Tag Archives: prison

Going grey behind bars: meeting the care needs of older people in prisons

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The population is ageing. People are living longer, and are in need of greater levels of care than ever before. But how is this increase in life expectancy and demand for care being met in prisons? Our prison population is also ageing, at a time when the sector is under increasing pressure, low staff numbers, higher levels of prison violence and disorder, and poor, crowded living conditions. In an environment which is largely designed to support young, able bodied men, how are prison staff and care teams liaising to help meet the needs of older prisoners?

A care plan for ageing prisoners

A report published in 2017 by the Scottish Prison Service called for a specific care plan for ageing prisoners to react to and provide planning to reflect the change in demographic of the prison population. The report found that between 2010 and 2016, the number of men aged over 50 in Scotland’s prison population rose by more than 60%, from 603 to 988. According to a Ministry of Justice report on prison population, the number of inmates aged over 50 is projected to grow from 12,700 to 13,900 by the end of June 2020, a rise of 9.5%, while the number of over-60s behind bars will grow by 20% from 4,500 to 5,400 over the same period.

In July 2017 Prisons and Probation Ombudsman produced the Thematic Review: Older Prisoners, which stated that HM Prison and Probation Service needs a national strategy to address the needs of the increasing numbers of elderly prisoners. It highlighted six areas where lessons still needed to be learned: healthcare and diagnosis, restraints, end-of-life care, family involvement, early release and dementia, and complex needs.

The difficulties older prisoners face on prison estates are far reaching. Not only are there physical barriers to moving around and living within a prison environment, but the increased mental health and social care burden is significant, as well as the potential need to begin end-of-life care. Many prison inmates suffer from multiple, longstanding and complex conditions, including addiction, and these conditions are exacerbated by a phenomenon known as “accelerated ageing”, which suggests that prisoners age on average 10 years faster than people of the same age in the wider community.

While some prisons have effective care plans which allow older prisoners to live with dignity, often older prisoners rely on the goodwill of officers and fellow inmates to meet the gaps in their care needs. And while in England and Wales the Care Act means that, a statutory requirement to provide care lies with the local authority within which the prison is located, this is not a guarantee. Calls have been made for care planning in prisons to become more robust, with minimum standards of care and a clear pathway of delivery, with accountability and responsibility of specific bodies being made explicit.

 

Prison staff, care teams and the NHS in partnership

Any care planning for older people needs input from a number of different sources, and care planning for older people in prison is no different. It will require input from professionals across health, social care, and housing and the criminal justice system as well as wider coordination support and legislative and financial backing from central and local government.

Prisoners with physical disabilities or diseases such as dementia need specialist care at a level that standard prison officers cannot give. Research has suggested that prison staff are being expected to shoulder this extra burden, often having to perform beyond their duty to care for and look for signs of degeneration in prisoners, particularly those who show signs of Alzheimer’s and dementia.

A number of research studies have looked at the provision of training and the use of additional, multi-agency staff to try to bridge the gap in care for elderly prisoners. In 2013 a review was conducted of multiple prisons, including some in England, the USA and Japan, which examined the training available on each estate for prisoners with dementia and similar conditions.

A number of schemes have been trialled, including extra training for staff, the allocation of specific wings or cells adapted to cater to the specific needs of older and vulnerable prisoners, and the use of peer to peer buddying or befriending services to help with care and support. Some prisons have also trialled the introduction of “dementia champions” to identify and support those with early signs of dementia or Alzheimer’s.

Extra challenges on release

As well as social care needs inside prison, specific rehabilitative needs of older prisoners being released from prison is also something that prison charities and reform bodies are keen to raise onto the agenda. A report from the Prison Reform Trust in 2016 highlighted the challenges of rehabilitative and parole needs of older prisoners, commenting that older people released from prison are being “set up to fail” by a lack of adequate provision to meet their health and social care needs on release. It highlights the limited and inconsistent housing, employment, debt and substance abuse advice available specifically for older offenders and suggest that their particularly vulnerable position puts them at risk of serious harm or reoffending.

