Report on Drugs Strategy; Implementation & the BME

Prison Population (HMP Wandsworth)

Abd Al-Rahman
Drugs and Diversity Advisor
HMPS (London Area)

December 2003
 Contents
Page

1 Introduction 1

2 Objectives 1

3 Key Targets 1–2

4 Methodology 2

5 Meetings with key Stakeholders 3

6 Wandsworth Scrubs Drug Strategy Meeting 3

7 Substance Misuse Throughcare Co-ordintor 3-4

8 CARAT Service – HMP Wandsworth 4–6

9 RAPt – HMP Wandsworth 6–9

10 Healthcare – Substance Misuse Team 9 - 10

11 Mapping of treatment pathways at 11

HMP Wandsworth

12 Wandsworth Prison Statistics 12

And Monitoring System

13 Race Relations and Diversity 12 - 13

14 Workforce planning issues in the substance misuse sector in London 13 - 15

15 The RRAA 2000 and the BME Prison 15 - 16

Population in Wormwood Scrubs

16 Conclusion 16 – 17

20 Recommendations 18 – 23

References & Literature Review 24

Appendices 25 – 37

ii
1. Introduction

1.1 The Federation has been established as a national, membership body

actively supporting the needs of BME professionals in the drug and
alcohol field and their communities. The Federation also acts in a
consultant advisory capacity to central government, informing the
Updated Strategy (2002) from a culturally sensitive standpoint. The
Federation have established regional committees to support regional
government, other strategic partnerships and BME drugs & alcohol
professionals to address the aforementioned gaps and meet the targets
informed by the ten year drug strategy and updated strategy 2002, carried
forward through its key drivers (Drug Strategy Directorate, National
Treatment Agency, HM Prison Service, Drugs Action Teams, Crime
Reduction Partnerships etc). The Federation, through its regional
committees, will support the aforementioned stakeholders to deliver
joined up and inclusive services which meet the support needs of the
‘whole community’.

1.2 The regional structure is based on government models of best practice,

which allow for the step-organic model of change management as detailed
in the ‘Change Here’ booklet produced by the Audit Commission. The
Federation will ensure the drug and community safety related needs of
BME communities and wider communities are represented locally,
regionally and nationally.

2. Objectives

2.1 This report seeks to inform HM Prison Service (London Area) and The
Federation (London) Regional Management Committee (RMC) of the
contractual outcomes achieved to date. This report represents
performance of the Drugs and Diversity Advisor (London Area) in
relation to the contractual outcomes for the period October 2003 –
December 2003.

2.2 The Outcomes to date can be measured by the requirements of the Key
Targets agreed with between HMP (London Area) and The Federation, for
the period outlined above. 1

3. Key Targets

3.1 Key Target 2

Review Area and DSU data collection on BME use of drugs services.

1
See Key Targets and Work Programme (Appendix 0.01)
3.2 Key Targets 3.

Review and evaluate service diversity training for service, employed staff.
• Visit 6 named establishments; report on findings

3.3 Key Target 4.

Offer the contract drug services consultation and support their training
needs and operational considerations to assist complying with the prison
service duties and policies on diversity

• Produce and distribute letter of introduction to Service Managers of

contract agencies (1) explaining context of prison service work, rationale
and (2) offering Federation consultancy services2

• Make recommendations on any necessary systems improvements.

Highlight any indicated service shortfall or trends to be reviewed by
steering group.

• Equality Health Check Process Update3.

• Information gathered during the visit also pertains to the Prison service
Diversity training. This feedback will be included in a separate document
focusing on Prison Service Diversity training and training needs of
CARAT service providers after conducting a training needs analysis.

4. Methodology.

4.1 a). Meetings with key stakeholders to consider culturally sensitive service
provision4 in order to consider the service provision in relation to BME
prisoners in HMP Wandsworth. b). A mapping exercise to establish
existing pathways and services available to drug using inmates (i.e.
throughcare). c). Review of HMPS (London Area) prison statistics and
monitoring systems. d). Consideration of workforce planning issues
across the substance misuse sector; recruitment, retention and training of
BME professionals. e). Consideration of the implications of the Race
Relations Amendment Act (2000) in respect of the BME prison population
in HMP Wandsworth. Culminating in a set of recommendations, which
aim to assist the process of developing equitable, and quality service
provision for BME inmates alongside the HMPS (London Area) Equality
Health Check process and findings from the national CARAT service
review.

2
See letter of introduction (Appendix 0.02)
3
See Equality Health Check Update
4
See list of meetings (Appendix 0.03)

2
5. Meetings with Key Stakeholders

5.1 Informal meetings with key stakeholders were held during the 8th – 12th
December 2003. Discussions took place pertaining to the impact of the
drugs strategy and intervention in relation to BME prisoners at HMP
Wandsworth. The meetings were made as informal as necessary to
facilitate the exchange of varied perspectives held by those concerned.

6. Wandsworth Drug Strategy Meeting

6.1 A meeting was arranged 12th December 2003 at 10.45am with the P.O. of
Drug Strategy. However, on arrival at the prison the P.O. was not
available due to unforeseen circumstances. After this, despite attempts,
the DDA was not able to arrange a meeting. After numerous phone calls
an email was sent with questions regarding drug strategy and
intervention5.

7. Substance Misuse Throughcare Co-ordinator (SMTCO)

7.1 The DDA was informed by the SMTCO that her role is like a bridge
between an Officer and treatment worker. Information and an application
form that covers all services are provided on the wings. Application forms
are picked up by the SMTCO who then fills in the relevant referral forms
and assists inmates with making service access. As well as this the
SMTCO gives advice and motivates inmates to help themselves.

7.2 Crack users, many of whom are African Caribbean, not accessing services
are usually referred to the CARAT team through this worker. However, it
is the choice of the inmate whether or not they go through the CARAT
team. The SMTCO in such cases refers directly to the required service.
Those who have a long sentence will be picked up by the CARAT team
within the last 8 months of their sentence6.

7.3 It was said that 300 inmates are referred from the SMTCO per month
approx 80 of which are referred to the CARAT team.

7.4 The SMTCO stated that the RAPt programme is very effective and has
assisted many inmates to achieve abstinence through a process change in
their attitude and behaviour. However it was also said that when
participants leave the programme and go onto the main wings it can be
difficult for them as the majority of inmates have not gone through this
process of change and are still often engaged in drug use. Inmates were
said to be the best advert for RAPt but some who have forwarded

5
see Appendix 0.08
6
See 13 Mapping of treatment pathways Figure 2.

3
7.5 applications retract them if they have found work within the prison before
their allocated place comes up.

7.6 It was said that most prison officers would benefit from training on drug
related issues in order to foster understanding of inmates with drug
related problems and those involved in substance misuse intervention.
Officers would, as a result of such training, become more emphatic and
more effective in their role.

7.7 The SMTCO also stated that feedback from others in regard to the way
Diversity training is facilitated is poor and this served to make some
attitudes even more distant from the aim of such training.

8. CARAT Service – HMP Wandsworth

8.1 The acting service manager informed the DDA that there are at present a
total of 6 staff members one of which is on long-term sick leave. 3 more
workers are due to start work soon including a new manager. The team
has a lack of BME male and female staff. There is at present 1 part-time
worker of mixed origin and 1 male non-BME worker who is hoping to
move to Wormwood Scrubs CARAT team.

8.2 It was said that it was not known why there was an all female team (apart
from one male worker). When asked how the makeup of the staff team
impacts on the work with inmates it was said that:

1) they are sometimes seen as a ‘soft touch’.

