Report of an announced inspection of La Moye Prison, Jersey, 27 June - 1 July 2005

Report on an announced inspection of

La Moye Prison, Jersey

27 June –1July 2005

by HM Chief Inspector of Prisons

Crown copyright 2006

ISBN 1-84473-855-8

Printed and published by:

Her Majesty's Inspectorate of Prisons 1st Floor, Ashley House

Monck Street

London SW1P 2BQ

England

Contents

Introduction  5 Fact page  7 Healthy prison summary  9

1  Arrival in custody

Security and rules  55 Discipline  57 Incentives and earned privileges  61

7  Services

I Inspection team  i II Prison population profile – young men  ii III Prison population profile – adult men  iv IV Prison population profile – women  vii V Summary of prisoner questionnaires and interviews  ix

Introduction

La Moye prison needs to fulfil the functions of an entire prison system. As the only prison in Jersey, it holds men, women and children charged or convicted across a wide range of criminal offences.

This inspection found some serious deficits in the processes and procedures needed to support that varied group of prisoners. Few of the recommendations in our previous report in 2001 had been actioned four years later. As a consequence, the safety and security of prisoners and staff, and the likelihood of prisoners' rehabilitation, were compromised. However, we also found examples of extremely good relationships between prisoners and staff, some of whom went out of their way to try to make good some of the systemic deficiencies.

Safety and security are key issues for prisons. La Moye lacked proper first night or induction procedures, and a large proportion of men and women felt unsafe on their first night. Prisoners told us that bullying was a serious problem, yet there were no systems to deal with it, other than to remove victims to a succession of separate areas, including an unstaffed and unsupervised unit which was little more than a collection of cupboards. This was used as an escape route from the vulnerable prisoners' unit, which was itself a location for bullying. Staff supervision of prisoners in some areas was poor, and there was no proper monitoring of incidents, assaults and complaints. Suicide and self-harm procedures were in place, though they relied too much on healthcare staff, and there was inappropriate use of strip-conditions for those at risk of self-harm.

Systems to support physical security were also weak. Potential weapons and escape equipment were lying around the prison. Night security was of particular concern, with unlocking procedures that placed both staff and prisoners at risk.

Crucially, the prison had no reliable prisoner database. As a result, it was unable to assess prisoners' needs or seek to meet them. This was a particular issue in relation to black and minority ethnic and foreign national prisoners. La Moye held a number of Madeiran Portuguese-speaking prisoners, nearly all of whom were located on the vulnerable prisoners' unit. There were no race relations or foreign national policies or procedures: indeed the resignation of the race relations liaison officer two years previously had not even been noted by the prison until our pre-inspection visit. Although many black and minority ethnic prisoners reported good relationships with staff, a quarter of young adults said they had been victimised by other prisoners because of their race.

Most living units lacked integral sanitation, and some prisoners needed to slop out in the mornings. However, we were impressed, in most areas of the prison, by the proactive relationships between staff and prisoners: most prisoners told us they knew their personal officer, and had a member of staff to whom they could turn. Healthcare was also well delivered, though there was need for better mental health provision. Food was better than we normally see.

Prisoners were rarely locked in their cells. However, there was not enough for them to do. There was very little by way of education or training, to try to provide prisoners with the skills they might need to gain employment on release, and to reduce the likelihood of reoffending. Education amounted to 25 hours of one teacher's time; there was little full-time employment, and what there was was mundane or domestic. This meant that prisoners entering La Moye were likely to leave without experiencing the positive interventions that might make it less likely that they would reoffend.

Nor had the prison yet addressed prisoners' resettlement needs. There were no policies, little sentence planning and very little, other than limited drug rehabilitation, to help prisoners address their offending behaviour, or prepare them for release. Very few prisoners, compared to other prisons we have inspected, knew where to get help in finding housing, employment or other support.

The prison held two discrete populations: women and children. The physical environment for the women was poor, and the work opportunities limited. Access to sanitation was unsatisfactory, and until the week of the inspection there had been no proper reception procedures for them. They were effectively out of the line of sight of prison managers. Their accommodation and opportunities needed urgently to be improved.

We did not consider La Moye to be an appropriate place to hold children. Very little education was available, and child protection arrangements and staff training were inadequate. No risk or vulnerability assessments of children were carried out.

La Moye is a complex establishment, with a diverse mix of prisoners. It has had to increase its capacity over the last five years, as more men and women have been sentenced to prison, and for longer periods. One of our main recommendations is that its complexity is reduced, by holding all juveniles separately, in the purpose-built unit now being constructed on Jersey. Having done that, there is an urgent need to put in place some of the infrastructure and resources that the prison needs to carry out its core task.

Both prison managers and those responsible for custodial provision in Jersey are aware of the need to tackle the underlying issues at La Moye, in order to ensure that the prison plays an effective part in crime reduction and public protection. Their task will be to retain the positives in the prison – particularly its good staff–prisoner relationships – while putting in place the systems and procedures that can ensure safety and help reduce reoffending. This needs to be done as a planned package, so that strengthened processes run hand in hand with increased opportunities for prisoners. Our second main recommendation, therefore, is that a performance improvement plan, including time-bound targets and costings, should be agreed between the prison and the Home Affairs Committee. We hope that this report, and our recommendations, will assist in that process.

Anne Owers September 2005 HM Chief Inspector of Prisons

Fact page

Task of the establishment

La Moye is a multi-functional establishment serving the courts and people of Jersey through the provision of secure accommodation for male and female prisoners. The prison caters for adults, young adults and juveniles (if required).

Area organisation States of Jersey

Number held

172

Normal accommodation (not certified) 184

Operational capacity 184

Last inspection

Full inspection: April 2001

Description of residential units

Seven residential units accommodate up to 184 prisoners, with separate wings for women and young adults, discrete segregation units for adult men and young adults, and a vulnerable prisoner unit on E wing. Remand and convicted adult prisoners are located on A, B, and C wings, and there are 35 enhanced-level prisoners on H wing. A wing is a voluntary drug testing unit and is used as the feeder accommodation for H wing. G wing is designated for young adults. The female unit is in a discrete area in the main accommodation building.

Healthy prison summary

Introduction

HP1  All inspection reports carry a summary of the conditions and treatment of prisoners,

based on the four tests of a healthy prison that were first introduced in this inspectorate's thematic review Suicide is everyone's concern, published in 1999. The criteria are:

Safety

Respect Purposeful activity

Resettlement

prisoners, even the most vulnerable, are held safely prisoners are treated with respect for their human dignity

prisoners are able, and expected, to engage in activity that is likely to benefit them

prisoners are prepared for their release into the community and helped to reduce the likelihood of reoffending

HP2  La Moye Prison, Jersey, caters for all people remanded or sentenced to custody

within its jurisdiction. It therefore fulfils a number of roles – it is a local and training prison, women's prison, adult male prison, young offender institution, and a juvenile facility that, occasionally, holds boys and girls under school-leaving age. In this report we have mostly identified differences in provision for the different groups under our usual headings.

Safety

HP4  Men, women and children travelled on the same vehicle to the prison. This practice

was unacceptable and could be easily avoided, as receptions of women and children were infrequent. Very little, or no, information arrived with prisoners at their first reception, and prisoner escort forms were not used.

HP5  Reception was clean and tidy but had little information for new arrivals. Women

bypassed reception procedures and went straight on to F wing, which had far worse facilities for receiving prisoners. Prisoners were booked in in an efficient manner and did not spend long in reception. Staff were welcoming, prisoners were put at their ease in a relaxed atmosphere, and the use of first names was commonplace. However, strip-searching procedures were inappropriate. Prisoners, including children, were strip-searched routinely by one member of staff, which was unacceptable. There were not enough holding cells to separate men, women and children if they arrived together.

HP6  Our survey revealed that a large proportion of men and women felt unsafe on their

first night in prison. There were no special first night arrangements. Prisoners could spend their first night in a variety of locations. There were no risk assessments, no cell-sharing risk assessments, and no special vulnerability assessments for children. The only intervention was a personal interview with a member of staff on the wing, to complete a form opened in reception. New prisoners were offered telephone calls. There was no induction programme on any wing.

HP7  Prisoners said that bullying was a serious problem, and our observations confirmed

this. The prison's response to bullying had been to create more areas to hold vulnerable prisoners, with some held separately from others. The largest vulnerable prisoner unit was on E wing, but during our inspection, it became clear that some bullies had arranged to move there. There were no formal systems to prevent this. There was no strategy for tackling bullies, or support systems for victims, and the victim was often moved away from normal location.

HP8  The most extreme manifestation of this policy was in the old reception unit, where up

to seven prisoners were held in a tiny area. Some were in cells which were in fact former cupboards, had no natural light, and no cell door other than a curtain. The prisoners were locked in the unit and left unsupervised. They had no emergency cell call system and had to press the general alarm to attract the attention of staff. Such conditions were totally unacceptable.

HP9  There was no anti-bullying strategy, committee or other arrangements and no

violence reduction strategy. A draft policy document had been written but not published. It was copied from HM Prison Service policies and its information did not directly relate to local issues. There had been a needs analysis but its findings had not been used to inform the draft policy. Allegations of bullying were not formally investigated in most cases, and complainants did not receive responses. Security information reports were not used to communicate concerns, and the content of complaints forms was not analysed by numbers or location. The number and nature of adjudications, assaults or self-harm monitoring were not correlated. The situation was made worse because staff supervision was poor in some areas. Groups of prisoners were left for long periods on their own when they were unlocked, particularly on the second and third landing, of E, B, and C wings. The prison seemed unable to identify the extent of the problem, and this area required urgent management attention.

HP10  In contrast, self-harm and suicide management arrangements were in place. There

was a published strategy document. The governor chaired a suicide prevention committee with inclusive membership. The nominated coordinator provided good statistical information, which the committee used to identify trends and problem areas. However, systems were over-reliant on healthcare staff. The healthcare manager

organised and conducted all reviews, and most F2052SHs (self-harm monitoring forms) were opened by healthcare staff after referral from residential units. Personal officers and other residential staff had little involvement in reviews. However, they made regular and informative written entries in F2052SHs. Training in suicide prevention was not delivered (apart from on initial officer training) but staff carried ligature shears. We were concerned that strip-cells were used to manage some cases of self-harm.

