Probation Circular

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PREVENTING DEATHS OF APPROVED PREMISES RESIDENTS
PURPOSE
To provide further advice about reducing the incidence of deaths and self harm amongst Approved Premises residents.

REFERENCE NO: 35/2006 ISSUE DATE: 22 September 2006 IMPLEMENTATION DATE: 2 October 2006 EXPIRY DATE: September 2008 TO: Chairs of Probation Boards Chief Officers of Probation Secretaries of Probation Boards CC: Board Treasurers Regional Managers AUTHORISED BY: John Scott, Head of Public Protection and Licensed Release Unit ATTACHED: Annex A – Statistical information about deaths of residents Annex B – Prison Service Instruction on Cell Sharing Annex C – List of Voluntary Organisation Contacts

ACTION
For Probation Areas and Voluntary Management Committees: • To note the practice advice contained in this Circular and, in particular, the requirement to update and submit revised local strategies for reducing deaths and self harm by 31 December 2006 To nominate, by 13 October, Approved Premises Managers to be involved in discussing and, if required, piloting new arrangements for ‘in possession’ medication.

SUMMARY
The attached practice guidance draws on lessons learnt from reports produced by the Prisons and Probation Ombudsman (PPO) as a result of their investigations into deaths of Approved Premises residents. A number of common themes, such as the importance of effective information sharing across NOMS and with partner agencies, emerge from the reports, which are set out in detail below. The PPO’s reports on the deaths of individual residents also highlight instances of good practice in the care of residents prior to their deaths, and some of these are also highlighted in the Circular. In addition, this Circular advises of the setting up of a working group to examine issues surrounding the control of medication in Approved Premises.

RELEVANT PREVIOUS PROBATION CIRCULARS
PC40/2004, PC15/2006

CONTACT FOR ENQUIRIES
mike.tennant@homeoffice.gsi.gov.uk or 020 7217 8226

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National Probation Directorate
Abell House, John Islip Street, London, SW1P 4LH

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1. This Circular provides further guidance on policy and practice issues arising from a number of recommendations contained in reports from the Prisons and Probation Ombudsman (PPO) into deaths of residents in Approved Premises. The published reports are available on the PPO’s website www.ppo.gov.uk. Annex A to this circular provides statistical data about deaths of Approved Premises residents over the past eight years. 2. Some of the recommendations require further work at a national level across NOMS. Work is ongoing to address issues of common interest such as improving access to healthcare and developing information sharing protocols with prisons, healthcare providers and specialist interventions agencies. Equally, many of the reports highlight areas for improvement which can be implemented locally to contribute to reducing the incidence of deaths of Approved Premises’ residents, as well as improving the effectiveness of their overall supervision and risk management. These themes are set out below, with specific action points for probation areas and voluntary management committees (VMCs), although the term probation areas is used throughout to include action required by VMCs. PPO reports often also contain examples of good practice in relation to managing residents’ suicide and self-harm risk, and these too are highlighted below.

POINTS REQUIRING ACTION BY PROBATION AREAS AND VMC
A: Review and Updating Of Local Strategies 3. Probation Circular 40/2004 required all probation areas to have in place a local strategy for reducing sudden deaths and self-harm. These should now be reviewed and updated in the light of the guidance contained in this circular. Revised strategies should be in place by 31st December 2006, and a copy submitted electronically to approvedpremises@homeoffice.gsi.gov.uk B: Risk Assessments Access to OASys and Other Risk Assessments 4. A key theme running through PPO and HMIP reports into the management of individual cases has been about access to comprehensive information about offenders. This is vital both to effective management of risk of harm to the public and management of risks of suicide and self-harm. In line with the requirements in Probation Circular 15/2006 (Annex A- 8.9), which deals with access to OASys by providers and all other parties involved in delivering parts of the order/licence, offender managers and other referrers should ensure that OASys assessments include risk of self harm assessments and are included with all referrals. Information should, where possible, also be sought from any assessments based on previous contacts with the criminal justice system, e.g. previous OASys, records of previous supervision or records held on the Police National Computer such as information from Prisoner Escort Forms (PER). 5. Probation Circular 37/2005 (S4) sets out clearly the requirements of referring officers in terms of providing OASys. Care should be taken to ensure that information from OASys or other sources about risk of suicide and self-harm is fully addressed in supervision and risk management plans. This is also covered in detail in Section 4 of PC37/05 which elaborates on what referring officers should provide by way of supervision and risk management plans. Approved Premises are required to produce an Approved Premises supervision plan, derived from the Offender Manager’s plan, which describes in detail what work will be done in the Approved Premises and by whom. It should, of course, be noted that whilst there may be several interventions plans, the Offender Manager’s sentence plan is the main plan. Access to Prison Service and Court Escort Information on Risk of Suicide and Self Harm

