Appendix 4: continued
Safeguards for vulnerable individuals (see Chapter D.5 in volume II)
| Recommendation | Report | Reference in this Report | |
| 41 | All staff need to be trained in signs of trauma and torture as well as mental health awareness training to ensure that signs of mental health issues are not inappropriately treated as behavioural issues. Special training needs to be provided to those working in segregation unit. (p96) | ‘A Secret Punishment’ – The Misuse of Segregation in Immigration Detention, Medical Justice, October 2015 | |
| 42 | I recommend that the words ‘which cannot be satisfactorily managed in detention’ are removed from the section of the EIG [Enforcement Instructions and Guidance] that covers those experiencing serious mental illness. (recommendation 11, p89) | Review into the Welfare in Detention of Vulnerable Persons, Stephen Shaw, Cm 9186, January 2016 | The 2016 Shaw report |
| 43 | I recommend that those with a diagnosis of Post Traumatic Stress Disorder should be presumed unsuitable for detention. (recommendation 12, p90) | Review into the Welfare in Detention of Vulnerable Persons, Stephen Shaw, Cm 9186, January 2016 | The 2016 Shaw report |
| 44 | The Home Office should consider introducing a single gatekeeper for detention. (recommendation 20, p99) | Review into the Welfare in Detention of Vulnerable Persons, Stephen Shaw, Cm 9186, January 2016 | The 2016 Shaw report |
| 45 | I recommend that the Home Office immediately consider an alternative to the current rule 35 mechanism. This should include whether doctors independent of the IRC system (for example, Forensic Medical Examiners) would be more appropriate to conduct the assessments as well as the training implications. (recommendation 21, p106) | Review into the Welfare in Detention of Vulnerable Persons, Stephen Shaw, Cm 9186, January 2016 | The 2016 Shaw report |
| 46 | Where a detainee claims they have been tortured, the Rule 35 report should include an assessment of PTSD [Post Traumatic Stress Disorder]. Where there is independent evidence of torture, the Home Office should only detain in very exceptional circumstances. Reasons for maintaining detention in such cases should be comprehensive. (para 1.80, p29) | Report on an Unannounced Inspection of Brook House Immigration Removal Centre, 31 October– 11 November 2016, HM Chief Inspector of Prisons, March 2017 | The 2016 HMIP inspection report |
| 47 | The ACDT [Assessment Care in Detention and Teamwork] process should be reserved for detainees assessed as at risk of self-harm, and should not be used to monitor those who do not eat food provided by the centre. ACDT documents should identify specific triggers and daily entries should reflect interactions with detainees in crisis. (para 1.25, p22) | Report on an Unannounced Inspection of Brook House Immigration Removal Centre, 31 October– 11 November 2016, HM Chief Inspector of Prisons, March 2017 | |
| 48 | A care suite for detainees at risk of self-harm should be established. (para 1.27, p22) | Report on an Unannounced Inspection of Brook House Immigration Removal Centre, 31 October– 11 November 2016, HM Chief Inspector of Prisons, March 2017 | The 2016 HMIP inspection report |
| 49 | All staff should have effective training in the adults at risk guidance. There should be effective multidisciplinary oversight of detainees in this group. Their vulnerability should be monitored carefully and developments communicated promptly to Home Office case workers. (para 1.33, p23) | Report on an Unannounced Inspection of Brook House Immigration Removal Centre, 31 October– 11 November 2016, HM Chief Inspector of Prisons, March 2017 | The 2016 HMIP inspection report |
| 50 | The Home Office should review its systems for raising concerns about detained individuals, including the current Rule 35 process. (recommendation 1, p59) | Locked Up, Locked Out: Health and Human Rights in Immigration Detention, British Medical Association, September 2017 |
| 51 | The Home Office and NHS England must ensure that appropriate training is provided to all IRC GPs so they are appropriately skilled to carry out Rule 35 assessments. (recommendation 4, p60) | Locked Up, Locked Out: Health and Human Rights in Immigration Detention, British Medical Association, September 2017 | |