HP11  There were inadequate child protection arrangements. With nine juveniles held over

the previous six months, this was a significant weakness. The child protection coordinator was keen but had no allocated time to carry out specialist duties. That officer represented the prison at the Jersey equivalent of the area child protection committee; no member of the senior management team was present. There was inadequate training of staff. Such training will be a priority if the prison is to continue to hold children. Apart from some ad hoc education provision, there were no special arrangements for children. No additional support, such as social or youth workers, was available for detained children. The practice of strip-searching children needed to be reviewed and systems for risk assessments needed to be improved. Jersey was proposing to build a secure unit to hold all 15 year olds and we supported this proposal. Indeed, we questioned whether a separate unit for all juveniles might not be a better idea, as this would better protect children. Representatives of the prison should be involved in the development of the local youth action team to strengthen preventative strategies and ensure young people are diverted from custody wherever possible.

HP12  There were three separate segregation areas for male adults (E wing), young males

(G wing) and women (F wing). Some cells on the E wing unit had in-cell sanitation but the rest had none. The lack of staff continuity on E wing was problematic and led to inadequacies with documentation. However, there were good relationships between staff and prisoners and we observed staff dealing sympathetically with some very disturbed people. Both E and G wing units were used regularly to hold vulnerable prisoners, some for long periods with no proper review of their status. Efforts were made to provide vulnerable prisoners with a level of regime, including association, physical exercise and access to the library. Those on E wing could also pay for in-cell television. For those segregated for good order or disciplinary reasons there was no formal written authorisation, notes in wing files were limited, and statutory visitors did not always visit each day.

HP13  Not all adjudicators had attended a recognised training course, and there were no

standardisation meetings and no agreed tariffs for specific offences. Hearings took place in wing offices, which were unfit for the purpose. Prisoners were informed verbally that they had been placed on report, with no written information explaining the process or their entitlements. There were instances where charges had not been fully investigated, and a prisoner's incentives and earned privileges level could be reduced as an adjudication award for a single incident.

HP14  Most staff were trained in control and restraint techniques. Recorded levels of the use

of force were low, with only 12 incidents in 2005 to date and only 11 in 2004, but there was some evidence of under-reporting. Use of force documentation was generally completed to a good standard. There was only one special cell, which was in E wing segregation unit. This was routinely laid out with strip-clothing, but we were satisfied that normal clothing was not automatically removed. The special cell had been used on five occasions to date in 2005 and three times in 2004. On at least

three occasions in 2005, placement in the special cell had been authorised solely to prevent self-harm. Authorisation documentation was generally completed to a good standard but the time of removal from the special cell was not routinely recorded.

HP15  There were a number of security concerns that affected the safety of staff and

prisoners. There were not enough staff in the security department to operate effective security systems; there was little use of security information reports; no security committee; and no security meetings for at least five years. Despite the good relationships between staff and prisoners, dynamic security was not a key part of the security system. We saw potential weapons and escape equipment lying around the prison, and tool security was abysmal. There was a significant problem with illicit items entering the prison, and over the past 18 months, over 100 mobile telephones had been found inside the prison.

HP16  Despite this, officers on 'shopping runs' for prisoners were not searched when they

returned to the prison, making them vulnerable to pressure from both sides of the prison fence. Routine searches of prisoners' cells were not carried out due to staff shortages, and even target searches were not always completed. Contingency plans had been revised but were not being tested, and security keys rings had not been sealed. Night unlocking arrangements, usually to allow use of the toilet, were of particular concern. Solitary officers, carrying a full bunch of keys, unlocked cells, many of which were doubled, putting themselves and other prisoners at serious risk of harm.

HP17  The detoxification protocols were not in line with best practice, and resources were

insufficient to introduce methadone. The treatment regime was judged to be safe if not ideal. Jersey law does not allow for mandatory drug testing, but a form of voluntary testing was available. In our survey, prisoners told us that it was easy to get drugs.

Respect

HP19  Cells in most living units were small, poorly furnished and most lacked integral

sanitation. Prisoner access to toilet facilities at night depended upon night staff answering cell bells and unlocking prisoners one at a time. Prisoners complained to us that it could take up to one hour to have their cell bells answered. Prisoners were 'slopping out' in the mornings.

HP20  The standards of cell cleanliness were generally acceptable with some notable

exceptions (particularly on E wing). Cell inspections were carried out in the young adult wing, and prizes were awarded to encourage cleanliness. Some rooms not designed as living accommodation had been converted for that use, most notably the dormitory on E wing and the storerooms, cupboards and office in the old reception unit. Conditions in these areas were crowded and put pressure on limited facilities.

HP21  Association facilities were generally poor, and the rooms used for communal dining

were small, ill equipped and run down. In-cell power was supplied by cables hooked to power sockets outside of cells. This practice had not been risk assessed, and needed to be. Prisoners had daily access to showers and telephones during association.

HP22  All prisoners were allowed to wear their own clothing, and there was good access to

clean bedding and washing facilities.

HP23  Different incentives and earned privileges schemes operated for adult males, young

people and women. There was no system on the vulnerable prisoner unit. The schemes were not well publicised, and prisoners on B and C wings had little understanding of how their scheme operated. Enhanced status for adult males was location-based and only available for those within the last two years of their sentence, but serving more than 12 months. Access to enhanced status for women and young people was easier, although the system for women was not really effective.

HP24  Most staff and prisoners had good relationships. We saw impressive examples of

staff interacting with prisoners, seeking to help them through practical or emotional support, or even trying to get them work after release. Many staff clearly cared about their charges. But some prisoners had very little contact with staff, and it was rare to find staff challenging poor behaviour.

HP25  All prisoners were allocated a personal officer and most knew who they were, but

formal contact was not made and recorded. Personal officers did not maintain a diary of contact or make routine entries in personal files. There was no policy document or guidelines to inform officers what was expected of them. Prisoners knew whom to go to if they had a problem, and officers helped prisoners with their problems, but this was usually achieved informally and outside the scheme.

HP26  The prison food was of a good standard and our survey results for this were better

than the benchmarks. Prisoners could eat communally. All kitchen workers and one servery worker were trained in food hygiene. The kitchen was clean and well decorated. Food was appropriately stored and temperature checks were recorded. The menu cycle offered adequate meal choices, but there was no provision for Madeiran prisoners, the largest minority group. The gap between meal times was too long at night. We had some concerns about food hygiene, food temperature and the control of prisoners at the point of serving. There was no catering committee or formal means for prisoners to feed back their views about food.

HP27  The prison shop sold a modest range of items. No hobby items were available, and

only one product was specifically aimed at meeting the needs of women. There were no products for any black or minority ethnic group, except hot chilli sauce. Reception packs were available, although not for women, as they missed out on the reception process. Advances of earnings were not made.

HP28  The prison lacked a prisoner database, which meant that it could not monitor race

and diversity issues effectively. There was a small healthcare database and race featured on it, although the categorisations used were locally devised. According to that source, roughly 17% of the population were black or minority ethnic (Madeiran, Bengali, Irish and Black British/Caribbean). Race relations had received little managerial attention since the last inspection, and none of the recommendations in our 2001 report had been implemented. There was no local race relations policy, no race relations management team, no race relations liaison officer (RRLO) and no systems for reporting racial abuse. The RRLO had resigned from his post in 2003, and this was not discovered until our pre-inspection visit in May 2005. There were no plans to appoint a new RRLO to carry out race relations duties. Black and minority ethnic prisoners, including young adults, reported good relationships with staff and other prisoners. However, there was an acceptance of racist name-calling between young adults without appropriate challenge. In our survey, 25% of young adult respondents said they had been victimised by prisoners because of their race, significantly worse than the 4% benchmark.

HP29  The prison could not readily identify the total number of its foreign national population.

However, statistical information provided by reception and healthcare suggested they made up roughly 15% of the black and minority ethnic population, the largest number being Madeiran. There was no foreign nationals policy and the support offered to this group was very limited. No immigration and detention support was available. However, some foreign nationals received a five-minute international telephone call in lieu of visits. Nearly all Madeirans were held on the vulnerable prisoner unit.

HP30  Survey results on applications and complaints were disappointing. There was one

system for both processes, with no centralised record. There were some records in individual wing ledgers, but these were incomplete and inconsistent. Most forms were used for applications, rather than complaints. Although many issues were resolved informally, prisoners were reluctant to make formal complaints. There were no management checks on the subject matter or the appropriateness of responses.

HP31  No staff were trained in legal services work and no facility time was available.

Prisoners had very limited access to legal reference books. However, access to external legal advisers was available through a free phone system. We were unable to judge the effectiveness of this system but in our survey prisoners responded positively.

HP32  The ability to practise their religion was minimal for prisoners of all faiths. There was

no chapel, no coordinating chaplain, no daily chaplaincy team or regular visiting ministers. A Methodist preacher had conducted a one-off service, two nuns visited regularly, and an imam had agreed to visit occasionally to speak to Muslim prisoners. This was in breach of legal requirements and needed urgent attention.

HP33  Healthcare provided a good service. There was a nurse-led primary care service that

had further improved since 2001. Staff were professional, competent and caring and provided good clinical care, despite the cramped healthcare centre and the absence of wing-based facilities. All healthcare staff were nurse-qualified and the skill mix was good, if limited. There was no formal nurse triage and only a few nurse-led clinics, such as smoking cessation. There was no clinical supervision and no clinical governance. The pharmacy service was supply-only and in-house services were needed. Patients had good access to doctors from a local practice. The dental waiting list was relatively short, as was the waiting list to see the physiotherapist. Patients also had reasonable access to secondary care in the local hospital. Specialist mental health nursing care was limited and provided from the local forensic psychiatric team. There were no secure mental health beds on the island, and minimal primary mental healthcare for prisoners.

HP34  We strongly supported the proposals for service development submitted to the health

and social services and home affairs committees. The appointment of a health promotion coordinator in the prison was a good first step. We also strongly supported plans to shift responsibility for prison healthcare and funding from the home affairs committee to health and social services committee to better meet the healthcare needs of prisoners.