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6. Several PPO reports made comment and recommendations concerning the availability of information from prisons (both public and contracted) and court escort contractors about risks identified during the custodial period. Approved Premises managers should endeavour to obtain from the Prison Service, contracted prisons and court escort services full information on risk of self-harm and suicide. Where managers are unsure who to contact to obtain information from prisons, they should in the first instance approach the Resettlement Manager or the Suicide Prevention Co-ordinator. Once C-NOMIS has been implemented across prisons and probation it will become the usual means of communicating risk of self harm information between HMPS, Offender Managers and Approved Premises staff. We have had the following advice from the Prison Service: “Legal advice to prisons is that they have a legal duty to inform other relevant agencies of the self-harm or suicide risk that a prisoner/trainee presents. That duty comes from the ordinary law of negligence, and can be paraphrased as the duty of care to take reasonable steps to avoid reasonably foreseeable risks. The duty also comes from Article 2 of the ECHR, the duty to protect the life of those in the State's custody, which includes information sharing. All prisons will have moved from using the F2052SH (care of at-risk prisoners system) to the new Assessment, Care in Custody and Teamwork (ACCT) system by 31 March 2007; three quarters will have done so by 30 September 2006. It is mandatory for prisons using ACCT to provide partner agencies with information about prisoners who are at risk and are due for discharge. In the meantime those prisons still using the F2052SH system have been reminded that it is good practice for them to also do this. Prisons using ACCT are instructed that if an at-risk prisoner is to be under the supervision of the Probation Service upon discharge, a photocopy of the final Case Review, CAREMAP, front cover and inside front cover of the ACCT Plan must be provided to their Offender Manager or Approved Premises manager in accordance with local protocols. Ideally this should be provided at least 48 hours before discharge. This is in addition to any requirements in respect of updating Risk of Harm information on OASys. Similarly, where an at-risk prisoner released at court is to be under the supervision of the Probation Service upon discharge, depending on the type of risk warning form open, either a photocopy of the Suicide/Self-Harm Warning Form, or a photocopy of the final Case Review, CAREMAP, front cover and inside front cover of the ACCT Plan must be provided to their Offender Manager or Approved Premises manager in accordance with local arrangements agreed between escort contractors and the local Probation Service”. 7. Approved Premises managers should note that if closure of an at-risk prisoner’s ACCT Plan is because s/he is being discharged from custody to the supervision of Probation, the prisoner’s ACCT Case Manager must involve Probation staff in at least the final prison based Case Review. Prison staff have also been informed that it is good practice to involve Probation staff as early as possible in updating the ACCT CAREMAP to promote effective planned support into the community, and to develop local protocols with Probation in respect of this. Prisons are instructed to ensure there are local arrangements in place to ensure that where an at-risk prisoner is to be discharged from custody, the relevant external Offender Manager and/or Approved Premises manager is invited to participate (preferably by attending in person) in the final Case Review and in updating the CAREMAP to reflect the care required in the community. Approved Premises managers should, wherever possible, respond positively to any such requests for involvement in the care planning of prisoners being released to their care. 8. Approved Premises in the North West probation region are in the process of introducing a modified version of ACCT as their preferred suicide and self-harm management framework. The NPD is considering how the learning from that initiative might best inform practice development across the estate. Threat Assessments