2) there is a degree of fear around seeing some inmates on a
one-to-one basis.
3) the staff make-up affected the perception of officers, who are
mostly male, towards the team.
4) The advantage of the staff make-up was that some inmates
preferred to speak to a female as they saw them as more
understanding.

8.3 There was concern expressed that there may be issues present in the work
of the CARAT team but these cannot be identified because there are no
full-time BME staff that may be able to “see particular issues from a
different perspective”.

8.4 The DDA was informed that induction into Wandsworth prison needs
improvement. An officer was said to read from a sheet of paper describing
services but with no ‘gusto’ leaving new inmates with little motivation to
take in information. It was also said that there are no service leaflets in a
variety of appropriate languages. This is the case even though some other
London prisons stated that they have information in various languages.

4
8.5 After receiving a referral the CARAT team conducts an assessment and
care-plan. Inmates can then be referred to Enhanced Thinking Skills
(group sessions), AA, NA, Crack awareness group (run by CARAT
team/nurses), Relapse Prevention session (3 day course), RAPt, GUM
clinic, Dual Diagnosis nurse, acupuncture groups. Concern was expressed
at the lack of pre-release groups to assist inmates with preparation for
their exit.

8.6 Referrals to groups were said to be good. Over half are said to be BME.
However, no information was available in regard to numbers starting
groups, attrition rates or completion figures. A new monitoring system
came into place at the beginning of December 2003. Before this a manual
tally had to be done in order to collate data including breakdown by
ethnicity. Although time consuming this system was said to be more
qualitative as opposed to the new system the data on which is seen as
more quantative.

8.7 The DDA was informed that for 9 months there was no admin worker and
no ethnic monitoring. When asked what the London Area Office was
receiving from the service for those 9 months the answer was not known.

8.8 Figure 1 shows data from the CARAT team for December 2003. As can be
seen the total number of crack users (Primary and secondary use) being
assessed is 79%. The present crack awareness course lasts 1 week and,
compared to crack groups within HMP Brixton or in the community, is far
too short and not intense enough. The figures shown in terms of crack
users, according to the SMTCO, are typical of most months.

8.9 The priorities for the team are those inmates identified as a suicide risk, at
risk due to self-harm, those on remand and those with 8 months or less to
serve. All contacts with inmates are treated as if it is the last in case it turns
out that it is.

8.10 It was said that nothing has filtered down to the team in relation to
QuADS or other quality systems related process.

8.11 B wing is the Voluntary testing wing (unit). The CARAT team stated that
on this wing everyone has a compact. However, other members of staff
have stated that the wing is in the same condition it was in earlier in the
year, as reported in the HM Inspectorate of Prisons Report7.

8.12 The acting manager has attended prison service diversity training but
could not remember much about the content because “nothing new came
out of it in terms of learning”. One person walked out of the training
disgruntled. It was also said that Cranstoun has not provided any
diversity training to the Wandsworth CARAT team.

7
HM Inspectorate of Prisons ‘Report on an unannounced Inspection’ p.64

5
 Fig. 1

CARAT Team figures for December 2003

Total assessments 84

B1, B2, B9 23 (27%)

W1, W2, W9 54 (64%)
A1, A2, A3, A9 6 (7%)
M1, M2, M3, M9 1 (1%)

Total BME 30 (35%)

Drug usage

Crack/cocaine as primary drug 28 (33%)

Crack/cocaine as secondary drug 38 (45%)
Total crack users 66 (79%)
Heroin as primary drug 34 (40%)
Heroin as secondary drug 14 (17%)
Total Heroin users 48 (57%)
Used in last 30 days 83 (99%)
No fixed abode 28 (33%)
Release date 2003/2004 43 (51%)

8.13 The range of issues presented by inmates and matching services to assist
them both within the prison and outside is cause for concern for the
CARAT team. Through-care was said to be in need of development,
particularly at the point of prison exit. The DDA was informed that as far
as through-care is concerned a phone call is all that can be done at present.
To make matters worse 33% of those seen in December by the CARAT
team alone had no fixed abode and 51% had an earliest release date of
2003 or 2004. Also, it was felt that Counselling could be enhanced, i.e.
more quality time to spend in one-to-ones.

9. RAPt – HMP Wandsworth

9.1 The acting manager (previously the Senior Counsellor) for the RAPt
programme (Rehabilitation for Addicted Prisoners Trust) informed the
DDA that the programme within HMP Wandsworth is accredited by the
Home Office and Probation as well as being audited by the Joint
Accreditation panel. The 3 month programme is abstinence-based using
the 12 steps model of Alcoholics/Narcotics Anonymous (AA and NA) as
its core. The programme has three phases:

1) Assessment, Education Pre-Admission; Lasting up to 8

weeks part-time. Allows all involved to assess suitability to
the programme and prepares inmates for 2nd phase.

6
 2) Primary Programme; Intensive (full-time) 12 week rolling
programme with components familiar to provision within
the community, i.e. within a residential rehab or day
programme.
3) Aftercare; Includes a part-time rolling programme of 12
sessions, ongoing through-care and release planning
assessment. Aims at assisting inmates in remaining
abstinent.

9.2 Those on remand are excluded from the programme. The criteria for
programme entry are for inmates to be sentenced with 22 weeks or more
left to serve.

9.3 It was said that there is a greater ability to attract and employ male staff
for the RAPt programme due to a 1 year training course provided by the
organisation for those wanting to work in the sector, including ex-
offenders. This training has a lack of BME participants and as a result it
was said that there are no BME workers within RAPt at the prison. This
training is not yet accredited.

9.4 When the DDA asked if RAPt staff work in a culturally sensitive way the
reply was, “I’m not sure that RAPt does”. The DDA was informed that the
team is aware of its limitations. For example, it was said that there was no
BME staff member to perhaps give a view from different angle. This
mirrored the view of the CARAT team.

9.5 It was said that the lack of BME staff did not appear to impact on inmates
and this was evidenced by the lack of racially sourced anger from
participants on the programme. However, It was admitted that BME staff
were required. It was also said that some differences in culture, attitudes
and beliefs can be more difficult for some inmates to share in groups
possibly making them appear as if they are not opening up and engaging.
This was said to lead, at times, to the impression that they may not be
right for the programme.

9.6 The DDA gave the example of the rationale for adjustments being made in
drug awareness sessions to suit the audience (i.e. between young people
and adults or mixed groups and specific cultural groups) and whether
adjustments would be made if there was a 90% BME group in RAPt. It
was said that in such a case no adjustments in style would be made within
sessions. This is because the 12 step model is said to be generic and and as
such participants draw from their own cultural references, beliefs and
understandings8. The 12 step model was said to be what was needed in all
prisons partly due to extensive networks already existing outside of
prisons.

8
see appendix 0.05

7
9.7 Figure 2 is a collation of an activity table given to the DDA on request and
represents a sample period where full figures were available. The
ethnicity of those leaving the Pre-Admission and Primary programme
phases due to their own choice or being asked to leave was not included
in the Activity report supplied to the DDA. As RAPt provides a rolling
programme ‘new starters’ join already established participants.

