HM Prison and Probation Service
Central Government
Action Taken
Detox unit staff completed training on supervising opiate substitution medication, and awareness training is scheduled for completion in January 2016. Monthly strategy meetings are held to discuss drug misuse, and attendance from prison officers on B Wing is mandatory. Widespread testing for psychoactive substances as part of the MDT process is planned for April 2016. (AI summary)
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Dear Mrs Hunt Thank vou for vour Regulation 28 report dated 25 November 2015 addressed to Michael Spurr, Chief Executive of the National Offender Management Service (NOMS) concerning the recent inquest into the death of Dean Boland at HMP Birmingham on 17 April 2015. Your report has been passed to the Equality, Rights and Decency (ERD) Group at NOMS headquarters, as we have responsibility for the policy on suicide prevention and self-harm management and for sharing learning from deaths in custody: have consulted with the Director of HMP: Birmingham and : with Birmingham Community Healthcare NHS Trust In formulating this response, which has been reviewed and approved by each organisation (also including Birmingham and Solihull Mental Health Foundation Trust in view of the shared healthcare arrangements at HMP Birmingham) to submission to you; The report raises twelve concerns wlll address each one in turn: Prison_Officers need a comprehensive education_program to_understand_what drugs_are being used and soldandhow prisoners come by those drugs Following the Inquest; training on supervising the administration of oplate substitution medication has been completed with detox unit staff and awareness training is scheduled for completion by 31 January 2016. strategy meetings are held monthly and the purpose of these meetings is to discuss current issues and trends around misuse within the prison and to agree actions and strategies going forward These meetings are attended by a cross-functional group of interested parties including clinical staff, residential managers and DART workers: From 9 December 2015 there has been mandatory attendance at these meetings from prison officers who work on B Wing All staff on the detox and recovery unit will be required to sign a document indicating that they have read the minutes of the meeting each month_ Also included in this meeting is discussion of those prisoners receiving opiate substitution medications who have failed both mandatory and compliance based drugs tests This provides officers with a heightened awareness of misuse on the residential units and allows them to factor that information into their observations and risk assessments: prior and drug being Drug drug drug
officers_health workers and DART workers donot adequately discuss trendsand Besenoifigers_heedbo EOLL astanare u2t2 dateandaware Qi theprobleni BeWing is now managed outside of the normal residential function; by the drugestrategy as part of his role_ Each prisoner undergoing opiate substitution treatment has & manager and DART worker who work collaboratively with the individual on their named IDTS nurse members of the DART team are trained prison officers and others recovery journey: Some Inclusion; are drug and alcohol support workers from the prison'$ partner organisation, Issues around misuse of illicit drugs and prescribed medication are discussed during rrethlyratug strategy and security meetings , During the meeting trends and issues around misuse Of all kinds are discussed and actions to reduce the risk and likelihood of these Occerresces are ldentdfiedand Pusfa place Due consideration is given to confidentiality, but this does not prevent discussion around these issues: As result of these meetings significant amounts of work have been carried out with regad as that of new psychoactive substances (NPS) which are widely to emerging issues This work has been carried out misused both in custody and in the community; collaboratively by clinicians, drug workers and prison officers. Following intelligence around the illicit use of Buscopan, an emergency medicines meeting was convened on 20 Aprii 2015, which included operational prisof management well as clinical managers: A joint decision was taken to suspend use of managers and further. clarification; This was also escalated Buscopan as a medication whilst awaiting 'of the potential for through the NHS to ensure that other establishments were made aware illicit use _ administration does not involve a check of_the mouth so prisoners_can General medicine conceal tablets to sell later carried in line with the HMP The administration of medication within the prison is Medicines Code (an overarching medicines management policy) which reflects Birmingham NHS Clinical Governance procedures_ IDTS medication is supplemented by a check of the mouth in line with the Administration f with their treatment pathway: This is similar to compact signed by IDTS recipients to comply supervised consumption being requested by the prescriber in the community administration is carried out by two nursing staff in line with medicine code Controlled drug: requirement to check the mouth of prisoners However, in policy: There is no clinical practitioner pocordancee with the published standard operating procedure; the designated obcerdencee prisoner Ptaking his medication and annotates the medication chart to indicate that it has been taken and swallowed medication is administered by one nurse in line with the standard operating General procedure: This is observed and recorded in the same way. the administration of both controlled and general medication to An officer is present during diversion raised bY the nursing staff The officer deal with any concerns of concealment or and IEP scheme to deter challenges unacceptable actions and uses the adjudication system such behaviour. review of a prisoner' s prescribed medication may follow an and manage incident of this nature, the such easily out