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9. A concern was raised by the PPO about the proper identification of potential threats to the safety of prospective residents. Approved Premises managers should ensure that referral forms ask for information about potential threats to prospective residents. Threat assessment should cover potential risks to individual residents from within the Approved Premises or the wider population, and be updated periodically once an offender is in residence. Risk Assessment Prior to Allocation to Shared Rooms and Care Of Vulnerable Residents 10. In some circumstances, shared rooms can be useful in helping to reduce the risks of self-harm or suicide; equally sharing a room may potentially increase risk. Managers should therefore assess whether allocation to a shared room has the potential to be a protective factor or to increase risk. In addition managers, before allocating residents to shared rooms, for whatever reason, should undertake a risk assessment to identify any potential risks to the residents’ safety. For potential residents held in custody, information should be sought from prisons about any risk factors identified by cell sharing risk assessments. In due course this will flagged up on C-NOMIS, but in the interim, Approved Premises should amend their referral forms to ensure that this information is requested. A copy of the current Prison Service Instruction is attached at Annex B. Approved Premises will wish to consider adopting similar criteria as part of their own risk assessment procedures. Approved Premises owe a duty of care to all residents, many of whom may be vulnerable for a range of different reasons. Additional welfare checks should be put in place at night to safeguard vulnerable individuals, including those with special health or mobility needs. Induction Interviews – Prevention of Drug Overdoses 11. One of the main causes of deaths amongst Approved Premises residents is a drug overdose, often due to reduced tolerance after release from prison. Where this topic is not already covered at the induction interview, Approved Premises should ensure that advice and guidance is given to all residents on reduced drug tolerance following release from custody. It is good practice for this to be included in a leaflet for residents, which could include contact details for drugs advice agencies. C: Access to and Recording of Information and Communications with Offender Managers and Partner Agencies Access to Local Strategies and Other Policy Documents 12. The PPO has specifically drawn attention to instances where members of staff of Approved Premises were unfamiliar with local policies and practices on sudden death and self-harm. Approved Premises Managers must ensure that all staff are made aware of the local strategy for reducing sudden deaths and self harm and other relevant guidance, including the Approved Premises Handbook on induction, and that this is reinforced at regular intervals thereafter. Recording of Referrals 13. Attention was drawn to an instance where, because of a lack of clarity in communicating a decision on a referral, staff at an Approved Premises were unprepared for the arrival of a new resident. In the light of this, Approved Premises Managers should ensure that the outcome of all referrals is communicated in writing (letter, fax, or e mail) to referrers. Recording of Significant Events & Drawing Them to the Attention of Staff 14. Managers should ensure that, as required by National Standards, significant events in relation to residents are recorded in the house record or equivalent log and drawn to the attention of all staff coming on duty. Staff should then annote the record to indicate that they have read and noted relevant entries. The importance of clear and contemporaneous record keeping on offenders’ case records is also highlighted in Probation Circular 15/2006 (Annex A-8.2). A review of OASys and the sentence plan should take place following a significant change in PC35/2006 – Preventing Deaths of Approved Premises Residents

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circumstances, and therefore the Offender Manger should be notified of any significant changes; ideally there should be a three-way review as to how best to proceed. Information Sharing Arrangements and Protocols 15. A theme which emerges from many PPO reports is the timely sharing of information between key partners such as providers of drug treatment. In line with National Standards and Probation Circular 15/2006 (Annex A -8.1012), offender managers are required to ensure regular exchanges of information. Where offenders are resident in Approved Premises, the Approved Premises should be included in information exchanges and should, in turn, communicate all key information promptly to offender managers e.g. the results of drug tests conducted at Approved Premises. Probation Areas should ensure they have information sharing protocols and effective liaison arrangements in place with local prisons, healthcare providers and partner agencies such as CJIP and other drugs providers. D: Enforcement 16. Effective and timely enforcement action is fundamental to the work of the probation service in protecting the public and reducing reoffending. Probation Areas should ensure that all Approved Premises follow National Standards guidance on enforcement of orders, licences and conditions of residence imposed by courts on bailees (General Standard 9 and Specific Standards 9.1 to 9.9). This is reinforced in Probation Circular 15/2006 (Annex A-8.1). The Offender Manager in the community holds ultimate responsibility for enforcement. Where the Offender Manager is not based in the Approved Premises, then any failures to comply should be communicated to him/her on the day of the failure, or the following day in the case of evening/overnight failures, so that appropriate action may be taken. Particular issues arising from the supervision of those on life licence will also be addressed in a forthcoming revision to the Lifer Manual. E: Safety and First Aid First Aid 17. Both PPO reports and correspondence from coroners following inquests have highlighted the importance of staff having appropriate and up to date first aid skills. Probation areas should refer to the Health and Safety Risk Assessment “Approved Premises Management Guidance” which has been circulated to Areas and is also available on EPIC. This states that “all supervisory staff must be trained, as a minimum, in basic first aid”. Details of the different levels of training are available in the training guidance “Approved Premises - Working Safely”, also available on EPIC. In addition, Probation Areas/VMCs should ensure that staff considering whether to commence cardiopulmonary resuscitation (CPR) should follow advice given in their training, and that where mouth guards and other resuscitation aids are issued they are of the type with non-return valves and are carried on the person of staff at all times. Probation Areas may also wish to seek advice from their local Primary Care Trusts (PCTs) about technical issues such as first aid techniques and equipment to be provided on site. Retention of CCTV Records 18. Preservation of records is vital to the conduct of PPO investigations as well as for use in other investigations that could lead to enforcement action or criminal proceedings against residents. Approved Premises managers must ensure that CCTV records relevant to incidents are retained, and made immediately available to investigating officers. CCTV and other records should be retained until after any inquest. Carrying of Personal Alarms, Radios and Mobile Phones 19. Summoning assistance immediately on discovery of an incident may be critical to avoiding fatalities. Approved Premises managers should ensure that staff carry personal alarms and other safety equipment such as radios at PC35/2006 – Preventing Deaths of Approved Premises Residents