Fig. 2

Activity Table April 2003 – Aug. 2003

Applications received 97

Ethnicity 48 white,
17 Black-Caribbean
11 Black-African
14 Black-Other
6 Indian
1 Pakistani

Total BME Applications 49 (50.5% BME)

Total new starters on Pre- 42
Admission (Phase 1)

BME 17 (40%
Total new starters on Primary 17
Programme (Phase 2)

BME 9 (52%)

BME Completion of Primary 5 (35%)

Programme
Total Aftercare Graduations 6
BME Aftercare graduates 3 (50%)

9.8 It was said that the Primary phase of the programme fluctuates between
being predominantly White and predominantly Black. Black inmates
tended to come at once. Asians were said to be rare on the RAPt
programme and greater numbers would probably make contact if the
team was more pro-active.

9.9 It was stated that within staff meetings and within groups with inmates
there is an ongoing exploration of issues that are linked to diversity. For
example, discussions occur in regard to whether or not to bring in rules
that seek to assist challenging and changing the perceived old drug related
behaviour and language of inmates. It was admitted though that there are
expressions and ways of being that are informed by cultural background

8
 unbeknown to RAPt staff. It was said that these discussions are an
important element to the process of treatment and communication
between RAPt staff and inmates.

9.10 The RAPt manager informed the DDA that she had not attended Prison
Diversity training but received feedback from others who had attended.
Prison service Diversity training was said to be poor. Some attendees were
known to walk out because, “the manner in which it is conducted is
inappropriate” and as a result participants get defensive. The RAPt Head
Office has provided an outline of available training that has a
Diversity/Equal Opportunities session. However, staff are able to choose
from this what sessions they want to attend.

9.11 All staff were said to have received multi-cultural/Diversity based

training on various University courses such as part of a Masters or
Diploma. However, the DDA was informed that staff would benefit from
training that focused on actually working more effectively with diverse
groups. All staff were said to be enthusiastic about change and continued
learning.

10. Healthcare – Substance misuse team

10.1 A meeting with the Senior Substance Misuse Nurse revealed that the work
is to NHS standards but not directly under their management. A
Wandsworth there is a 16 bed detox unit. 98% of those on in-patient detox
are on methadone for stabilisation then discharged to D wing. Before
discharge inmates have already received a CARAT assessment.

10.2 It was stated that those who use only crack do not generally enter in-
patient detox. For these inmates acupuncture is available as well as a one
week crack awareness group co-facilitated with the CARAT team.

10.3 Space for facilitating groups is said to be an issue. It was said that co-
ordination is beginning to happen and E wing is to be set up as a post
detox unit with a dedicated group room.

10.4 The data in figure 3 was obtained from the Senior Substance Misuse Nurse
and represents a snap-shot from November 2003. As can be seen BME
detox figures, both in-patient and on the wings, are low. Substance misuse
staff state that they see every new inmate with a drug problem. It was
stated that approx. 100 of the 153 total drug and poly-drug detox’s used
crack. In other words, crack users accounted for 65% of drug and poly-
drug detox’s. Since BME drug and poly-drug users accounted for only
11% of the total one would rightly question what happens to the other
BME drug/poly-drug users?

9
 Fig. 3

Detox Figures for November 2003

Drug, Polydrug and Alcohol
Total Inpatient Detox’s 73
Inpatient Detox - BME 12% (9.5% ‘Black’, 2.5% ‘Mixed’)
Total Detox’s on wings 104
Detox on wings - BME 10.2% (.9% ‘Mixed’, 2.7% ‘Asian’,
6.6% Black)
Total Drug and Poly-drug detox’s 153
inpatient and on wings
BME Drug and poly-drug 11%
inpatient and on wings
Total Alcohol detox’s inpatient 24
and on wings
BME Alcohol in/outpatient 12.5%

10.5 Concern was shown in regard a lack of structured programmes in place

for those on remand and those on short sentences. Other concerns put
forward:

• More training needed for staff on running groups.

• Programmes need to be more intergrated within the prison regime.
• Work needs to be done in regard to co-ordination between prison
regime and work of detox.
• Drug treatment not given high enough priority and resources until,
for example, a death occurs.
• There are many instances found regarding MDT’s and inmates
moving to heroin.
• The treatment system in the prison is reliant on inmates coming
forward with their drug problems.
• More focus required on the specific needs of inmates.

10.6 It was said that the RAPt programme is a positive process for inmates but
it excludes 90% of inmates due to the access criteria. For example, those on
remand, short sentences and those who had problems with literacy. Crack
and relapse prevention groups are also problematic for those lacking in
basic literacy because written work is required.

10.7 It was stated that HMP Wandsworth has a very good chemical detox
considering the workload and staffing problems. However, It was
acknowledged that more groupwork is needed.

10.8 Groups were said to be well received by inmates with minor attrition rates
because they have a short time span. African Caribbean take-up of groups
is said to be high. However no evidence is available to prove this.

10
11. Mapping of Treatment Pathways at HMP Wandsworth

11.1 Figure 4 below was put together from information received during
meetings with service providers. Mapping services and the process in this
way allows for ease in understanding what is available, to what level, for
whom it is available and for ease in assessing where problems areas
occur/are likely to occur. As well as this it facilitates ease of comparison
with other Prisons.

Fig. 4

Reception Healthcare Prescribing

Holding
screening
Identifyrooms
drug
users Assessment
completed by nurse

In-patient Detox
Wings clinic
16 bed.

Referrals Supplemented by
SMTCO Methadone
Self Referrals programme on
D-Wing (approx 20
inmates)
Referrals
Referrals
Referrals
CARAT Team
Referrals
Crack
awareness
Conducted by
CARAT team
RAPt Pre- and Nurses
Admission 1 week course
Sentenced
with 6 months Relapse
minimum to Prevention
serve group 3 Day
Course
RAPt Primary
Programme
Full-time12
weeks
RAPt After- ETS AA/NA
care
Part-time 12
weeks
Acupuncture

11
12. Wandsworth Prison Statistics and Monitoring Systems

12.1 The monitoring system used, termed the ‘traffic light system’ allows
disproportional representation in all areas of prison work to be
highlighted to ‘Take Action’ or to give a ‘Warning’, as such the system
itself appears effective.

12.2 Contained in Fig.5 is information gained from the Diversity Officer and
represents figures for December 2003. It was said that the figures are
representative of the usual breakdown.

Fig.5.

Total Wandsworth prison population 1404

December 2003
BME prison Population 620 (44.16)

BME (excluding Vulnerable persons 511 (48.81%)

unit)
Asian 5.64%, Black 36.68%,
Other 6.49%, White 51.19%

12.3 The Diversity Officer does not monitor drug related interventions. Due to
this the summary data supplied by the Diversity Officer had ‘No data’
written under the following headings: Voluntary Drug Testing Unit,
detox, CARATS, Drug testing programmes, Rehabilitation services and
Mental health.

12.4 ‘Take Action’ was stated on the following: total segregated days, Incentives
and earned privileges, accommodation and Work Shops,

13. Race Relations and Diversity

13.1 The Diversity Officer, in post in Wandsworth since August 2003, stated
that she is the first Black female P.O. in Wandsworth. The DDA was
informed that the role is new at P.O. rank.

13.2 The P.O. informed the DDA that she is bogged down with Race Relations
due to many outstanding cases, there are 62 outstanding racial complaints
from prisoners and 6 from staff. Complaints range from inmates reporting
that they were physically assaulted by officers or other prisoners to
complaints due to language used. It was stated that at times some officers
communicate with inmates by using profanities.

12
13.3 Work was said to be frustrating at times because it is difficult to get things
done in the prison. It was said that attitudes at Wandsworth are dated and
the prison was not change oriented.

