementing Race Equality in Prisons’.
12) HM Prison Service performance rating system. 2nd Quarter 2003/04.
http://www.hmprisonservice.gov.uk/corporate/dynpage.asp?Page=950
13) a. Prison Drug Strategy – detailed initial impact assessment (CARATs).
b. Prison Service impact assessment (Reception).
http://www.hmprisonservice.gov.uk/life/dynpage.asp?Page=807
14) Sangster D, Shiner M, Patel K and Sheikh N (2002) – ‘National Scoping Study’
15) Audit Commission – ‘Changing Habits’

22
 Appendix 0.01

The Federation

Abd Al-Rahman – Diversity & Drugs Adviser (London Prison Service)

Work Program (21st October 03 – March 04)

Key: Area Drugs Coordinator (ADC) Chief Executive Officer (CEO), Head of
Consultancy (HC), Drugs & Diversity Advisor (DDA), National Training
Officer (NTO).

Action Target Date Comment

.
Identify Mentor/Coach for external support and supervision 28th November Essential
03 requirement
(1) Support/advise steering group in relation to issues
pertaining to diversity and drugs in prisons

• Organise, coordinate and minute meetings,

disseminate information TBA – after DDA/Prison Service
second meeting (PA)
with Huseyin
• Produce quarterly reports
(December, March) 17th Dec 03
and 29th March
DDA
04
) Review all existing area and DSU data collection
on BME use of prison drugs services

• Review transcripts of Focus groups and produce 31st Oct. 03

report of key findings
DDA/HC
st
• Review findings and responses to Action 31 Oct. 03
Research questionnaire.
DDA/HC
• Visit HMPS London Area Office and access Week
intranet (1 full day). commencing
DDA
3rd Nov.03

• Highlight any indicated service shortfall or trends. 31st October

Report findings (plus Focus groups, Action 2003/ongoing
DDA,
Research) to ADC, Steering Group, FSC, FCEO

(3) Evaluate Training needs and develop training

pack for service employed staff

• Develop, disseminate, evaluate training needs January 2004

questionnaire. February

23
 questionnaire. February DDA, HC,NTO

• Make recommendations to steering group February 2004

DDA, CEO, HC

(4) Review and evaluate service diversity training for service

employed staff

• Organise Federation Diversity Training Session February 2004

“Identity & Difference” for prison drug service DDA, HC
staff

• Disseminate Evaluation forms, collate and February 2004

feedback DDA, HC

• Make recommendations for further training. February/March

2004 DDA, CEO, HC
(5) Offer the contract drug services consultation and support
their training needs and operational considerations to assist
complying with the prison service duties and policies on
diversity

• Produce and distribute letter of introduction to

Service Managers of contract agencies (1) 7th November
explaining context of prison service work, 2003 DDA, CEO, HC
rationale and (2) offering Federation consultancy
services

• Visit 6 named establishments on at least two

occasions each. by 9th January
2003 DDA
• Make recommendations on any necessary
systems improvements. Highlight any indicated 19th January
service shortfall or trends to be reviewed by 2004 CEO, HC, DDA
steering group

• Follow up letter to Chief Executives of contract

agencies in conjunction with ADC to arrange 15th January
meetings with Contractors CEO’s & CEO, HC 2004 DDA, CEO, HC
following completion of the Equality Health
Check Process

• Inform development of audit tool to

establish awareness and practice pertaining TBA
to prison service duties and diversity DDA, CEO, HC

Notes – Abd Al-Rahman, as discussed -

fortnightly supervision is an essential criteria as
well as your identifying an appropriate individual
to provide you with professional mentoring and
coaching

24
coaching

This template will work in conjunction with your London

HMPS Outcomes.doc and Rationale.doc. In addition to your
supporting Federation activities as specified by the CEO.
This document will be reviewed monthly and any
adjustments made.

25
 (Appendix 0.02)

Dear ,

I am writing to inform you of work that is taking place within the London Area prison
service in relation to drug strategy/intervention and BME inmates.
The Prison Service London Area Office has funded The Federation of Black and Asian
Drug and Alcohol Professionals for the post of Drugs and Diversity Adviser. The
Federation is a national organisation established to support the needs of Black and
Minority Ethnic (BME) professionals in the drugs, alcohol and related sectors, and their
communities. The Federation acts in a consultant advisory capacity to central
government; Drug Strategy Directorate (DSD) Drugs Prevention Advisory Service
(DPAS), National Treatment Agency (NTA) etc. Informing the updated, National Drug
Strategy, from a culturally sensitive standpoint.

The role of Drugs and Diversity Adviser entails the following:

1. Support and advise the Area Drugs Co-ordinator, the Federation and the HMPS
(London Area) Diversity steering group in relation to issues pertaining to
diversity and drugs within the London area prisons.

