Recommendation 1
Mental health services in the prison are poor. This is mainly due to staff shortages. We request that the minister review budgets for mental health staff especially in local prisons.
Source · IMB Annual Report
Bedford
AI-generated report summary HMP/YOI Bedford faced significant challenges during the reporting year, operating under "restrict" regimes due to COVID-19 and staff shortages, leading to widespread cell confinement. While positive steps were made in safety initiatives, particularly with a new young adults' wing and improved ACCT processes, the prison continues to struggle with high levels of self-harm and violence. Mental health services are critically under-resourced and inadequate, further exacerbated by persistent overcrowding and delays in relocating the inhumane segregation unit.
Year: 2022
Published: 13 Dec 2022
Type: Prison · Cat B, YOI
Recommendations: 20
Key concerns
Positive findings
Safety statistics
| Indicator | This year | Previous |
|---|---|---|
| Deaths in custody | 3 | 3 |
| Self-harm incidents | 367 | — |
| Prisoner assaults | 146 | — |
| Assaults on staff | 184 | — |
Positive findings
AI-generated summaryThe Board notes positive developments in safety, particularly the new young adults' wing and improved self-harm support processes. Reception and induction are professional, and the vulnerable prisoners' wing is well-run. There are indications of reduced drug use, improved laundry facilities, and acceptable food. Education attendance and the library service have seen significant improvements, as has purposeful activity provision. The prison is commended for genuine progress in ACCT implementation and the effective management of the vulnerable persons' wing. Staff generally manage use of force appropriately and are praised for adapting to new routines and managing prisoners with lower-level interventions.
Key concerns
Mental health services in the prison are poor. This is mainly due to staff shortages.
Many prisoners at HMP Bedford with such severe mental health issues that effective treatment by the local mental health team has not been possible. These men do not belong in prison: they get no better and take up an enormous amount of officer time. Transfer to an appropriate mental health facility is hugely difficult and the target time for transfer (28 days) is seldom met.
As far as we are aware there have been no attempts to evaluate the effectiveness of the assessment, care in custody and teamwork (ACCT) process to understand whether it has achieved (or failed) its objective of supporting those at risk of self-harm.
The layout of the ACCT form does not facilitate care coordinators to summarise the prisoner’s story to bring together a description of triggers, coping strategies and other relevant factors into an individual ‘formulation’. We believe this remains a fundamental flaw in the ACCT process.
The prison remains overcrowded with two prisoners in cells designed for one.
Facilities for disabled people in HMP Bedford are woefully lacking and as it deals with an ageing prison population, more cells will need to be adapted for disabilities.
The digitising of the personal escort records has made it harder for healthcare staff to access them.
We feel that the focus of the prison should be reviewed to see if it is providing the appropriate services for a prison that now houses predominantly unsentenced prisoners.
We have made several suggestions in relation to suicide and self-harm. This includes considering whether the number of meetings to review these individual’s care could be streamlined to improve the quality and consistency of decision-making.
We believe that the formulation of ACCT care plans should begin by asking prisoners about their coping strategies and preferred sources of help. The care plan should proceed from there.
We have made several suggestions in relation to violence and violence reduction including exploring if there is a link between the remand prisoners and violence, and reviewing how prisoners with serious mental health problems are assessed and the process for moving them to specialist psychiatric facilities.
Forms are not easily and regularly available on all wings, indeed on D wing there have been occasions where no forms were available at all.
We have been made aware of numerous issues with catalogue buys, particularly with items going missing after purchase.
We hope that this year the segregation unit will finally be moved from its underground location.
We are concerned that, on occasions, prisoners have been kept in segregation without the proper process being completed.
We hope that the key worker scheme can be returned to full implementation.
Performance on complaints has got worse and prisoners tell us that they have little confidence in the system.
We made some suggestions about how the mental health service might become more effective including spending less time on the procedures for new referrals and more training of officers ‘on the job’ so that prisoners with mental health problems could be identified earlier.
We echo the view of HMIP that the reallocation of gym staff should be a last resort.
We believe that there would be significant benefits in the co-location of healthcare and mental health services and are disappointed that this has not yet happened.