Final thoughts

The population of older prisoners in our prisons is growing, and it is clear that a comprehensive strategy is needed to ensure that the specific, and at times unique care needs of these prisoners are met. This will mean greater cooperation from social care, health and criminal justice agencies, but will also mean reassessing how we think about social care, how it should be delivered and funded. The needs of older prisoners go beyond physical adaptations, to mental health, dealing with social isolation, the onset of chronic illnesses and at times the provision and planning of end of life care.

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If you enjoyed this blog, you may also be interested in our other articles:

Helping people with dementia to live well through good urban design

Planning for an ageing population: some key considerations

Co-production in the criminal justice system

Co-production in the criminal justice system

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Community concept word cloud background

By Rebecca Jackson

Co-production in criminal justice was the core theme of a conference held last Wednesday by the Scottish Co-Production Network.

The speakers were invited to showcase their organisations as three examples of best practice. All the organisations have integrating partnerships and co-production at the heart of their values, and they spoke of the benefits and challenges they had faced, as three very different organisations, all looking to use co-production in the context of criminal justice.

Startup Stock Photos

Startup Stock Photos

Supporting vulnerable women

Tomorrow’s Women Glasgow, is part of a national pilot which aims to develop community- based justice options for people who are offenders. This specific pilot focuses on vulnerable women with complex needs who are in, or have recently been involved in, the criminal justice system.

The women-only centre offers a safe space for women to come and spend time and to work with mentors to address the barriers and issues which prevent them from leading positive, healthy lives. In addition to this, the women are invited to contribute ideas towards the running of the centre, planning activities, contributing to a newsletter and hosting open days.

“The scheme gives vulnerable women a choice, a voice, a direction and opportunities”

The project is run in association with the social enterprise Outside the Box. There are some examples of Outside the Box’s other projects here.

woman hands isolated on sky background

Improving transitions from prison

Pete from Positive Prison? Positive Futures… delivered an inspiring and thought-provoking presentation about his experiences as a person with a conviction who had served time in prison and how that drove him to help others upon their release from prison. He helped to set up the organisation Positive Prison? Positive Futures… (PP?PF) which seeks to “improve the effectiveness of Scotland’s criminal justice system so as to reduce the harms caused by crime and to support the reintegration of those who are or have been subject to punishment”.

He was keen to stress that the charity is not a service provider; rather it is an initial point of contact to help direct people with convictions to the available and relevant services which already exist.

“We’re kind of like in space when you use the gravitational pull of an object to slingshot you in the right direction (Apollo 13 reference anyone?!). People are coming to us going one way, we come into contact with them, build their speed and send them in another, safer, hopefully better direction!”

In addition to this, the charity engages regularly with the Scottish Government as part of committees looking into reform of the prison service, the redesign of community justice and have, among other things, influenced policy decisions around the release of individuals from prison including transitional care.

The charity works with recently released, or soon to be released people with convictions, looking at building relationships during the vulnerable first few weeks ‘on the outside’ where re-offending and suicide rates are high. They also offer mentoring to help prepare people for the transition from prison life.

Two adult education students studying together in class.

Co-production and young people

Space Unlimited is a social enterprise based in Glasgow, which offers a creative space for young people to become involved in the planning and review of the criminal youth justice system. It encourages young people from vulnerable backgrounds, as well as young people who have served time in prison, to use their experiences to change how offending and criminal justice is viewed by young people.

The scheme aims to provide a space to show how young people can use their views to influence how the system can work best for them, to avoid re-offending and help integrate them back into society. The young people interact with adult stakeholders from across the local authority and criminal justice sector, as well as charities and third sector organisations.

“We promote and encourage children and young people to view themselves as experts in their own right, using their own experiences to promote positive change in the youth criminal justice system”

Category Picture Community Development

Creating new spaces for dialogue

What all of the case studies sought to highlight were the key elements of co-production:

      • Assets
      • Capacity
      • Mutuality
      • Networks
      • Shared roles
      • Catalysts

The speakers discussed their learning and experiences, as well as the challenges they face, but all highlighted the fundamental belief underpinning co-production – that service users and service providers can learn from one another. We create better services by engaging service users – creating services with people, not for them.