2. SAMPLE
Review Area and DSU data collection on BME use of drugs services.

3. Review and evaluate diversity training for service employed staff.

4. Evaluate Training needs and develop training pack for service employed staff

5. Offer contract drug services within the London area prisons, consultation and
support with their training needs and operational considerations to assist
compliance with prison service duties, race equality and diversity policies

In order to carry out these responsibilities I have been visiting HMP’s Wormwood
Scrubs, Wandsworth, Latchmere House, Pentonville, Brixton and Feltham to meet with
service providers and others to gain insight into what services are available, to what
extent BME inmates access them and how these services work with these inmates. The
task is one that aims to advise and assist services wherever necessary in order to
further enhance the quality of practice.

I have already attended after which I had a chance to briefly

introduce myself to . I am now booked to attend various meetings at
between the .

If you require any further information regarding this work please call me at The
Federation.

Yours Sincerely,

Abd Al-Rahman
Drugs and Diversity Adviser

26
 (Appendix 0.02i)

The letter overleaf was sent to the following Area Managers/Directors of Drug
services within London area prisons

HMP Brixton

Adrian Davies
Area Manager
CRI
1st Floor Lorenzo Street
Kings Cross
London
WC1X 9DJ

CARATs Brixton and Wormwood Scrubs

Peter O’Loughlin
Area Manager
Cranstoun Drug Services
112 – 134 Broadway House
The Broadway
Wimbledon
SW19 1RL
______________________________________________________________________

HMP Feltham/Latchmere house (South Staffordshire – CARATs)

Alistair Sutherland Director of Inclusion, Drug and Alcohol Services

20 Mill Lane
Yately
Hants
GU 46 7TN
alistair.sutherland1@ntlworld.com

______________________________________________________________________

HMP Wandsworth

Joe Bernadello
Director of Operations South
RAPt
Riverside House
27 – 29 Vauxhall Grove
London
SW8 1SY
0207 582 4677
0207 820 3716 fax
info@rapt.org.uk
www.rapt.org.uk

27
CARAT
Peter O’Loughlin
Cranstoun Drug Services
112 – 134 Broadway House
The Broadway
Wimbledon
SW19 1RL
______________________________________________________________________

HMP Wormwood Scrubs

Andy Hillas
Area Manager
Turning Point
100 Christian Street
London
E1 1RS

0207 265 2010

andrew.hillas@turning-point.co.uk

HMP Pentonville

Andy Hillas
Area Manager
Turning Point
100 Christian Street
London
E1 1RS

0207 265 2010

Andrew.hillas@turning-point.co.uk

28
 (Appendix 0.03)

Name Position Date visited

Hitash Dodhia C & E Wing Governor 2nd December

Roslyn Anderson Foreign Nationals 4th December

Steve Tutty Clinical Governance 5th December

Substance Misuse (NHS)
Drugs Strategy
Dave Sherwood Coordinator 1stDecember/
open access

Kenny Jarvis Race Relations Liaison 5th December

Officer

Senior Officer 2nd December

2 x Officers 2nd December

Sapna Dhall CARAT Team 1st December

(Cranstoun)

Maureen Sancaster CARAT Team - Detox 4th December

Steve Smith Team leader Turning 4th December

Point

Turning Point Worker 2nd December

Dorothy Yesufu CARAT Admin 1st December

2x ‘Listeners’ or
5 x BME Inmates designated inmates who 1st, 4th and 5th
provide support for those December
with concerns

29
 (Appendix 0.04)

Questions asked during meetings

The following questions acted as a guideline and directional prompt They were
asked within the framework of a semi-structured discussion. Questions asked
were based on relevancy to the staff member and their role.

• What is the nature of the drug treatment offered? (Detox, groups, one-to-one’s,
models used, etc.)

• Is there Information in various languages?

• How many BME inmates are referred to the service?

• What is the ethnic breakdown of those referred?

• Are there mechanisms for inmate feedback?

• What are the drug related outcome targets?

• What are the output targets?

• How are inmates assisted at the prison exit stage? (links with outside
agencies,etc).

• What has been done previously to address any BME unmet needs?

• Treatment service policies – On Diversity and Eq. Opps. How are they made
live?

• Can you outline staff training in relation to Diversity?

• Do services feel that provision is sensitive to cultural differences?

• Do services feel that they meet BME inmate diverse needs? If so, how?

• How do they assess how well they are doing in relation to the above?

• How does the Race/Diversity agenda play a role in the Drug Strategy Group?

• Does a Race Relations Officer/Diversity lead attend Drug Strategy meetings?

30
 (Appendix 0.05)
1. Inmate perspectives

1.1 The BME inmates who were met with have a negative view of drug
services in Wormwood Scrubs. The DDA was allocated a room to speak to
one inmate who is a ‘Listener’, someone who is available to give time to
other inmates who need someone to talk to about their general concerns.
During this discussion the inmate mentioned the RAPt course that he
attended in another prison. He spoke highly of the course but said that it
was not available to all inmates due to capacity. He also spoke highly of
two individual CARAT team members and their efforts to help. He spoke
less favourably of the CARAT service feeling that it did not have the
capacity or the expertise to deal effectively with the client group.