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all times. Mobile phones should be made available and carried by staff patrolling the premises so that they can summon assistance from the emergency services immediately in the event of an incident. Monitoring Residents and Wellbeing Checks 20. Probation Circular 35/2004 requires residents’ movements in and out of premises to be controlled and recorded; where appropriate this information should be communicated to the Offender Manager. It is vital for public protection and risk management reasons that managers and staff on duty know which residents are on the premises at any given time. In addition, as part of delivering the duty of care to residents, staff should ensure that residents’ whereabouts can be established whilst they are on site, particularly after curfew and at weekends. Approved Premises should, for example, ensure that checks are undertaken of residents’ rooms if they are not present at mealtimes. Car Numbers 21. Approved Premises managers should ensure that the registration numbers of residents’ vehicles are recorded to assist in the identification of residents absent from the Premises. F: Medication Recording & Storage 22. In some PPO reports, attention is drawn to poor recording practices that have made it difficult to establish whether residents have been issued with the correct dosage of medications at the required intervals. Approved Premises managers must ensure that accurate records are kept of all medication made available to residents, including medication issued to new residents on leaving prison, and should undertake regular audits of both stock and the standards of record keeping. Risk Assessment Prior to the Issue of More Than One Day’s Medication 23. The PPO has highlighted an instance where a resident was able to take an overdose through stockpiling medication. Approved Premises managers should ensure that a risk assessment is undertaken prior to the issue of significant quantities of medication, e.g. to residents going on home leave or moving out of the Approved Premises, so as to avoid potential overdoses or sale of medication. Risk assessments should also include consideration of whether room mates or others who associate with at-risk residents may represent an additional risk factor, e.g. of sharing/illicit sale of medication. Review of ‘In Possession’ Medication 24. Practice in the Prison Service is to allow prisoners to retain their own medication, subject to risk assessment, and there are some views that this should be extended to Approved Premises. The implications of such a change would be far reaching and will need further consideration and consultation before any change is implemented. A working group is being set up involving colleagues from NOMS, the Department of Health and the PPO. Probation Areas and VMCs are invited to submit nominations for managers/practitioners who would be willing to participate in discussions on the proposals and, if required, to assist in piloting any new arrangements in their Approved Premises. Nominations should be submitted electronically to approvedpremises@homeoffice.gsi.gov.uk by Friday 13 October 2006. G: Good Practice Examples The following are examples of good practice which probation areas and VMCs may wish to consider adopting. PC35/2006 – Preventing Deaths of Approved Premises Residents

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Attendance at Funerals 25. Subject to the views of the family and where practical, probation areas should consider sending a representative to attend the funeral of former residents. Memorials 26. Premises may wish to consider the planting of a tree or shrub or installing another form of memorial in the grounds to commemorate deceased former residents. Support and Counselling For Residents and Staff 27. Following a sudden death Probation Areas should consider providing support to residents and staff, including making counselling available for residents in addition to their current arrangements for staff to access such services. There are a number of organisations, both national and local, that can offer support to both residents and staff following a sudden death. These include: Samaritans 08547 90 90 90 CRUSE Bereavement Care 08701 671677 National Association of Bereavement Services 020 7709 2090 Healthcare 28. Local arrangements with NHS medical centres for comprehensive health checks for residents are an example of good practice. Similarly, establishing good links with local Primary Care Trusts can result in the development of more appropriate services for Approved Premises residents. Family Liaison 29. Probation areas may wish to consider appointing a named individual at each Approved Premises as the first point of contact with bereaved families, and should consider whether there are any training needs which should be addressed prior to individuals taking up this role. The role could encompass giving information to families after the initial notification of the death by the police, arranging for the family to visit the Approved Premises and organising the return of property to the family. Areas may wish to draw on the experience available in local prisons or voluntary organisations to assist with this. A list of voluntary organisations which may be of assistance is attached at Annex C, and the Prison Service guidance on Family Liaison will be placed as a reference document on EPIC.