13.4 The Diversity Officer stated that at present she does not sit on drug
strategy meetings but thinks that she should and this has been discussed
before. On the ‘traffic light’ reports held by the Diversity Officer
Education figures showed that BME inmates are over-represented and
some courses have waiting lists. However, drug testing figures as well as
those for rehab services, CARAT team and healthcare had ‘no data’
written under their headings. When asked why it was said that these are
held by drug strategy. The Officer has questioned this in the past.

13.5 It was said that inmate turnover is too great to do in-depth work. Also,
parole is possible if inmates address offending behaviour yet a
programme focusing on this is not done in the prison. An Inspection
report from early 20039 also highlighted this as an issue:

“Offending behaviour programme awareness training should take place to

increase understanding and encourage prison officers to participate in the
delivery of the programmes.” P.138

13.6 In regard to diversity training It was stated that attitudes in relation to

race have come out that were on the extreme side. The Diversity Officer
has facilitated training at Wandsworth with mixed reviews. In the absence
of evaluation materials it is difficult to properly gauge the effectiveness of
Diversity training.

14. Workforce Planning Issues in the Substance Misuse Sector in London

14.1 Much of the information gathered throughout the process of this visit
suggests that workforce developmental issues, present a significant
challenge to HMP Wandsworth in relation to the successful
implementation of its drugs strategy. As a consequence of this exercise, it
has been established that HMP Wandsworth should not consider the
implications of equitable drugs treatment and service provision in
isolation, but within the broader context of challenges faced across the
substance misuse sector as a whole within the capital. Health Works
UK’s10 findings regarding the recruitment and retention of staff in the
substance misuse field also supports this view. They describe the issue of
recruitment and retention as:

9
HM Inspectorate of Prisons – Report on an unannounced inspection of HMP Wandsworth (2003)
10
Health Works (UK) is a National Training Organisation for the health sector. They are currently
developing national occupational standards for people working in the drug and alcohol sector.

13
 “A national problem, largely due to overall shortages across the health and
social care professions…the rapid development of the drug treatment sector –
with new criminal justice interventions developing alongside the expansion
of drugs commissioning and policy – has exasperated these pressures. Many
agencies reported difficulties retaining staff due to new opportunities
elsewhere. Such pressures are unlikely to diminish… Estimates suggest that
the number of drug treatment specialists will need to increase by up to 50 per
cent in the next five years to meet demand”

14.2 It should be noted that London demonstrates consistently higher rates of

drug use than any other region in the U.K11 The Mayor for London
established the Greater London Drug and Alcohol Alliance (GLADA)12
who in 2001 agreed that the crisis in recruitment, retention, training and
workforce planning faced by the sector in London should be addressed as
a matter of priority. As a first step, GLADA commissioned the Cranfield
School of Management to undertake a systematic assessment of workforce
requirements. The information generated by the assessment is being
utilised to develop a human resource action plan for the specialist drug
and alcohol sector in London. The Federation are members of GLADA.

14.3 London and the South East of England have long been “hotspots” for
recruitment difficulties and for pressures on all aspects of employment.
Therefore, an important aspect of the research programme was to form an
overall demographic profile of the sector in London. The Training Needs
Analysis has generated a reliable profile of age, gender and ethnicity for
different areas of the workforce population, its findings are as follows.

In the area of service delivery (TNA A) the population breaks down

broadly as:

• 69% White, 16% Black and 7% Asian

• For managers (TNA B) the same three broad groups break down as
75% White, 13% Black and 7% Asian
• There is a small disparity between the practitioner ratio and
manager ratio that implies ethnic minority workers, particularly
from a black background, may have more difficulty progressing to
management levels
• Ethnicity profiles for commissioners indicate an entirely White
sample
• The community care assessors profile is 78% White

11
Audit Commission – Changing Habits (2002)
12
GLADA is a London based partnership alliance established to provide a mechanism to tackle London
wide problems and to promote better co-ordination of policy and commissioning of drug and alcohol
services

14
 • Gender profiles for practitioners reveal a majority of Female
workers, the ratio being 61% Female and 39% male
• In the managers sample there are 45% Male and 55% Female

14.4 The National Treatment Agency has committed to recruiting an extra 3000
practitioners into the drugs treatment workforce, a significant number of
which will be recruited from BME communities. Between 1991 and 1993 a
much smaller increase in BME employees in the drugs field led to a 30%
increase in disciplinaries involving BME staff. It is generally recognised
that the majority of services have not developed the polices, processes,
structures and professional competencies to deal with the challenges that
will come with an increasingly diverse workforce13 and the communities
within which they serve.

15. The Race Relations Amendment Act (RRAA2000) & the BME prison
population in HMP Wandsworth

15.1 ‘Institutional racism consists of the collective failure of an organisation to provide

appropriate and professional service to people because of their colour, culture or
ethnic origin. It can be seen or detected in processes attitudes and behaviours
which amount to discrimination through unwitting prejudice, ignorance,
thoughtlessness and racist stereotyping which disadvantage minority ethnic
people’. MacPherson

15.2 The Task Force Review Report, NTA HR Strategy; Developing Careers,
Updated Drug Strategy (2002), and National Scoping Study14; Delivering
Drug Services to Black and Minority Ethnic Communities (Home Office),
state clearly that the drug related needs of BME communities and BME
professionals in the drugs field have not been met by drugs service
commissioners and drug service providers.

15.3 Lack of cultural competence (absence of culturally sensitive treatment

modalities, lack of competent management support and developmental
opportunities for BME staff), ineffective needs assessment/consultation
with BME communities, inadequate HR/Performance Management
Frames, inadequate data collection systems (ethnic monitoring is
particularly poor), research gaps in relation to the specific needs of BME
drug users and inadequately trained staff, particularly in relation to
diversity, have been sighted as key areas in need of development if BME
communities are to experience equitable access to drugs services and
equal opportunity in the appointment to and development in professional
roles within the drugs field15.

13
Federation Equality Health Check (2002)
14
Sangster D, Shiner M, Patel K and Sheikh N (2002)
15
Ahmun V, 2000

15
15.4 The Federation Equality Health Check currently being carried out on
behalf of London Area will recommend any necessary training, policy
and/or procedural development that is required including a full race
equality specific training needs analysis. The EHC uses an assessment tool
that is DANOS and QuADS compliant and designed to compliment the
RRAA(2000) related audit tools developed by local authorities, PCT’s and
Criminal Justice Services across the country. The findings will be
consolidated in a confidential report to HMP London Area.

16. Conclusion

16.1 There are aspects of service provision in HMP Wandsworth that have
received excellent feedback from inmates namely the RAPt programme.
Although the drawbacks are said to be that many inmates have too little
information about it and the capacity of the programme is too small,
inmates see the process as “the benchmark for treatment in prisons”. The
BME population is able to access the programme in relatively high
numbers and the treatment process mirrors provision within a community
setting. Also, inmates saw the work of the SMTCO as crucial to their
motivation and paving the way for their access into services. This role
would make a good addition to provision in other prisons.

16.2 However, There is not enough intervention on offer. Also, the information
gathered suggests that drugs strategy and intervention as a whole within
HMP Wandsworth lacks the required culturally sensitive approach to
meeting effectively the drug treatment needs of its BME prison population
as well a users of specific drugs such as crack.

16.3 As was the case in HMP Wormwood Scrubs, findings suggest that the
nature and level of provision does not provide the BME prison population
with an effective response, particularly with regard to stimulant users and
remand prisoners. In addition, it was found that treatment staff did not
reflect the diverse prison population they seek to serve. Some treatment
staff echoed these concerns.

