PRISONERS WERE NEVER explicitly excluded from being eligible for social care support. They just, sort of, got forgotten. Which is why the Department of Health refer to the Care Act as `clarifying' councils' responsibilities for identifying and meeting the social care needs of people in prisons and approved premises.
I first started working with the Department of Health, Ministry of Justice, The National Offender Management Service (NOMS) and NHS England on the Care Act and prisoners in the summer of 2012 when a call went out through the ADASS Bulletin for a volunteer to help develop policy and guidance. I have continued this work as an ADASS Associate and am genuinely excited about where April 2015 may take us.
We must not forget that the punishment of being sent to prison is no more and no less than being deprived of liberty. It is not about then suffering further loss of dignity and ability as long term health conditions and disabilities take their toll.
In the community, we do not ask questions about what antisocial or criminal things people have done earlier in their lives before allowing them access to social care support. Neither should we in prison even though some of the things that individuals have done may anger us.
Our prison population is changing with those over 65 years being the fastest growing cohort. Some of this is due to the positive effects of improved wellbeing in the community which means that people are fit enough to continue to commit offences in the community way past retirement age.
There are also two other groups that contribute to this growth. The first are those who committed serious crimes and received long sentences and are still serving them and the second is those whose crimes of yesteryear have now caught up with them - think various high profile celebrities for examples.
In summer 2012 the focus was very much on older prisoners, not least because of the interest taken in them by a Parliamentary Select Committee. But social care extends to people with mental health, learning disabilities, autistic spectrum disorders and substance misuse of whom there are many in the prison system. These are generally the younger offenders who, often with a background in local authority care, frequently slip between health and social care services in the community. They never quite make the threshold for either and often their lifestyle is too chaotic for anyone to engage with them properly.
As part of this group there are also those whose disabilities are the cause of their offending and need, to quote the programme, `Care not Custody'. People working in the prison system know that these people are inappropriately placed but have to accommodate them as long as courts continue to send them there.
As I said earlier, few social care professionals and managers have spent much time in their prisons and few people working in those settings know much about what we do and how we do it. So what are our new partners like? My experience, whether talking to staff in prisons or to those commissioning and managing prison services is that they have a genuine concern for the wellbeing of their charges. They see the consequences of deteriorating health and disabilities and genuinely welcome the arrival of social care professionals with their skills and experiences (and resources).
It is really encouraging to see colleagues in NOMS who are working on re-drafting their national operating instructions looking to harmonise them with adult social care processes and also to use the language and concepts of safeguarding
So what of safeguarding? There have been many who for a long time have argued that local authorities should have the right and responsibility to investigate safeguarding concerns within prison settings. The Care Act however has firmly shut down this option. Personally, I am not too worried by this as long as prisons have robust and adhered-to procedures to protect vulnerable prisoners in the first place, to identify when things are going wrong and to deal with them. The important thing is how prisons are then held to account for discharging these responsibilities. All of these elements are being worked on but exactly how the holding to account will be delivered is something that ADASS should be very interested in.
I am delighted to see Local Safeguarding Adult Boards placed on a statutory footing and for prisons to be part of them (albeit at their discretion rather than as full members). But I do wonder what being part of an LSAB will really mean? Membership gives prisons access to multi-agency training initiatives but I wonder if this really should be the limit of our ambition? LSAB's are meant to be where a whole system comes together to provide, through sharing and mutual challenge, an assurance that in all parts of that system, everyone is alert to those who are most vulnerable and are responding accordingly.
If the Care Act makes prisoners citizens of the area where their prison or approved premises is located, then my personal view is that the LSAB should be a place where their safeguarding is overseen at a strategic level. The final Care Act Guidance may well not go this far and leave things more open ended allowing perhaps for more local determination on what prisons being part of LSAB's mean. Alternatively it may be left for NOMS to advise and instruct prison managers on what they can share in this more public setting - we shall see.
Finally, we must not forget about engaging with prisoners directly. This is a group of people who have forfeited their right to freedom but not their rights to apply for and to have a say in how they receive care and support. Prisoners cannot have the choice of where they live and they cannot have a direct payment or be a carer. But in all other respects they have the same rights and expectations as anyone living in the community. As we develop our engagement with our communities we must remember that prisoners are one of our communities as well.
Will the Care Act provisions for prisons be implemented smoothly without problems either locally or nationally? - I doubt it. Social care, prisons, and prison health care working together with serving prisoners is new and each part of the system has its own culture and language. I confidently expect that somewhere someone will try and open a debate about whether the prisoner's need for assistance is a social care or health need and in turn there will undoubtedly be prisoners who try it on to gain access to some relief from the inconveniences and discomfort of the prison system. I have not mentioned the money but with so little hard evidence and experience to draw on, it is almost certain that there will be a council that finds its budget allocation for meeting prisoners’ needs to be insufficient and a public outcry will follow that services for the law abiding may have to be cut to allow people who have committed crimes against the community to live in luxury.
Nothing new ever works perfectly first time. But I have a sense that all parts of the prison system, both nationally and locally want this to succeed and therefore I am optimistic that we will all make this work. The Care Act provides an opportunity to give dignity to those prisoners who would be eligible for care and support in the community while they serve their sentences and provide them with the opportunity having paid their due, to re-enter society at the proper time to continue their lives properly supported.