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Annex A

Data on deaths of Approved Premises residents Details on total number of deaths of residents of Approved Premises, and the causes of death, are set out below.

YEAR 1998 1999 2000 2001 2002 2003 2004 2005* Total

Suicide 3 4 8 3 3 4 2 7 34

Overdose 11 4 13 12 8 3 8 6 65

Natural Causes 3 1 2 5 8 3 8 2 32

Accident/ Homicide 3 0 1 2 2 1 2 0 11

Currently Total unknown 0 20 0 9 0 24 0 22 0 21 0 11 0 20 2 17 2 144

*Provisional analysis for 2005

Annex B
Number

Prison Service Instruction Cell Sharing Risk Assessment (Replaces PSI 26/2002) PSO 2750 Violence Reduction 8 August 2005

32/2005

7 August 2006

CONTAINS MANDATORY INSTRUCTIONS For Action Monitored by

Area Managers, Prisons, Governors, Directors & Controllers of Contracted Prisons
For Information

Area Managers & Director of High Security, SAU & Self- Audit
On authority of

All prison service staff

Prison Service Management Board

Contact Point Gill Brigden, Safer Custody Group, tel. 020 7217 2174
Other Processes Affected

PSO 0500 Reception PSO 0550 Induction
NOTES

Cell – sharing risk assessment and ongoing risk management is an integral part of the violence reduction strategy. There is no change to the initial cell-sharing risk assessment process on reception, new requirements are explained in the text Mandatory Actions are written in italics and must be acted upon.

Issued

29/7/05

Policy and Output
PSI CELL SHARING RISK ASSESSMENT / RISK OF HARM TO OTHERS Purpose 1. This Prison Service Instruction (PSI) replaces PSI 26/2002 on Cell-Sharing Risk Assessment and accompanying forms which were introduced on 20 June 2002. It incorporates changes to improve the efficiency and effectiveness of the current risk assessment and subsequent risk minimisation process. The revised PSI, additional forms and guidance notes will come into effect on [8th August 2005] and should be implemented as part of each establishment’s violence reduction strategy. The first form (xf 001) remains unchanged. The risk assessment process has been evaluated by Research Development Statistics RDS) under the direction of a working group including policy, research and operational staff. Additionally a small working group of Governors & other key officers has undertaken a special review, motivated by a homicide incident. The main changes to the risk assessment process are Change Includes a risk minimisation plan & management arrangements Facility to record a risk review triggered by circumstances other than re-location Reasons for change To ensure that any risks identified are minimised and that the document is kept ‘live’ Recognition from case studies that new events and circumstances can trigger new risks

2.

3.

A manager is designated to To provide consistent ongoing oversee the risk management risk assessment & management process as part of the violence relating to cell-sharing reduction strategy. A register of prisoners To provide a reference point for designated high or medium risk overview of risks and an audit must be held centrally in each trail of open and closed cases establishment 4. The purpose of the risk assessment tool remains the same to: • • • • • draw together information about risk make best use of documentary evidence; support staff judgement about allocation to cells and risk management; record additional operational precautionary measures for a prisoner identified as a potential risk, where cell sharing is unavoidable; provide a record about risk of harm to others as a prisoner moves between wings/ prisons;

to enable early identification of racist, homophobic or violent prisoners, to ensure that other Prison Service procedures to protect potential victims are followed.

5.

The cell sharing risk assessment system does not: • replace staff judgement • provide an actuarial risk score • rule out cell sharing by prisoners who pose a risk.