16.4 The HM Prison Service and in particular CARAT providers should

encourage greater levels of diversity in teams. Diversity is a gateway to
being more effective. Belbin (1981)16 talks about balance in a team,
ensuring that a whole range of individual differences in areas such as
skills, attitudes, attributes and personality is taken into account. The more
diverse the team is in terms of shared interests, attitudes and
backgrounds, the more potential for increased productivity and practice;
thus fostering a more cohesive work-force.

16
Organisational Behaviour P.96

16
16.5 Recruitment, retention and training of appropriately skilled staff and in
particular professionals from BME communities are workforce challenges
currently reflected in the wider community. For example, the Audit
Commission’s review of the sector; Changing Habits (2002) states that
workers in the sector experiencing problems with delivery of treatment
may be doing so as a consequence of “low levels of staff training and
expertise…as staff in the sector are drawn from a wide variety of
professional backgrounds”.

16.6 Whilst this report acknowledges it is still early day in the life of the HMPS
drugs strategy more can be achieved by utilising examples of best practice
as they exist within the wider community i.e. Nafas, the Federation, The
Blenheim Project etc. These can be adapted and tailored to suit the
changing needs of the prison environment. Thus, supporting HMP
Wormwood Scrub’s aim to provide more equitable service provision in
relation to drugs treatment and intervention for those from BME and
marginalised communities.

17
Recommendations________________________________________________

1 Wandsworth Drugs Strategy Group

1.1 Issues pertaining to Diversity and BME inmates within Drug Strategy
Meetings are often seen as confusing to discuss due to a lack of knowledge
of just how the areas play a role. This is especially so if the attendees are
themselves unrepresentative of the prison population. As a result
Diversity and BME inmates, if agenda items, usually translate into a brief
look at statistical data coupled with the statement, “our services are open
to everyone”, meanwhile gaps and service provision related shortfalls go
unnoticed. There needs to be a mainstreaming of the Diversity agenda
within Drug Strategy meetings as a standing agenda item or within
service updates to be evidenced within minutes. However, before this can
occur in a meaningful way consultation needs to occur with those
involved in drug strategy to assist them in a better understanding of what
to look for and options for change.

1.2 Within Drug Strategy Meetings services need to address the question:
“How might services evolve in order to meet the needs of BME inmates,
Crack users and poly-drug users utilising independent consultants who
have expertise in this area to assist the process wherever necessary.

1.3 The Diversity Officer receives data from all areas of the prison except data
related to drugs intervention. Although to date it has not been standard
practice to do so, the Diversity Officer should to be supplied with full
drug related data especially because, as stated by the S.O. of Drug
Strategy, “The DSG at Wandsworth fully supports all issues of Diversity,
Race Relations and Equal Opportunities”17. Perhaps the most important
reason is in order to bring together the areas of Drug
strategy/intervention and diversity/BME inmates.

1.4 Prison Officers in general should be offered training in drug related issues
and recovery in order for them to work alongside and as part of the prison
drug strategy

1.5 There needs to be a review of the prison induction process in relation to

the giving of drug related information on services and motivating inmates
to seek assistance or at the very least to declare their drug use18.

1.6 Leaflets in a variety of languages on available services need to be made

available at induction.

1.7 Measures need to put in place to transform the VTU into a genuine drug
free wing with full access to a range of aftercare intervention.

17
see appendix 0.09
18
see appendix 0.08

18
2. Substance Misuse Throughcare Co-ordinator

2.1 The SMTCO can be a useful resource in identifying numbers of BME

inmates not accessing services. Data should be compiled from inmate
applications in regard to drug used, ethnicity and whether or not they
are/have been in contact with services in the prison. This would also give
a better idea in regard to the issue of drug users slipping through the
reception stage without staff identifying that they are drug users.

2.2 The role of SMTCO would make an effective addition to provision in

other prisons such as Wormwood Scrubs.

3. CARAT Service HMP Wandsworth

3.1 Home Office guidance, the Development and Practice Report, states that,
“Further developments in CARAT teams should concentrate on (1)
increasing the number of places on therapeutic programmes and (2) pre-
release planning to address employment and housing needs, and to
establish ongoing contact with services outside prison”. p.6.

a) Instead of or alongside the 1 wk crack awareness group there needs to

be a rolling, intensive training/support group that targets (but not
exclusively) those on remand or short sentences. These programmes need
to be deeper than simply cognitive behavioural and broader than a focus
on ‘the drug’ enabling participants to explore who they are. Such groups
need to be facilitated by experienced, credible and confident workers.

Extensive focus on longer term inmates occurs to the detriment of Short-

term/remand inmates a, who arere all too often excluded from provision.
An alternative would be to put in place group-work that is specific to the
needs of those who will very soon be out in the community. The Drugs
and Prisons Report by The Select Committee on Home Affairs stated back
in 2000:

59 “Drug treatment in prisons has focused on longer-term prisoners. The

same attention needs to be paid to remand and short-term prisoners. They are
more likely to be in prison for drug-motivated crime and treatment is more
urgent because they will be released sooner. They are the greatest challenge if
the cycle of addiction, crime and imprisonment are to be broken. We
recommend that the Prison Service should make more drug rehabilitation
programmes available to remand and short-term prisoners beyond what is
currently envisaged under the CARAT service.”

b) Offending behaviour groups should be provided or at least the

inclusion of this subject within the above groups.

c) 33% of those seen in December 2003 had no fixed abode and this is said
to be approximately representative of month-by-month figures. As a result

19
 it is essential that through-care/pre-release planning is reviewed in order
to put forward a more realistic view of what can be done for inmates.
Also, contract services need to be better informed of what community
based services are currently available and ensure that time is allocated to
assisting inmates with planning for their release.

3.2 Access to structured counselling is an important aspect of treatment19 for

drug users and those seeking to maintain abstinence. Although this takes
place for those on the RAPt programme there appears to be little in the
way of structured one to ones for inmates with no experience of RAPt.
Culturally appropriate talk therapy needs to occur to further enhance
intervention in the prison.

3.3 CARAT recruitment and retention policies need to be reviewed to ensure

recruitment process and procedures for CARAT’s are designed to appeal
to a wider audience and therefore are able to successfully attract
professionals from BME communities. The NTA states that: “There is clear
evidence that issues of anti-discriminatory practice in employment and
issues of equity in service provision for diverse communities are, and
should be considered as, related and not as separate issues”. p.7

3.4 Training needs to occur for CARAT staff on Diversity and working with
diverse groups (Intercultural Therapy). Group-work skills training is also
required.

3.5 The Federation should support HMP Wandsworth to develop specific

means by which the needs of BME inmates can be adequately explored in
terms of the manner in which services are delivered.

According to a questionnaire conducted within the prison with 10% of

BME inmates20 there is some work to be done in relation to raising
awareness amongst BME inmates of the CARAT team. Also, work needs
to be done in order to change BME inmate perception of the CARAT team.

4. RAPt – HMP Wandsworth

4.1 An unannounced inspection of the prison that took place in January 2003
stated that the marketing of the RAPt programme needed to be looked at
due to a lack of referrals onto the Primary programme. This situation has
improved somewhat but inmates state that the programme is not as well
known as it could be. It was stated by the SMTCO that RAPt Graduates

19
NTA –Models of Care
20
see Appendix 0.08

20
 are the best advert for the programme and that these graduates should
facilitate informal groups that focus on answering questions that inmates
may have regarding the programme. This idea would be perhaps the most
effective way of raising awareness of the RAPt programme.

