Pain-inducing restraint

Government still undecided on pain-inducing restraint

The Government’s response to the Joint Committee on Human Rights’ inquiry into solitary confinement and restraint in youth detention is published today. It shows that Ministers remain undecided about the Ministry of Justice’s policy of training custody officers to deliberately inflict pain on children – despite the Independent Inquiry into Child Sexual Abuse (IICSA) concluding in February that the techniques are a form of child abuse which must be prohibited by law.

The Government says it will respond to the Committee’s recommendation that pain-inducing restraint be banned once it has considered the findings of a review by Charlie Taylor, which was launched in October 2018 following litigation by Article 39.

Carolyne Willow, Article 39’s Director, said:

When a public inquiry says that children are being abused as a result of government policy, it is incumbent on Ministers to take immediate action to change that policy and stop the mistreatment. We are coming up to five months since the Independent Inquiry into Child Sexual Abuse recommended the prohibition of pain-inducing restraint, and we don’t even know whether Ministers want to remove these violent techniques let alone how they will go about training and supporting staff to eschew prison forms of control.

In April, the parliamentary committee urged the prohibition of pain-inducing restraint, which is part of the Minimising and Managing Physical Restraint (MMPR) system in use in juvenile young offender institutions (YOIs) and secure training centres (STCs).

MMPR is also followed by GEOAmey escort custody officers contracted to take remanded and sentenced children to and from YOIs, STCs and secure children’s homes.

Staff in secure children’s homes are prohibited from inflicting pain as a form of restraint. Pain-inducing restraint is also not permitted in health settings. At the end of last month, the Department for Education and Department for Health and Social Care published non-statutory guidance on reducing restraint and restrictive interventions in children’s health, social care and special education settings. A key principle is that:

restraint is not used to punish or with the intention of inflicting pain, suffering or humiliation

Government guidance issued 27 June 2019 in respect of children’s health, social care and special education

Carolyne Willow adds:

Government departments focused on children’s welfare and health don’t allow staff to deliberately inflict pain. There is absolutely no justification for Ministers operating a separate set of values and child protection rules for children in custody.

There has been no public call for evidence to the Charlie Taylor review. Earlier this month, the Royal College of Paediatrics and Child Health published its letter to Charlie Taylor, which states:

… pain-inducing restraint techniques are a form of child abuse, violate children’s rights and must be prohibited.

Royal College of Paediatrics and Child Health letter to Charlie Taylor, 5 July 2019
Medway secure school

Oasis Charitable Trust to run Medway secure school

Days after another child died in prison, the Ministry of Justice has announced that the Oasis Charitable Trust has been selected to run its first experimental secure school.

Article 39’s Director, Carolyne Willow, said:

“The site chosen for the experimental secure school is a child prison beset by abuse scandals and systemic failures.

“Three years ago, BBC Panorama undercover footage showed serious emotional and physical abuse, with officers using restraint as a cover for mistreatment. In January, a serious case review reported that every local and national agency working in and with Medway secure training centre had failed to safeguard children, with a lack of proper analysis of allegations by the Local Safeguarding Children Board. A previous review found there had been 35 separate whistleblowing communications to the Youth Justice Board over a period of seven years. Ofsted found unlawful use of pain-inducing restraint when it last inspected the prison, and the Independent Inquiry into Child Sexual Abuse reported in February that there were 44 alleged sexual abuse incidents in the centre between 2012 and 2017. 

“When we and others wrote to the Minister to object on child protection grounds, the only specific reason he gave for choosing the site was that the Government owns the land and building and doesn’t have to go through a protracted planning permission process. The safety and welfare of very vulnerable children should govern decision-making, not the convenience of already owning a prison building. 

“Oasis Charitable Trust appears to lack any experience of looking after children in a residential setting. There are inevitable parallels with G4S and Serco being handed contracts to run secure training centres in the late 1990s without any relevant experience. Secure training centres were similarly marketed as centres of excellence in children’s education and care. Nothing I have seen or heard shows that the Government has properly reflected on why children suffered so badly for so long in those institutions. There has been no explanation either as to why the law has been changed to allow 16-19 academies to become secure children’s homes, when additional investment in the best of existing provision would have been the most obvious and safer path to take.”

Child protection

Another child dies in prison

The BBC has reported that a 16 year-old boy, Caden Steward, died in Cookham Wood young offender institution in Kent on Thursday 27 June. His death is not believed to have been self-inflicted, and is said not to be suspicious.

This is the third child to die in Cookham Wood YOI since 2012. An investigation by the Prisons and Probation Ombudsman will take place.

Article 39’s Director, Carolyne Willow, said:

“This is desperately sad news. No child should ever come to the end of their life in prison. The prison service has apparently said the boy’s death is not suspicious. But we should all question and distrust the morality of keeping very vulnerable children in these unsafe and archaic institutions.”

Two days before the boy’s death, a debate was held in Parliament on closing child prisons, led by Labour MP Emma Lewell-Buck. The Minister, Edward Argar, refused to give a timetable for the closure of child prisons, even though the Government agreed two and a half years ago that they would be phased out. In 2016, the Youth Justice Board admitted that young offender institutions and secure training centres are not fit for the purpose of keeping children safe or rehabilitation.

35 children have died in young offender institutions and secure training centres since 1990, the year the UK signed the United Nations Convention on the Rights of the Child. The treaty requires that children are only ever detained as a last resort and for the shortest period possible.

