Presentation on theme: "Nick Hardwick HM Chief Inspector of Prisons"— Presentation transcript:
1Nick Hardwick HM Chief Inspector of Prisons EPSO European Partnership for Supervisory Organisations in Health and Social CareBrussels, AprilINSPECTING THE USE OF FORCE AND RESTRAINT IN SECURE ACCOMMODATIONNick HardwickHM Chief Inspector of Prisons
2Inspecting the use of force and restraint HM Inspectorate of PrisonsOPCAT and the UK National Preventative mechanismWhy independent inspection is necessaryUse of force and restraint in social care settingsInspection principles
3About HM Inspectorate of Prisons Independent, human rights based with the experience of the detainee at the heart of our workA long history – dating back to C18Role: To report on the treatment of prisoners and the conditions in prisonsRemit: prisons, youth custody, police and courts custody, immigration detention, military custody
4OPCAT (1)‘Optional Protocol to the UN Convention Against Torture and other cruel, inhuman or degrading treatment or punishment’ – 2002Some overlap with the Council of Europe Committee for the Prevention of Torture (CPT)OPCAT requires an independent ‘National Preventative Mechanism’NOT a regulator, auditor or complaints handlerAdequately resourced with diverse and expert personnel
5OPCAT (2)Regular independent inspection of all places where people are detainedFreedom to choose where and when to goComplete access and opportunity for private interviewsAccess to informationPublic reportingMake recommendations and free to comment on legislation
6The UK NPM (1) OPCAT ratified 2003 NPM established 2009 18 existing bodies inspecting or monitoring criminal justice, immigration, health/social care and childrenEngland, Scotland, Wales and Northern IrelandCo-ordinated by HMI Prisons
7The UK NPM (2) ENGLAND AND WALES SCOTLAND NORTHERN IRELAND HMI Prisons Independent Monitoring BoardsIndependent Custody VisitorsHMI ConstabularyCare Quality CommissionOffice for the Children’s Commissioner for EnglandOffice for Standards in Education, Children’s Services and SkillsCare and Social Services Inspectorate WalesHealthcare Inspectorate WalesSCOTLANDHMI Prisons for ScotlandHMI Constabulary for ScotlandScottish Human Rights CommissionMental Welfare Commission for ScotlandCare InspectorateNORTHERN IRELANDIndependent Monitoring BoardsCriminal Justice InspectorateRegulation and Quality Improvement AgencyIndependent Custody Visitors
8OPCAT in Europe www.justice.gov.uk/about/hmi-prisons NPM ESTABLISHED AlbaniaArmeniaAustriaCroatiaCyprusCzech RepublicDenmarkEstoniaFranceGermanyHungaryLiechtensteinLuxembourgMacedonia, FRYMaltaMoldovaMontenegroNetherlandsPolandSerbiaSloveniaSpainSweden (NPM established)SwitzerlandUkraineOPCAT RATIFIED, NPM TO BE DESIGNATEDBosnia and HerzegovinaBulgariaGeorgiaItalyPortugalOPCAT STILL TO BE RATIFIEDBelgiumFinland (treaty still to be ratified)GreeceIcelandIrelandNorway (treaty still to be ratified)RomaniaTurkey
9Why independent inspection is necessary? The power imbalance between the detainee and custodianThe closed nature of the institution and the supposed lack of credibility of the detaineeThe normative effects of custodyThe ‘virtual prison'Low morale and poor training of staff
10What is detention? Prisons, police cells etc People with dementia in a care facility who are prevented from leaving for reasons of safety?People in hospital with mental health problems who are not formally detained but are ‘detainable if wishes to leave’?People in community settings who are locked in at night or for part of the day?Children detained in community settings with the consent of their parents?
11Is it detention? (1)Is the person confined in a restricted space for more than a very short time?Has the person given valid consent to the confinement?Is the state responsible? For example, independent care homes may breach article 5 of ECHR if they unlawfully detain an individual who has been placed there by, or with the permission of, a state authority.Is the person free to leave?Duration of the measure?
