The Prisons and Probation Ombudsman, who investigates deaths and complaints in prisons, echoed the findings of the Chief Inspector of Prisons’ report of an inspection at HMP Nottingham.
The Acting PPO, Elizabeth Moody, said: “It is highly troubling that HMP Nottingham has a history of failing to implement recommendations from our investigations into deaths at the prison”.
The PPO makes recommendations following investigations into deaths in prisons so that the prison service can learn from mistakes and prevent them being made in the future. Final PPO reports on deaths investigations are not published until the end of inquests but important findings and recommendations that could lead to greater safety in a prison are shared with the prison and HM Prison and Probation Service (HMPPS) as they emerge.
Elizabeth Moody added: “It is a matter of great concern that we found some similarities, not only between the deaths of the five prisoners who took their own lives last autumn, but also with deaths which happened earlier in the year and before. The Chief Inspector is right to highlight the apparent inability of the prison to learn lessons and I agree that until it can demonstrate progress in this critical area the risk of future deaths will remain high.”
She also said: “Complaints from prisoners frequently indicate poor custodial care. I am troubled that my office upheld proportionately more complaints from prisoners at HMP Nottingham, than in other similar prisons. This is consistent with the findings of the Chief Inspector and should be a source of concern to the management of HMPPS.”
The Chief Inspector, Peter Clarke, wrote publicly to David Gauke on 18 January, invoking a new procedure to demand urgent action on HMP Nottingham from the Justice Secretary. He raised concerns over eight apparent self-inflicted deaths at HMP Nottingham in the two years up to January 2018, as well as high levels of self-harm.
At the same time, Elizabeth Moody raised key concerns with the Ministry of Justice which had been identified in her investigations into recent deaths at the prison:
- The importance of initial identification in prisoners of risk of suicide or self-harm.
- Assessment and management of those individuals, particularly applying multi-disciplinary assessment rather than relying on the way the prisoner presents and talks on arrival in the jail.
- Referring mental health concerns and issues to healthcare or other experts.
- The importance of staff responding, in line with HMIP expectations, when prisoners press their cell call bells and of staff entering cells promptly when prisoners are found unresponsive.
- Keeping proper medical records.
- Effective emergency response.
Elizabeth Moody said: “HMPPS is preparing an Action Plan to address the urgent concerns raised by the Chief Inspector, particularly in relation to suicide and self-harm at HMP Nottingham. It is vital that, this time, HMPSS fully incorporates PPO recommendations into the Action Plan. That will help HMP Nottingham create a new culture of safety and protection for vulnerable prisoners. Put simply, it will help save lives and prevent a repetition of the tragedies we saw in 2017.”