The_number_of searches_on _ Bwing seems insufficient_glven_the extent gf_the_drug problems In line with contractual requirements agreed with NOMS, HMP Birmingham's search takes place over a 6 month period; During that 6 month period each of the 996 cells within prison is searched and each search is recorded on the appropriate form; AIl intelligence received is graded by intelligence analysts using the same systems as NOMS. This will rate the validity reliability of the source and contribute to the decision about what action to take; The security team carries out target searches or intelligence-led searches on the basis of information received, but in addition to this ad hoc searching of cells, prisoners and specific areas can take place at any time that it is deemed necessary: Cells are checked daily by officers as part of AFCs (accommodation fabric checks), and anything of concern can lead to the decision being taken to complete a cell search_ There is an important balance to be struck between security and decency, ensuring that we maintain order and prevent Illicit activlties, but also that staff build positive, appropriate relationships with prisoners as part of dynamic security and to encourage responsible and respectful behaviour; Drug dogs are also deployed strategically for use in targeted areas, including B Wing: This also assists in maintaining appropriate levels of security: Prisoners_onB Wing are _not viewed or _monitored_gvernight_unless_they are_on an ACCT giving them a considerable period of time to smokeand_use drugs Across the prison service there is no routine night time monitoring for prisoners other than those subject to the Assessment, Care in Custody and Teamwork (ACCT) case management process and those who are segregated or located on an inpatient ward; It is important that during night state the reduced numbers of staff are deployed to supervise those most vulnerable or at risk Staff who are deploved as night patrols can report suspicious activity to the person in during night state. This may lead to test or a cell search being carried out. At Birmingham in 2015, 266 suspicion drug tests were carried out on individuals as a result of staff submitting intelligence reports (IRs) stating that they believed illicit were being used, IRs can be submitted by any member of staff at time of day or night: The_grlson deploys e security_gificer_to_B Wing_at night_who_is_only_there to answer call bells_This_ seems inadequate given that this Broup gfprisoners arg at_high tiskof use particularlxat night when there are no cellchecks The individuals deploved to B Wing are trained members of G4S staff; In common with the practice in all public and private prisons, they are not fully qualifiled prison officers, but they have all been specifically selected and trained for the role Training includes modules on ACCT procedures, security awareness, health and safety and violence reduction These are delivered during a two week training course that also makes provision for shadowing of existing security officers, including shadowing a night duty before becoming operational On Wing there is direct access for the security officer to senior staff located adjacent to the and to the medical team located on the 3rd landing of the wing The clinical support during night state includes both general nurse and a detox nurse. concerns can be discussed with the Night Orderly Officer, a manager who is present throughout the cell cycle the and charge drug drugs any drug wing Any grade
night: HMP Birmingham has no plans to introduce additional night staff; and they already deploy a greater number than required by the contract with NOMS. DARL workers are_unable_to access compact based drug results as ther are_unable _to the computer This issue has been resolved since the inquest; At the time, only the dedicated DART staff carrying the compact based tests (CBDT) had access to the database of results. Results were analysed and communicated to the DART team information produced for the strategy meeting each month: Read only access has now been given to all members of the DART team to enable them to have contemporaneous information regarding the clients on their caseload, Prison gfficers are_unaware of_positive drug_test results_and therefore_unable_totake_anx action in response The details of individual prisoners testing positive on mandatory drug tests (MDTs) communicated to wing managers so that; in line with our zero tolerance 'no drugs no violence' policy, reduction to basic level on the incentive and earned privileges (IEP) scheme can take place: managers brief staff about the information that they receive: A case note entry is added on PNOMIS whenever a prisoner tests positive. Personal officers review this information when making their weekly entries A database Is available on a shared drive of the local computer system, accessible to all staff; with details of each prisoner who has failed a drug test; including information about what substance was taken, Only two exercise yards_have