Category: Physical restraint

CHAIR OF YOUTH JUSTICE BOARD TO LEAD REVIEW OF PAIN-INDUCING RESTRAINT ON CHILDREN

In a letter this week to Shadow Children’s Minister Emma Lewell-Buck MP, Justice Minister Edward Argar MP announced that Charlie Taylor has been appointed to lead a review of the authorisation of pain-inducing restraint on children detained in young offender institutions and secure training centres, and during escort to these prisons and secure children’s homes.

The announcement comes days after we lodged our judicial review application with the High Court challenging the Government’s decision to allow escort officers working for the private contractor GEOAmey to inflict pain on children during their journeys to and from secure children’s homes. Staff working within secure children’s homes are prohibited from using such techniques, which Department for Education statutory guidance states can never be proportionate.

Article 39 is also challenging the lack of legal protection for children from being physically restrained simply to follow orders when they are under the control of escort officers, including when they attend hospital appointments or family funerals. The Court of Appeal has declared restraint for good order and discipline within secure training centres a breach of children’s right to protection from inhuman and degrading treatment or punishment.

Argar’s letter says the Chair of the Youth Justice Board “will bring excellent knowledge and experience after leading the Government’s comprehensive review of youth justice in 2016, and spending much of his career in various educational and behaviour management roles”.

Article 39’s Director, Carolyne Willow, states:

We are naturally delighted that there is a possibility that pain-inducing restraint of children could be removed from all custodial settings. Deliberately causing children mental and physical suffering has no professional place in education, health and social care environments, and we have consistently argued that children should have the same protection from violence wherever they are placed.

“Charlie Taylor leads an organisation which has historically stood isolated on this issue in not opposing pain-inducing restraint. From the appalling death of 14 year-old Adam Rickwood, who hanged himself after he was inflicted with a sharp blow to the nose – which was then an authorised restraint technique – onwards, the Youth Justice Board has traditionally failed to put its weight behind complete cultural change in custodial institutions. The YJB like many of those working within and around the penal estate have hitherto shown themselves incapable of seeing that children can be looked after without recourse to severe violence as a form of restraint. However, the organisation seems to be changing under Taylor’s leadership. His background in education could prove pivotal during this review since the culture and practice of schools working with children who have similar needs to those who end up in custody is markedly different from prisons. It would be fantastic for Taylor’s review to finally bring an end to the pain-inducing restraint of children.

“We don’t yet know the scope and timeframe of this review. It is over 14 years since Adam left behind a note saying he had asked officers what gave them the right to hit a child in the nose, and they said it was restraint. I have long given up on this being treated with any sense of urgency though, of course, every day that Ministers allow officers to deliberately hurt children is a day too long.”

In 2009, the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment recommended the UK stop the use of pain-compliant restraint techniques in child prisons. The same recommendation has been made by the UN Torture Committee, the UN Committee on the Rights of the Child and the UK’s four Children’s Commissioners. Her Majesty’s Inspectorate of Prisons, the Association of Directors of Children, the NSPCC and parliament’s Joint Committee on Human Rights have similarly opposed the use of deliberate pain during the restraint of children.

Article 39 is represented by Dan Squires QC and Tamara Jaber from Matrix Chambers and Mark Scott from Bhatt Murphy Solicitors. Its legal challenge was only made possible through a crowdfunding appeal, which elicited nearly 200 donations.

Minimising the use of restraint with disabled children

Article 39 has responded to the Department of Health and Department for Education’s consultation on ‘Reducing the need for restraint and restrictive intervention’ with children and young people with learning disabilities, autistic spectrum disorder and mental health difficulties.

In October 2017, the UN Committee on the Rights of Persons with Disabilities urged the UK to:

Adopt appropriate measures to eradicate the use of restraint for reasons related to disability within all settings … as well as practices of segregation and isolation that may amount to torture or inhuman or degrading treatment.

We used this as the backdrop to our consultation response, which you can download here: Article 39 Consultation response Reducing the need for restraint and restrictive intervention Jan 2018

Medical assessment of restraint

Article 39 has obtained a copy of the Independent Medical Assessor’s rating of different restraint techniques and scenarios applying to:

  • children in custody;
  • children escorted to custody; and
  • children being deported on aircraft.

This is the first time this information has entered the public domain. We elicited the information through freedom of information request to the Ministry of Justice, prompted by the Government’s announcement that escorts taking children to secure children’s homes would now be using the Minimising and Managing Physical Restraint (MMPR) techniques. One-third of the MMPR techniques rely on officers deliberately inflicting pain.

