Month: March 2019

Hospital restraint probe reveals lack of basic safeguards

Following the suspension of 20 members of staff from the Westwood Centre at West Lane Hospital in Middlesbrough, Article 39 submitted a freedom of information request to gain details of restraint techniques authorised for use on children there. The staff were suspended after using unauthorised restraint methods.

The FOI response from Tees Esk and Wear Valleys NHS Foundation Trust reveals an alarming lack of accountability, reporting and sparse information sharing with child patients and their parents/carers.

Westwood Centre cares for just 12 children at a time. Our FOI request reveals that:

  • In 2013/14 two formal complaints were made by children and young people and/or their parents;
  • This rose to 10 complaints in 2017/18; and
  • Eight complaints have been lodged from 2018 to date.

No written information was given to us about approved restraint techniques, and in the FOI response the Trust said no information is provided to children and parents.

The Mental Health Act 1983 grants children detained in the Westwood Centre the right to an independent mental health advocate when they make a complaint.

However, we’ve been told no child received assistance from an independent advocate when making a complaint between 2013/14 and 2016/17.

In 2017/18 only two children received support (when 10 had made complaints). Similarly, just two of eight complainants have received help from an advocate from 2018 to date.

Helen Donohoe, Article 39’s Assistant Director, said:

“A child or young person’s right to an independent advocate in settings such as the Westwood Unit is an essential safeguard against poor and dangerous practice, including the use of excessive restraint. We are alarmed that so many complaints could occur without children and young people receiving assistance from independent advocates, to make sure they are heard and their rights upheld. We are seeking assurance that the current investigation will address that now, and for future practice.”

The CQC inspected the NHS Foundation Trust in 2018 and found that:

The trust had made improvements since the last inspection as continued to monitor the use of restraint on Newberry and Westwood wards. The numbers of restraint on both wards have increased which management attributed to the acuity of patients. However, in 2015 prone restraint was 25% and 50% of total restraints on the respective wards however this had reduced significantly to the current figures of 3% and 6% of all restraints on these wards. Staff understood that the use of restraint was a last resort. They used de-escalation and low levels of restraint to manage incidents of aggression wherever possible. Staff ensured they documented episodes of restraint, and rapid tranquilisation in accordance with trust policy.

Extract from CQC inspection report, 2018

Article 39 is now seeking further information, including:

  • What was done in the five years before the staff suspensions to address the rise in complaints.
  • What restraint methods were approved for use on children, and why is information about authorised techniques not given to children and their parents.
  • Why is there a seemingly low use of independent advocates? Has material been produced especially for children about their right to an independent advocate? Who is responsible for making sure children and young people detained in the Centre are heard and their rights upheld?
  • How the perspectives of children and young people and their parents were considered during the CQC inspection in 2018; and how they they will be included in the current investigation.

Medway child prison will be site of experimental secure school, despite history of failure to protect children

Last month, Article 39 and 35 others wrote jointly to the Ministers responsible for child protection and child prisons urging them to abandon plans to open an experimental secure school on the site of Medway secure training centre.

A serious case review showed substantial failure both within the institution, and among local and national agencies, to keep children safe. This was followed by an inspection report, published on 29 January 2019, which revealed children had been recently unlawfully inflicted with pain as a form of restraint. The secure training centre transferred from G4S to Ministry of Justice management in July 2016.

We received a letter this week – see below – from Edward Argar MP, responsible for child prisons. He said he was also replying on behalf of Nadhim Zahawi MP, whose Ministerial portfolio includes child protection and safeguarding vulnerable children.

Given our joint letter was wholly about the safety and welfare of very vulnerable children, many of them in the care system, it is very disappointing that Minister Zahawi did not, at the very least, countersign the letter.

But the most astonishing part of the response is the Government’s explanation for using Medway secure training centre as its first experimental secure school:

“Medway STC stood out for several reasons – including location, our ownership of the site and the absence of any need to go through a potentially protracted and expensive planning application.”

Edward Argar MP, Youth Justice Minister

On location, official data published by the Ministry of Justice shows 58 children from the South East region of England were detained in December 2018. However, 228 children were detained within the region – meaning that 170 children were from outside the area. Over a quarter (27%) of children in custody are sent to the South East region. The Government’s own data therefore shows that extra provision is not required in this location.

Moreover, one of the documents produced by the Ministry of Justice to encourage companies to apply to run the first experimental secure school notes that there are no secure settings in England’s Eastern region – yet 77 children from that area are detained, according to latest figures.

That the Ministry of Justice owns the prison site has no credibility as a reason for choosing it as the place to pilot an institution meant to be completely different from existing child prisons.

There is a very long history of the prison service’s ownership of land, as opposed to children’s needs, determining where institutions are built. The location of Medway secure training centre itself was selected in the late 1990s because the prison service ran the nearby Cookham Wood young offender institution and Rochester prison.

Prior to its opening in 1998, Medway secure training centre was known as Cookham Wood secure training centre – showing its links to the adjacent prison. Its other neighbouring prison, Rochester, was once called Borstal prison, and was the site of the first ever experimental child prison – which opened in 1902.

Similarly, the Government’s avoidance of having to “go through a potentially protracted and expensive planning application” makes no sense if Ministers genuinely want to abandon penal institutions for children. Whenever a local authority or health body wishes to open a new residential service, for children or adults, they must go through the planning process.

Article 39’s Director, Carolyne Willow, said:

“The Minister’s response signals his department continues to be trapped in a cycle of failure with the perpetual remodelling of child prisons. The first experiment in child prisons started in the same geographical location as the planned secure school. That was 117 years ago.

“If Ministers are truly behind replacing young offender institutions and secure training centres, they must surrender their dependence on prison land and prison property.

“And if they genuinely want secure schools to be secure children’s homes, as their promotional literature says, then why not build upon and develop the best of existing provision run by local authorities as part of their wider services to children and families?”

The Minister’s letter can be read here.
Our joint letter to the minister can be read here.

In December 2016, the Government announced it shares the long-term vision of Charlie Taylor (Chair of Youth Justice Board) to replace juvenile young offender institutions and secure training centres with secure schools.