12Is it detention? (2) Physical restraint? Sedation? Contact with outside world?What is the overall purpose of measures to control or restrict the individual’s movements?Is there a relevant comparator?
13Types of restraint (1)physical – using physical force without equipmentmechanical – using equipment such as handcuffs or leg restraintschemical – using medication to restrain a detaineeenvironmental – for example, using seclusion to restrict a detainee’s movement
14Types of restraint (2)technological – for example, using electronic tagging, pressure pads or alarms to alert staff to a detainee’s movementspsychological – for example, repeatedly telling someone, especially a vulnerable person, that they are not allowed to do something or that it is dangerous, or depriving a detainee of something that is necessary for what they want to do, such as a walking aid
15Restraint concerns in health and social care settings (1) Mental Welfare Commission Scotland (MCWS):113 incidents/20 required restraint3 ‘floor restraint’/others seated or guidance6 restrained regularly (fortnightly to daily)Staff trained1 inappropriate incident1 institution with no records
16Restraint concerns in health and social care settings (2) MCWS concerns cont.People with different security needs on same wardInappropriate use of chemical restraintsLack of restraint – failure to assist a mentally ill patient with terminal cancer to die with dignity
17Restraint concerns in health and social care settings (3) Regulation and Quality Improvement Agency (RQIA)Range of restraints found: rapid tranquilisation, bed rails, lap straps, arm splints, specialist sleepwearInadequate training and policesPatients complained of injury
18Restraint concerns in health and social care settings (4) RQIA concerns cont.In non-secure settings:Locked internal doors, locked external doors and gates, use of exclusionLack of understanding services were restrictive, failure to assess impact on individuals, poor assessment processes and little consultation with services users and/or their representativesAbsence of safeguards
19CPT standards for the use of restraint in adult psychiatric establishments Subject to clearly defined policyLast resort and usually restricted to manual controlTrained staffPhysical restraints only used with medical authorisation, for the minimum time possible and never as a punishmentProfessional supervision of medication and sedationSeclusion should be avoidedAll incidents fully recorded to facilitate management and oversight
20UK inspection and monitoring framework ‘Expectations’ (1) Monitoring bodies should be independent of the authorities visited/ inspected and of the government. OPCAT Articles 17, 18(1)Monitoring bodies should be impartial. SPT Guidelines 18, 19, 30Monitoring bodies should have the right to publish their findings and to make recommendations for the purpose of preventing ill-treatment and improving standards in detention. OPCAT Articles 19(b), (c); SPT Guidelines 36
21UK inspection and monitoring framework ‘Expectations’ (2) Monitoring bodies should have unfettered access to places of detention. Access should be granted even where monitoring bodies arrive unannounced. OPCAT Articles 20(c), (e); SPT Guidelines 25Monitoring bodies should have unfettered access to all detainees and to information about them. OPCAT Article 20The voice of the detainee is an essential component of any monitoring of places of detention. OPCAT Article 20(d)There must be a focus on the prevention of ill-treatment. OPCAT Articles 1, 3
22UK inspection and monitoring framework ‘Expectations’ (3) All places of detention should be monitored regularly. OPCAT Articles 1, 19(a)Monitoring bodies should set their own criteria against which they monitor the treatment of and conditions for detainees. SPT Guidelines 12Criteria for monitoring should be firmly grounded in human rights standards and should be transparent. OPCAT Article 19(b)Monitoring bodies should be sufficiently resourced to perform their role. OPCAT Article 18(3)
23UK inspection and monitoring framework ‘Expectations’ (4) The remit of monitoring bodies should be set out in statute. SPT Guidelines 7The staff of monitoring bodies should be recruited and appointed in an open and fair manner. SPT Guidelines 16Monitoring bodies should promote and encourage respect for diversity, both in their own workforce and when monitoring places of detention. OPCAT Article 18(2); SPT on Prevention 5
24Summary Is it detention? Is the person restrained? Can they move where they wish?Is any restraint necessary, proportionate, safe, authorised, recorded?Is there a human rights based, regular, independent, preventative inspection and monitoring framework?