Purposeful activity

HP36  The provision of education was significantly below the required levels. The prison had

just 25 hours a week of one teacher's time and occasional sessional teachers. The range of education offered included English for speakers of other languages, literacy and numeracy, basic computer skills, European computer driving licence, Maths GCSE, Spanish, yoga, first aid, bookkeeping and accountancy, and GCSE/A level distance learning courses. All prisoners on distance learning courses had to pay 50% of course costs, which had an impact on those on low income. If school-aged children were held, one teacher could be provided on a grace-and-favour basis until they left, but this was not guaranteed. Provision for prisoners in learning averaged one to two hours a week. One module in City and Guilds horticulture was available, but there was no other vocational training.

HP37  There were proposals for prison education to become the responsibility of the

education committee rather than the home affairs committee. We supported such a move.

HP38  There was little full-time unemployment. The prison operated a labour pool from

which people could be sent to workplaces where a shortfall had occurred. Work opportunities for male adults included kitchen, laundry, French polishing, refurbishment and manufacture of garden furniture, upholstery, vehicle painting, making emergency blankets, pallet making, gardening and wing cleaning. The provision for young adults was limited to vehicle washing and valeting, and motorcycle repair and wing cleaning. There were not enough work opportunities and training for women, who were restricted to gardening or wing cleaning. No work attracted recognised work skills qualifications.

HP39  The prison had no monitoring system for prisoner time out of cell, but we noted that

prisoners were rarely locked in their cells and the prison routine allowed all prisoners to have association at weekends.

HP40  The library facilities were generally poor with an inadequate selection of educational

and recreational books. External library agencies provided cast-off books. There were links with the external library service, and some prisoners could access outside library facilities monthly. There was a small selection of books on the corridors for young people but none for vulnerable young people. There had been no attempt to match prisoners' cultural, social needs and interests. Reference books were limited across the prison.

HP41  Physical education facilities were limited – most noticeably by the lack of a sports hall

– and the only provision was recreational, with some weights and exercise cycles. Access was good for adult male prisoners on A, B and C wings. There was less access for women and young adults, although some cardio-vascular equipment was available for use on their wings, and they had access to sports and games in the evenings.

Resettlement

HP43  The prison had no resettlement policy, committee or clear management lead. Work

on resettlement matters was haphazard and patchy. Local restrictions had been imposed on temporary release, and the absence of parole in Jersey created additional difficulties. There was valuable strategic work to develop a small, open unit to introduce some form of post-custody supervision.

HP44  Sentence planning was uncoordinated, fragmented and largely ineffective. There

were individual pockets of good work, particularly in the female wing, which could be a model for future improvements. Funding had been agreed to appoint three additional staff from January 2006 specifically to develop this area.

HP45  There were no special arrangements for lifers, except for initial 'special watch'. All

cases were subject to early transfer to the mainland, and had to be arranged between governors. Delays in sentencing were arising, caused by changes in legislation. There were potential human rights issues for island lifers who wished to serve their time on the island.

HP46  No accredited offending behaviour programmes were available to prisoners. There

had been no needs analysis and there were no plans to conduct one. There was clear scope to introduce programme work for drug importers.

HP47  Most prisoners remained in Jersey after release. Survey results about preparation for

release were poor. There was little systematic activity, although there were individual cases where officers had provided help to individuals. There was also some useful temporary release work, and some limited casework from in-house psychology and probation staff. There was a proposal for a new scheme involving community work, paid work and tagging. Job Club provided a weekly surgery, but there were poor links with housing providers. Support for prisoners returning to the UK was particularly poor as there were no routine links with UK probation.

HP48  The prison's first drug strategy meeting had taken place during the month of our

inspection. The draft strategy document was already outdated. The focus was on supply reduction, and there was no action plan or performance measures, no linkage of supply and demand initiatives and no reflection of the needs of the different populations. A newly appointed drug strategy coordinator was keen to move things forward. This needed to be a priority. The single alcohol/drugs counsellor provided one-to-one counselling and drug/alcohol awareness courses, but was employed for only 25 hours a week; this was wholly inappropriate. There was no voluntary drug testing; but there was compliance testing within the incentives and earned privileges scheme, which was over-punitive.

HP49  The main visits room had uncomfortable, fixed plastic seating and two long, fixed

tables. Seating was close together, there was little privacy, and the area appeared crowded and was noisy. There was a lack of information notices for visitors, no facilities for refreshments, no children's play area and no visitors' centre. Evening visits and family visits were offered. The latter took place off-site in more pleasant surroundings.

HP50  There was no public protection policy, committee or any accurate management data

available. As a result, it was not possible to identify, monitor and review all relevant cases confidently. Although staff had above average knowledge about local cases, there was an over-reliance on anecdotal means of identifying high-risk cases. The seconded probation officer carried out some useful work, but the lack of a permanent post undermined the consistency required. Agencies on the island were debating which model of public protection to adopt, and this also needed to be decided as a priority.

Main recommendations

HP51  Children and juveniles should be held in a separate secure unit.

HP52  The prison should have a prisoner database and IT system so that it can

effectively analyse and manage its prisoner population.  

HP53  The States of Jersey should consider transferring responsibility for prison

health and education to the island's health and education departments.

HP54  The prison should draw up a Performance Improvement Plan, using the

detailed recommendations in this report, and setting priorities and timed targets for action. It should include :

Effective first night and induction processes

A violence reduction strategy, and systems, procedures and staff training to deal with bullying

Procedures for identifying and supporting vulnerable prisoners in appropriate locations

Refurbishment of the accommodation for women, and specific policies and practices to meet their needs

Effective child protection measures, while children remain at La Moye

Systems to record prisoners' ethnicity, monitor access to regime facilities by race and ethnicity, identify and meet the needs of black and minority ethnic and foreign national prisoners

Facilities for religious observance that meet statutory requirements

A review of security, and the implementation of effective procedures and management systems

The introduction of more education and skills training

A resettlement needs analysis, followed by the implementation of effective resettlement strategy, supported by a committee and led by a manager.

HP55  New night unlocking arrangements should be introduced immediately to ensure

that an officer unlocking a cell does not carry other keys. The remaining keys should be held in a place where no prisoner has immediate access.

Section 1: Arrival in custody

Courts, escorts and transfers

Expected outcomes:

Prisoners travel in safe, decent conditions to and from court and between prisons. During movement the individual needs of prisoners are recognised and given proper attention.

1. Prisoners were transported the short distance from La Moye to the courts in Jersey's one cellular vehicle. Adult men, women, children and vulnerable prisoners travelled together. No personal information accompanied prisoners, other than their committal documents.
2. Police provided the court escort service in Jersey. The distance from La Moye to the island's courts was short, and there were no excessive journey times or late arrivals.
3. The prison received new prisoners every day of the week, including weekends. Adult men, women, children (both male and female) and vulnerable prisons travelled together in Jersey's one cellular vehicle. Although the distances were small and the time spent on vehicles was short (usually less than half an hour), the practice was unacceptable and, with the low numbers involved, unnecessary and easily avoided.
4. Prisoners arrived at La Moye without any personal information from the other agencies that had looked after them previously. There was no form of prisoner escort record. It was not clear how important information about a prisoner would be conveyed from other agencies to prison staff. We were told that important medical information about individuals was passed on by the police surgeon. However, there was no information accompanying one young person with a serious medical condition who arrived during the inspection.
5. Staff knew many new receptions already from previous sentences, and there was a heavy reliance on this. But there were no safeguards or systems to cover prisoners who were not known to staff.

Recommendations

6. Adult men, women and children should be transported separately to and from La Moye and the courts.
7. A prisoner escort record should be introduced.

First days in custody

Expected outcomes:

Prisoners feel safe on their reception into prison and for the first few days. Their individual needs, both during and after custody, are identified and plans developed to provide help. During a prisoner's induction into the prison he/she is made aware of prison routines, how to access available services and how to cope with imprisonment.

8. Staff in reception were welcoming. New arrivals could be located on any of five different wings. There were no first night arrangements and no formal assessments of prisoner risk, suitability to share a cell or vulnerability. There was no induction process for newly arrived prisoners.

Reception

9. New receptions averaged only around seven per week. Most new arrivals were processed through the new reception on H wing. However, women were received straight on to F wing, which was not designed for receiving prisoners and had worse facilities. We could see no reason why all new arrivals should not be processed through the new reception. When we pointed this out the prison agreed, and by the end of the week newly arrived women prisoners were also processed through the new reception.
10. Reception was a reasonable facility. It was extremely clean and well maintained. However, there were only two holding rooms, which were unscreened, and lines of sight from the staff office into one of these rooms were poor. The shortage of holding rooms could cause problems if women, men, children and vulnerable prisoners came in together. There was no proper strategy or contingency to deal with such a situation. We were told that staff would manage such a situation as they saw best, if and when it arose.
11. New prisoners were booked in in an efficient manner, and did not spend long in reception. Staff were welcoming and put prisoners at their ease in a relaxed and informal atmosphere. Use of first names was normal. Prisoners were offered a shower and given a hot meal from H wing servery.
12. The arrangements for searching newly arrived prisoners were unacceptable. Most prisoners, including children, were strip-searched routinely by just one member of staff, unless another officer happened to be in the vicinity. This was unacceptable practice for searching any prisoner, but had particularly serious child protection implications. A member of healthcare staff also attended reception for a health screening interview with new receptions.
13. In La Moye's reception the dressing gown that should have been provided to prisoners during a strip-search had been replaced with an anti-ligature strip-gown. Strip-clothing is designed to replace prisoners' normal clothing as a last resort to prevent self-harm, and its routine use in reception was inappropriate. When this was pointed out, it was removed immediately.
14. All newly arrived children were routinely strip-searched in reception. Although this was done sensitively, it was not based on any risk assessment. Especially as all new arrivals had several searches before they arrived at La Moye, it was inappropriate to subject children to routine strip-searching.
15. Prisoners were issued with a smoker's or non-smoker's shop pack in reception. As women had bypassed reception until the week of the inspection, they had not previously benefited from this.

First night

16. Prisoners spent their first night in one of a variety of locations. Adult men were usually assigned to C2, but could also go on to B wing. Prisoners requesting protection were allocated

to E wing. Young male prisoners went on to G wing. Women prisoners of all ages were allocated to F wing.

