It s important to note that many of the points I raise here will also be true for detainees held in prisons under immigration powers.

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1 Elizabeth Moody Acting Prisons and Probation Ombudsman T E mail@ppo.gov.uk Rt Hon. Yvette Cooper MP Chair, Home Affairs Committee House of Commons London SW1A 0AA 3 May 2018 Dear Ms Cooper, IMMIGRATION DETENTION INQUIRY I understand that the Home Affairs Committee is undertaking a short inquiry into immigration detention, following oral evidence sessions on Brook House, Morton Hall and Yarl s Wood Immigration Removal Centres. It s important to note that many of the points I raise here will also be true for detainees held in prisons under immigration powers. My role I carry out independent investigations into deaths and complaints in custody. My role and responsibilities are set out in detail in my office s terms of reference 1. I have two main duties: To investigate complaints made by prisoners, young people in detention (young offender institutions and secure training centres), offenders under probation supervision and immigration detainees. To investigate deaths of prisoners, young people in detention (including residents in secure children s homes), approved premises residents and immigration detainees due to any cause, including any apparent suicides and natural causes. The purpose of these investigations is to understand what happened, to correct injustices and to identify learning for the organisations whose actions we oversee so that we can make a significant contribution to safer, fairer custody and offender supervision. Learning Lessons Every year we put together a programme for our Learning Lessons bulletins and thematic reports. These identify lessons to be learned from collective analysis of our investigations. 1

2 Our aim is to encourage a greater focus on learning in order to contribute to improvements in the services we investigate, potentially helping to prevent avoidable deaths and encouraging the resolution of issues that might otherwise lead to future complaints. Relative to prison, the low number of deaths in immigration detention and the low volumes of complaints can make this difficult. We started three fatal incident investigations in 2016/17 and 20 complaints investigations. From our most recent published annual report:

3 Fatal Incident Investigations Detainees in IRCs are subject to a range of risk factors which are similar to those experienced by prisoners, some of which are magnified by the specific nature of their immigration status and the basis of their detention. In recent years, our Fatal Incident Investigations have made recommendations for improvement on the following issues: Emergency response A fast and efficient emergency response can mean the difference between life and death. It is crucial that those who are responsible for responding to a medical emergency have the training, equipment and systems in place to facilitate an effective reaction to the situation. Our most recent investigations at IRCs have found: staff who are making medical observations not fully aware of health conditions and of the purposes of the observations; emergency radio codes not being used and staff unclear on their responsibilities during medical emergencies; delays in calling ambulances and delays in admitting medical professionals; and staff with out-of-date first aid training. Sadly, the need for improved emergency response was a recommendation from one of our very earliest fatal incident investigations at an IRC. That was over 10 years ago. This apparent lack of progress is troubling. Psychoactive Substances (PS) Drugs, and Psychoactive Substances in particular, continue to present a significant problem. The effects of PS vary, depending on the strength of the drug, the amount taken, the circumstances of the individual and the environment in which they take the drug. PS are difficult to detect and can affect people in a number of ways, including increased heart rate, raised blood pressure, reduced blood supply to the heart and vomiting. Detainees under their influence can also display marked levels of disinhibition, heightened energy levels, a high tolerance of pain and a potential for violence. There is also the potential for PS use to exacerbate an individual s mental health issues. The use of PS, like other drugs, can be closely associated with organised crime, debt, bullying and violence, with attendant risks to vulnerable people, of mental ill health, suicide and self-harm. There is a greater need than ever for more effective drug supply and demand reduction strategies, including better monitoring by drug treatment services and effective violence reduction strategies. IRCs must increase staff awareness and training; managers need to robustly address the bullying and debt associated with PS; and demand for PS among detainees needs to be reduced, with IRCs and healthcare providers ensuring that there are engaging education programmes which outline the risks of using them. In particular, our most recent investigations at IRCs have found: residents talking openly to staff about using PS but staff failing to effectively tackle the issue; staff unclear on the signs of PS use and on how to respond.

4 Managing risks of suicide and self-harm Detainees can have significant mental health issues. These may be exacerbated by the fact of their detention and their possible removal from the UK. Some of the most difficult and challenging behaviour in IRCs is displayed by distressed people with mental ill health trying to communicate that they need help. A therapeutic, not a punitive, response is required. Our investigations have highlighted challenges in identifying residents needs, accessing appropriate services to manage those needs and setting appropriate care plans that are meaningful, reviewed and updated. Our most recent investigations have found: staff lacking a clear understanding of their responsibilities and the need to consider all known risk factors. Too often, decisions have been based on how a resident presents himself, without regard to all the other factors; lack of input by immigration casework staff in case reviews for detainees at risk; the frequency of observations has not related directly to the level of risk; caremaps have not been properly completed with realistic goals and clear actions; caremaps have not been updated or changes made, even in response to very worrying developments (such as an attempted suicide); limited input from healthcare professionals and limited attendance at multidisciplinary case reviews; detainees assessed at risk then held in separation units without other options being considered and without a documented explanation of how the heightened risks will be managed; staff that have not received the mandated training on mental health issues or suicide and self-harm prevention and monitoring. Communicating decisions on detention It is critical that detainees are kept fully informed of the reasons for their detention. We have found unacceptable deficiencies in communication from the Home Office to onsite teams, which has caused detainees considerable frustration and distress. In some cases, this appeared to be a key factor in the detainee s decision to take their own life. Everyone in immigration detention should know how to access the latest on their situation and have confidence in the information they receive about their detention. Effective family liaison Next of kin must be notified of the death of their friend/relative promptly and sensitively. Unfortunately, there have been occasions where mistakes have been made, sometimes repeatedly at the same establishments. Fatal Incident Investigations release of detainees to hospital I would like to recognise the challenge that we have when immigration detainees are released to die in hospital. If a detainee becomes seriously unwell and the prospect of a removal seems remote, IRCs will release the detainee. In practice, of course, this might be someone who collapses in an IRC, never regains consciousness and then dies in the hospital subsequent to their release.

5 A case where someone collapses and dies in an IRC would automatically trigger a PPO fatal incident investigation. A case where someone collapses, is taken to hospital, is released by the IRC and then dies, would not. The PPO does have discretion to investigate these cases. The challenge is around us being notified that this has happened and the risk of cases not being shared with us, particularly where someone might have been unwell in hospital for a long time. Complaints Investigations The number of complaints As stated above, the number of complaints which the PPO receives from immigration detainees is small. Additionally, if we compare it to the number of complaints we receive from prisoners, it seems likely that the number is smaller than we might expect it to be. The table below gives an indication of this difference: Population in December 2016 Complaints PPO received in 2016/17 Prisons 84, , % Immigration detention 2, % Complaints received as % of population There could be a number of reasons for this. Most obviously, but perhaps most unlikely, immigration detainees may find less to complain about. The PPO will only investigate once the internal complaints process has been exhausted and so it may be the case that IRCs are very good at resolving issues locally. Were this to be the case, however, we would expect to see an impact on the percentage of cases we find to be ineligible. In fact, this rate for immigration complaints is around 50% and this is the same rate as complaints from prisoners. We know that in , 29% of our completed complaints investigations were from prisoners held in the Long-term and High Security Estate (LTHSE). The LTHSE holds only 7% of the prison population. Immigration detainees, whose periods in detention should be much lower than the average prisoner in the LTHSE, might be expected to submit proportionally fewer complaints. It is also the case that immigration detainees may focus their energies on challenging the fact of their detention to the Home Office and this, of course, is outside our remit. Our experience with young people in prison and female prisoners who proportionally submit fewer complaints to the PPO than the adult male population has identified a number of factors which seem to drive fewer complaints being made. In our 2015 study 4, women and young people reported mistrust in prisons processes and a lack of confidence

6 that their complaints would not be altered or destroyed by prison officers. Some prisoners and young people reported that they did not think they would be believed or that the issues they raised would be looked at objectively by prison staff. There were also fears around reprisals and that complaining would negatively affect: incentives and privileges; prison employment; decisions on suitability for home detention curfew (HDC); Parole Board decisions. Anecdotal evidence suggests that similar factors are likely to account for the low number of complaints the PPO receives from immigration detainees. And it is likely that such issues will only be intensified where there are the communication difficulties that can arise where English-speaking may be limited. The nature of the complaints we receive We receive complaints about a variety of issues. In recent years we have made recommendations to IRCs as a consequence of investigations into: allegations of staff assaulting detainees, staff failing to respond during an assault from other detainees, escorts not leaving the room during hospital appointments. Complaints about lost or damaged property, however, are the largest category of complaints we have received from immigration detainees. IRCs handle a significant throughput of detainees, some of whom have very large amounts of property and I am happy that in recent years there has been some progress in improving property handling (a revised DSO was issued in 2016). However, there continue to be challenges at establishments. One of my recent investigations into a lost iphone found poor recording and that valuable property was held insecurely (in unsealed bags in a room to which staff and accompanied detainees had frequent access). It is important to remember that in cases like these, issues can and really should be resolved locally. I appreciate that I ve stated that the PPO appears to receive too few complaints, and now I m saying that there are complaints we shouldn t see. But if someone reports a lost iphone and staff can see that it wasn t always stored securely, then detainees should not have to come to my office for fair resolution. I hope that you find this a useful summary. Please feel free to contact me for further information. Yours sincerely Elizabeth Moody Acting Prisons and Probation Ombudsman