Recommendations
Recommendation 2
We have also seen many prisoners at HMP Bedford with such severe mental health issues that effective treatment by the local mental health team has not been possible. These men do not belong in prison: they get no better and take up an enormous amount of officer time. Transfer to an appropriate mental health facility is hugely difficult and the target time for transfer (28 days) is seldom met. We feel that there should be better cooperation between the Ministry of Justice and the Department of Health and Social Care to enable prisoners who are assessed as requiring mental health care in the NHS to be placed early in the appropriate facility.
Recommendation 3
As far as we are aware there have been no attempts to evaluate the effectiveness of the assessment, care in custody and teamwork (ACCT) process to understand whether it has achieved (or failed) its objective of supporting those at risk of self-harm.
Recommendation 4
The layout of the ACCT form does not facilitate care coordinators to summarise the prisoner’s story to bring together a description of triggers, coping strategies and other relevant factors into an individual ‘formulation’. We believe this remains a fundamental flaw in the ACCT process.
Recommendation 5
The prison remains overcrowded with two prisoners in cells designed for one.
Recommendation 6
Facilities for disabled people in HMP Bedford are woefully lacking and as it deals with an ageing prison population, more cells will need to be adapted for disabilities.
Recommendation 7
The digitising of the personal escort records has made it harder for healthcare staff to access them.
Recommendation 8
We feel that the focus of the prison should be reviewed to see if it is providing the appropriate services for a prison that now houses predominantly unsentenced prisoners.
Recommendation 9
We have made several suggestions in relation to suicide and self-harm. This includes considering whether the number of meetings to review these individual’s care could be streamlined to improve the quality and consistency of decision-making.
Recommendation 10
We believe that the formulation of ACCT care plans should begin by asking prisoners about their coping strategies and preferred sources of help. The care plan should proceed from there.
Recommendation 11
We have made several suggestions in relation to violence and violence reduction including exploring if there is a link between the remand prisoners and violence, and reviewing how prisoners with serious mental health problems are assessed and the process for moving them to specialist psychiatric facilities.
Recommendation 12
Forms are not easily and regularly available on all wings, indeed on D wing there have been occasions where no forms were available at all.
Recommendation 13
We have been made aware of numerous issues with catalogue buys, particularly with items going missing after purchase.
Recommendation 14
We hope that this year the segregation unit will finally be moved from its underground location.
Recommendation 15
We are concerned that, on occasions, prisoners have been kept in segregation without the proper process being completed.
Recommendation 16
We hope that the key worker scheme can be returned to full implementation.
Recommendation 17
Performance on complaints has got worse and prisoners tell us that they have little confidence in the system.
Recommendation 18
We made some suggestions about how the mental health service might become more effective including spending less time on the procedures for new referrals and more training of officers ‘on the job’ so that prisoners with mental health problems could be identified earlier.
Recommendation 19
We echo the view of HMIP that the reallocation of gym staff should be a last resort.
Recommendation 20
We believe that there would be significant benefits in the co-location of healthcare and mental health services and are disappointed that this has not yet happened.
Applications to the IMB
| Category | Current | Previous |
|---|---|---|
| Accommodation (including transfers) | 25 | 34 |
| Chaplaincy and Faith | 1 | 0 |
| Discipline | 1 | 1 |
| Diversity | 0 | 0 |
| Finance | 1 | 0 |
| Food | 2 | 0 |
| General | 11 | 16 |
| Healthcare (including dental) | 11 | 16 |
| Legal | 0 | 0 |
| Property | 24 | 10 |
| Release issues | 4 | 3 |
| Security (including categorisation) | 3 | 1 |
| Segregation | 3 | 0 |
| Staff behaviour and attitudes | 6 | 12 |
| Visits (including legal, family & official) | 9 | 11 |
| Work, training & education | 3 | 5 |
Related inspections & investigations
Safety 1
· Respect 1
· Activity 1
· Release 2
Sorin Fodor · Natural causes
Edward Hands · State Custody related deaths
Ezra Tamiem · State Custody related deaths | Suicide (from 2015)
Mark Vagnoni · State Custody related deaths
Other reports for Bedford
Population 367
· Concerns
Population 370
· Self-harm 484
· Concerns
· Concerns
Population 370
· Self-harm 138
· Concerns
· Concerns