Gaps in care of vulnerable Maghaberry prisoners

By Niall McCracken

GAPS still exist in the care of vulnerable prisoners at Maghaberry Prison, according to a new report from the Criminal Justice Inspectorate.

It is the largest and most complex of the three prisons that make up the Northern Ireland Prison Service (NIPS) but inspectors found that only half of the staff at Maghaberry had suicide prevention training and that near-fatal incidents were not “adequately investigated.”

Concerns also emerged around “unequal treatment” of Catholic prisoners as well the resettlement of prisoners back into society.

Inspectors concluded that while there had been some “positive developments” since the previous inspection in 2009, there was still no effective monitoring of violent incidents to identify when or where they were likely to occur or how they could be prevented.

VULNERABLE PRISONERS

The report sets out that Maghaberry Prison holds 1,000 men including remand prisoners, fine defaulters, lifers and a small number of separated paramilitary prisoners. A significant number have mental health problems and learning difficulties, while others are vulnerable because of their offences or disputes with other prisoners.

Previous inspections have been critical of the way Maghaberry responded to these challenges. In the latest inspection it is noted that the prison has progressed by one level in three out of the four healthy prison tests but that “significant weaknesses remain.”

The report highlighted that the management of prisoners with substance misuse issues was poor and it found that waiting times for treatment were too long. This meant that many prisoners were experiencing significant discomfort and led to an “unsafe detoxification/retoxification practice.”

Inspectors were complimentary about initiatives for vulnerable prisoners on the Donard landing and the Donard day centre, but said that while a vulnerable prisoner policy had been introduced overall, it was not fully embedded.

SELF HARM & SUICIDE PREVENTION

There had been three self-inflicted deaths in the prison since CJI’s last inspection in 2009. Two other deaths had occurred shortly after release. Inspectors felt there was a good focus on learning from death investigations following several high profile and critical reports over recent years, including a review of vulnerable prisoners by CJI.

However, the report stated that near-fatal incidents were not adequately investigated or acted upon by the prison. Inspectors note that while there was good knowledge concerning prisoners at risk of self-harm, Supporting Prisoner at Risk (SPAR) procedures were in need of improvement and observation cells were used too frequently.

There were an average of 21 incidents of self-harm and 46 SPAR documents opened per month. While inspectors noted that, given the population, this did not appear “excessive”, they highlighted that limited routine investigations of serious self-harm incidents were carried out.

Inspectors found that not all staff targeted for suicide prevention training had received it. Four hundred and twenty-three (51%) of staff had completed training in applied suicide intervention skills and 274 (33%) in SPAR.

The investigating team also said they were not convinced that managers could be assured that all actions described as “completed” in action plans were actually in place. For example, some night managers were unaware that they could use an override key to gain access to units as outlined in the prison’s action plan following a high-profile death. Other measures such as access to ligature cutters and cell keys at night had improved.

The prison and the South Eastern Health and Social Care Trust held quarterly ‘lessons learned’ meetings to review adverse incidents and recommendations outlined in death investigation reports. However, a review of death in custody reports by the inspection team indicated that not all recommendations had been achieved and that attendance by staff from the prison at recent meetings had been poor.

The report outlines that there were 18 observation cells around the prison. They included sealed units with a camera, a television and a direct call facility to the Samaritans. Although the physical condition of these cells was monitored regularly, inspectors said there was no data on the length of time for which they were used.

Figures suggested that from September 2011 to February 2012 these cells had been used on 86 occasions and prisoners placed in strip clothing on 45 occasions. Inspectors said they were not assured that these measures were being used only as a last resort.

The report also noted plans to introduce limb restraints for use with self-harmers and said that there was “a danger that too much emphasis was being placed on physical methods to prevent self-harm in the short-term rather than on individual staff interaction to support prisoners through a crisis.”

MATTERS OF CONCERN

As previously reported by The Detail, the Prisoner Assessment Unit (PAU) or ‘step down’ facility in Belfast had been closed leaving lifers with no opportunity to test themselves and demonstrate reductions in risk in a less secure environment. Projections made in an internal presentation by the Northern Ireland probation Board in 2011 included confirmation that there was the potential for 70 life sentence prisoners to be released over the next five years.

In April 2011, the NIPS decided temporarily to suspend its Prisoner Assessment Unit (PAU) in Belfast, which was an annexe of Maghaberry and operated as a ‘step down’ facility after allegations of misconduct. All staff and prisoners were returned to the main prison. Very few of the 21 prisoners were alleged to have been involved in the misconduct and were aggrieved because they felt that the NIPS was subjecting them to collective punishment. The suspension of the PAU was a major setback for lifers’ release preparations.

CJI inspectors noted that this needed to be addressed urgently as the focus on drug and alcohol issues in particular was poor. In November 2012 the Justice Minister, David Ford, announced his intention to redevelop the unit on the Crumlin Road.

At the time of the inspection, some separated Republican prisoners in Roe House were engaged in a dirty protest. They had been refusing to wash and in some cases smearing their cells with excrement in opposition to full body searches as part of the prison’s security regime.

A scanner is currently being tested at Magilligan Prison, while another is being tested at Hydebank Wood prison and in November of this year 22 inmates aligned to a group calling itself the IRA ended their protest.

In the report inspectors claimed during the protest the resulting conditions posed a threat to the health of prisoners and staff but that hygiene arrangements were being carefully managed and nobody had suffered any ill effects at the time of writing.

Data outlined in the prison report also indicated that Catholic prisoners received unequal treatment in a range of areas. Inspectors said that the prison service should “monitor all protected characteristics and understand and investigate all identified inequalities, particularly those relating to Catholic prisoners and in areas where staff discretion can be applied. It should ensure that robust action is taken to address these in order to deliver equality of outcomes for all prisoners.”

Prison Service Director General Sue McAllister welcomed the publication of the latest inspection report on Maghaberry Prison.

She said: "While there is still much room for improvement, progress has been made in three of the four ‘healthy prison’ tests, with the fourth remaining unchanged. I particularly welcome the improvements in safety, though accept that some issues remain unresolved, and in resettlement, where the outcomes for prisoners were assessed as being ‘reasonably good.

“The governor of Maghaberry, with my total support, is committed to delivering on the changes recommended by the inspectorate and the action plan addressing each of the recommendations will serve as an important driver for change and is in keeping with the wider Prison Service Strategic Efficiency and Effectiveness Programme.”