netting_Further consideration needs_to be_given to _netting other_areas given the number_of packages_being_thrown over_the_walLand then secreted bYprisoners on their_person Onlxa smallproportion of packagesare seized as theycome over the_wall Preventing illicit articles from entering the prison is part of the prison'$ supply reduction strategv, and a vast amount of work has been undertaken, in conjunction with West Midlands Police, on closing down the most significant ingress point_ Where the establishment considers it necessary it can submit bids for capital expenditure, and It would do so if it believed that additional security measures would make an impact on supply: The_prison should Investigate_whether 3 prison_officers_on_duty_in_the_exercise_area_is sufficient for 472 prisoners given the_number_of_packages_that_are thrown_over_the_walls every_week Staffing levels for exercise are risk assessed appropriately: B wing exercise yard has no external ingress point: the detox wing was moved to B on account of this, so that no throw overs can reach the exercise vard_ Increasing the number of staff supervising exercise is not felt to be necessary, and it would not be the best use of resources There_is_no_availability to_search or_screen_prisoners_or_visitors _for_drugs_concealed on their person when ther come_into the prison_Further consideration needtobe given_ona pational level as tohow concealed drugs can beidentified Prisons currently employ comprehensive range of searching techniques and security measures to detect and uncover drugs at the point of entry or concealed in the establishment; and anyone caught with them will be punished and could face prosecution; Such measures include basic and enhanced rub down searching and full searching of prisoners, staff and visitors, as appropriate, ad the use of X-Ray machines, drug detection dogs and CCTV surveillance cameras and the imposition of closed (non-contact) visits. The forthcoming Psychoactive Substances Bill will control the sale and supply of all psychoactive Jog onto ~drug out and drug are Wing key wing
substances: It includes a new offence_of possession of psychoactive substance in custodial institution, which will tackle the dangerous and pervasive use of new psychoactive substances in prisons, The Government recentiy commenced a clause in the Serious Crime which introduces a new offence of throwing ay item over a prison wall, including psychoactive substances Plans are in place to introduce widespread testing_ for psychoactive substances as part of the MDT process by April 2016, ad NOMS has trained more than 300 specialist to search and detect new psychoactive substarces in prisons NOMS is also evaluating the effectiveness of body scanners to tackle further the threat posed by drugs smuggled into prisons Consideration needs to_be given tohavlng more dogs so that prisoners and visltors_coming into the prison willalways be screened HMP Birmingham has four operational drug at its disposal. There are two handlers each of whom has two drug dogs: passive drug (trained to search people) and an active drug dog (trained to search areas) The monthly security committee meeting discusses the deployment of and results from the drug dogs, with the aim of ensuring that the resource is used tactically in line with current intelligence and known risk factors. Ingress of illicit substances Into any establishment is not achieved through only one route For example, prisoners subject to licence recall have been identified as a high risk group with regard to potential trafficking, and dogs are therefore deployed when are entering the establishment on return from court Active dogs are also used as part of cell searches, and passive dogs can be used to support prisoner searches to deter possession of items or locate them where they are suspected to be present Two operations took place in 2015 where additional canine support was drawn from central resources to carry out 'blitz' operations on two residential wings: hope this provides vou with assurance that the matters of concern that you have identified are being fully addressed:
officers_health workers and DART workers donot adequately discuss trendsand Besenoifigers_heedbo EOLL astanare u2t2 dateandaware Qi theprobleni BeWing is now managed outside of the normal residential function; by the drugestrategy as part of his role_ Each prisoner undergoing opiate substitution treatment has & manager and DART worker who work collaboratively with the individual on their named IDTS nurse members of the DART team are trained prison officers and others recovery journey: Some Inclusion; are drug and alcohol support workers from the prison'$ partner organisation, Issues around misuse of illicit drugs and prescribed medication are discussed during rrethlyratug strategy and security meetings , During the meeting trends and issues around misuse Of all kinds are discussed and actions to reduce the risk and likelihood of these Occerresces are ldentdfiedand Pusfa place Due consideration is given to confidentiality, but this does not prevent discussion around these issues: As result of these meetings significant amounts of work have been carried out with regad as that of new psychoactive substances (NPS) which are widely to emerging issues This work has been carried out misused both in custody and in the community; collaboratively by clinicians, drug workers and prison officers. Following intelligence around the illicit use of Buscopan, an emergency medicines meeting