M.05.03 Observing and managing at-risk prisoners

The purpose of observing and managing at-risk prisoners is to ensure that they are managed safely through accurate recording of information, frequent observation, following a management plan, and careful consideration of transfer.

M.05.03.01 Managing a prisoner at risk to themselves

  1. Prisoners who have been assessed at risk must:
    1. be strip searched each time the prisoner enters an at-risk cell, until an at-risk management plan is established for the prisoner. Thereafter only in specific situations set out in the at-risk management plan, or where reasonable grounds exist, following an incident or event that compromises the safety and security of the prisoner.
    2. have the same opportunities for involvement in prison activities as other prisoners, consistent with maintaining their safety and the safety of others
    3. be provided suitable resources for their management, including:
      1. appropriate accommodation, i.e. special needs units, dedicated care units, Intervention and Support Unit (ISU) etc. (The items specified in Part A of Schedule 2 of the Corrections Regulations 2005 and as far as practicable those in Part C and D of Schedule 2 of the Corrections Regulations 2005 and the at-risk cell must have natural lighting.
      2. bedding and clothing designed to assist with suicide prevention that is checked daily for signs of damage and deterioration and replaced if it has been tampered with.
  2. If a prisoner requires mechanical restraints to prevent further self harm, the officer in charge of the incident must:
    1. seek the approval of the prison director before applying any restraint (other than for escorting the prisoner)
    2. complete form IR.02.Form.01 Approval for / report on the use of mechanical restraints if the circumstances require an immediate reaction and it is impractical to gain the approval of the prison director but must, as soon as possible inform the prison director
    3. ensure that a prison nurse examines the prisoner within 3 hours if the type of restraint used is a head protector.
  3. Any prisoner who has been placed in a mechanical restraint to prevent further self harm must be referred to the At Risk Multi Disciplinary team by the prison director (see M.05.03.Res.01 Managing at-risk prisoners requiring mechanical restraints for information on the At Risk Multi Disciplinary team actions and responsibilities).
  4. All actions are designed to ensure that prisoners are only restrained for the least time necessary to safeguard their wellbeing.
  5. Staff managing at-risk prisoners who have been authorised to be placed in mechanical restraints must follow the guidelines detailed in the Custodial Practice Manual.

M.05.03.02 Intervention and Support Unit Notification schedule

  1. The notification schedule applies to prisoners:
    1. who have been in an ISU for a substantial period of time (more than 30 days) or who have been placed in an ISU three times or more within the last 12 months and/or
    2. on segregation orders for being at risk of self-harm or suicide (section 60 of the Corrections Act 2004) and are managed in another part of the prison e.g. “Separates units”.

This process is intended to encourage discussion and provide support to staff managing those with complex needs that result in substantial or frequent periods of time in the ISU.

If prison staff (including health) have concerns that they do not have the required skills and/or resources to care for a prisoner in the ISU, then the notification process can commence at any time, even if the prisoner has been in the unit for less than 30 days.

Additionally, concerns should be raised with the prison director. The regional clinical director can be approached for advice, or assistance sought from Regional High Risk Panels and then the National High and Complex Needs Panel.

The focus is on the individual’s needs and the support the site may need from internal staff or external agencies.

If a prisoner has been in the ISU for 30 consecutive days or has had numerous stays across the last year; the following process must be followed.

CriteriaActionDocumentation
Approaching 30 days in ISU

OR

3rd presentation to ISU in 12 months
The Health Centre Manager (or the Clinical Manager if the Intervention and Support Practice team has been established at the site) advises the Prison Director of any prisoners who are not improving, or whose behaviour seems to be worsening. The Health Centre Manager or the Clinical Manager documents the advice to the Prison Director in the prisoners electronic clinical file (Medtech).
Over 30 days in ISU (but less than 60 days)

OR

4th admittance to ARU / ISU in last 12 months
  1. The Prison Director is responsible for advising the Regional Commissioner of the situation and the plan that is in place to manage the individual. They will also advise the Regional Commissioner if additional support is required to implement or manage the plan.
  1. The advise must be provided by e-mail, and a local record maintained by the Prison Director.
  1. The Regional Commissioner then refers the prisoner to the Regional High Risk Panel (RHRP) who determines what, if any, action is required by the region, for example the Regional Director Practice Delivery team, including the Regional Clinical Director, to review or assist and possibly engage external parties etc.
 
  1. The Regional Commissioner or their delegate (i.e. Senior Advisor) advises the Prison Director of any action or support to be provided.
  1. The advice must be provided by e-mail, and a local record maintained by the Prison Director.
  1. The Prison Director advises the Chief Inspector.
  1. The advice must be provided by e-mail, and a local record maintained by the Prison Director.
Over 60 days in ISU

OR

5th admittance to ISU in last 12 months
  1. The Prison Director will notify the Regional Commissioner and the Senior Advisor.
  1. The advice must be provided by e-mail, and a local record maintained by the Senior Advisor.
  1. The Regional Commissioner or Senior Adviser will notify the National High Complex Needs panel [1]
    highrisknational@corrections.govt.nz

    [1] The prisoner must be managed by RHRP prior to escalation to HCN panel
  1. The template for High and Complex cases will be sent to the Prison Director when this has been actioned.
  1. The Prison Director advises the Chief Inspector.
  1. The advice must be provided by e-mail, and a local record maintained by the Prison Director.