17. There were no special first night procedures to ensure the safety of new arrivals. There were no formal risk assessments or assessments of the suitability of individuals to share cells. There were no special vulnerability assessments of children. The only intervention was a brief interview with a member of staff on the wing, when the information sheet opened in reception was completed.
18. In our survey, we asked prisoners if they felt safe on their first night. Although many newly arrived prisoners had been at La Moye before, more than 30% of respondents, and 50% of women respondents, said that they felt unsafe on their first night. This position had worsened since the last inspection, when only 15% of prisoners surveyed said that they felt unsafe on their first night.
19. An example of some of the comments we received was from an adult male prisoner who said: the first night, I won't forget for the rest of my life how depressed and painful I was in the cell'.

Induction

20. There was no formal induction programme on any wing. On F wing, staff went through procedures with new receptions on the day they arrived, and a prisoner Insider saw all new arrivals and explained about life inside La Moye. Prisoners on other units did not benefit from even this limited service. Although peer supporters were not a substitute for an induction programme, this system could be expanded to other units in the short term, at no cost.
21. All new prisoners who passed through the main reception were given a booklet about La Moye. However, much of the information in it was out of date and the content needed reviewing, ideally in consultation with the prisoner population.
22. In the absence of a proper induction programme the prison had no means of assessing individuals' needs and risk areas, making referrals where necessary or setting early custodial targets and objectives for prisoners.  

Recommendations

23. No prisoner should be strip-searched with only a single member of staff present.
24. All newly arrived prisoners should be received into the reception area on H wing.
25. There should be a proper first night strategy including, as a minimum, procedures for assessing individual risk factors and suitability to share a cell.
26. There should be formal vulnerability assessments of all newly arrived children.
27. An induction programme should be designed and implemented.
28. Prisoner Insiders should be trained to operate as peer supporters on all wings.
29. The content of the induction leaflet should be reviewed and updated in consultation with prisoners.

Housekeeping point

30. Anti-ligature strip-clothing should not be used for strip-searches in reception.

Section 2: Environment and relationships

Residential units

Expected outcomes:

Prisoners live in a safe, clean and decent environment within which they are encouraged to take personal responsibility for themselves and their possessions.

1. Except for H wing, cells on most on the residential units were small, poorly furnished and lacked integral sanitation. The standards of cell cleanliness were generally good. Association facilities were generally poor, and the rooms used for communal dining were small and run down. The female wing (F wing) and the vulnerable prisoner unit on E wing were particularly dreary and cramped. All prisoners could wear their own clothing. Prisoners had good access to clean bedding and washing facilities, and daily access to showers. Prisoners in the converted, former reception unit were held in unsafe conditions.

Accommodation and facilities

2. Seven residential units accommodated up to 184 prisoners. None of the accommodation was certified.
3. There were separate units for adult men, women and young people, and a vulnerable prisoner unit (VPU) on E wing. All residential units were accessible through a single corridor in the main prison.
4. Remand and convicted adult prisoners were located on A, B, and C wings. H wing housed 35 enhanced-level prisoners. A wing was designated as a drug-free unit and used as the feeder accommodation for H wing. G wing was designated for young people. F wing, for women, was in a discrete area in the main prison.
5. All residential units had a mixture of single, double and dormitory cells. There were communal association rooms, but little office and interview room accommodation. Apart from H wing, the general conditions of the wings were poor. Although generally clean, they were old and tired looking. Communal areas on the older units were small, landings were narrow, and sight lines were poor. Association facilities were generally poor, and the rooms used for communal dining in residential units (apart from H and G wing) were small, ill equipped and run down.
6. The female wing was particularly dreary and cramped, with a marked lack of recreational equipment. The communal areas in F wing were dark and needed decoration. There was a room with a rowing machine and exercise bike, but this was too small for purpose. The dormitory, accommodating nine prisoners, was crowded.
7. Except for H wing, cells on the residential units were small, poorly furnished and lacked integral sanitation. Access to toilet facilities at night depended upon night staff answering cell bells and unlocking prisoners one at a time. Single officers answered cells bells at night and allowed prisoners to use the toilets. Prisoners complained that it could take up to one hour for their cell bells to be answered due to the number of people who required attention. As a result, many prisoners slopped out in the mornings.

8. Most cells had in-cell televisions. In-cell electricity was supplied by cables hooked to power sockets outside cells. Risk assessments had not been carried out. Cables on the third landing of C wing were laid across the communal floor and posed an obvious trip hazard.
9. A variety of rooms not designed as living accommodation had been converted for that purpose, most notably the dormitories on E and F wings, and the storerooms, cupboards and office in the old reception unit. Conditions in these areas were crowded, putting pressure on limited facilities.
10. E wing (the VPU) was in a particularly poor state. It was originally designed to hold up to 18 prisoners in single accommodation. At the time of inspection, it held 43. There were dormitories that were converted classrooms, and most of the cells designed for single occupation had been doubled up. The old reception unit (near A wing) had recently been converted into accommodation for prisoners deemed unable to cope on the VPU. The conversion was crude. Storage space, holding rooms and offices had been turned into makeshift bedrooms for up to two prisoners. There were no doors to separate the rooms, and prisoners had tacked blankets to the doorways for greater privacy. There were no windows in the bedrooms and no natural light. Seven adult male prisoners occupied the 'unit'. There was a single emergency alarm bell in the small association room but no general call system to allow prisoners to reach staff for situations that were not emergencies.
11. H wing was clean, well decorated and bright. Cells were equipped with in-cell power and were well furnished. All had in-cell televisions. Association facilities were good. Pool tables and communal televisions were in a good condition and well looked after by prisoners.

Clothing and possessions

12. All prisoners were allowed to wear their own clothes. Good quality prison clothing was issued to those who preferred not to wear their own. Prisoners had weekly access to wing laundries on all residential units, run by wing orderlies.
13. Personal items sent in were processed quickly through reception and often reached the prisoner the same day. Some items for everyday use (such as socks and underwear) were always delivered to the prisoner on the day they arrived. Prisoners could have their own bed sheets and bedding sent or handed in on visits. Prison bedding was available through weekly applications.
14. In our survey, 99% of respondents said that they were offered enough clean and suitable clothing for a week.

Hygiene

15. Prisoners had adequate supplies of their own toiletries. Soap, toothpaste and shampoo sachets were available on the residential units on request. Toiletries were available in the prison shop and there were no restrictions on the amount that prisoners could have in- possession.
16. Prisoners had good access to showers during periods of association. In our survey, 100% said they could have a shower every day.

17. We did not see systems for prisoners to get cell cleaning materials, but they were issued with mops, vacuum cleaners and other cleaning items on request. There were weekly cell inspections on the young adult wing (G wing) with prizes for the cleanest cell.
18. Cells were generally clean and free from graffiti. Mattresses were in good condition and were exchanged as necessary.

Recommendations

19. There should be a full health and safety risk assessment of the arrangements for in-cell electricity.
20. The converted accommodation in the old reception unit is unfit for purpose and should be refurbished or closed. An emergency cell call system should be installed there as a matter of urgency.
21. There should be a programme of refurbishment for A, B, C, E, F and G wings.
22. All cells should be fitted with integral sanitation.

Staff–prisoner relationships

Expected outcomes:

Prisoners are treated respectfully by staff, throughout the duration of their custodial sentence, and are encouraged to take responsibility for their own actions and decisions. Healthy prisons should demonstrate a well-ordered environment in which the requirements of security', control' and justice' are balanced and in which all members of the prison community are safe and treated with fairness.  

23. Staff–prisoner relationships were in general friendly. Some good informal work helped prisoners to address their needs. Staff did not challenge inappropriate language or behaviour.
24. Our survey recorded that 80% of respondents felt that most staff at the prison treated them with respect.  
25. We were impressed by the friendly nature of relationships between prisoners and staff. The use of first names was not uncommon, although not universal. Many of the staff knew prisoners from the small community outside the prison, and this was reflected in the nature of many of the interactions we saw. Some staff knocked on doors before entering, and there were greetings at unlocking times.
26. Because of the lack of prisoner opportunities for learning, addressing offending behaviour or making resettlement plans, we were unable to judge the extent of staff involvement in helping prisoners to change their lifestyles. However, there were examples where individual staff or groups of staff had worked with prisoners informally to help them address drug or other problems, and there had been cases where staff had arranged jobs for prisoners after release. There were no recording systems for these types of activity and we were unable to judge the extent of the informal help for prisoners. Many staff at La Moye genuinely cared about the

prisoners in their care, and did what they could to assist them, with little help or guidance from prison managers.

27. Some areas of the adult prison appeared to have few visible officers, and staff–prisoner contact was minimal. We saw inappropriate behaviour or language go unchallenged in all the male parts of the prison. For example, one officer was barged out of the way by a young adult on G wing. There was no apology and the officer made no attempt to correct this behaviour.

Personal officers

Expected outcomes:

Prisoners' relationships with their personal officers are based on mutual respect, high expectations and support.

28. All prisoners were allocated personal officers and most knew who they were, but there was no formal contact or records. Prisoners knew whom to go to if they had a problem, and staff helped them. However, this was generally done informally.
29. Prisoners were interviewed by wing managers as they arrived and given the name of their personal officer. Lists were displayed on boards in wing offices. Prisoners knew who their personal officers were, but many said they had not seen them formally since their arrival.
30. Formal contact between prisoners and personal officers was not scheduled or recorded. There were no identifiable entries in wing files from personal officers to indicate systematic work with prisoners. Entries in wing files were predominantly concerned with day-to-day behaviour and did not generally deal with the personal and individual circumstances of prisoners. Some entries in wing files showed a good knowledge of the prisoner's personal circumstances, but these were unrelated to the formal personal officer scheme. Personal officers did not routinely approach their prisoners to monitor their welfare, challenge their patterns of behaviour or support their progress.
31. There was no policy document to describe the role of the personal officer at La Moye. Staff were not issued with guidance on what they were expected to do and when, and were not allocated time to see prisoners formally. The scheme was not well supported by managers.
32. Most prisoners felt that staff were generally responsive when they had problems. In our survey, 76% said that there was a member of staff that they could go to if they had a problem.