Policy and Output 6. The first form (xf 001) must be completed as part of the Reception procedure before the first night in custody. It should be reviewed by the Induction Board. Evidence of risk should be recorded clearly, so that officers referring to the form will be sure about the risks present and be able to plan on the basis of that risk. The Prisoner Escort Record (PER), warrant, probation reports, OASys and previous convictions must be consulted, if available, when the cell-sharing risk assessment form is being completed. Where available and in compliance with PSO 0905, the Police National Computer Link, must be used to access pre-conviction data as soon as possible. If staff are on duty and trained to access the PNC for previous convictions, arrangements must be made to provide pre-conviction data to reception/induction staff on the first night. A prisoner with a history of violence in custody (situational violence) presents a heightened risk. Particular attention should be paid to section 2 of form xf 001 (initial risk assessment) if the prisoner is known to the service. In compiling any subsequent risk minimisation plan and/or reviewing the risk assessment, a prisoner who has exhibited over reactive behaviour in response to perceived threats or who is known to have armed themselves with a weapon whilst in custody should be managed with extreme care. In prisons with a first night centre, the form may be completed there as long as documentary evidence is used and information from health care staff is available. Typically, reception officers and health-care staff should handle the assessment process with allocation decisions taken by the reception manager. More sensitive decisions about cell allocations (for example, if a prisoner represents risk to self and others) should be referred to a more senior manager. Where a prisoner is identified as being at risk of selfharm or suicide, an F2052SH or an ACCT plan must be opened. (If the prisoner is newly arrived at reception, local protocols may allow for any riskto-self information to be passed to the reception healthcare screener for them to decide if an F2052SH or an ACCT plan should be opened). In the case of a transferred prisoner, the sending prison must ensure an upto-date (i.e. reflecting the current circumstances if different to when the assessment was completed) cell sharing risk assessment form, and any risk management plans, accompany the prisoner to the receiving prison as part of the transfer documentation. These must be read before location decisions are made in receiving closed prisons where there is the option of other than single cell occupancy. Prisons without shared accommodation must complete a risk assessment form on every prisoner by the end of the Induction process. This will allow them to make informed decisions about the management/control of prisoners who exhibit potentially violent, racist, or homophobic behaviour.

7.

8.

9.

10.

11.

12.

13.

14.

15.

A risk minimisation plan must be in place to manage any high or medium risks identified. This must be agreed within 7 days and signed by the duty governor. This plan will form the core of the prisoner’s history sheet and a copy should be kept on the wing file. These plans must be consulted when relocating prisoners. They can be cancelled, confirmed or revised at any subsequent review. Particularly sensitive judgements are needed if a prisoner is seen to be at risk of harming him/ herself as well as others. The incidence of self-harm and suicide is significantly higher than murder. Cell sharing can be an important element of the support provided for an at-risk prisoner, and placement in a single cell could increase risk. Where an at-risk prisoner is to be placed in a single cell the ACCT CAREMAP (or F2052SH support plan) should take this into account, in respect of frequency of conversations and observations (level of supervision), additional support for the prisoner, and location, e.g. use of a safer cell. Where cell sharing may be a medical recommendation, such as having someone to call for help for in case of illness, the prisoner must still be managed according to the identified risks (to self or others). If there are difficulties then these should be resolved through a multi-disciplinary case conference. Full account needs to be taken of the implications for the cell mate of such a locating decision, and that beyond the everyday responsibility all individuals hold towards each other, the care of their cell mate is not their responsibility; this remains the responsibility of management and staff.

16.

17.

18.

Diversity 19. Cell sharing risk assessment can aid identification and management of prisoners who show signs of racism, or other forms of bigotry or discriminatory behaviour. But it is not an appropriate way of managing prisoners who press for scarce single cell accommodation. Sharing with someone from a non-targeted group can be considered. Racist, or other discriminatory attitudes may be visible (e.g. tattoos), but should be evidenced by monitoring behaviour. It must be made clear to any prisoner who appears to pose a threat to any group of prisoners that racist or harassing behaviour is in breach of Prison Rules, and will be treated as a serious disciplinary offence (using the racially aggravated offences where evidence is available.)

20.

Impact and resource assessment Training 21. The principles of risk assessment remain unchanged. incorporated into the additional forms. Guidance is

22.

Reception and Health care staff will need to be familiar with the revised form. All staff will need to be familiar with the principles and procedures of risk management.

Mandatory Action

23.

PSI 26/2002 must be replaced by this PSI and the changes reflected in local policies and procedures. Governors of all closed prisons and YOIs and directors of contracted prisons must satisfy themselves that staff are aware of this Instruction. They must also be satisfied that; • the cell sharing risk assessment form is being used and completed properly, • risk minimisation plans are agreed for those prisoners who present a significant or increased risk, and a review schedule agreed • a manager is designated to oversee the risk management process as part of the violence reduction strategy. • a register of prisoners designated as high or medium risk must be held centrally in each establishment to provide an audit trail of open and closed cases. These will be monitored by the area manager on their regular visits.

24.

25.