was convened on 20 Aprii 2015, which included operational prisof management well as clinical managers: A joint decision was taken to suspend use of managers and further. clarification; This was also escalated Buscopan as a medication whilst awaiting 'of the potential for through the NHS to ensure that other establishments were made aware illicit use _ administration does not involve a check of_the mouth so prisoners_can General medicine conceal tablets to sell later carried in line with the HMP The administration of medication within the prison is Medicines Code (an overarching medicines management policy) which reflects Birmingham NHS Clinical Governance procedures_ IDTS medication is supplemented by a check of the mouth in line with the Administration f with their treatment pathway: This is similar to compact signed by IDTS recipients to comply supervised consumption being requested by the prescriber in the community administration is carried out by two nursing staff in line with medicine code Controlled drug: requirement to check the mouth of prisoners However, in policy: There is no clinical practitioner pocordancee with the published standard operating procedure; the designated obcerdencee prisoner Ptaking his medication and annotates the medication chart to indicate that it has been taken and swallowed medication is administered by one nurse in line with the standard operating General procedure: This is observed and recorded in the same way. the administration of both controlled and general medication to An officer is present during diversion raised bY the nursing staff The officer deal with any concerns of concealment or and IEP scheme to deter challenges unacceptable actions and uses the adjudication system such behaviour. review of a prisoner' s prescribed medication may follow an and manage incident of this nature, the such easily out
The_number_of searches_on _ Bwing seems insufficient_glven_the extent gf_the_drug problems In line with contractual requirements agreed with NOMS, HMP Birmingham's search takes place over a 6 month period; During that 6 month period each of the 996 cells within prison is searched and each search is recorded on the appropriate form; AIl intelligence received is graded by intelligence analysts using the same systems as NOMS. This will rate the validity reliability of the source and contribute to the decision about what action to take; The security team carries out target searches or intelligence-led searches on the basis of information received, but in addition to this ad hoc searching of cells, prisoners and specific areas can take place at any time that it is deemed necessary: Cells are checked daily by officers as part of AFCs (accommodation fabric checks), and anything of concern can lead to the decision being taken to complete a cell search_ There is an important balance to be struck between security and decency, ensuring that we maintain order and prevent Illicit activlties, but also that staff build positive, appropriate relationships with prisoners as part of dynamic security and to encourage responsible and respectful behaviour; Drug dogs are also deployed strategically for use in targeted areas, including B Wing: This also assists in maintaining appropriate levels of security: Prisoners_onB Wing are _not viewed or _monitored_gvernight_unless_they are_on an ACCT giving them a considerable period of time to smokeand_use drugs Across the prison service there is no routine night time monitoring for prisoners other than those subject to the Assessment, Care in Custody and Teamwork (ACCT) case management process and those who are segregated or located on an inpatient ward; It is important that during night state the reduced numbers of staff are deployed to supervise those most vulnerable or at risk Staff who are deploved as night patrols can report suspicious activity to the person in during night state. This may lead to test or a cell search being carried out. At Birmingham in 2015, 266 suspicion drug tests were carried out on individuals as a result of staff submitting intelligence reports (IRs) stating that they believed illicit were being used, IRs can be submitted by any member of staff at time of day or night: The_grlson deploys e security_gificer_to_B Wing_at night_who_is_only_there to answer call bells_This_ seems inadequate given that this Broup gfprisoners arg at_high tiskof use particularlxat night when there are no cellchecks The individuals deploved to B Wing are trained members of G4S staff; In common with the practice in all public and private prisons, they are not fully qualifiled prison officers, but they have all been specifically selected and trained for the role Training includes modules on ACCT procedures, security awareness, health and safety and violence reduction These are delivered during a two week training course that also makes provision for shadowing of existing security officers, including shadowing a night duty before becoming operational On Wing there is direct access for the security officer to senior staff located adjacent to the and to the medical team located on the 3rd landing of the wing The clinical support during night state includes both general nurse and a detox nurse. concerns can be discussed with the Night Orderly Officer, a manager who is present throughout the cell cycle the and charge drug drugs any drug wing Any grade
