The prison service and local authorities are failing to plan for the future needs of a growing population of elderly, ill and frail prisoners, according to a report on social care in jails by HM Inspectorate of Prisons and the Care Quality Commission published on Tuesday (16 October 2018).

The inspectors’ headline findings were:

Many older jails are ill-equipped for prisoners in wheelchairs, or with mobility problems. Some prisoners struggle to wash and look after themselves and others who have fallen cannot get help during the night. The quality of care is inconsistent across prisons. The number of people in prison aged 50 and over was 13,522 in December 2017 – 16% of the total adult prison population aged over 18. Projections show this number is likely to increase. Reports have suggested that factors in prisoners’ lives, in and out of jail, lead to a faster ageing process.

The responsibility for social care in prisons falls on 58 English authorities with jails and five in Wales. The joint report by the two inspectorates says: 

The ageing population within prisons, coupled with increasing frailty and incidence of dementia, has accelerated the need for prisons to address social care needs. In addition, a significant proportion of prisoners also have learning disabilities, autism, mental health disorders or difficulties which may also inhibit their ability to cope with life in prison.

However, troubling evidence gathered from individual prison inspections by HMIP and the CQC have led to some key conclusions:

• • • • At a national level, Peter Clarke, HM Chief Inspector of Prisons, and Steve Field, CQC Chief Inspector of General Practice, say: “We are concerned that developments in social care in prisons are only related to current need. We are not convinced that there is adequate consideration of what will be required in the very near future, such as the obvious needs that will flow from the projected growth in the older prisoner population. This, in our view, represents a serious and obvious defect in strategic planning.”
      • At a prison level, the report notes, “there continue to be wide variations between social care services in prisons, so that as yet they are neither equitable nor consistent. Gaps remain in provision of services in English prisons. Gaps also remain in the provision of support for those prisoners requiring assistance with personal care who do not meet the eligibility threshold for social care. There are clear signs that the disparity in services between prisons is disadvantaging prisoners in their ability to be rehabilitated, because transfers to suitable establishments cannot be effected when receiving prisons are unable to offer services that can adequately respond to the individual’s social care needs.”

Background

In addition to the growing proportion of older prisoners, it is important to remember that it is widely accepted that what is considered old age in prisons differs from that in the community. According to several reports, prisoners experience a faster ageing process due to a wide range of factors which occur both during the prison sentence and prior to detention.

Prison itself is considered to be an environment which can give rise to the development of physical and mental impairments. In addition, prisoners’ mental and physical health are widely recognised as poorer than the wider population.12 For the purpose of this thematic, as well as its inspections, HMI Prisons uses the age of 50 as a benchmark for defining ‘old age’ in prisons.

The number of prisoners with dementia is a further concern. In the general population, dementia affects around 5% of those aged over 65 and 20% of those over 80. The prevalence of dementia in the prison setting is largely unknown and dementia may go undetected.

In addition to the challenges of old age, a significant proportion of prisoners also have learning disabilities, autism, mental health disorders or difficulties which may also inhibit their ability to cope with life in prison.