Recommendations

33. A policy document should be published setting out the operation of the personal officer scheme and managerial responsibilities, and there should be guidance for personal officers on their role.
34. There should be routine management checks of personal officers' contact time and the quality of entries in prisoners' personal files.
35. Personal officers should have scheduled times to carry out their duties.

Section 3: Duty of care

Bullying

Expected outcomes:

Everyone feels safe from bullying and victimisation (which includes verbal and racial abuse, theft, threats of violence and assault). Active and fair systems to prevent and respond to bullying behaviour are known to staff, prisoners and visitors, and inform all aspects of the regime.

2. There was no published anti-bullying policy, anti-bullying coordinator or dedicated committee at La Moye that could measure and monitor the extent of bullying. There was no staff training programme. Officers said that they relied upon their good relationships with prisoners to tackle bullying as it happened.
3. A draft policy had been written in 2004 but had not been implemented. Its content was based on strategies used in England and Wales, and did not consider local conditions or an analysis of the required resources for implementation.
4. The prison psychologist had carried out a prisoner survey in May 2004 on the nature and extent of self-reported bullying. Sixty prisoners (including young people) were surveyed: 71% said that bullying was a serious problem, and 61% that it was better to get help from prisoners than staff if they were being bullied. Managers and staff were unaware of these results. The information had not been analysed and was not informing strategies for dealing with the apparent problem.
5. Allegations of bullying were not formally investigated and prisoners did not receive responses to complaints. There was no log of bullying incidents. Of the 50 most recent applications from prisoners requesting segregation for their own protection, 38 were because of threats or bullying from other prisoners. These requests were accepted without formal investigation of the circumstances.
6. Attention was given to suspected victims rather than alleged perpetrators. Victims were moved systematically to the vulnerable prisoner unit on E wing with no assessment of the possible risk to themselves or others. Officers arranged transfers to E wing without the authority of residential managers, and there was no scrutiny of the reasons that informed the authorisation for segregation of these prisoners. There were no reviews of changing circumstances after a prisoner was admitted to E wing, and there were no reintegration plans or any interventions to allow prisoners to develop coping strategies.

7. The number of people requesting places of safety far exceeded the prison's capacity to provide appropriate accommodation. E wing had been designed to accommodate 18 prisoners and held 43. Nearly all of the small cells, designed for one, held two prisoners, and an old classroom converted into a dormitory accommodated up to eight prisoners. These areas were not supervised regularly, and there were no records to show that officers patrolled them. C1 landing was used as an overflow unit for those unable to find space on E wing.
8. Some prisoners told us they were afraid to come out of their cells during association and that bullying on E wing was a real problem. Staff did not record instances where prisoners were known to be spending time in their cells when unlocked.
9. Prisoners who complained that they were not safe on E wing were housed in the old reception unit, accommodated in converted storerooms and cupboards. Seven prisoners were sharing accommodation separated by blankets hanging from doorways (see paragraph 2.10). Prisoners there were not supervised, and were locked in the unit and left alone for most of the day and night without staff support or supervision.
10. Staff supervision was poor in some areas of the residential units. Groups of prisoners were left on their own for long periods when unlocked, particularly on the second and third landings of A, E, B, and C wings. Three officers were designated to supervise prisoners on A, B and C wings. They were unable to supervise all of the nine landings where prisoners had access while unlocked. This provided good opportunities for bullies.
11. Information to identify the extent of the problem or to identify areas of particular risk was not used. Security information reports (SIRs) were not used to communicate concerns, and the contents of complaints from prisoners were not analysed. In 2004, there had been no SIRs from staff on possible incidents of bullying.
12. There were no correlations between the number and nature of adjudications, assaults by prisoner on prisoner, recorded suicide and self-harm attempts, or other relevant information that might have indicated bullying behaviour.

Recommendations

13. An anti-bullying coordinator should be appointed.
14. An anti-bullying committee should be set up to monitor and measure the quality of the anti-bullying strategy.
15. Staff should be trained in anti-bullying procedures.
16. There should be systems to ensure that all information concerning bullying is correlated, communicated and used to inform intervention.
17. Prisoners should not be located in the vulnerable prisoner unit without an examination of the reasons for application and an assessment of risk.
18. A senior manager should give authority for segregation at the request of the prisoner.
19. A senior manager should monitor the population profile of E wing each month.
20. Managers should ensure that staff can supervise prisoners adequately.

Self-harm and suicide

Expected outcomes:

Prisoners at risk of self-harm or suicide are identified at an early stage, and a care and support plan is drawn up, implemented and monitored. Prisoners who have been identified as vulnerable should be encouraged to participate in all purposeful activity. All staff are aware of and alert to vulnerability issues, are appropriately trained and have access to proper equipment and support.

22. A self-harm and suicide strategy document had been written and published. Its content set out, in simple language, the prison's guiding principles, priorities and targets, and described underlying factors in the causes of self-harm and suicide.
23. The healthcare manager had been nominated as the prison's suicide prevention coordinator and managed the process and intervention methods on a day-to-day basis. A suicide prevention committee had been set up to manage the systems prescribed in the policy. Meetings were held monthly and were chaired by the governor. Although attendance at these meetings was good, not all areas of the prison were represented. Healthcare, psychology and probation departments were consistently represented, but staff from the residential units did not always attend and prisoners were not involved or consulted.
24. Good statistical information was provided and was being used by the committee to identify trends and potential areas of concern. However, possible correlations between incidents of self-harm and possible bullying were not made.
25. Systems were over-reliant on healthcare staff. All reviews of active self-harm cases were organised and conducted by the healthcare manager. Healthcare staff opened most F2052SHs after referral from residential units. In 2004, they opened 38 of the 47 F2052SHs.
26. There were four live F2052SHs during our inspection. The quality of entries was good and concentrated on levels of mood and not single examples of behaviour. The suicide prevention coordinator made daily management checks. All cases were communicated to staff during a formal handover period each morning. Case reviews were held on time. They were organised by the suicide prevention coordinator exclusively and regularly attended by the psychologist and a member of the healthcare team. Personal officers, residential managers and the prisoner concerned attended regularly.
27. Prisoners had been located in special cells under strip-conditions to manage their self-harming behaviour in three cases in 2005 to date. These situations were not brought to the attention of the suicide prevention committee or documented as any part of the case management process.

Recommendations

28. Residential managers should be responsible for managing prisoners considered to be at risk of suicide and self-harm.
29. Residential staff should attend all F2052SH (self-harm monitoring) case reviews.
30. Residential managers should regularly attend suicide prevention committee meetings.
31. The suicide prevention committee should examine the correlation between bullying and self-harm each month.
32. An anti-bullying coordinator should attend all suicide prevention committee meetings.
33. Prisoners considered at risk of self-harm should not be managed in strip-conditions.

Child protection

35. The child protection coordinator was an officer who had volunteered for the post. He was extremely keen and willing. He had completed relevant training at the prison training school in the UK and had a firm grasp of basic child protection issues. The coordinator was regarded as the key worker for children throughout the prison, and carried out much useful support work between children and their families, often in his own time. He had no allocated time to carry out this task.
36. The child protection coordinator was the prison's representative at the Jersey child protection committee. This was not appropriate, as someone in a management position should have taken this role.
37. Although there was a child protection policy, it was clear that there was no common understanding about how the procedures should operate. The coordinator told us that there had never been a referral generated from inside the prison. However, the prison's probation officer said that she had made child protection referrals herself directly to the children's service department in the community. There was no internal child protection committee, and there did not appear to be a nominated senior manager responsible for this area.
38. We were unable to determine how many staff had received child protection training. Our best estimate was that approximately half of all staff had completed relevant training. This was a concern given the high level of cross-deployment in the young adult and the women's wings, where children were located. As far as we could establish, staff had had a standard police check only. This was inadequate when there was a prospect of them coming into contact with children.

39. A further concern was the absence of any risk assessment or vulnerability assessment of juveniles (those under 18). Juveniles were located in the young adult and women's wings, where the levels of informal welfare support were generally good. Based in these areas, boys would not have come into contact with adults over the age of 21. However, because of the lack of rigour in public protection arrangements (see public protection section), they could still share accommodation with young adults, who could be a risk to them. Girls had their own cell on the women's unit, but unsupervised mixing with adults was possible at times. Although the level of informal support available to the younger population was good, there was no system to assess the distinctive needs of vulnerable children. This needed to be introduced.
40. No juveniles were held at the time of the inspection, but there had sometimes been several at a time during the preceding year. Despite the best efforts of staff, and even if the recommended improvements were introduced, the prison was an entirely unsuitable environment for children. Approval had recently been given for a new 12-bed secure unit to be built on the island, where it was hoped to hold 15-year olds. We support this and believe that all juveniles could be held here to properly protect all children required to be kept in secure conditions. Because of the small numbers involved, the local authority had a realistic prospect of being able to avoid placing children in prison.
41. A youth action team (YAT) was due to be set up in Jersey, an initiative similar to the youth offending teams (YOT) in the UK. At the time of the inspection, prison staff were not involved in the planning of this new initiative and this was a missed opportunity to strengthen preventative strategies to divert young people from custody.

Recommendations

42. Children should never be strip-searched by a solitary member of staff and should never be strip-searched without a documented risk assessment beforehand.
43. A senior member of staff should represent the prison at the Jersey child protection committee.
44. The child protection coordinator should be allocated protected time to carry out this function.
45. An internal child protection committee should be set up.
46. Child protection training should be delivered to all staff who have contact with children.
47. There should be enhanced police checks on all staff who have contact with children.
48. There should be risk and vulnerability assessments to ensure that children are not exposed to individuals who might be an unacceptable risk to them, and that their individual needs are met.
49. Prison staff should be represented in the planning for the youth action team.

Race relations

Expected outcomes:

All prisoners experience equality of opportunity in all aspects of prison life, are treated equally and are safe. Diversity is embraced, valued, promoted and respected.

