The Ministry of Justice announced that a national strategy would be developed for older people in prison. In this guest blog, Chief Officer of RECOOP, Paul Grainge, talks about the ageing prison population, RECOOP’s work with older people in contact with the criminal justice system, and the many years of advocacy that finally led to the government announcing that a national strategy would be developed.
Many of us will remember Norman Stanley Fletcher, Ronnie Barker’s role in the BBC comedy Porridge. His cheeky, stereotypical, older prisoner character enjoyed notoriety, kudos and the ability to make life inside prison far more manageable. Many people still visualise prison life to be just the same for the ‘old lags’ today. In reality, this hidden and often marginalised group has been struggling to cope and be heard for years.
Older people have been the fastest growing prisoner cohort for the last 20 years. The Ministry of Justice (MoJ) forecasts that by the end of June 2021, the older prison population will reach 14,800. This equates to nearly one in five people in prison. In just over 12 years, it will have grown by 200%. Despite this, there is no defined means to address their health and social care needs.
RECOOP was set up in 2008 to specifically support the older prison population and meet its differing needs. This is a group that is seldom heard from, and is recognised by the World Health Organisation as being ‘under served.’ Our first service was an informal peer support model for the frail and vulnerable as they tried to adapt to a prison (often Victorian) physical environment, limited regime opportunities, and long spells in their cells.
Throughout our years of work, there was a very obvious elephant in the room - the absence of formalised social care support for older people in prison by way of a national strategy.
The need for a strategy
Older people in prison have unique needs when compared to the younger population. Up to 90% of prisoners aged 50 or over have at least one moderate or severe health condition, and over 50% have three or more. We saw that trying to get a bigger pair of shoes because your feet had swollen up due to diabetes; or getting a replacement set of dentures or spectacles because a pair had broken, became a lottery and a waiting game because it was not part of a prison officer’s role. Old and frail individuals were still being put on top bunks or allocated to cells on the first or second floor landings as the norm despite mobility issues. Training for staff in understanding the differing needs of this cohort wasn’t – and still isn’t – routinely offered. Combining this with limited regime opportunities that were typically geared towards younger people in prison, we witnessed individuals deteriorate both physically and mentally.
In 2013, the Justice Select Committee inquiry into older prisoners produced a report highlighting 30 recommendations, the most important being the introduction of a national strategy. Nevertheless, it didn’t happen, though the introduction of the Care Act in 2014 offered an opportunity to introduce some consistent good practice across the estate. Six years later, although improvements have been made, older people in prison continue to have unmet health and social care needs, and reside in an environment and regime that is designed for young men.
This did not go unnoticed. In 2018, a thematic report of Social care in prisons in England and Wales was jointly undertaken by Her Majesty’s Inspectorate of Prisons and the Care Quality Commission. The review found that:
“There is no comprehensive national strategy for the provision of social care in prisons. Without such a strategy it is hard to see how the requirements arising from local prison assessments of social care needs, and the projected growth in groups likely to require help with those needs, will be met.”
Peer support for older prisoners
In the absence of a formal means to support the needs of older people in prison, RECOOP took action by developing a formalised prisoner ‘buddy’ training and support service, adapting the national Care Certificate modules to fit a prison setting.
Buddies support fellow prisoners with the day-to-day challenges they face within an often difficult environment. We delivered the programme and managed the Buddies ourselves, meaning the programme wouldn’t fail when officers were detailed elsewhere at short notice. Our objective has always been to empower and support older individuals to control and maintain their independence, health, and well-being. The well-managed Buddy service increased both confidence and self-esteem, promoting better mental health, reducing anxiety, and increasing resilience – even during Covid-19.
I can’t deny that it has been a long process getting traction to champion this work, with few grant funders having criteria that fits well for this field coupled with an expectation that statutory bodies should fund it themselves. Few organisations are equipped or trained to support the specific needs of this group.
The final push for a strategy
Last year, RECOOP worked with Clinks on some research, outlined in Flexibility is vital, a report that highlighted the importance of the voluntary sector in supporting older people in the criminal justice system. A second Justice Select Committee inquiry into older prisoners followed soon afterwards, and we responded jointly with written evidence, after which RECOOP was invited to give oral evidence in April this year.
The evidence presented at the inquiry highlighted some acute challenges and risks for this cohort if not addressed. Covid-19 magnified the potential health and social care time bomb for all should the 23 hours a day lock up roll on for more weeks. Six months later and we still don’t know what the full detrimental impact will be. ‘Long Covid’ is emerging in the community and it is not a stretch to take a wild guess that the impact in custodial settings will be far worse.
Considering this, the needs of older people in prison have never been more urgent. So, we were delighted and relieved that the Justice Committee’s report from this inquiry again recommended a national strategy for older prisoners, which the Ministry of Justice has now agreed to develop and implement across England and Wales.
Although the pandemic-tainted backdrop is very dark, there is light ahead for the first time. After years of advocacy and campaigning, I can finally visualise a time where there might be regime adaptations that support the ability to provide a sense of purpose and belonging to older prisoners; a regime that offers meaningful and purposeful activity in settings that are conducive to helping individuals maintain their independence and build their self-esteem and confidence, and uphold their right to health and social care.
Paul Grainge is the Chief Officer at RECOOP. RECOOP, founded in 2010, promotes the care, resettlement and rehabilitation of older prisoners, people with current or past convictions, particularly the over-50s. This is done through the provision of carefully-designed support services, advocacy, financial advice, mentoring on employment and training and advice on housing and health. The organisation provides consultancy, training and direct support services for prisons, working with them to explore innovative and low cost solutions to challenges posed by the growing elderly prison population.
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We are extremely disappointed that the JCVI advice on phase 2 of the COVID vaccination programme does not prioritise people in prison and those who work with them, including voluntary sector staff and volunteers https://gov.uk/government/publications/priority-groups-for-phase-2-of-the-coronavirus-covid-19-vaccination-programme-advice-from-the-jcvi/jcvi-interim-statement-on-phase-2-of-the-covid-19-vaccination-programme