4.2 RAPt recruitment and retention policies need to be reviewed to ensure

recruitment process and procedures for staff are designed to appeal to a
wider audience and therefore are able to successfully attract professionals
from BME communities. The NTA states that:

“There is clear evidence that issues of anti-discriminatory practice in

employment and issues of equity in service provision for diverse
communities are, and should be considered as, related and not as separate
issues”. p.7

5. Healthcare – Substance Misuse Team

5.1 The DDA was informed that there are plans to set up E wing as a post
detox unit with a dedicated group room. However BME inmate access to
in/out-patient detox is very small and those who use crack only do not
generally enter the in-patient facility. As a result it is highly possible that
there will be very small numbers of post-detox BME inmates moved to E
wing. Any moves to develop the above facility need to be backed by a full
impact assessment.

5.2 There needs to be work done on exploring the various ways through
which inmates can slip through the reception/induction phase without
declaring or testing positive for drug use. Included in this would be
identifying strategies to fill in the gaps. For example, a drug user may
have been in prison in the past so has some experience. He may not have
used his drug of choice within the last 2 weeks so his test comes up
negative…. This inmate may still use while in prison.

6. Race Relations and Diversity

6.1 The lack of drug related information in a variety of languages has been an
ongoing issue within the field in general.

6.2 There is some confusion regarding feedback on Diversity training. The

Drug Strategy Group sees it as “effective in reaching its aims”, while
individually most of those on the group give opposite feedback.

6.3 The Diversity Officer needs to receive full statistical data on drug related
activity in order to be fully informed about the prison as a whole. As well
as this, The Diversity Officer’s input on Drug Strategy meetings is vital in

21
 order for the Officer an others to become better acquainted with drugs
and diversity crossover issues.

6.4 Diversity training needs to be properly evaluated with opportunities to

discuss issues after the training so that concerns are not left to fester. Good
practice would be to hold one or two open groups at monthly intervals
after such training.

7. Workforce Planning

7.1 Carry out Equality Health Check to consider implications for Prison
Service, BME professionals and Communities.

7.2 Work with the Federation to develop diversity strategy; which defines
what diversity means for the prison service (particularly in relation to race
– common understanding that is flexible enough to accommodate the
providers varying ways of working with BME inmates).

7.3 Work with Federation to develop Diversity Manual – ‘Identity &

Difference’ for bespoke diversity training programme for service staff and
providers.

7.4 Provision of leadership and management training for service staff and
providers working with BME communities.

8. Workforce & Cultural Competence

8.1 There is a need for experienced drug workers who have the ability to
effectively engage and relate with inmates at the reception stage allowing
inmates to familiarise themselves with providers and to become motivated
to seek further assistance. This earlier contact with drug services will aim
to lower the number of drug users, in particular crack users, refusing to
see the CARAT team.

8.2 There is a need for crack specific workers – 49% of reception tests are
positive for crack. Crack users also benefit from structured talk therapy
and groups – this is a gap that needs to be filled if the Prison is to make
significant progress in preparing inmates for life outside.

8.3 Services as a whole would benefit from a survey as well as ongoing

feedback groups into what inmates want from a drug service and their
perceptions of current services. As well as informing the evolution of
provision this would include inmates in the change process. The Audit
Commission states that:

“Without knowing anything about the people who use your service, how can
you begin to understand their needs? Without hearing what they want from

22
 you, how can you focus on the areas that really matter to them? Without an
accurate picture of their experiences, how can you be sure that you fully
understand what works and what needs fixing, especially where your
contribution is part of an extended process involving other agencies as well as
your own?” p.64

8.4 The Drug Strategy needs to, as part of its vision, map out what constitutes
a service matrix that will ensure the most effective treatment provision.
This could be drawn up on the back of consultation with inmates and with
assistance from specialists in the drug treatment field.

8.5 Drugs related information (Harm Reduction, Information on dangers

associated with various drugs, changing from one drug to another to try
and avoid MDT positive results, etc.) in various languages would be
beneficial for those at reception and within services on the wings.

9. Other Services

9.1 The Federation, Blenheim project or other organisation with a track record
of running crack groups for BME communities needs to be approached
with the view to developing a programme as part of service provision
open to those on short and longer sentences as well as on remand.

9.2 There needs to be stronger evidence gathered for BME take up of groups
and evidence of the effectiveness of such groups.

9.3 Consultation should take place across the board in order to develop a
culturally sensitive model of working suited to the prison.

8. Security

8.2 The balance between security, supply and the availability of treatment
needs to be explored. There is also evidence that due to MDT’s some
inmates switch from cannabis to heroin

23
References & Literature Review

NTA for Substance Misuse - RRAA 2000 – Implementing good practice

Home Office - development and practice Report – ‘The Substance misuse treatment needs of minority
prisoner groups: Women, young offenders and ethnic minorities’ (2003)

DOH - ‘Drug Misuse and Dependence – Guidelines on Clinical Management’ (1999)

Audit Commission – ‘Change Here!’ (2001)

Select Committee on Home Affairs Second Special Report - ‘Drugs and Prisons’ (2000)
http://www.publication

The McPherson Report

Belbin – ‘Organisational Behaviour’ p.96 (1981)

HM Inspectorate of Prisons – ‘an unannounced inspection of HMP Wandsworth (Jan.2003

1) Home Office – ‘Findings 186. Prisoners’ drug use and treatment: seven studies’
2) Home Office – ‘Prison Population Brief’
3) Home Office online report 33/03 – ‘Differential substance misuse treatment
needs of women, ethnic minorities and young offenders in prison: prevalence of
substance misuse and treatment needs’.
4) Home Office DSD – Updated Drug Strategy 2002
5) Home Office – ‘Tackling Crack – A National Plan’
6) NTA/COCA – ‘Treating crack and cocaine misuse - A resource pack for
treatment providers’
7) NTA – ‘Models of Care’.
8) CRE – ‘Race equality in prisons’ (2003).
9) CRE – ‘The duty to promote race equality. Performance guidelines
10) CRE – ‘Public procurement and race equality’.
11) CRE/HM Prison Service – ‘Implementing Race Equality in Prisons’.
12) HM Prison Service performance rating system. 2nd Quarter 2003/04.
http://www.hmprisonservice.gov.uk/corporate/dynpage.asp?Page=950
13) a. Prison Drug Strategy – detailed initial impact assessment (CARATs).
b. Prison Service impact assessment (Reception).
http://www.hmprisonservice.gov.uk/life/dynpage.asp?Page=807
14) Sangster D, Shiner M, Patel K and Sheikh N (2002) – ‘National Scoping Study’
15) Audit Commission – ‘Changing Habits’

24
 Appendix 0.01

The Federation

Abd Al-Rahman – Diversity & Drugs Adviser (London Prison Service)

Work Program (21st October 03 – March 04)

Key: Area Drugs Coordinator (ADC) Chief Executive Officer (CEO), Head of
Consultancy (HC), Drugs & Diversity Advisor (DDA), National Training
Officer (NTO).

