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  1. There are inconsistencies between the accounts of D1851 and D390, and the footage. In particular, there is no evidence to support D390’s allegation that batons were used, or D1851’s allegation that two shields were used against him. D1851 said in his response to questions asked by the Inquiry pursuant to Rule 9 of the Inquiry Rules 2006 that he was screaming for the officers to release the pressure on him, but this cannot be heard on the footage.1)
  2. However, there are also inconsistencies between the footage of the incident and the Use of Force reports completed by Mr Povey-Meier, Mr Bromley, Mr Sayers and Mr Shadbolt, which give an inaccurate impression of the circumstances in which force was used.

26.1 Mr Bromley and Mr Sayers made reference to D390 not complying with instructions given by Mr Sayers, when the footage is clear that no such instructions were given.

26.2 Mr Shadbolt stated that there was an excessive amount of steam outside the cell, and that Mr Povey-Meier spoke to D390 through the viewing panel. However, the footage demonstrates that there was no steam outside the cell, and that Mr Povey-Meier said D390’s name only once before he started addressing D1851.

26.3 Mr Povey-Meier did not acknowledge that a shield was used against D1851.

  1. As a result of the inconsistencies that I identified, I relied heavily on the footage to determine the facts of what happened during this incident.
  2. During the relevant period, there was an assumption that full PPE would always be used, with no apparent consideration of the fear or distress that might be caused to detained people by its routine use.2 The Use of Force reports did not reference any historical aggressive or refractory behaviour by D390 or D1851, and there was no other evidence to suggest that PPE was necessary in this situation. I discuss the inappropriate use of PPE further in Chapter D.7 in Volume II.


  1. The Inquiry saw no evidence from the footage to support the assertion that D390 was “repeatedly” boiling the kettle. I am sure that he was not. Mr Povey-Meier looked through the viewing panel twice, for a total of less than 15 seconds, before telling his colleagues that a kettle was being boiled. He did not say anything about excessive steam in the cell and there was no evidence of steam in the air when the cell door was opened. In the circumstances, and given the time of day, the most plausible explanation for the kettle being boiled is that D390 was either making a hot drink or some food. Moreover, force was used approximately one minute after Mr Povey-Meier stated that a kettle was being boiled in the cell. None of the officers asked D390 why he was boiling the kettle or asked him to stop doing so; in addition, there was no attempt to turn off the electricity to the cell, nor any suggestion that the officers should come back once the water had cooled down sufficiently. The officers did not discuss the appropriate approach to the situation among themselves, and it is not clear what risk D390 was said to pose that necessitated the officers entering the cell immediately. In the circumstances, I find it implausible that Mr Povey-Meier actually believed the kettle posed a risk of harm to the officers.
  2. In my view, the incident on 5 June 2017 is an example of officers and managers resorting to force too quickly. They did not appear to view force as a coercive tool that was only to be used when all other alternatives had been exhausted. Rather, there was an assumption on the part of the officers that force was necessary and inevitable, and the reference to the risk of the boiling water appeared to serve as justification for not attempting to de-escalate the situation and negotiate with D390. Indeed, in line with other evidence seen by the Inquiry, there was a casual approach to the use of force, with no apparent consideration of the impact that it could have on those subjected to it.
  3. I agree with Mr Collier’s assessment that the use of force on D390 was not justified. Regardless of what conversations had taken place in advance, there should have been meaningful attempts to engage with him and persuade him immediately prior to any use of force. It is clear from the footage that Mr Povey-Meier made no attempt to talk to D390 before or after the cell door was opened. Although Mr Sayers told the Inquiry that it was his normal practice to give a detained person the opportunity to walk compliantly, there is no evidence to suggest that he did so on this occasion.3 The speed with which the shield was applied to D390 indicates that there was no final attempt to persuade him to walk with the officers.
  4. In my opinion, the force used against D390, particularly considering the use of PPE, was likely to have caused him humiliation. I consider that there is credible evidence that these facts are capable of amounting to treatment that was degrading.


  1. D1851 was one of the few former detained people who were able to give live evidence regarding their experience, and I found him to be an honest and reliable witness. He was candid about what he could see, and readily accepted that he could not see a baton being used. Moreover, he voluntarily clarified that he had to sit up and push a shield away, rather than being pinned as he originally described.
  2. It is not clear whether Mr Povey-Meier and D1851 could hear each other through the crack of the cell door, or whether there was a misunderstanding. In any event, Mr Povey-Meier did not communicate effectively with the other officers to explain what he understood D1851 to have said. Nor did he tell the officers how they should interact with D1851 once it was clear that he was remaining in the cell.
  3. I cannot be sure that the shield made direct physical contact with D1851 but, from the evidence in the footage, I think it is likely that it did. This was disproportionate, unnecessary and inappropriate. The force used was not used as a last resort and was therefore unjustified.
  4. Mr Timms, the officer who used the shield against D1851, did not write a Use of Force report. He should have done so. A shield is a form of PPE, and Mr Timms used it to block and control D1851’s movements during this incident.
  5. D1851 gave a compelling account to the Inquiry regarding the impact of this incident on him. D1851 told the Inquiry in his written statement:

“They did not care what I had to say and did not respond to me at all. The way they were dressed made the whole experience even more menacing and distressing.”4

  1. The Inquiry heard evidence of fundamental deficiencies in the operation of the safeguards contained in Rule 35 during the relevant period; these are discussed extensively in Chapter D.5 in Volume II. The failures in the system of safeguards for vulnerable people in detention left them exposed to a risk of harm, and to deterioration in their mental state and mental health. In my view, D1851’s account of mental deterioration during his period of detention in Brook House suggested that he should have been referred for a Rule 35 report at this time, regardless of the fact that he did not specifically request one.5
  2. In my view, force was not used against D1851 as a last resort when all other alternatives had been exhausted, and it was therefore not justified. I accept D1851’s account that he had confirmed to the officers that he would sit on his bed and not intervene in their efforts to remove D390. I consider that, particularly in light of the fact that the officers were in PPE, the use of force was a frightening experience for D1851, which was likely to exacerbate the anxiety, fear and distress with which he was already suffering. Indeed, D1851 said that this incident left him feeling “helpless and completely vulnerable”. Therefore, in my view, there is credible evidence that this incident was capable of amounting to degrading treatment.


  1. DL0000143_012 para 43; CJS0074063 UOF 137.17 (2[]
  2. Steven Dix 9 March 2022 79/16-81/15; David Webb 3 March 2022 151/5-154/3; Nathan Ring 25 February 2022 106/18-107/15; Stewart Povey-Meier 17 March 2022 14/19-25[]
  3. Sean Sayers 10 March 2022 138/2-13[]
  4. DL0000143_012 para 44[]
  5. DL0000143_025 para 93[]