The Guardian newspaper has reported our findings.

Staff working in secure children’s homes are prohibited from deliberately inflicting pain during restraint. Children in secure children’s homes can be as young as 10. In May 2016, the same month escorts taking children to secure children’s homes started using MMPR, Ofsted issued advice on children’s homes inspections which states:

“Ofsted does not condone or support any method of restraint that inflicts pain or any care arrangement that is abusive or emotionally harmful.”

The deliberate infliction of pain during restraint in child prisons has been criticised by many bodies including the UN Torture Committee, the UN Committee on the Rights of the Child, Her Majesty’s Inspectorate of Prisons and the UK’s four Children’s Commissioners.

Each restraint technique and scenario (there are 66 in all) is rated according to the likelihood of harm occurring to children, and to the level and type of harm potentially suffered.

28 of the 66 techniques / scenarios are rated as 2 out of five for the likelihood of children’s airway, breathing or circulation being affected – with the potential consequence of death or permanent severe disability.

Moving a child who is wearing the ‘waist restraint belt’ through a doorway is given a 3 out of 5 risk rating for breathing difficulties that could cause catastrophic harm (death or permanent severe disability).

Children being taken to hospital is rated a “minor” consequence of restraint and hospital admission is rated “moderate”. Only hospital admission that carries a risk to the child of long term disability is rated as “major”.

Children strip-searched on the floor while held under restraint is rated as having a 4 out of 5 likelihood of fracture/dislocation and ligament/tendon damage requiring hospital attendance.

Many scenarios are more likely than not (rated 3 out of 5) to result in a child having to attend or be admitted to hospital.

The document includes a risk assessment of children being held face down on the floor and inflicted with pain. There is also reference to the waist restraint belt being applied to a compliant child.

The medical assessment does not consider the likelihood of children suffering psychological harm.

GeoAmey holds the contract for escorting children to secure children’s homes and child prisons.

We are now considering how the law may be used to protect vulnerable children taken by escort to secure children’s homes.

Children unable to breathe during restraint

Two reports obtained by Article 39 reveal there were 119 restraints in child prisons which compromised children’s breathing, or led to them being seriously injured, between 2013 and 2015.

It took 11 months for the Ministry of Justice to hand over the 2014/15 report, which was first requested in May 2015. A version of the report was given to us in December 2015, but virtually all of the contents were redacted. We complained to the Information Commissioner and, after further delay, the report was given to us last month. It shows that, between 1 April 2014 and 31 March 2015:

  • There were 65 incidents in six prisons (two juvenile young offender institutions and four secure training centres) where a child’s breathing was compromised, or they were seriously injured, during restraint
  • G4S-run Rainsbrook secure training centre had the highest number of incidents – 20 or 31% of the total
  • G4S-run Medway secure training centre had the second highest – 16 incidents (25%)
  • G4S-run Oakhill secure training centre had the third highest of the six prisons – 15 (23%)
  • The other three prisons had a total of 14 incidents (two of these, Hassockfield secure training centre and Hindley young offender institution, stopped detaining children in January and February 2015 respectively).

Of the 65 incidents, 71 warning signs and symptoms were recorded: 19 breathing difficulties; 18 occasions when a child complained  of being unable to breathe; 4 serious physical injuries; 6 incidents when a child vomited whilst being restrained; 8 petechial rash (haemorrhages); 11 incidents when a child lost consciousness or suffered reduced consciousness; and 5 incidents were listed as “other”.

In all of the incidents where a child suffered breathing difficulties and a petechial rash was observed, the head hold was used. The report does not state where the rashes were present: eye and face petechial are linked with asphyxial deaths. NICE clininal guidelines indicate that petechia should be suspected as child abuse if not associated with a medical condition or there is not a suitable explanation; and that such a rash on a child’s face, head or neck could indicate attempted strangulation and suffocation.

In one of the emergencies included in the 2014/15 report, a child was held in a seated hold in Rainsbrook. The child vomited. Notes in the report state the restraint was “prolonged” and “The handcuffs should have been applied much earlier” and there was no single person supervising the restraint (the role was changed between staff “several times”).

In another restraint in Rainsbrook, a child was reported to have “lost or reduced consciousness”. The notes refer to staff being “coached on application of head hold and risks to YP surrounding the use of arm across the throat”.

In another restraint in Rainsbrook, the recommendations include staff being told about “the Laws of use of force and its justification… and to be reminded if a young person verbalises they cannot breathe to ‘check and adjust’ as a minimum response”.

