1. Assisted Living Unit ALU
Presented by Paul Goodridge
HMP/ YOI Parc
Introductions
My name is Paul Goodridge, and I am an operational manager at HMP/ YOI Parc in Bridgend.
I have worked at HMP/ YOI Parc for 18 years, in various ranks and roles, and currently I am the Older Prisoner and Disabilities Manager, and also manage the Assisted Living Unit.
I have lead the development and implementation of Palliative & End of Life Care and Dementia Pathways, locally, member of Steering Group Committee (OHRN & NHS project) on older prisoner social and clinical needs assessment and Training facilitator in ‘Best Practice in Dementia Care’ with DSDC, Stirling University, but that’s enough about me.

2. What is the ALU What was the Need? Challenges and Milestones
Sharing Practice
Measuring Success
Objective
The ALU (Assisted Living Unit) is designed to meet the needs of an ageing population with complex clinical and social needs i.e. Palliative and end of life, various types of dementia, Parkinson’s etc. whilst providing support and care within a proactive and socially inclusive environment. But this is the end result, and getting there was an interesting journey

3. What was the Need? At Risk Population Impact At Risk Population
The prison was experiencing an explosion of older prisoners, who were found to be disengaged.
An increase in complex clinical and social care needs.
An increase in hospital escorts and bedwatches – resource implication.
Impact
Operational staff were overwhelmed, due to a lack of knowledge, understanding. Staff believed that prisoners with such needs should be managed clinically, clinical teams believed that it was a social care matter.
Service provision and application was patchy, inconsistent and failed to meet the needs of this population cohort
Resulted in the most vulnerable at a greater risk
Older prisoner's reported that they felt isolated and withdrew themselves
Impacted on their mental health
Increase in negative self worth

4. Challenges and Milestones (Key Aspects)
Buy-In
Service Development & Care Planning
Training
Internal Alignment
Buy-In
From the ‘top’ – to preserve its aims and objectives
Departmental – to ensure that the role of the unit is understood.
Prisoners – initial engagement help to align expectations but also understand their experiences.
ALU Staff selection – critical area, correctly selected for their enhanced skills, willing to learn and develop
Service Development
Bringing together key external groups who have the knowledge and appetite to develop services within the custodial environment.
Adopting a Person Centred approach to care, which led to the introduction of Supported Living Plans and after trialling was extended to the whole prison. “a symbiotic approach to social and clinical care”, to connect staff to individuals’ care and keep their “voice at the heart of all matters.”
Work with those who’s lives you want to improve – what works what doesn't. Working with the older prisoner population gave an insight into their fears, expectations and needs.
Review – test that processes and procedures are fit for purpose. For those who were end of life, we invited Macmillan in to examine service provision.
Training
Staff sent to work in a care home for a day
Age training with AgeCymru
Macmillan
Alzheimer's Society
DSDC
Internal Alignment
The introduction of the CVOP – which included Chaplaincy, ALU staff, OMU staff, GP’s and other Healthcare staff as mandatory, with external experts (Macmillan etc.), Security and the prisoner's family on a case by case basis.

5. Sharing Practice Evaluation & Planning Third Sector The Family
Important to understand the needs of the older prisoner population, if you group older prisoner’s together just on age they are more likely to age quicker than those who have access to a multi-generation population group. Proven research.
Always have in mind that we must ensure that the purpose is to meet the needs of the individual rather than duplicating an example of good practice
Understand and compare service provision with community based models which should compliment and integrate into current care planning and provision
Be realistic – Rome wasn’t build in a day.
Examine resource implications – probably the biggest hurdle. We were fortunate that the majority of work was provided free, including some health training ie. Syringe Driver training
Third Sector
Wealth of knowledge and expertise in the community – who have proven willing to engage with the prison.
Foster relations – this can take time, so please be patient but remain determined.
The Family
Involving the family and loved ones in care planning (CVOP), particularly those who where palliative or end of life is a key aspect in communication, understanding what care provision is in place and that placing the prisoner into a hospital surrounded by strangers rather than being with friends that they know.
Clear Vision & Goals
Whilst you may develop a pathway with an end goal – break down your plan into ‘bite-size’, evaluate and adjust whilst keeping your focus. This will help you to adapt any plan which is developing and maintain your sanity!

6. Measuring Success Butler Trust Award Care Wales Awards The Individual
Silver Award for Excellence in Palliative and End of Life Care
Spirit of Care Award
The Individual
One prisoner returned from hospital to die among people he knew, and who cared not just for but about him – this is the greatest compliment and achievement we could have hoped for.