night: HMP Birmingham has no plans to introduce additional night staff; and they already deploy a greater number than required by the contract with NOMS. DARL workers are_unable_to access compact based drug results as ther are_unable _to the computer This issue has been resolved since the inquest; At the time, only the dedicated DART staff carrying the compact based tests (CBDT) had access to the database of results. Results were analysed and communicated to the DART team information produced for the strategy meeting each month: Read only access has now been given to all members of the DART team to enable them to have contemporaneous information regarding the clients on their caseload, Prison gfficers are_unaware of_positive drug_test results_and therefore_unable_totake_anx action in response The details of individual prisoners testing positive on mandatory drug tests (MDTs) communicated to wing managers so that; in line with our zero tolerance 'no drugs no violence' policy, reduction to basic level on the incentive and earned privileges (IEP) scheme can take place: managers brief staff about the information that they receive: A case note entry is added on PNOMIS whenever a prisoner tests positive. Personal officers review this information when making their weekly entries A database Is available on a shared drive of the local computer system, accessible to all staff; with details of each prisoner who has failed a drug test; including information about what substance was taken, Only two exercise yards_have netting_Further consideration needs_to be_given to _netting other_areas given the number_of packages_being_thrown over_the_walLand then secreted bYprisoners on their_person Onlxa smallproportion of packagesare seized as theycome over the_wall Preventing illicit articles from entering the prison is part of the prison'$ supply reduction strategv, and a vast amount of work has been undertaken, in conjunction with West Midlands Police, on closing down the most significant ingress point_ Where the establishment considers it necessary it can submit bids for capital expenditure, and It would do so if it believed that additional security measures would make an impact on supply: The_prison should Investigate_whether 3 prison_officers_on_duty_in_the_exercise_area_is sufficient for 472 prisoners given the_number_of_packages_that_are thrown_over_the_walls every_week Staffing levels for exercise are risk assessed appropriately: B wing exercise yard has no external ingress point: the detox wing was moved to B on account of this, so that no throw overs can reach the exercise vard_ Increasing the number of staff supervising exercise is not felt to be necessary, and it would not be the best use of resources There_is_no_availability to_search or_screen_prisoners_or_visitors _for_drugs_concealed on their person when ther come_into the prison_Further consideration needtobe given_ona pational level as tohow concealed drugs can beidentified Prisons currently employ comprehensive range of searching techniques and security measures to detect and uncover drugs at the point of entry or concealed in the establishment; and anyone caught with them will be punished and could face prosecution; Such measures include basic and enhanced rub down searching and full searching of prisoners, staff and visitors, as appropriate, ad the use of X-Ray machines, drug detection dogs and CCTV surveillance cameras and the imposition of closed (non-contact) visits. The forthcoming Psychoactive Substances Bill will control the sale and supply of all psychoactive Jog onto ~drug out and drug are Wing key wing
substances: It includes a new offence_of possession of psychoactive substance in custodial institution, which will tackle the dangerous and pervasive use of new psychoactive substances in prisons, The Government recentiy commenced a clause in the Serious Crime which introduces a new offence of throwing ay item over a prison wall, including psychoactive substances Plans are in place to introduce widespread testing_ for psychoactive substances as part of the MDT process by April 2016, ad NOMS has trained more than 300 specialist to search and detect new psychoactive substarces in prisons NOMS is also evaluating the effectiveness of body scanners to tackle further the threat posed by drugs smuggled into prisons Consideration needs to_be given tohavlng more dogs so that prisoners and visltors_coming into the prison willalways be screened HMP Birmingham has four operational drug at its disposal. There are two handlers each of whom has two drug dogs: passive drug (trained to search people) and an active drug dog (trained to search areas) The monthly security committee meeting discusses the deployment of and results from the drug dogs, with the aim of ensuring that the resource is used tactically in line with current intelligence and known risk factors. Ingress of illicit substances Into any establishment is not achieved through only one route For example, prisoners subject to licence recall have been identified as a high risk group with regard to potential trafficking, and dogs are therefore deployed when are entering the establishment on return from court Active dogs are also used as part of cell searches, and passive dogs can be used to support prisoner searches to deter possession of items or locate them where they are suspected to be present Two operations took place in 2015 where additional canine support was drawn from central resources to carry out 'blitz' operations on two residential wings: hope this provides vou with assurance that the matters of concern that you have identified are being fully addressed: