It is clear from the work undertaken in preparing this report that older people in prison experience a high degree of loneliness and boredom, and possess a strong sense of dread and fear about what the future holds.
Over a quarter of the population of prisoners over the age of 60 are serving a sentence of five years or more. This has long term consequences for those managing prisons in Scotland, who may now expect to be looking after an increasing number of elderly prisoners well into their 70s and 80s. The number of men convicted of historic sexual offences is continuing to rise, suggesting that the increase in older prisoners serving longer sentences will continue for some time. As a consequence there will be an increasing need for social care for prisoners as well as medical care.
There is an urgent need for the SPS and the Scottish Government to consider how to balance the issues of custody and care. Appropriate social and health care must be provided within the context of secure custody.
Significant challenges face the SPS, the Scottish Government, local authorities and health and social care providers in relation to providing older people in prison with the care and support they are entitled to. The issues raised in this report demand close co-operation and joint working across all parties with responsibility for ensuring that the needs of older people in prison are met, both within the prison and subsequently on release.
The current degrading treatment experienced by some older prisoners cannot be allowed to continue. Older prisoners are too often isolated and receive inadequate healthcare. There is an urgent need for change.
My hope is that this study will support rapid and effective change in the treatment of older prisoners in Scotland. HMIPS will continue to monitor the treatment and conditions for older prisoners and how the needs of this population are being met.
HM Chief Inspector of Prisons for Scotland
The Evidence Gathered During This Process Points Towards A Number Of Key Areas That Need To Be Addressed.
- The health care and other needs presented by this population should be a primary determinant of the accommodation and regimes provided to them. This may require the development of non-traditional units for at least some older prisoners whether within, or outside the grounds of existing establishments.
- The SPS should ensure that staff who work with older prisoners are identified as suitable for the role and appropriately trained. They should be provided with the training necessary to support them in their tasks, including specific training in dementia care and other age related health subjects. Their work should be valued and supported in prisons, with sufficient resources committed to provide the necessary care for these prisoners.
- Prisoners should be supported to maintain positive contact with their families and arrangements made to encourage family visits.
- The range of work and activities available within prisons needs to be tailored to the physical abilities of an older population and with a particular emphasis on ensuring that 'social time' is built into the daily regime.
- The SPS should develop and implement a clear strategic policy position on the management of elderly prisoners. A systematic appraisal of all available options in light of international experience and research evidence would assist this development.
- The SPS needs to review the prisons estate to ensure that the facilities that are provided not only match the needs of the population, but also those of the service providers working with them. Communal areas and in particular cells need to be designed in such a way to ensure that they provide the space to allow nursing and care staff to maintain their professional standards and operate safely.
- The SPS and Scottish Government need to agree a joint approach on the location and management of these prisoners. The prisoners involved in this survey were generally of the view that an age specific population was not desirable. Nonetheless it seems inevitable that a rising population of ageing prisoners in SPS custody will begin to present distinct and more concentrated needs and challenges. It may be that alternative accommodation should be considered, which maintains the level of security that a prison sentence requires, but is suited to the provision of appropriate health and social care for this population. Local authorities and NHS Boards, too, have a key role to play in the care of older prisoners.