Regular reviews will be required for those prisoners initially rated as high or medium risk, and whose rating was then confirmed at the Induction Board. This should initially be after one month, then at least three monthly intervals. The review form must be used for ongoing assessment. Where other risk management processes offer the potential to manage this process, ( OASys, MAPPA) these can be used. The focus of cell-sharing risk assessment must be maintained e.g personal safety of cellmate. The review form must also be used for re-assessment of any prisoner if there is a significant event that triggers concern. There will be some prisoners who have a completed OASys prepared by the Probation Service. The OASys document, particularly the sections dealing with self harm and harm to others, must be consulted at the time of any subsequent review carried out on prisoners identified as at risk of harming a cellmate or others. Circumstances that may trigger a review are for local judgement. Here are some examples; repeated or escalated threats of violence, particularly towards cellmates; discharge from segregation following violent or threatening behaviour; unexpected conviction or harsh sentence.

26.

Advice and information 27. Queries about the cell sharing risk assessment form should be made to Safer Custody Group (Gill Brigden) on 020 7217 2174, or gill.brigdenSCG@hmps.gsi.gov.uk.

Ordering of forms 28. Prisons that require additional supplies of form xf 001 should submit orders to Corby Customer Liaison Team on 01536 274674. The forms xf 001 can also be obtained from the intranet.

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Templates for a Risk Minimisation Plan and for the Cell Sharing Risk Assessment Review form are only available on the intranet on the Violence Reduction Toolkit, and under forms. There will be no printed version The use of Form xf 002 will cease. The cell sharing risk assessment review form replaces it.

31

(signed) Peter Atherton Deputy Director General.

CELL SHARING RISK REVIEW
Prisoner name Date of review Current risk rating Low / Medium / High

Number
Reason for review Scheduled Revised assessment *see below * Circumstances that may trigger a review of the initial assessment are for local judgement; here are some examples; Repeated or escalated threats of violence, particularly towards cellmates; Discharge from segregation following violent or threatening behaviour; Unexpected conviction or harsh sentence. Evidence of arming with weapon Assessment information Has there been any new information to link the prisoner with violent offences? Yes No
Brief details

Has the prisoner displayed any homophobic or racist behaviour? Yes No
Brief details

Based on the information the risk of harming a cell-mate is high

Has the prisoner displayed any anti-social behaviour, bullying, threats, damage to property, aggression, hate-motivated behaviour, assaults? Yes No
Brief details

Is there a reason to suspect that the prisoner is abusing drugs/ alcohol
Brief details

Yes

No

Does the prisoner have a history of self-harm?
Brief details

Based on the information the risk of harming a cell-mate is medium

Yes

No

Does the security department have any information that may affect the risk assessment – eg evidence of weapon? Yes No
Brief details

Does the Health Care Team have any information that may affect the risk assessment?
Brief details

Based on the information the risk of harming a cell-mate is low

Yes

No

Personal/ Wing Officer……………………………… signed…………………………….
Duty Manager/ Duty Governor Comment Signature …………………………………….……. date………………

Outcome of review The last plan is cancelled and normal location recommended The plan dated ………………………still stands A New Risk Minimisation Plan must be agreed within 7days Copy to history sheet and wing file

copy to history sheet & wing file

CELL SHARING RISK MINIMISATION PLAN
Date: Prisoner name number Significant / Increased risk

Details of those contributing to plan Name Prisoner Designation

Unit Manager How does the prisoner feel about the situation? Ask open questions; e.g. ‘Can you tell me what you think this is about?’ Explore the source of the risk/ prejudice, what the prisoner thinks would trigger violence /how the prisoner thinks he/she can learn to cope with his/her risky behaviour

Elements of Risk Minimisation Plan
Consideration may be given to the following: alcohol and drugs, mental illness/ distress, fears, self-care, medication, social needs, custodial/legal problems, occupation, sentence plan, colocation. Specific Need Action Required

Timing of review e.g 1 month, 3months

NB Events would trigger review sooner E.g. adjudications, violent behaviour, security information, anti-bullying logs, conviction/change of status

Duty Manager/Duty Governor
Comments of Duty Manager/Duty Governor:

Name: Signature:

Date

Annex C

INQUEST: Provides information, support, guidance and legal advice to families bereaved by death in custody on inquest procedures and basic rights in coroners’ courts. Can also put families in touch with each other. Comprehensive information booklet available. Helpline hours: 10.00 – 18.00, Monday – Friday. Tel: 0207 263 1111

Address: INQUEST, 89-93 Fonthill Road, London, N4 3JH inquest@inquest.org.uk www.inquest.org.uk

SAMARITANS: Offering emotional support for people who are experiencing feelings of distress or despair. Local branches can be visited or telephoned. See local directory. Helpline hours: 24 hours, Monday - Sunday.

