Social care needs in prison

Focus needed on actively identifying adults with social care needs in prison, study finds

Research shows that the consistent, proactive identification of people with social care needs in prison is rare

Greater active case finding is needed in prisons to ensure that people with social care needs are identified and supported, research by the University of Manchester has found.

The mixed-methods research found that a ‘high proportion’ of existing prisoners have social care, as well as physical and mental health, needs.

Identifying prisoners with social care needs and providing them with support is the responsibility of the relevant local authority under the Care Act 2014.

The findings suggested there is ‘considerable variation’ in the way local authorities interpret the national eligibility criteria for the provision of care and support.

The study aimed to provide local authorities with more information to help them develop services for prisoners with social care needs. The researchers carried out face-to-face interviews with prisoners, workshops with frontline staff and a national survey of local authorities.

Sue Tucker, a senior researcher on the study team, said that the study “provides a unique and important insight into the social care needs of prisoners… [a] very vulnerable (and previously neglected) population”.

Identifying care needs

There is a growing prison population, but the total number of people who have social care needs (and the extent of those needs) remains unclear. One-sixth of the 482 male prisoners interviewed across Lancashire for this study said that they needed ‘some help’ with activities of daily living such as maintaining personal hygiene and managing toilet needs.

Two-fifths of those interviewed reported physical health concerns, and half screened positive for mental health problems. Substance misuse and problems with memory and orientation were also common.

Most prisoners came from troubled backgrounds, and approaching a quarter had been placed in local authority care as a child.

The study found that the full extent of prisoners’ social care needs is likely to be greater than the research identified. It called for a proactive approach to identify current prisoners in need of social care support.

Assessing eligibility

The research suggests that there is significant variation in the way local authorities assess prisoners’ eligibility for social care provision. Thirteen case studies were presented to staff across nine local authorities; they only held consistent views for five of these examples.

Some authorities appeared to interpret the national eligibility criteria more narrowly than others. Certain authorities focused on prisoners’ immediate needs, while others took a long-term perspective.

Some assessments were being carried out by specialist prison practitioners in new roles created by the local authority, and others by community teams as part of their normal casework. The number of staff (mostly social workers) carrying out assessments of prisoners with potential social care needs was typically low. However, a high calibre workforce is developing.

Providing support

In many cases, people’s social care needs were being met by other prisoners or by the prison regime.

A quarter of people interviewed said they received no support from family, friends, staff or other inmates.

Where care and support was being commissioned for eligible prisoners, this focused on personal care and safety and was mainly provided by prison healthcare staff.

‘No one model of good practice’

The research showed that local authority practice for the provision of care and support for prisoners with social care needs varies considerably. Although many authorities had introduced screening tools to identify prisoners who may be in need of social care and support upon reception to custody, active case-finding of existing prisoners was rare; the research concluded that this must attract greater focus.

The research team said “Perhaps not surprisingly, given the early stage of this responsibility, no one model of good practice was identified.”

The researchers concluded that “further evaluation is needed of the relative advantages and disadvantages of the different options”.

Full summary findings

NIHR SSCR (2020) Social Care in Prisons: A Needs Assessment and Service Requirements, Research Findings 80, NIHR School for Social Care Research, London.

See also:

Tucker S, Hargreaves C, Roberts A, Anderson I, Shaw J, Challis D (2018) Social care in prison: Emerging practice arrangements consequent upon the introduction of the 2014 Care Act, British Journal of Social Work, 48, 6, 1627–1644.

Tucker S, Hargreaves C, Cattermull M, Roberts A, Walker T, Shaw J, Challis D (2019) The nature and extent of prisoners’ social care needs: Do older prisoners require a different service response? Journal of Social Work, published online.

Further information

This study was funded by the NIHR School for Social Care Research and undertaken by the Social Care and Society research centre and the Offender Health Research Network at the University of Manchester.

The findings were completed before COVID-19 and have been published to support NIHR SSCR’s requirement that findings from all completed studies are made publicly available.