51. The prison did not have accurate figures for its black and minority ethnic population because there was no formal mechanism for recording prisoners' ethnic origins. However, according to the figures supplied by reception and healthcare, approximately 17% of the population were black or minority ethnic (Madeiran, Bengali, Irish and black British/Caribbean). The figures were inaccurate as we saw more Madeiran prisoners than recorded, but they had clearly been included in the white/British category.
52. Race relations had received little managerial attention since the last inspection, and there had been no work in this area since 2002. There was no local race relations policy. The prison's equal opportunities and race relations policy statements had been publicised around the prison by the race relations liaison officer (RRLO) in 2002, but were no longer in evidence on the residential wings.
53. There was no race relations management team, no systematic recording of prisoners' ethnic origins, no formal mechanism for monitoring different black and minority ethnic groups' access to facilities or services, no promotion of positive race relations or cultural diversity within the prison, and no diversity training for staff.
54. The RRLO had resigned from his post at the end of 2003 and had not been replaced, but this fact was not noted until our pre-inspection visit in May 2005. Although the governor said the promotion of good race relations was important to the prison, there were no firm plans to appoint a new RRLO to carry out race relations duties.
55. The previous RRLO had been enthusiastic and committed, but had not received any facility time to carry out race relations duties in his two and a half years in post. He had produced a business plan in August 2002, but very few of the objectives had been achieved. He had also carried out an assessment exercise on the language needs of Madeiran young adults, ensured catering arrangements were in place for Ramadan, and compiled a list of Madeiran individuals, including staff, willing to interpret.
56. He had also established contact with the RRLO from HMP Moorland, and subsequently, introduced racist incident complaint forms to the residential wings. A racist incident complaint log was created and four incidents were dealt with, although only three were logged during 2002. There was evidence of sound investigative practices and a clear commitment to address issues of discrimination. For example, in one case where an Asian prisoner complained about an officer's inappropriate handling of racist graffiti, the complaint was upheld and the officer received guidance and training on race relations.
57. In our survey, 5% of respondents said they had been victimised by prisoners because of their race. On the whole, black and minority ethnic prisoners reported good relationships with staff

and other prisoners. However, there was an acceptance of racist name-calling between young people without appropriate challenge from staff.

58. The catering department routinely organised a special menu for Muslim prisoners to celebrate Ramadan. However, no dishes were provided to meet the needs of Madeiran prisoners, who were the largest minority group. There were information leaflets in Portuguese and French in healthcare, and a few Portuguese books in the library, on the women's wing and on the vulnerable prisoner unit.
59. Staff reported that one Madeiran and one black member of staff had both received a high level of racial abuse from some staff and prisoners, and this was ignored by management. Management leadership and training in race relations and diversity would help to raise awareness and confidence in dealing with race and cultural issues.

Recommendations

60. The prison should set up a race relations/diversity committee to champion work on race relations and diversity.
61. A race relations liaison/diversity officer should be appointed to carry forward the work started by the previous race relations liaison officer.
62. A programme of training on race relations and diversity should be organised for all prison staff.

Foreign national prisoners

Expected outcomes:

Foreign national prisoners should have the same access to all prison facilities as other prisoners. All prisons should be aware of the specific needs that foreign national prisoners have and implement a distinct strategy, which aims to represent their views and offer peer support.

64. The prison could not readily identify the total number of its foreign national population. However, statistical information provided by reception and healthcare showed they made up roughly 15% of the population. The largest number of this group was Madeiran-Portuguese (9%), Bangladeshi (3%) and Irish (2.25%). A significant number of foreign nationals lived on the vulnerable prisoner (VPU) unit, and almost all prisoners of Madeiran origin resided on that unit.
65. Nobody had responsibility for looking after the needs of foreign nationals. There was no policy and the support offered to this group was limited. There was evidence that some foreign nationals received a five-minute international telephone call in lieu of visits, but this was not offered to all prisoners routinely and there was no formalised system.

66. Telephone translation services were not used, but some Portuguese-speaking officers interpreted for prisoners. English for speakers of other languages (ESOL) classes were provided, but for only an hour a week. Reception had kept copies of the prisoner information booklet (compacts) in Portuguese and French, but these were no longer available. The reception risk assessment form was available in French, but this was outdated. Healthcare had information booklets in Portuguese and French, including literature about safer injecting and help available for detoxification and smoking cessation.
67. The library had 40 books in Portuguese, and women from F wing could get Portuguese books from the local library every three weeks. The women's wing also had a small collection of foreign language books and magazines that had been left there by prisoners. There was an information leaflet in the visits room, and the dedicated Portuguese officer on the VPU had put together a small collection of two Portuguese/English bilingual dictionaries, 20 Portuguese books (mainly fiction), as well as notices in Portuguese about obtaining visiting orders and making an appointment to see the doctor.
68. There was no immigration and detention support available for foreign nationals. Three prisoners said they would be deported on completion of their sentence and had to use their own resources to speak to their solicitors. However, staff on E wing had allowed one prisoner to make calls seeking legal and immigration advice free of charge.
69. The foreign nationals we spoke to during the inspection said they had not experienced any racial discrimination. However, the seven foreign nationals (Bangladeshi and Madeiran) whom we spoke to in a focus group discussion were angry and frustrated. They felt that staff ignored their requests for assistance (with free international telephone calls, supervised visits, and immigration and resettlement issues). While they said staff were reasonably pleasant, they lacked knowledge about their needs, and consequently, appeared unsupportive. They said that staff, however, tended to be receptive to requests for help from local men.

Recommendations

70. The ethnicity and racial origins of all prisoners should be recorded in reception when they arrive.
71. The prison should produce a policy for dealing with foreign nationals and appoint a coordinator to ensure their needs are met appropriately.
72. The process of giving foreign national prisoners a free five-minute telephone call or letters in lieu of visits should be formalised, and telephone calls for foreign nationals isolated from family and friends should be subsidised.
73. Management should examine the reasons why foreign national prisoners, particularly Madeirans, are placed on the vulnerable prisoner unit and should find appropriate solutions.

Family and friends

Expected outcomes:

Prisoners are encouraged to maintain contact with family and friends through regular access to mail, telephones and visits.

Mail

75. There were no restrictions on the number of letters prisoners could send or receive. Prisoners received one letter a week to send at public expense, and could buy stationery and stamps from the prison shop.
76. All incoming mail was received into the centre office where it was opened, checked for enclosures, and sorted according to residential units. Legal correspondence, when identified, was delivered unopened on the day of arrival. There were no systems to identify mail that had been legitimately targeted for censorship, and there were no public protection measures in place (see section on public protection). Ten per cent of mail was routinely censored.
77. Mail was delivered to prisoners on the day of its arrival. Only 23% of those surveyed said that they had experienced problems with sending or receiving mail. Outgoing mail was processed on the residential units and taken to the administration department for posting out on the same day.

Telephones

78. Access to telephones was primarily during association. There were card-operated telephones on all residential units, except for the old reception unit. Prisoners there were given access to the office telephone in the evening at times determined by patrolling officers. These times varied daily. Prisoners had daily access but were unable to plan calls due to the unpredictability of the time that staff visited the unit. Calls were free of charge.

Visits

79. Social visits were offered from 1pm to 4:40pm, Monday to Saturday. Legal visits were available during weekday mornings. Adults, vulnerable prisoners and young people had separate visits. All were given a minimum of 30 minutes a week. Visits for convicted men and women took place between 1:30pm and 3:30pm. The 30-minute entitlement was not strictly adhered to in practice. If the room was not full, prisoners were allowed to continue their visit until 3:30pm.
80. Visiting times were from 3:30pm to 4pm for young adults and from 4:10pm to 4:40pm for vulnerable prisoners. These visits were strictly 30 minutes. Remand prisoners were entitled to a 15-minute visit per day but booked visits as convicted prisoners. Prisoners were allowed two adult visitors per visit. There was no set limit on the number of children who could accompany adult visitors.
81. Prisoners booked their visits through application on their residential unit. In our survey, 80% of respondents said they could have the number of visits that they were entitled to.
82. There was no visitors' centre. A visitors' waiting room next to the main visits room had a few uncomfortable, plastic chairs. Warning notices were displayed in English and Portuguese, but there was nothing to inform visitors about what to expect from their visit or procedures they

could follow to get help with problems. A suggestion box was fixed to one of the walls but there was no paper to write on. There were unanswered suggestions in the box dated January 2005.

83. The visits room was small, cramped and needed decoration. Information notices were not displayed. There were no facilities for visitors to buy refreshments, and no facilities for children. The room could accommodate 14 visits per session. It had two long rows of fixed tables with two fixed chairs on one side for visitors and one for the prisoner on the other. Seating for visitors was packed close together. When fully booked, there could be up to 28 adult visitors and an unpredictable number of children. This meant inadequate space between visitors and minimised privacy. It was crowded and noisy.
84. Some chairs were broken and the tables were in a poor state of repair. There were no observable public protection measures, although the area was well supervised by three officers. CCTV cameras were in place but were not always in operation due to staff shortages.
85. There was one room for closed visits. It was adequately designed and clean. Planned closed visits had been used six times in 2004. Two prisoners were currently on closed visits. There were no formal systems to ensure systematic reviews of prisoners on closed visits. The deputy governor said that he reviewed all cases monthly, but reviews were not recorded. Closed visits were used as a punishment award following adjudication when it had been proved that unauthorised articles had been smuggled in for prisoners during visits.
86. A prison drug detection dog screened visitors before admission into the prison. Managers said that closed visits were offered as a result of a single indication from the drug dog. There was no protocol for the use of the dog, and there were no records on the number of single closed visits that had been authorised. No closed visits took place at the time of inspection.
87. Prisoners on the enhanced level of the incentives and earned privileges scheme with family difficulties could apply for family visits (see paragraph 5.43). These took place in a local community centre and were supervised by prison staff. The scheme was not open to other prisoners or young adults, regardless of their needs.

Recommendations

88. There should be a prisoners' telephone in the old reception unit.
89. A visitors' centre should be established and should provide information on what visitors can expect from their visit and how to receive help when needed.
90. The physical conditions for visits should be improved to bring them up to an acceptable condition, and there should be better facilities, particularly for those with children.
91. There should be formal, scheduled, monthly reviews of prisoners on closed visits.
92. Protocols on the use of the prison drug dog should be written and published.

