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Department of Health

Care Act 2014: How should local authorities deliver the care and support reforms? Please give us your views


Prisons, approved premises and bail accommodation

The Act establishes that the local authority in which a prison, approved premises or bail accommodation is based will be responsible for assessing and meeting the care and support needs of the offenders residing there.

The provision of care and support for those in custodial settings is based on the principle of equivalence to provision in the community. The Act clarifies the application of Part 1 for people in custodial settings, including aspects which do not apply, because the current law is not clear on responsibilities in this area.

The draft guidance on prisons, approved premises and bail accommodation covers:

  • setting the context of care and support in custodial settings
  • the application of specific care and support functions in custodial settings
  • complaints, investigations and inspections

There are a number of aspects of providing ‘equivalent’ care and support in prisons where the custodial setting may mean that the handling of steps in the process of assessment and commissioning of care and support could be improved by consideration of experience or good practice.
Respond to question 59 below.

There is a high prevalence of mental ill health, substance misuse and learning disability in the custodial population.
Respond to question 60 below.

The provision by local authorities of care and support in custodial settings raises questions of equivalence with other residential settings about responsibility for provision of reasonable adjustments, aids, adaptations and equipment, ranging from fixtures and fittings, such as adapted bathrooms, to items specific to meet the individual’s needs.
Respond to question 61 below.

We know that prisoners move prison relatively frequently compared to people in the community, and it therefore seems disproportionate to require local authorities to conduct a full re-assessment every time a prisoner moves area. In addition, prisoners may spend a very short time in some prisons, particularly at the beginning of their sentence.

An assessment at the beginning of their sentence which can be shared, reviewed as necessary and used to inform their care and support plan in subsequent prisons would enable the second and subsequent local authorities to plan to meet the same needs that the first authority was meeting and when carrying out the new assessment to carry it out in a proportionate manner. For example, where the person is only staying in the prison for a short period the local authority should focus on the person’s identified eligible needs and how the change in environment might impact on these.

This frequent movement means that it is important to ensure that a prisoner is referred for assessment in their first prison where they are likely to have some care and support needs on which the local authority can advise, even if they do not have eligible needs. However, referral processes must be proportionate and avoid placing an undue assessment burden on local authorities.
Respond to question 62 below.

Question 61: How might these be best provided in custodial settings and how might responsibility for provision best be identified?

Read: guidance on prisons, approved premises and bail accommodation Back to prisons, approved premises and bail accommodation

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