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Social care in prisons in England and Wales

Even the most psychologically robust and able-bodied man or woman finds being imprisoned to be a disturbing experience. And for those men and women who are imprisoned, but who need assistance with their social or personal care, it is especially challenging and daunting. Prisons were designed to accommodate physically fit and mentally stable individuals, with prison life being arranged to address the needs of the many. Prisoners with social care needs – unable to fully care for themselves, needing help in getting around the prison or in participating socially – are at a significant disadvantage.

Thankfully, the difficulties facing men and women with social care needs imprisoned in England and Wales were recognised by respective Westminster and Welsh governments. Legislation was enacted to enable the prisons and local authorities to provide a response. This, our joint review of social care in prisons has been undertaken to identify the state of developments in prisons following the introduction of new social care services to prisoners.

The review has identified several developments that are good practice in the social care of prisoners. However, there continue to be wide variations between social care services in prisons, so that as yet they are neither equitable nor consistent. Gaps remain in provision of services in English prisons. Gaps also remain in the provision of support for those prisoners requiring assistance with personal care who do not meet the eligibility threshold for social care. There are clear signs that the disparity in services between prisons is disadvantaging prisoners in their ability to be rehabilitated, because transfers to suitable establishments cannot be effected when receiving prisons are unable to offer services that can adequately respond to the individual’s social care needs.

We are also concerned that developments in social care in prisons are only related to current need. We are not convinced that there is adequate consideration of what will be required in the very near future, such as the obvious needs that will flow from the projected growth in the older prisoner population. This, in our view, represents a serious and obvious defect in strategic planning.

We hope that this review will provide prisons and local authorities in England and Wales with ideas to better develop their approaches in delivering personal and social care to men and women in prisons. Additionally, we hope that the review will stimulate strategic thinking and service development, so that our concern about social care in prisons in the future proves to be unfounded.

Peter Clarke CVO OBE QPM

HM Chief Inspector of Prisons

Professor Stephen Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice, Care Quality Commission