Good practice

93. Adult prisoners on enhanced status with family difficulties could attend family visits in the community.

Applications and complaints

Expected outcomes:

Effective application and complaint procedures are in place, are easy to access, easy to use and provide timely responses. Prisoners feel safe from repercussions when using these procedures and are aware of an appeal procedure.

95. There was only one system and a single form for prisoners to make both applications and complaints. The forms were entitled request/complaint forms but were referred to locally as wing application forms' and also governor's application forms'.
96. The forms were kept on residential wings. In most cases, prisoners used them for making applications rather than complaints. There was no formal, centralised log of prisoner complaints. Some records were kept in individual wing ledgers on E, G and in the centre office for A, B and C wings. However, these were incomplete and inconsistent. For example, there were gaps of over two months between entries on some of the ledgers.
97. It was clear from talking to staff and prisoners that many issues were resolved informally by staff, without prisoners needing to make formal applications and complaints. However, prisoners also made it clear that they were reluctant to make formal complaints as they were afraid of having their privileges withdrawn. This was especially apparent on H wing.
98. Our survey results in this area were extremely poor and reinforced this message. More than 90% of respondents did not feel that complaints were resolved fairly. The absence of a formal, auditable complaints system made it impossible to verify this perception.

Recommendation

99. A formal, auditable prisoner complaints system should be introduced.

Legal rights

Expected outcomes:

Prisoners are told about their legal rights during induction, and can freely exercise these rights while in prison.

101. No staff were trained in legal services. Prisoners could access legal representation and advice on related matters via the batonnier' system. Jersey-based solicitors took on the role of batonnier in turn, allocating solicitors to prisoners requiring legal representation. The batonnier

could be contacted though a free telephone number publicised on the residential wings or available from wing managers.

102. Our survey findings on the services provided by the batonnier were generally positive. They provided a source of advice and allocated solicitors efficiently. However, some prisoners were dissatisfied with the quality of legal representation that they eventually received. They felt that, as solicitors in Jersey did not get paid for legal aid cases, they did not always represent them as robustly as they could have done.
103. Access to legal reference books was poor, with no provision whatsoever in the prison's library. One of the senior managers had some legal reference material that could be loaned out to prisoners individually. However, this provision had not been publicised to prisoners and few were aware of it.

Recommendation

104. Legal reference material should be available to prisoners in the prison library.

Section 4: Healthcare

Expected outcomes:

Prisoners should be cared for by a health service that assesses and meets their needs for healthcare while in prison and which promotes continuity of health and social care on release. The standard of healthcare provided is equivalent to that which prisoners could expect to receive in the community.

1. Healthcare was a nurse-led, primary care service, and the good quality of care we saw at our last inspection had improved. This was supported by our survey. Staff were professional, competent and caring and provided good clinical care, despite a healthcare centre that was cramped, and the absence of wing-based facilities. Nurses were still used for non-clinical work, which meant there was no capacity to introduce formal nurse triage or regular nurse-led clinics. Most healthcare policies were out of date. Mental health services were limited. A comprehensive health needs assessment, published in 2004, had been used to good effect to support joint working between the prison and local services. We supported the proposals for service development and to shift responsibility for prison healthcare and funding from the home affairs committee to the health and social services committee.

Environment

2. The healthcare centre was a single-storey wing situated centrally in the prison off the main corridor and opposite the segregation unit. The environment was generally clean and well equipped, although small.
3. The patients' waiting room was immediately inside the entrance and was the only access to the healthcare centre. It had some wooden seating and racks for health promotion material, some of which was in French and Portuguese. Notices were in Portuguese as well as English.
4. The door into the nurses' office and the pharmacy was off the waiting room and was locked when healthcare staff were absent or if only one member of staff was present when medicines were administered. A small, barred hatch linked the pharmacy to the waiting room.
5. The pharmacy was small and clean. Many medicines were not stored in lockable cupboards but left out on the work surfaces. Many doses were prepared before treatment times and left out on the worktops in 'tots' bearing just the prisoner's name and not identifying the drug itself.
6. A portable, lockable medicine trolley was secured to a wall. This contained medicines for prisoners in the segregation unit, the vulnerable prisoner unit, women's and young adults wings. There were no controlled drugs, although a secure cabinet was available if they were needed.
7. The pharmacy fridge had a device that ensured continuous minimum/maximum temperature recording to ensure that heat sensitive medicines were stored correctly. Healthcare staff checked the emergency resuscitation drugs regularly. The only reference book, the British National Formulary, was out of date.
8. A locked gate separated the waiting room from the rest of the healthcare centre. Lockable filing cabinets storing old clinical records were in the corridor. There was a small interview room with comfortable seating, and a gated door that opened on to the garden, which had been an

exercise yard when there were inpatients. This valuable space would have been better used to extend the healthcare centre accommodation.

9. The dental surgery was small but reasonably clean and well equipped. Some of the equipment was old and unreliable and needed to be replaced. The equipment, unit, autoclave, compressor and water lines had been regularly serviced and certificated, and met current standards for health and safety. Cross-infection control standards were satisfactory, and emergency oxygen, airways and drugs were available.
10. Other accommodation included the healthcare manager's office and the doctors' consulting room. The latter had a connecting door to a treatment room, which had an examination couch. This room was used by the doctor for physical examinations, and by the visiting physiotherapist, optician and chiropodist when required.
11. The room used for health screening in reception was clean and adequately equipped.

Records

12. All current clinical records were stored in non-lockable drawers in the nurses' office. A good numbering system enabled old records to be retrieved if prisoners returned to prison.
13. We reviewed several sets of notes and were impressed by the overall quality of record keeping. A stand-alone, electronic information system had been introduced and this enabled effective health and demographic data collection, as well as collation of clinic lists. However, it was not a primary care system and was not linked to prescribing or compatible with the GPs' practice system. There was no prison-wide, electronic, prisoner information system and no electronic links between healthcare and other departments.
14. There was no pharmacy computer system. Although there were some patient medication records on the computer at the community pharmacy, these were incomplete.
15. Prescriptions were written on administration charts on to which additional administration sheets could be added. Duplicate private prescriptions were also written by the doctor and were faxed to the pharmacy for dispensing, with the originals supplied to the pharmacy later that day or the next day. Nursing staff recorded medicines supplied to patients correctly on their administration charts.
16. There was evidence on some charts that the doctor had not signed the prescriptions, which made them invalid. There was no system for the pharmacist to review or check prescription charts to ensure clinical appropriateness or legality.
17. There was a list of medicines to be supplied as 'special sick', but this also included prescription-only medicines, which was illegal. Supplies were recorded on a separate sheet and not generally recorded on the prisoner's administration card. Staff did not complete an error or intervention log.
18. Dental records were held securely in the clinical record, which gave the dentist access to medical histories.

Staffing

19. All healthcare staff were trained as prison officers as well as being nurse-qualified. The healthcare manager had worked at the prison for almost 20 years and had qualifications in both mental health nursing and learning difficulties (RMN/RMNH). As well as running healthcare, for the past two years he had been the lead for suicide and self-harm, and until a month before the inspection was also the drug strategy coordinator.
20. There were four other nurses, two of whom were registered general nurses (RGNs) and two were dual-qualified as general nurses with mental health or learning disability training. One of the nurses was on call from home each night. None of the nursing staff had clinical supervision, and there was no clinical governance. Healthcare staff had no administrative support.
21. Three doctors, including a woman GP, from a local practice provided medical care, including out of hours and emergency care. Pharmacy was a supply service from a local community pharmacy. The dentist, assisted by an experienced dental nurse, provided six half-day clinical sessions a month.
22. Other visiting specialists included a physiotherapist who visited once or twice a week as required, a consultant microbiologist, who came on request, and an optician, who came monthly. A chiropodist was available to see patients when needed.
23. Mental healthcare in the prison was limited. A clinical nurse specialist in forensic psychiatry visited for one session weekly, as did a consultant general psychiatrist under a private arrangement. A clinical psychologist visited for one session approximately twice a month.
24. There were no regular formal healthcare staff meetings. Although not a member of the senior management team, the healthcare manager attended the monthly wing managers' meetings.
25. Most healthcare policies were out of date and needed revision.

Delivery of care

Primary care

26. The healthcare centre was open between 7.30am and 9pm daily. As from the week of the inspection, a nurse saw all new arrivals in reception for an initial health screening. Before that, there had been different arrangements for male and female prisoners. Staff used a locally devised but comprehensive reception screening tool to review the patient's physical and mental health. This included taking basic physical measurements, such as height, weight and blood pressure, and screening for drugs.
27. New arrivals were given a leaflet explaining the range of healthcare available, and asked to sign a medicines compact. Those needing detoxification were started on medication on their first night and seen by a GP at the next surgery. All relevant reception information was entered into the healthcare database. Although there was no chronic disease register, the information was available through using the system. None of the women in the prison were pregnant at the time of the inspection.

28. The doctors provided a two-hour surgery on six mornings a week, seeing up to eight patients at each. This allowed a reasonable time for each patient. The female doctor was routinely available to see women on one day a week, but women could be seen at other times if they were happy to see a male doctor. The doctors encouraged patients to see the same doctor on each visit as this improved continuity of care.
29. There was no formal application system. Healthcare staff had developed a form, but wing staff were reluctant to use it. Prisoners who wished to see one of the healthcare team usually asked one of the nurses when medicines were being administered, or wing staff telephoned their request to healthcare. There was no formal nurse triage and only a few nurse-led clinics, such as smoking cessation.
30. There was also no formal appointments system, but this was largely because the nurses tried to ensure that all patient groups had fair access to care. Patients were often told they had an appointment to attend the healthcare centre the night before or called up the same day so staff could ensure separation of patient groups, given the very limited space in the healthcare centre. Staff made efforts to ensure that prisoners who usually went to work stayed in their cells to be called to the healthcare centre so that they didn't miss their appointment. The system generally worked well as the clinic lists were entered into a daily diary and on to the electronic database. Staff were fully aware of who should be seen when. Patients were followed up if they did not attend.
31. Patients not fit to go to work were allowed to 'rest in cell', but there was no formal policy on this.
32. All significant events relating to patients were entered on to the database as well as in their clinical record. These included records of referral letters sent to the hospital and any outpatient appointments received. The latter were also noted in the diary and escorts arranged. Although staff were aware that such action had been taken, there was no system to reassure patients that referral letters had been sent.
33. Nurses still undertook many non-clinical duties, such as all the administration, escorting patients when required, and cleaning the healthcare centre. As trained prison officers they were also required to perform tasks such as locking up wings and take part in control and restraint operations. This undermined their primary role as nurses.
34. Only main wing prisoners could attend the healthcare centre to collect medicines or talk to staff at the four treatment times each day (three at weekends) at 8am, 11.30am, 4.20pm and 8pm. Most medicines were prescribed as not in-possession and therefore administered during these treatment times. They were supplied to prisoners through the pharmacy hatch to the waiting room. There was little privacy, although few patients at a time came into the waiting room. Nurses took patients into another room in the healthcare centre if a private conversation was needed.
35. Some items, such as vitamins and creams, were available for prisoners to buy from the prison shop. Paracetamol and indigestion tablets could be issued out of hours from the central office. These supplies were logged on a recording sheet but were not transcribed on to patients' administration charts.
36. A nurse distributed medication to women, young adults and men in the segregation and vulnerable prisoner units from a drug trolley, which went to their wings just twice a day at 8am and 8pm. Men in the enhanced wing also had difficulty attending the healthcare centre because of the temporary fence, but most had their medication in-possession.