National Helpline: 08457 90 90 90 (local rate) Or write to: Samaritans at PO Box 90 90, Stirling, FK8 2SA www.samaritans.org. uk

CRUSE BEREAVEMENT CARE: Provides support services for people who have been bereaved. The Helpline offers listening support and practical advice related to bereavement. Local (rate) numbers offering individual and group support. Helpline hours: 09.30 – 17.00 Monday - Friday. Tel: Office: TW9 1UR 0870 167 1677 (national rate) Cruse House, 126 Sheen Road, Richmond, Surrey,

www.crusebereavementcare.org.uk helpline@crusebereavementcare.org.uk SURVIVORS OF BEREAVEMENT BY SUICIDE (SOBS): Helpline and support services run by a self-help group for people bereaved by suicide. The Helpline provides listening support and will put people in touch with their nearest local group. There are monthly meetings in various locations. Helpline hours: 09.00 – 21.00 everyday. National Helpline: 0870 2413 337 (national rate) Welsh -phone: 01792 774646 Address: SOBS Centre 88, Saner Street,Hull, HU3 2TR www.uk-sobs.org.uk WINSTON’S WISH: Bereavement support for children and their families. National Helpline: Address: 0845 20 30 205 (local rate)

The Clara Burgess Centre, Gloucestershire Royal Hospital, Great Western Road, Gloucester, GL1 3NN www.winstonswish.org.uk info@winstonswish.org.uk THE COMPASSIONATE FRIENDS: A Helpline and support service run by bereaved parents offering support to parents and their immediate families after the death of a child/children of any age and from any cause. Local contacts and support meetings offered. Helpline hours: 10.00 – 16.00 and 18.30 – 22.30 everyday. National Helpline: 0117 953 9639 (national rate)

Address: 53 North Street, Bristol, BS3 1EN www.tcf.org.uk info@tcf.org.uk

CRUSE BEREAVEMENT CARE – YOUTH INVOLVEMENT: Helpline and support for young people aged 12 – 18 following a bereavement. Helpline hours: 09.00 – 17.00 Monday – Friday. Telephone Helpline: Office: Surrey, TW9 1UR www.rd4U.org.uk 0808 808 1766 (free phone) Cruse House, 126 Sheen Road, Richmond,

BEREAVED BY SUICIDE: Provides support to anyone bereaved by suicide. Telephone Helpline: 01252 661002 (national rate)

Address: 139 Reading Road, Farnborough, Hampshire, GU14 6NZ www.bereavedbysuicide.org bereavedbysuicide@ntworld.com

DESPAIR AFTER SUICIDE: One to one support offered. Telephone Helpline: 01772 760662.

THE CORONERS SOCIETY OF ENGLAND AND WALES: www.coroner.org.uk ASSIST ASSISTANCE SUPPORT AND SELF HELP IN SURVIVING TRAUMA Offers counselling and support to individuals and families affected by Post Traumatic Stress or Post Traumatic Stress Disorder. Helpline 01788 560800

ASIAN FAMILY COUNSELLING SERVICE A dedicated counselling service to members of the Asian community. Telephone: 020 8567 5616 Address: Asian Family Counselling Service 76 Church Road Hanwell London W7 8LB JEWISH BEREAVEMENT COUNSELLING SERVICE Emotional help and support to bereaved members of the Jewish community throughout the UK. Telephone: 020 8349 0839 or 020 8343 8989 Address; The Jewish Bereavement Counselling Service PO Box 6748 London N3 3BX LESBIAN AND GAY BEREAVEMENT PROJECT A help line for gay men and women who have been bereaved and family, friends, colleagues and carers. Telephone: 020 8455 8894 Address: Lesbian and gay Bereavement Project Vaughan M Williams Centre Colindale Hospital London NW9 5GH Email: lgbp@aol.com/lgbp BRITISH ASSOCIATION FOR COUNSELLING AND PSYCHOTHERAPY For information on counselling services in your area. Telephone: 01788 550899 Address: The British Association for Counselling and Psychotherapy 1 Regent Place Rugby Warwickshire CV21 2PJ (Enclose SAE) Website: www.bacp.co.uk