| 52 | The Independent Chief Inspector of Borders and Immigration should be invited to report annually to the Home Secretary on the working of the Adults at Risk process. (recommendation 14, p36) | Assessment of Government Progress in Implementing the Report on the Welfare in Detention of Vulnerable Persons, Stephen Shaw, July 2018 | The 2018 Shaw follow-up report |
| 53 | Without further delays, implement the recommendations from previous reviews and reports about the ‘Adults at risk in immigration detention’ policy (by Stephen Shaw, ICIBI [Independent Chief Inspector of Borders and Immigration] and other statutory bodies), producing a revised timetable for this work and resourcing it so that it is completed during 2021-22, or if this is not possible, by a specified later date, and including in this process related recommendations from ICIBI reports concerning Non- detained Vulnerable Adults, and Reporting and Offender Management. (para 4.1, p11) | Second Annual Inspection of ‘Adults at Risk in Immigration Detention’, July 2020– March 2021, Independent Chief Inspector of Borders and Immigration, October 2021 | |
| 54 | In respect of Detention and Escorting Services (DES), and in collaboration with NHS England and Scotland: i. Monitor and analyse the take-up of Rule 34 appointments at each IRC, to identify and address the reasons for missed appointments and using the lessons learned to inform and develop a Home Office owned IRC estate-wide approach to increasing attendance at Rule 34 appointments. (para 4.5, p11) | Second Annual Inspection of ‘Adults at Risk in Immigration Detention’, July 2020– March 2021, Independent Chief Inspector of Borders and Immigration, October 2021 | |
| 55 | In respect of Medico-Legal Reports (MLRs): i. Carry out a thorough, robust investigation into suspicions that MLRs are being systematically abused and share findings with staff and external stakeholders; ii. In consultation with key stakeholders, agree any changes in the MLR process that are supported by the evidence from the investigation of possible abuse, with the aim of ensuring that MLRs are regarded by all parties as a robust and effective means of raising concerns about vulnerable individuals; iii. In future, where a case of fraud is suspected, take urgent action to bring this to the attention of the regulatory bodies responsible for investigating professional misconduct and malpractice. (para 4.8, p12) | Second Annual Inspection of ‘Adults at Risk in Immigration Detention’ July 2020-March 2021, Independent Chief Inspector of Borders and Immigration |
| 56 | In respect of Rule 35: As a priority, roll out planned training to GPs regarding Rule 35; Evaluate compliance with the two-day Home Office response time for Rule 35 reports;Review the effectiveness of Rule 35(1) and (2) as safeguarding mechanisms, with the aim of ensuring their scope and use are fully understood by anyone called upon to write or assess a Rule 35 report;Expand the list of the medical professionals who can complete a Rule 35 assessment to include qualified psychiatrists. (para 4.10, p13) | Second Annual Inspection of ‘Adults at Risk in Immigration Detention’, July 2020– March 2021, Independent Chief Inspector of Borders and Immigration, October 2021 | |
| 57 | As a matter of priority, commission an independent review to develop an in-depth, robust understanding of the abuse of Rule 35. It should be evidence-based and make assessments as to the prevalence, shape and impact of the abuse, with particular reference to how perceptions of abuse may impact how staff undertake their roles. It should assess the impact that abuse may have on the effectiveness of Rule 35 and make recommendations for improvement. (recommendation 1, p3) | Third Annual Inspection of ‘Adults at Risk in Immigration Detention’, June–September 2022, Independent Chief Inspector of Borders and Immigration, January 2023 |
| 58 | Within 3 months, ensure that planned training on Rule 35 for doctors draws on feedback from the Rule 35 team, and is tailored to the identified needs of doctors, to enable the production of consistent, and high quality, Rule 35 assessments and reports. (recommendation 4, p3) | Third Annual Inspection of ‘Adults at Risk in Immigration Detention’, June–September 2022, Independent Chief Inspector of Borders and Immigration, January 2023 | |
| 59 | Within 3 months, develop wider training, complemented by regular communications with healthcare, contractor and Home Office staff on the purpose and process of Rule 35, including raising awareness of the psychology of trauma. (recommendation 5, p3) | Third Annual Inspection of ‘Adults at Risk in Immigration Detention’, June–September 2022, Independent Chief Inspector of Borders and Immigration, January 2023 |
Restrictions on detained people (see Chapter D.6 in Volume II)
| Recommendation | Report | Reference in this Report | |
| 60 | The use of segregation as a form of punishment must cease. (p96) | ‘A Secret Punishment’ – The Misuse of Segregation in Immigration Detention, Medical Justice, October 2015 | |
| 61 | Segregation under Rule 40 and Rule 42 should not be used for the management of vulnerable detainees in crisis or to manage self-harm or suicidal behaviour. (p3) | ‘A Secret Punishment’ – The Misuse of Segregation in Immigration Detention, Medical Justice, October 2015 |
| 62 | Policies and practices must be developed to ensure that challenging behaviour is not met by the use of segregation, the use of force and other disciplinary measures but, rather, is dealt with in the least restrictive and most therapeutic way possible. Segregation should only be used in exceptional circumstances, as a last resort when all other options have been exhausted and for the shortest time possible. The exceptional circumstances as well as efforts to find alternatives must be thoroughly recorded in each case. (p97) | ‘A Secret Punishment’ – The Misuse of Segregation in Immigration Detention, Medical Justice, October 2015 | |
| 63 | Special training needs to be provided to those working in segregation unit. (p96) | ‘A Secret Punishment’ – The Misuse of Segregation in Immigration Detention, Medical Justice, October 2015 | |
| 64 | I recommend that the Home Office consider amalgamating and modernising rules 40 and 42. (recommendation 37, p145) | Review into the Welfare in Detention of Vulnerable Persons, Stephen Shaw, Cm 9186, January 2016 | The 2016 Shaw report |
| 65 | The Home Office should review all the rule 40 and rule 42 accommodation to ensure that it is fit for purpose. All contractors should be asked for improvement plans to ensure that the name Care and Separation Unit is something more than a euphemism. (recommendation 38, p147) | Review into the Welfare in Detention of Vulnerable Persons, Stephen Shaw, Cm 9186, January 2016 | The 2016 Shaw report |
| 66 | Detainees in the separation unit should be held in clean and fully furnished cells, and they should be able to access a full regime. (para 1.59, p26) | Report on an Unannounced Inspection of Brook House Immigration Removal Centre, 31 October– 11 November 2016, HM Chief Inspector of Prisons, March 2017 | The 2016 HMIP inspection report |
| 67 | In particular, segregation units should not routinely be used as a way of managing individuals at risk of suicide, self-harm, or those experiencing a serious mental health crisis. (recommendation 2, p60) | Locked Up, Locked Out: Health and Human Rights in Immigration Detention, British Medical Association, September 2017 | |
| 68 | Detainees in the segregation unit should be offered full access to the regime, subject to individual risk assessments. (para 1.71, p31) | Report on an Unannounced Inspection of Brook House Immigration Removal Centre, 20 May–7 June 2019, HM Chief Inspector of Prisons, September 2019 | the 2019 inspection report |
Use of force (see Chapter D.7 in Volume II)
| Recommendation | Report | Reference in this Report | |
| 69 | The Home Office … should: Take ultimate responsibility for their contractors’ use of force and the consequences. They should, at least in part, be held legally liable for any assault inflicted by a company or individual contracted by them to enforce their policy and decisions. (p4) | Outsourcing Abuse: The Use and Misuse of State- Sanctioned Force During the Detention and Removal of Asylum Seekers, Birnberg Peirce & Partners, Medical Justice and the National Coalition of Anti- Deportation Campaign, July 2008 | |
| 70 | The Home Office … should: … Impose sanctions against companies whose staff commit assaults, such as revoking of licences, imposing fines, removing contracts or imposing penalties on bidding for future contracts. When any such necessary steps are taken, they should be reported publicly. (p4) | Outsourcing Abuse: The Use and Misuse of State- Sanctioned Force During the Detention and Removal of Asylum Seekers, Birnberg Peirce & Partners, Medical Justice and the National Coalition of Anti- Deportation Campaign, July 2008 | |
| 71 | All planned uses of force should be filmed, and the film retained for a reasonable fixed period. (para 7.47, p62) | Report on a Full Announced Inspection of Brook House Immigration Removal Centre, 15–19 March 2010, HM Chief Inspector of Prisons, July 2010 | |
| 72 | The Home Office should examine the role body-worn cameras might play in providing additional safeguards in the removals context. (p60) | Report of the Independent Advisory Panel on Non-Compliance Management, Independent Advisory Panel on Non-Compliance Management, March 2014 |
| 73 | The Home Office should develop and implement a governance structure reflecting the minimum requirements set out in this report. (p61) | Report of the Independent Advisory Panel on Non-Compliance Management, Independent Advisory Panel on Non-Compliance Management, March 2014 | |
| 74 | The immigration removals contractor should be required to adopt a use of force minimisation strategy. (p61) | Report of the Independent Advisory Panel on Non-Compliance Management, Independent Advisory Panel on Non-Compliance Management, March 2014 | |
| 75 | The Board recommends that MoJ [Ministry of Justice] commissions a cross- departmental review of behaviour management policy and practice in STCs [Secure Training Centres], across the wider youth justice system and beyond to other sectors. The purpose of the review should be to produce a coherent policy on risk, restraint and behaviour management across government that proactively drives the best interest of the child and promote interventions that are proportionate to the risks presented by the behaviour rather than the setting in which the behaviour occurs. (recommendation 13, p50) | Medway Improvement Board: Final Report of the Board’s Advice to Secretary of State for Justice, Dr Gary Holden, Bernard Allen, Sharon Gray and Emily Thomas, Medway Improvement Board, 30 March 2016 |
| 76 | All use of force should be necessary, proportionate and competently applied. (para 1.58, p26) | Report on an Unannounced Inspection of Brook House Immigration Removal Centre, 31 October– 11 November 2016, HM Chief Inspector of Prisons, March 2017 | The 2016 HMIP inspection report |
| 77 | The Home Office should roll out the use of body worn cameras to all IRCs and robustly monitor their use. (recommendation 40, p112) | Assessment of Government Progress in Implementing the Report on the Welfare in Detention of Vulnerable Persons, Stephen Shaw, July 2018 | The 2018 Shaw follow-up report |
| 78 | The SMT should ensure staff have time for debriefing and reflecting about serious incidents in which they have been involved and an opportunity to learn from them. (recommendation 5, p93) | Independent Investigation into Concerns about Brook House Immigration Removal Centre, Ms Kate Lampard and Mr Ed Marsden (Verita), October 2018 | The 2018 Verita report |
| 79 | The SMT must ensure regular and timely review of all use-of- force incidents by appropriately trained staff and that regular meetings take place, involving the SMT, dedicated to considering matters arising from use-of-force incidents and to ensuring that any concerns are addressed. (recommendation 50, p209) | Independent Investigation into Concerns about Brook House Immigration Removal Centre, Ms Kate Lampard and Mr Ed Marsden (Verita), October 2018 | The 2018 Verita report |
| 80 | An in-depth review of use of force should be conducted to ensure that such incidents are minimised in line with the level used in other immigration removal centres. (para 1.70, p31) | Report on an Unannounced Inspection of Brook House Immigration Removal Centre, 20 May–7 June 2019, HM Chief Inspector of Prisons, September 2019 | The 2019 HMIP inspection report |
| 81 | … the CPT [European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment] recommends that the terms of Prison Service Instruction 04/2017 should be amended to make it mandatory for BWVCs [body worn video cameras] to be issued, worn and turned on by all prison staff who may have to use force against prisoners and non-compliance with this obligation (in the absence of an explanation of exceptional circumstances) should be treated as a disciplinary offence … (para 58, p29) | Report to the United Kingdom Government on the Visit to the United Kingdom Carried Out by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) from 13 to 23 May 2019, European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment, 30 April 2020 |