1.2 Another inmate said, when asked what he thought of the drug treatment
in the prison, “What drug treatment? There’s no drug treatment here.” In
relation to the Turning Point course he stated that he had tried to access it
after it was a number of weeks into the sessions. He felt he should have
been allowed to access it because nearly all had dropped out (two were
left) but he was refused access. He felt that the course should be more
flexible, “They have 4 workers. Why don’t they run two courses 2 workers
each”? He also said that he waited about 9 weeks for a CARAT
assessment. As a result of his particular experience he said that nothing is
happening in drug services.

1.3 Two inmates were approached on the landing for an informal discussion.
They had a lot to say in regard to inmates switching to heroin and crack
due to MDT’s. They also said that the amount of drugs inside couldn’t
come in over the wall and from visitors alone. They stated that officers
and various staff were also bringing it in to “pacify an overcrowded
population” and assist an understaffed workforce. It was also stated that
about a month previously there were fights on the landings everyday all
over drugs because the supply had temporarily gone down. It is widely
said that some people come in clean and end up drug users in prison.

1.4 Inmates said that Black male staff are needed in drug services – “White
staff can be OK but most can’t relate to where we’re coming from”.

1.5 Resettlement was seen as a major issue. An occurrence was related of an

inmate who left prison and had nowhere to live so he slept in a car. He
later committed a crime in order to get back to the relative comfort of the
prison.

31
 (Appendix 0.06)

2 Staff perspectives

2.1 In order to mask identity everyone quoted below is referred to as ‘a

member of staff’. The following came out within meetings.

2.2 Within discussion a member of staff admitted that, “Drugs intervention

does not hit home with inmates”.

2.3 One member of staff felt that everything was being done that could be
done. He also expressed that he was sick of people focusing on what
White workers were not doing for BME communities and they should go
and sort out their issues themselves. The DDA felt it was necessary at this
point to give a reminder of the remit and that it ran contrary to his
statement.

2.4 Resettlement is seen as the number 1 issue. Members of staff see many
inmates leave only to return soon after. A high number also leave with no
fixed abode.

2.5 A member of staff said that there are, “Too many fingers are in too many
pies” and a more co-ordinated approach is needed to working with drug
users. At times inmates were referred to outside agencies knowing that
they will not get a place for a variety of reasons.

2.6 Another staff member said that the underlying issues are not being
addressed and there was no quality time allocated to do this. There needs
to be more 1-to-1’s and group-work for all because what is being done
now is surface work.

2.7 During one meeting it was stated that Turning Point were “perpetrating a
fraud on the prison service” and should be “turned out of Wormwood
Scrubs” because issue was taken with the credibility of their data and the
quality of their work. He had asked for data from them on numerous
occasions but this was not forthcoming. Having questionnaires alone was
seen as not enough to show that work was completed to a high standard.
These could be rigged in favour of the service. Experiences with Turning
Point outside of Wormwood Scrubs also informed the position that they
were the weak link in services.

2.8 It was said that there are no anger management courses yet this is
something that is a necessity.

2.9 Intervention was seen by one member of staff as too drug related. Groups
need to go into the areas of personal experience and being that led to drug
use, crime and so on. There was a “lack of substance” to intervention.

32
 (Appendix 0.06)

2.10 Many staff members echoed what was said by inmates, “too much drugs
are available in prison to be coming over the wall and through visits.

2.11 It was said that not enough emphasis is put on links between Drug
Strat/Chaplaincy(who do a lot of unaccounted for counselling, Education,
family, etc.

2.12 During one meeting it was stated that basic human rights must to be taken
into account before minority issues. In other words, staff must keep to
their word with inmates, treat all with care and ensure that their basic
requests are respected and dealt with. In relation to quality and calibre of
staff it was said that, “If staff have integrity and have understanding
within their lives then they don’t have to refer all the time to policy (in
relation to equalities)”. Doing this will keep down levels of stress amongst
inmates and keep up standards. This perspective is a theme running
through services. However, issues specific to the variety of BME inmates
must not be seen as separate from basic human rights, lower down on a
list of priorities.

2.13 One officer, spoken to on the landings, informed of one occasion when an
inmate was ‘puffing’ outside his cell and was told not to be stupid and get
in his cell if he wants to smoke. It was also said that generally this is the
unspoken policy as long as inmates are discreet.

33
 (Appendix 0.06)

3. General observations

3.1 There is a disjointed approach to dealing with inmates between the

various health/treatment focused staff and many prison officers. Some
officers do not demonstrate an understanding of the need for intervention
that seeks to rehabilitate inmates and this, at times, impacts upon the
relationship between Officers and treatment staff.

3.2 There is a perception that to look at BME specific issues is in some way
discriminatory, especially as drugs themselves do not discriminate. As a
result, diversity issues are masked behind the phrase “our service is open
to all”.

3.3 Treatment staff make-up is female heavy. One inmate viewed most drug
treatment staff working outside of the detox end of the process as too
removed from knowledge of their reality. Hence a feeling of “what do
they know”.

3.4 Innovation within drug services is stifled in Wormwood Scrubs. There

was no evidence of innovative ways of working born out of consultation
between services and with inmates. Innovation is all the more necessary
when one considers, for example, that E wing is 81% BME.

3.5 There is no data found regarding completion/retention in treatment by

ethnic group.

34