37. The pharmacist had recently begun to visit the prison and had now produced a written report and action plan. He was available to speak to prisoners about their medicines if required, but there was no formal system to facilitate this. The chief pharmacist for Jersey had been involved in a preliminary pharmacy needs analysis for the prison population, but there was no medicines and therapeutics committee, few up-to-date procedures, no formulary for prescribing and no agreed stock levels, and the prison did not receive official drug recalls.
38. The dentist usually saw eight patients per session. Very few patients failed to attend. The waiting time for routine treatment was only five weeks. Emergencies that could not be dealt with by the healthcare staff or deferred to the next session were referred to the practitioner's surgery outside or to the dental department at the hospital.
39. The dentist treated patients according to need. There was special emphasis on oral hygiene for young patients so that they could access the free dental scheme for young people on the island on release. For women there was also a special concern for an aesthetic result to aid rehabilitation and self-confidence upon release. Treatment for male prisoners, other than pain- relief and functional treatment, depended on their level of cooperation to maintain a high standard of oral hygiene. More advanced treatment was available in very exceptional cases, usually upon referral and /or at cost to the prisoner. Electric toothbrushes and floss were available from the prison shop.
40. The physiotherapist was a community physiotherapist who offered a wide range of treatments, and her care was much valued by patients. There was no waiting list. Patients could be referred to the local hospital for hydrotherapy or the sports injury clinic. Nineteen patients also took part in remedial gym sessions, available for an hour each weekday from gym staff in the prison.  
41. Patients also had reasonable access to secondary care in the local hospital, as well as regular clinics in the prison from a consultant microbiologist who provided advice and screening for blood-borne viruses.
42. Healthcare staff saw all patients before their release and gave them a duplicated form with information on help and support agencies. The potential danger of overdosing on opiates on release was highlighted in red in English and Portuguese.

Mental health

43. Specialist mental health nursing care was limited. It was provided from the small, local forensic psychiatric team, which also undertook police/court liaison. The team had a total caseload of about 40 patients, 10 of whom were in prison. A female community psychiatric nurse was due to join the team and would focus on the needs of the women. The local general psychiatry services were available for emergency care but had not been needed in the past year.
44. There were no secure mental health beds on the island. Patients who needed inpatient care could be admitted to the local mental health hospital (St Saviours). If a secure bed was needed, patients were transferred to a medium secure unit (The Trevor Gibbons Unit) in Kent, with whom the Jersey mental health service had a service level agreement for two beds (one male and one female). Only one patient was waiting for a psychiatric assessment for transfer to the NHS.
45. The consultant general psychiatrist had 21 patients on his caseload and saw four each week. He worked closely with the healthcare manager and the head of psychology, who also saw

patients occasionally for anger management and counselling. Clinical psychology services were very limited, as a local psychologist visited about once a month only.

46. There was little primary mental healthcare for prisoners, other than from the GPs. The health needs assessment had highlighted the need for this.

Working with local health services

47. The relationship between the prison and local services differed from that in the UK as all primary care services were private. A comprehensive health needs assessment was published in 2004 and had been used to good effect to support joint working between the prison and local services. We strongly supported the proposals for service development submitted to the health and social services and home affair committees.
48. A job description for the appointment of a health promotion coordinator in the prison had been drafted and was a good indicator of the commitment to joint working.
49. We also strongly supported plans to shift responsibility for prison healthcare and funding from the home affairs committee to health and social services committee. This was likely to better meet the healthcare needs of prisoners.

Recommendations

50. The recommendations of the review group to transfer prison healthcare funding should be endorsed to implement the healthcare improvement proposals.
51. There should be formal mechanisms to promote continued joint working.
52. Algorithm-based nurse triage should be introduced.
53. Nurse-led clinics should be introduced.
54. Administrative staff should be employed to release nurses from non-clinical duties.
55. Staff shift patterns should be reviewed to maximise resources.
56. Nurses should not undertake discipline duties, such as control and restraint and locking of wings.
57. There should be clinical supervision for all staff, and clinical governance should be introduced.
58. A primary care-compatible IT system should be installed.
59. The garden space next to the healthcare centre should be developed to provide extra clinical accommodation.
60. A defibrillator should be provided and all staff (including the dentist and dental nurse) should have training in its use, as well as cardiopulmonary resuscitation.

61. There should be a medicines and therapeutics committee, including the chief pharmacist and doctors, to review all pharmacy policies and procedures and introduce medicines management, review the use of drug administration charts and the use of patient group direction.
62. Medication for administration should not be pre-prepared and left out in unlabelled 'tots'.
63. All prescriptions, including those for stock medicines, should be faxed through to the pharmacy.
64. All pre-packs and medicines issued to prisoners should be labelled in accordance with the Medicines Act requirements, and all dispensed medication should include a patient information leaflet.
65. There should be a formal procedure to enable healthcare staff to administer prescription-only medicines from stock in an emergency.
66. All prescriptions and instructions to administer drugs should be signed by the doctor involved.
67. Agreed pharmacy stock levels should be implemented.
68. Discontinued medicines awaiting destruction should be clearly quarantined, and an appropriate, licensed waste remover should be contracted to provide this service.
69. The dental unit should be replaced.
70. All healthcare policies should be reviewed and updated regularly.
71. There should be an increase in mental healthcare provision, including that for patients with counselling needs.

Housekeeping points

72. There should be an application system for requests to see healthcare staff.
73. Appropriate, lockable metal cabinets to store medicines should be provided.
74. There should be more health promotion material relevant to women.
75. Keys to the healthcare centre should not be taken out of the prison.

Section 5: Activities

Education and library provision

Expected outcomes:

Education and skills training meet the requirements of the Adult Learning Inspectorate's common inspection framework (separately inspected by ALI). Prisoners are encouraged and enabled to learn both during and after sentence, as part of sentence planning; and have access to good library facilities.

Education

2. Education services to prisoners at La Moye were provided by one teacher for 25 hours a week, with occasional sessional teachers. There was no administrative support. The teacher was enthusiastic and motivated, and supported well by prison officers and her small team. There was good communication between senior management, wing staff and education workers, and a high level of mutual respect between staff and prisoners. However, staffing levels were clearly insufficient. The one teacher was struggling, under very difficult circumstances, to deliver a basic educational programme to a broad range of individuals. She clearly could not meet the needs of the entire population almost single-handedly.
3. There was a more structured system of initial assessment since the last inspection, with up-to- date assessment of all learners before they attended education. The Basic Skills Agency entry level assessment was used to develop individual learning plans for young people, but there was no formal or routine recording of results for management purposes. The teacher was involved in the sentence planning process for young people. She also visited some wings to check progress of those attending education. Specific learning needs were identified and support provided, where possible. There was no guarantee of education for school age children.
4. Facilities had improved slightly for mainstream prisoners and young people, with the provision of some Portakabin classroom accommodation. However, educational facilities for vulnerable prisoners and women remained unsatisfactory, and there was poor use of the facilities in the evenings and at weekends. For example, there was no study space for prisoners after educational hours. There was good use of areas around the prison to support work activities. Computer hardware and software were dated, and there was limited IT technician support. There was a lack of teaching staff to support the current curriculum.
5. There had been no progress in the curriculum since the last inspection. It remained impoverished and inadequate to meet learners' needs. The range of education offered included English for speakers of other languages (ESOL), literacy and numeracy, basic computer skills, European computer driving licence, maths GCSE, Spanish, yoga, first aid, support for book keeping and accountancy, and GCSE and A level distance learning courses.

6. Access to education was poor. Most prisoners received insufficient time for education – often as little as one hour per week. Unsurprisingly, there had been an increase in the numbers on distance learning courses, but learners had to pay 50% of costs and this had an impact on those on low incomes. There was very little education provision in the evenings. The curriculum for IT was particularly poor, with a poor range of computers to support learning. The computers were not networked or linked to the internet. There was no clear rationale to support curriculum development – for example, an employment needs analysis.
7. Leadership and management were inadequate. There were no systems to assure the quality of education and training. Management information was collected manually. Plans for a more effective partnership arrangement with Highlands College had been slow to develop. A joint plan with the college for the development of education had been considered by the home affairs committee and was due to be submitted to the education committee. We strongly supported this.

Library

8. The library facilities were generally poor, with an inadequate selection of educational and recreational books. There were links with the external library service, and prisoners could access outside library facilities monthly. External library agencies provided cast-off books. There was a small selection of books on the corridors for young people, but none for vulnerable young people. There had been no attempt to match prisoners' cultural, social needs and interests. Reference books were limited across the prison.

Recommendations

9. The quantity and quality of education offered to prisoners should be increased substantially to meet the needs of the population.
10. Staffing levels should be increased and administrative support should be provided.
11. Library resources should be improved.

Work

Expected outcomes:

Prisoners are engaged in safe work and are treated fairly. Work should prepare prisoners for employment on release and help to reduce reoffending.