Revocation of notification

CriteriaActionDocumentation
Where a prisoner has been removed from the ISU and their prior status has been notified outside of the prison site to the Regional Commissioner, Chief Inspector and National High Complex Needs Panel.

The Prison Director to advise all prior persons notified that the prisoner is no longer managed in the ISU.

The advise must be provided by e-mail, and a local record maintained by the Prison Director.

M.05.03.03 Prisoner at-risk file

  1. Prisoners who have been assessed at risk must have a separate “at-risk” file established and maintained in the unit the prisoner is being accommodated. At a minimum, an at-risk file should contain:
    1. the current risk assessment form
    2. the prisoner's at-risk management plan
    3. a copy of all incident reports during the at-risk period
    4. daily observation reports completed during the at-risk period
    5. detailed reports from all support personnel, including medical / chaplains / psychological / psychiatric notes completed during the at-risk period and the current sentence
    6. any relevant secondary reports that would help the management of the prisoner, such as a pre-sentence report.
  2. The at-risk file should be clearly identifiable to all staff and, when the prisoner is no longer deemed to be at-risk, the at-risk file is to be placed in section C of the prisoner's penal file.
  3. The current penal file of an at-risk prisoner, or former at-risk prisoner, is identified with an “At-Risk” stamp on the front.

M.05.03.04 Observing an at-risk prisoner

  1. Prisoners identified as at-risk who do not have a management plan must be observed:
    1. by way of physical sightings (not by camera, unless being escorted in a single cell vehicle with CCTV fitted in the cells – refer M.04.01.Res.04 Instructions for using single cell escort vehicle)
    2. at intervals no longer than 15 minutes until a plan is developed.
  2. Prisoners with a management plan must be observed:
    1. by way of physical sightings (not by camera, unless being escorted in a single cell vehicle with CCTV fitted in the cells – refer M.04.01.Res.04 Instructions for using single cell escort vehicle)
    2. at intervals no longer than those specified in the management plan.
  3. Staff must record all observations (behavioural patterns) using the M.01.02.Form.02 Observations (IOMS) or M.05.03.Form.01 Observations, and:
    1. use a new M.01.02.Form.02 Observations (IOMS) or M.05.03.Form.01 Observations each day (i.e. beginning of standard work hours)
    2. refer recorded behavioural patterns to appropriate support personnel.
  4. Observation sheets for the 24 hour period of the previous day are to be reviewed and signed by a PCO within each 24 hour period and then filed in the prisoner’s at-risk file.

M.05.03.05 At-risk management plan

  1. Prisoners who have been assessed as being at risk must have an at-risk management plan (M.05.03 Form.02 At risk management plan). The management plans must:
    1. reflect their at-risk assessment
    2. be developed in consultation with appropriate support personnel, including input from health services , i.e. health centre manager or delegate and medical staff, cultural advisers relevant internal and external parties including whānau.
      Watch PointThe at-risk management plan must be completed within 24 hours of the prisoner’s assessment and following the prison director or their delegate consulting with and receiving advice from the health centre manager or their delegate, confirming the at-risk status of the prisoner.
  2. The prisoner at-risk management plans must include:
    1. placement of the prisoner to ensure their safety
    2. type of risk and reason for at-risk status
    3. frequency of any observations
    4. prisoner’s access to any support systems, programmes, or special requirements, including spiritual, cultural, social, religious, mental health, special or personal needs
    5. details of any restrictions on the opportunity to associate with other prisoners. (If the plan specifies restrictions on the opportunity to associate with other prisoners, the prisoner must be informed, in writing (via a copy of M.05.03.Form.02 At risk management plan), the restrictions on association and the reasons for those restrictions.)
    6. all the situations / circumstances where the prisoner must be strip searched. The plan may also include any additional searches necessary for the safe custodial management of the prisoner, i.e. rubdown, scanner searches or a reasonable grounds event-based strip search.
    7. times when the prisoner’s at-risk status is to be reviewed
    8. names and roles of key people involved in determining and implementing the prisoner’s at-risk management plan.
  3. The at-risk management plan of the prisoner ends when the prison director or delegate, after consulting with and obtaining advice from the health centre manager or delegate, revokes the at-risk status of the prisoner.
  4. The prison director or delegate, having consulted with and received advice from the health centre manager or delegate, may specify any ongoing assessment; treatment or monitoring that may be deemed necessary. This may include on-going follow up by the Regional Forensic Mental Health Team, on-going health treatment; the continuation of observations, and specific management interventions that will assist the prisoner to remain in mainstream residential units.
  5. The RISK OF SELF HARM alert on IOMS is deactivated before the prisoner is moved out of the Intervention and Support Unit (ISU).
    Note: The review date of the alert should be the sentence release date for sentenced prisoners or remand end date for a remand / accused prisoner. If the prisoner returns to custody, the RISK OF SUICIDE historic alert must be re-activated.

M.05.03.06 At-risk prisoner transfers

  1. Careful consideration must be given to the appropriateness of placing an at-risk prisoner on escort to another prison. Where such an escort is necessary and adjudged safe, the at-risk file and all relevant advice and information must be provided to escorting staff.
  2. An at-risk file is transferred with the prisoner when the prisoner transfers between units, or between prisons. All at-risk files relating to the period of imprisonment must arrive at the new location with the prisoner.