Train prisoners to look after ill inmates, report recommends

Prisoners should get health and social care training in order to help fellow vulnerable inmates, a review has suggested.

An independent evaluation of high care needs within the Scottish prisoner population recommended prisoners be given responsibility for helping others with daily living activities, such as pushing wheelchairs and cleaning and tidying cells.

The Scottish Prison Service, who commissioned the report, has also been urged to consider training prisoners in a SVQ health and social care qualification “with the aim of developing a cohort of health and social care ‘champions’”.

Prison officers could be put through the qualification too, the report adds, while their own responsibilities for the management of prisoners with severe ill health or disability should be agreed with staff unions.

Prison chiefs are now considering the recommendations, which also include holding prisoners with severe ill health or disability in a single specially adapted site, before settling on a way forward.

It comes as the prison service braces itself for an increase in older prisoners, driven in particular by a growing number of sexual offenders convicted for historic offences.

While evaluators were unable to determinate the prevalence of high care needs throughout Scottish prisons due to the absence of a single SPS definition, inmates with disabilities, social care needs and long-term conditions or terminal illness are generally among those who are deemed to fall into the category.

Responsibility for social care in the community currently sits with local authorities, though the lines of responsibility are “presently unclear” when it comes to Scottish prisons, the authors warn. Glenochil, for example, has had to contract a private provider to deliver daily personal care for one of its inmates.

The potential for a national memorandum of understanding between the SPS, NHS Scotland and local authorities should be explored in order to map out where specific responsibilities lie in terms of the social care needs of prisoners with high care needs.

This latest study said the high care needs of current prisoners are “generally being met” by prisons and the service more widely, albeit the built environment within the estate was a “major concern” among prisoners as well as prison officers and healthcare staff spoken to.

Last December, Nigel Ironside, governor of Glenochil, which holds convicted sex offenders as well as mainstream prisoners sentenced to over four years, told Holyrood changes to the prison’s physical infrastructure constituted a “patch fix”.

The review, which has been carried out by a Dundee-based consultancy, recommends a “comprehensive analysis” of the estate and an initial focus on “quick wins and relatively inexpensive adjustments” such as ramps leading into health centres and visit rooms.

All establishments should be made fit for holding inmates with high care needs for “very short timescales”, though a specific prison should be identified and equipped as a “first cluster facility specifically adapted to meet the needs of prisoners with high care needs”, according to the authors.

Options include refurbishment of an existing residential area or creation of a new one within a Scottish prison. Alternatively, the review also raises the prospect of creating a new residential area within SPS or government property, which could see prisoners suffering serious health problems held in a secure facility outwith the current suite of prisons.

Once evaluated, the prison service should consider extending this type of facility to three or four prisons throughout Scotland, the report recommends.

The SPS had previously launched a working group to consider the future management of offenders with high care needs, including social care issues, across Scottish prisons.

An SPS spokeswoman said: “The SPS is considering the evaluation of high care needs report. The findings will enable SPS to consider how best to respond to the future management of prisoners with high care needs.”