The report shows some children continue to be restrained on the floor, on their front or on their back, in breach of policy.

Large parts of the report summarising each incident, together with recommendations of the Behaviour Management and Restraint Governance Board in the National Offender Management Service, are redacted. In 20 of the 65 incidents, the Board gave no recommendations – which suggests it believes nothing could have been done to prevent the serious harm suffered by children.

The 2014/15 report does not state what the four serious injuries were but observes that one resulted from the “misapplication” of restraint and “a disregard by the staff member to respond to the young persons symptoms”, and another was investigated.

The shortest child to suffer breathing difficulties or a serious injury was 1.5m tall – less than five foot.

Serious incidents continued to take place in a child’s cell or “off camera”, in breach of policy.

The report shows Medway to have the highest rate of breathing warning signs or injuries as a proportion of restraints: 7% of restraints led to breathing difficulties or serious injuries. Next came Rainsbrook at 5%; then Oakhill at 4%; then Hindley at 3%; then Wetherby young offender institution at 1%; and, finally, Hassockfield at 0.8%.

The 2013/14 report, released to Article 39 last year, shows:

  • There were 54 serious injuries and warning signs that year
  • 48% of these serious incidents concerned children’s breathing (13 breathing difficulties and 13 complaints of difficulties breathing); and a further 30% involved a petechial rash. The report notes, “Petechial Rash and breathing difficulties constituted 78% of the [serious incidents]. This points towards a restriction of the mechanics of breathing to varying degrees”
  • Two incidents involved the child “appearing to lose consciousness”; both of these children had asthma. One child vomited after being given his/her inhaler “under restraint”
  • 7% of the incidents involved a child vomiting whilst being restrained: government guidelines state this is a medical emergency
  • Children suffered fractures whilst being restrained on four separate occasions
  • 39% of the 54 serious incidents occurred in Rainsbrook secure training centre, which was at that time run by G4S.

The Ministry of Justice report states, “The incidents that cause most concern are those where there is no camera coverage”.

Guardian news story here.

The Ministry of Justice does not appear to have made the reports available on its website.

7,784 restraints led to injuries in child custody 2007-2015

Data released today to Labour’s Shadow Justice Minister, Andy Slaughter MP, reveals there were 7,784 restraint incidents leading to child injuries in custodial institutions between 2007 and 2015. Across these eight years:

  • 4,092 restraints in young offender institutions resulted in children being injured
  • 2,583 restraints in secure training centres resulted in children being injured
  • 1,109 restraints in secure children’s homes resulted in children being injured

Sixteen institutions closed over the eight-year period.

Counting incidents for only those institutions which remained open for the whole eight years, the data reveals the four secure training centres had a much higher rate of restraints leading to child injuries: an average of 81 incidents per year per institution across each of the eight years.

The average for the nine young offender institutions with data for the full eight years was 48 restraint incidents per year per institution; and for 10 secure children’s homes with full data the average was 13 per home per year.

The five institutions with the highest incidents of restraint leading to child injuries across the whole time period were:

  • Hindley young offender institution, with 969 incidents (run by the UK prison service)*
  • Hassockfield secure training centre, with 945 incidents (run by Serco)*
  • Medway secure training centre, with 833 incidents (run by G4S)
  • Wetherby young offender institution, with 586 incidents (run by UK prison service)
  • Rainsbrook secure training centre, with 577 incidents (run by G4S)

The five institutions with the least number of incidents of restraint leading to child injuries were:

  • Barton Moss secure children’s home, with 7 incidents (run by Salford City Council Children’s Services)
  • Aldine House secure children’s home, with 25 incidents (run by Sheffield City Council Children’s Services)
  • Swanwick Lodge secure children’s home, with 69 incidents (run by Hampshire County Council Children’s Services)
  • Hillside secure children’s home, with 77 incidents (run by Neath Port Talbot County Borough Council Children’s Services)
  • Lincolnshire secure children’s home, with 89 incidents (run by Lincolnshire County Council Children’s Services)

Although the Shadow Justice Minister requested data on the number of child injuries, he was only provided with the incidents of restraints which led to injuries. This means the scale of child injuries remains unknown.

Annual restraint statistics published by the Youth Justice Board have to date included only restraint incidents that led to injuries requiring medical or hospital treatment. These latest figures go further than those released in January 2016, covering all types of injuries, since data for individual institutions is provided for the very first time.

The Parliamentary Question (answered 8 April 2016) is here.

*These two institutions have since closed. The data relates to the periods between the year ending March 2008 and the year ending March 2015.