Co-production is an approach which is widely spoken about in health and social care, but as the conference and its speakers highlighted, the application and remit of co-production could be rolled out over other areas of policy too. It is all about finding groups of people willing to engage and to listen – creating a space for an exchange of dialogue, knowledge and learning. And the results could potentially be hugely beneficial for both service users and service providers. This video from the New Economics Foundation (NEF) highlights some of the benefits of co-production in practice.

Co-producing Positive Futures learning event: how co-production, learning and partnership building can improve community experiences and engage people in the criminal justice system. Scottish Co-production Network, Glasgow, 28 October 2015.

Reducing re-offending: rehabilitation and integration through employment

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By Rebecca Jackson

Prisons in Britain have a poor record for reducing re-offending – 46% of adults are re-convicted within one year of release. And it’s estimated that each year, the financial cost to society of re-offending in Britain is £11bn.

In 2014, 68% of prisoners thought that ‘having a job’ was important in stopping re-offending.

However almost 50% of prisoners in the UK said that they had no qualifications, 40% needed help with education while in prison, and of these, 21% needed help with basic literacy and numeracy.

Government and academic research has supported the idea of employment post-sentence as being a key way to reduce re-offending and help integrate ex-offenders back into society. But opportunities within prison are often limited and once released, former offenders often find employers reluctant to hire them because their criminal record.

Roof Womens Prison Lincoln Castle, Creative Commons, rodtuk, July 2015.

Roof Womens Prison Lincoln Castle, rodtuk via Creative Commons, July 2015.

Building skills within prison

While in prison, inmates are given the opportunity to learn skills, trades and improve their basic literacy and numeracy ability. Some are allowed to do kitchen work within their prison; others work in offices alongside prison staff carrying out menial tasks in order to help strengthen their CV on their return to ‘normal life’.

However for many, there is little or no support, and the skills they learn are not sufficient to get them a job ‘on the outside’.

The prison service has introduced a number of schemes to attempt to improve this preparedness for work in the real world, but as the re-offending statistics show, success has been somewhat limited, with many struggling to stay in work or find work altogether.

Barriers to employment

While in some instances it is a lack of willingness or a lack of preparedness on the part of the former offender, another huge barrier to ex offender employment is the stigma associated with a criminal record and the reluctance of employers to consider people for roles who have served time in prison.

Efforts have been made by both government and independent employment and criminal justice organisations to reduce concern from employers.

Some firms have made a conscious effort, to deliver a series of very public and very successful ex offender training programmes, including companies such as National Grid, Timpsons, First Direct, Co-Op,Marks and Spencer, Virgin, Greggs and DHL.

And the Ban the box campaign, whcih aims to remove the tick box from application forms that asks about criminal convictions, hopes to reduce the impact of stigma even further by allowing ex offending applicants to reach the latter stages of an interview process, after it was found that many employers would automatically exclude someone who had checked this box on an application form.

Innovative offender employment projects

Creative Commons, Robert Fairchild, Cupcakes n sprinkles, 2011

Robert Fairchild via Creative Commons, 2011

The Freedom Bakery, based in Glasgow, is a social enterprise that employs ex-offenders, in the hope that employment will break the cycle of re-offending. The founder of the bakery said the aim of the scheme was to help encourage personal development as well as skills and integrate former offenders back into society. However he stressed that it is not about ‘pity employment‘ – people are given the chance to reform and develop, and the company hopes to make money.

Similarly Bad Boy’s Bakery, the brain child of TV chef Gordon Ramsay is now a well-established CIC (Community Interest Company) run by Working Links. Based at HMP Brixton in London, they sell goods to local Caffe Nero stores, as well as local sellers and within the prison canteen. Recruits are trained to industry standards in food quality and safety, including NVQ Levels 1 and 2 in Food Production, giving them skills in food preparation, baking, stock and time management, as well as knowledge of health and safety.

But it’s not just independent businesses who are engaging with ex- offenders. Well known high street chain Timpson’s also has one of the most successful and well established ex-offender employment schemes in the country. 16 of their shops in the UK are now managed by individuals who have spent time in prison and have come through their rehabilitation scheme.

The National Grid also offers offender training and employment programmes with people coming to the end of their sentences and provides training and a job on release for those selected. Over 2,000 prisoners have completed the scheme which has a re-offending rate of just 6%.

Our infographic breaks down some of the key facts.

Prisoners inforgraphic

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