Action Target Date Comment

.
Identify Mentor/Coach for external support and supervision 28th November Essential
03 requirement
(1) Support/advise steering group in relation to issues
pertaining to diversity and drugs in prisons

• Organise, coordinate and minute meetings,

disseminate information TBA – after DDA/Prison Service
second meeting (PA)
with Huseyin
• Produce quarterly reports
(December, March) 17th Dec 03
and 29th March
DDA
04
) Review all existing area and DSU data collection
on BME use of prison drugs services

• Review transcripts of Focus groups and produce 31st Oct. 03

report of key findings
DDA/HC
st
• Review findings and responses to Action 31 Oct. 03
Research questionnaire.
DDA/HC
• Visit HMPS London Area Office and access Week
intranet (1 full day). commencing
DDA
3rd Nov.03

• Highlight any indicated service shortfall or trends. 31st October

Report findings (plus Focus groups, Action 2003/ongoing
DDA,
Research) to ADC, Steering Group, FSC, FCEO

(3) Evaluate Training needs and develop training

pack for service employed staff

• Develop, disseminate, evaluate training needs January 2004

questionnaire. February

25
 questionnaire. February DDA, HC, NTO

• Make recommendations to steering group February 2004

DDA, CEO, HC

(4) Review and evaluate service diversity training for service

employed staff

• Organise Federation Diversity Training Session February 2004 DDA, HC

“Identity & Difference” for prison drug service
staff

• Disseminate Evaluation forms, collate and February 2004 DDA, HC

feedback

• Make recommendations for further training. February/March DDA, CEO, HC

2004
(5) Offer the contract drug services consultation and support
their training needs and operational considerations to assist
complying with the prison service duties and policies on
diversity

• Produce and distribute letter of introduction to

Service Managers of contract agencies (1) 7th November DDA, CEO, HC
explaining context of prison service work, 2003
rationale and (2) offering Federation consultancy
services

• Visit 6 named establishments on at least two

occasions each. by 9th January DDA
2003
• Make recommendations on any necessary
systems improvements. Highlight any indicated 19th January CEO, HC, DDA
service shortfall or trends to be reviewed by 2004
steering group

• Follow up letter to Chief Executives of contract

agencies in conjunction with ADC to arrange 15th January DDA, CEO, HC
meetings with Contractors CEO’s & CEO, HC 2004
following completion of the Equality Health
Check Process

• Inform development of audit tool to

establish awareness and practice pertaining TBA DDA, CEO, HC
to prison service duties and diversity

Notes – Abd Al-Rahman, as discussed - fortnightly

supervision is an essential criteria as well as your
identifying an appropriate individual to provide you with
professional mentoring and coaching

26
 (Appendix 0.02)

Dear ,

I am writing to inform you of work that is taking place within the London Area prison
service in relation to drug strategy/intervention and BME inmates.
The Prison Service London Area Office has funded The Federation of Black and Asian
Drug and Alcohol Professionals for the post of Drugs and Diversity Adviser. The
Federation is a national organisation established to support the needs of Black and
Minority Ethnic (BME) professionals in the drugs, alcohol and related sectors, and their
communities. The Federation acts in a consultant advisory capacity to central
government; Drug Strategy Directorate (DSD) Drugs Prevention Advisory Service
(DPAS), National Treatment Agency (NTA) etc. Informing the updated, National Drug
Strategy, from a culturally sensitive standpoint.

The role of Drugs and Diversity Adviser entails the following:

1. Support and advise the Area Drugs Co-ordinator, the Federation and the HMPS
(London Area) Diversity steering group in relation to issues pertaining to
diversity and drugs within the London area prisons.

2. SAMPLE
Review Area and DSU data collection on BME use of drugs services.

3. Review and evaluate diversity training for service-employed staff.

4. Evaluate Training needs and develop training pack for service employed staff

5. Offer contract drug services within the London area prisons, consultation and
support with their training needs and operational considerations to assist
compliance with prison service duties, race equality and diversity policies

In order to carry out these responsibilities I have been visiting HMP’s Wormwood
Scrubs, Wandsworth, Latchmere House, Pentonville, Brixton and Feltham to meet with
service providers and others to gain insight into what services are available, to what
extent BME inmates access them and how these services work with these inmates. The
task is one that aims to advise and assist services wherever necessary in order to
further enhance the quality of practice.

I have already attended after which I had a chance to briefly

introduce myself to . I am now booked to attend various meetings at
between the .

If you require any further information regarding this work please call me at The
Federation.

Yours Sincerely,

Abd Al-Rahman
Drugs and Diversity Adviser

27
 (Appendix 0.02i)

The letter overleaf was sent to the following Area Managers/Directors of Drug
services within London area prisons

HMP Brixton

Adrian Davies
Area Manager
CRI
1st Floor Lorenzo Street
Kings Cross
London
WC1X 9DJ

CARATs Brixton and Wormwood Scrubs

Peter O’Loughlin
Area Manager
Cranstoun Drug Services
112 – 134 Broadway House
The Broadway
Wimbledon
SW19 1RL
______________________________________________________________________

HMP Feltham/Latchmere house (South Staffordshire – CARATs)

Alistair Sutherland Director of Inclusion, Drug and Alcohol Services

20 Mill Lane
Yately
Hants
GU 46 7TN
alistair.sutherland1@ntlworld.com

______________________________________________________________________

HMP Wandsworth

Joe Bernadello
Director of Operations South
RAPt
Riverside House
27 – 29 Vauxhall Grove
London
SW8 1SY
0207 582 4677
0207 820 3716 fax
info@rapt.org.uk

28
www.rapt.org.uk
CARAT
Peter O’Loughlin
Cranstoun Drug Services
112 – 134 Broadway House
The Broadway
Wimbledon
SW19 1RL
______________________________________________________________________

HMP Wormwood Scrubs

Andy Hillas
Area Manager
Turning Point
100 Christian Street
London
E1 1RS

0207 265 2010

andrew.hillas@turning-point.co.uk

HMP Pentonville

Andy Hillas
Area Manager
Turning Point
100 Christian Street
London
E1 1RS

0207 265 2010

Andrew.hillas@turning-point.co.uk

29
 (Appendix 0.03)

Name Position Date visited

Linda Grice CARAT Team Leader - 8th December
Cranstoun

Joellen Reeves CARAT Admin 8th December

Remon CARAT Worker 8stDecember

James Taylor P.O. Drug Strategy Co- 9th December -

ordinator.

Nicky Francis Diversity Officer 9th December

Claudia Harding RAPt Acting Service 11th December

Manager

1 x RAPt Senior 11th December

Counsellor

Stella Love Senior Substance Misuse 12th December

Nurse

1 x Substance Misuse 12th December

Nurse

Jenny Mundon Substance Misuse 12th December

Throughcare Co-
ordinator (SMTCO)

4 x inmates 12th December

30
 (Appendix 0.04)

Questions asked during meetings

The following questions acted as a guideline and directional prompt. They were
asked within the framework of a semi-structured discussion. Questions asked
were based on relevancy to the staff member and their role.

• What is the nature of the drug treatment offered? (Detox, groups, one-to-one’s,
models used, etc.)

• Is there Information in various languages?

• What is the ethnic breakdown of those referred?

• Are there mechanisms for inmate feedback?

• What are the drug related outcome targets?

• What are the output targets?

• How are inmates assisted at the prison exit stage? (links with outside agencies,
etc).

• What has been done previously to address any BME unmet needs?

• Treatment service policies – On Diversity and Eq. Opps. How are they made
live?

• Can you outline staff training in relation to Diversity?

• Do services feel that provision is sensitive to cultural differences?

• Do services feel that they meet BME inmate diverse needs? If so, how?

• How do they assess how well they are doing in relation to the above?

• How does the Race/Diversity agenda play a role in the Drug Strategy Group?

• Does a Race Relations Officer/Diversity lead attend Drug Strategy meetings?

31
 (Appendix 0.05)
1. Inmate perspectives

Discussion was held with 3 inmates from the RAPt programme within a
group setting and an additional inmate who had completed the
programme some time prior to the visit.