Article 39 is running a national ‘End Child Imprisonment’ campaign with the Centre for Crime and Justice Studies, the Howard League for Penal Reform, INQUEST, Just for Kids Law, National Association for Youth Justice and the Standing Committee for Youth Justice. Read more about the campaign here.

Advocacy services

Advocacy services for children and young people must be strengthened – Children’s Commissioner

The Children’s Commissioner has today (13 June) published her review of independent advocacy services in England. This shows that 29% of local authorities do not know how advocacy services are provided to children in respect of health complaints – despite them having a legal duty to make such arrangements since 2012. Nine local authorities were unable to say what advocacy arrangements are in place for social care complaints, even though this has been a statutory duty for 30 years.

A survey of managers of advocacy services found majority support (68%) for moving towards ‘one-stop’, local advocacy services – working across services and systems.

Advocacy services provide independent information and help to ensure children and young people are heard and their rights protected. The first service was set up by Leicestershire County Council in 1987. This was for children in care and care leavers. Now local authorities have myriad duties to arrange for independent advocacy for children and young people, including:

  • When they receive (or are entitled to) social care services
  • When they wish to make a complaint about a health service
  • When they are detained in a mental health unit
  • Young people who are homeless
  • Children who run away or go missing.

Independent advocates also visit and help children in young offender institutions and secure training centres, though there is no statutory duty for this. Many children’s homes and mental health hospitals have ‘visiting advocates’ who regularly spend time with children, gaining their trust and being there to help them be heard as individuals or collectively.

The Children’s Commissioner makes 10 recommendations for strengthening and improving children and young people’s advocacy, including a consolidation of the law so that entitlements to advocacy are clear and the revision of national standards (statutory guidance). She urges advocacy providers to publish an ‘independence statement’ which sets out to children and young people how the advocacy service is separate from health, social care and other services. Continuing revelations of human rights abuses in prisons and mental health units underline the importance of advocates being able to act robustly and independently for children.

Article 39’s Director, Carolyne Willow, was a member of the Commissioner’s working group for this review. She said:

“Advocates are vitally important for children and young people living in institutional settings, whether this be children’s homes, mental health units or prisons. They give strength and power to children’s voices and make sure their rights are upheld. For a child who feels alone and unheard, having a person who respects them and takes the time to listen – and makes others listen – can be truly revolutionary.

“Advocates are also a lifeline for young people struggling in the community trying to access support and services.

“We hope the government, local authorities and advocacy providers will quickly accept and implement the Commissioner’s important recommendations. As we celebrate 30 years of the Convention on the Rights of the Child this year, this report shows how to practically implement the treaty’s obligations. Advocates empower children who are often in extremely powerless situations; they are not an optional extra but a crucial mechanism for making sure all children enjoy their rights.“

Article 39’s work with the Children’s Commissioner was instigated by the late John Kemmis, a brilliant champion for children and young people’s rights and advocacy services. We pay tribute to him.

The Commissioner’s report and recommendations can be found here.

St Andrew's Healthcare Adolescents service

Children not safe in St Andrews mental health hospital

The Care Quality Commission (CQC) has placed a mental health hospital for children in special measures.

St Andrew’s Healthcare Adolescent Service in Northamptonshire, which is registered as a charity, has been rated ‘inadequate’ overall and the same for safety, care and leadership following an inspection by the CQC.

Among the many damming findings, inspectors reported:

“On one occasion, staff did not respect a patient’s privacy and dignity when changing her clothing. While female staff were present, there were also male staff there at the time. It was the inspection team’s view that this was uncaring, undignified and disrespectful to the patient.”

Inspectors also found:

  • Between July 2018 and January 2019, there were 1,754 incidents of restraint. In one ward (Meadow), restraint was used 546 times with just 15 children during this period. Inspectors reviewed one incident where “staff had restrained the patient and changed them into rip proof clothing when the patient was presenting as calm and compliant”.
  • Eleven of the 15 ‘seclusion rooms’ did not have furnishings such as a bed, pillow, mattress or blanket.
  • Staff applied blanket restrictions without justification. All wards had imposed set snack times. Other restrictions were placed on access to drinks and takeaways. Children were not allowed to wear shoes on Meadow ward.
  • Staff on Willow ward locked en-suite rooms which meant children had to request staff to unlock them.
  • Staff shortages sometimes resulted in staff cancelling escorted leave, appointments or ward activities. Staff on Fern, Maple and Willow wards said the high use of bank and agency staff impacted on patient care.
  • There were sharp edges on door frames in ‘seclusion rooms’ and ‘extra care suites’, blind spots in ‘seclusion rooms’ and pieces of exposed sharp metal in ‘extra care suites’.
  • Staff did not always check emergency equipment and medicines.

Helen Donohoe, Assistant Director at Article 39, said:

“It is incomprehensible that such systematic abuse of children’s human rights can go on in an institution funded by the NHS. The denial of dignity and privacy and the failure to ensure basic levels of safety reveal a toxic environment that conflicts wholly with the care that children need to thrive and be well.

“It is clear from the CQC report that staff levels and the frequent use of agency staff was a factor in the poor care. This is a recurring issue and one that Article 39 is deeply concerned about.” 

Article 39 will be seeking information about the post-inspection actions taken to ensure the rights, dignity and safety of the children and young people in St Andrew’s Healthcare Adolescent Service. The inspection took place in March-April 2019.

We are especially keen to find out how children and young people are supported by independent advocates and how they are made aware of their rights. A review of 25 records found that nearly a third (7) failed to show that children had been informed of their rights either on admission or at the point of their detention.

Read the full inspection report.