After explaining why the DDA was at the prison one inmate stated that as
much information as possible should be collected regarding the RAPt
programme because, “it should be the benchmark for treatment services”.

Another said that the programme has been great because there is plenty of
help on the wing. The rest of the prison was said to be a joke – he couldn’t
go to church, education programmes took two months and the attitude of
staff were mentioned.

Also stated was that RAPt is good and works for those who want it to
work. In prison there is not enough emphasis on it because many are
crying out for help but can’t get it.

“There are about 1500 inmates but RAPt has 16 beds. There’s not enough
on offer. Not enough people know about RAPt.”

The SMTCO was said to be “the backbone of treatment services”. Added

to this was that, “If you want the tide to turn more need the course. If
more RAPt grads are on the wings this would be productive.”

“The VTU is there to make the prison look good but its not running like a
VTU.”

An inmate said that MDT numbers are being bumped up by testing those
on the RAPt programme who are known to be drug free.

The general prison regime was said to be “incompetent” – “how can they
not see what is wrong? The excuse is always lack of staff.”

Aftercare was said to be the weak part of the process because back on the
wings or even the VTU there are lots of drug users and others who have
been through the change process. “No matter where you go outside in
wings it will be deficient. Everyone is flowing the same in RAPt.” (i.e.
everyone has a shared understanding)

One inmate said that he originally got onto the programme because he
wanted parole and thought it would be a “soft touch”. However, when he
started the programme he was challenged by other inmates within groups
and this made him begin to look hard at himself.

Another inmate, who said he was now writing a book, said that “by doing
the course my son has benefited because I’ve changed so much, I thought I

32
had burnt my bridges with my family but not only have I got off drugs,
I’ve also got know myself. Every second of the day is important”.

One inmate said that he was 45 years old and has been clean for 7 months
now and this was like a miracle. It was said that the self-change could
really be noticed when with others who have not changed.

“The main thing about RAPt is that I was in denial before but the
programme allowed me to own and take responsibility for my own
actions.”

“The programme taught me how to work things out in a way that is

different from how I was before.”

The DDA was informed that heroin was the drug of choice in the prison
due to its effects and due to MDT’s. Many inmates in the general prison
population are leaving Wandsworth with a ‘taste’ for heroin.

All inmates felt that the programme is best at the beginning of a sentence
rather than near the end because afterwards more time can be utilised to
solidify changes.

33
 (Appendix 0.06)
2 Staff perspectives

2.1 In order to mask identity everyone quoted below is referred to as ‘a

member of staff’. The following came out within meetings.

2.2 A member of staff stated that the Voluntary Testing Unit - VTU has “gone
to pieces due to lack of staff.” It was also stated that if no staff are present
to conduct tests then what you have in the VTU is simply “a name on a
board”.

2.3 It was also stated that treatment programmes are irrelevant if drugs are so
prevalent within the prison. Added to this it was said that there was no
safe place after programmes and drug dealers do what they can to get
onto the VTU – “They are as organised in prison as in the street.”

2.4 With reference to the level of availability of drugs it was stated that
“people who work in the prison in general as well as officers” bring them
into the establishment.

2.5 It was stated that if measures were put in place to cut down availability by
60% - 70% the prison would be unstable leading to fights. Most fights
were said to be drug related.

2.6 A member of staff stated that courses are great but if security is weak then
what’s the point in having services.

2.7 One member of staff had not been on Diversity training in 7 years of
working in prisons. It was said that people accessing such training get
angry about the way it is facilitated and feel that it is part of a wider
“witch-hunt.”

2.8 It was said that many crack users are African Caribbean and this is more
to do with fashion. This group sees heroin seen as “a dirty thing”,
particularly injecting. It was also said that inmates see ‘lines’ as better than
‘piping’.

2.9 “The environment in prison is slow to change making many staff cynical
and deluded” – A member of staff.

2.10 “In Diversity training things were said that if people of a particular culture
were present they may have been offended” – A member of staff.

2.11 ”If it exists Diversity training is ineffective” – A member of staff who has
worked in prisons for 8 years.

2.12 It was stated that C and D wings are the worst for drug availability/usage.

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 (Appendix 0.07)

3. General observations

3.1 There is a disjointed approach to dealing with inmates between the

various health/treatment focused staff and many prison officers. Some
officers do not demonstrate an understanding of the need for intervention
that seeks to rehabilitate inmates and this, at times, impacts upon the
relationship between Officers and treatment staff.

3.2 There is a perception that to look at BME specific issues is in some way
discriminatory, especially as drugs themselves do not discriminate. As a
result, diversity issues are masked behind the phrase “our service is open
to all”.

3.4 Innovation within drug services is stifled in Wormwood Scrubs. There

was no evidence of innovative ways of working born out of consultation
between services and with inmates. Innovation is all the more necessary
when one considers, for example, that Crack users make-up a substantial
number of drug users in the prison.

3.5 There is no data found regarding completion/retention in treatment by

ethnic group.

35
 (Appendix 0.08)

Aware of CARAT Wandsworth Satisfied with Wandsworth

service? CARAT
Yes 31 Very Useful 5
no 17 Useful 7
Never heard of 8 Satisfactory 4
them
Unknown 1 Useless 4
Total 57 Unknown 37
Total 57

Drug User? Wandsworth Used Drugs in the Wandsworth

past
Yes 20 Yes 34
no 24 no 19
Unknown 13 No response 4
57 Total 57

Want access to Drug Wandsworth Meet Treatment Wandsworth

Treatment? cultural &
religious needs?
Yes 24 Yes 3
No 29 no 9
No Response 4 Satisfactory 10
Total 57 No response 35
Total 57

Want treatment on Wandsworth On Remand? Wandsworth

release?
Yes 19 Yes 15
no 20 No 36
No response 18 No Response 6
Total 57 Total 57

Waiting to see Wandsworth

CARAT worker

0-2 weeks 7
2-4 weeks 5
1-3 months 3
3 months + 0
Total 15

36
 (Appendix 0.09)
Questions emailed to the P.O. of Drug Strategy

1. Does the RRLO attend Drug Strategy Meetings? If not do they receive, as
standard practice, drug related figures?
2. Who sits on DSM?
3. How well do you feel drug services work with BME inmates?
4. Have any shortfall areas been identified in the past? If so what was done to
tackle this?
5. What part does the issue of diversity play in DSM’s?
6. Have you been on Diversity training? If so, how effective is it in reaching its
aims? 7. What are its aims?

Reply 27th January 2004

Dear Abd,

You e-mailed Jim Taylor last week and he has asked me to answer some
questions that you sent him.

1. You asked if RRLO attended our monthly meetings. She has not in the
past but will be invited in the future. It has not been standard practice for
her to receive drug related figures.

2. Carats, RAPt, SMTCO, Security, B-wing (VTU), Dog Section, Detox

(Healthcare), Visitors Centre, attend drug strategy meetings.

3. WE are in the process of issuing a Needs Analysis to prisoners on

induction and reception.

4. No shortfalls have been identified in the meetings regarding BME.

5. The DSG at Wandsworth fully supports all issues of Diversity, Race

Relations and Equal Opportunities.

6. Most staff on the DSG has been on Diversity training and is very effective
in reaching its aims.

If you would like to e-mail me your postal address then I will be able to send you
the further information you require regarding Carat services for a 3 month
period and the prison population and ethnic break down.

Regards
Senior Officer Kev Gwyther
Drug Strategy Unit.

37