Custody inspection report - Highland and Islands

• The custody centres inspected were found to be of varying age and construction, however all were fully functional and in good condition, with no ligature hazards. The only notable exception related to cell doors at Lerwick, which were of significantly older design and opened inwards.
• At time of inspection, Inverness custody centre was undergoing comprehensive renovation and, as such, was using temporary infrastructure both externally and internally to accommodate the ongoing works. Inspectors had some concerns regarding the cleanliness of treatment rooms as a result of the works and refer to this in our report.
• The CCTV observation facilities in both Lerwick and Stornoway were very poor, consisting of small single screens, made worse when multiple images are required to be viewed.
• There were no ‘Livescan’ fingerprint identification machines in any of the ancillary centres, which instead use ink and paper. This outdated approach invites risk as it negates the ability to immediately and confidently identify detainees who either fail to disclose or deliberately seek to conceal their identity.
• While the criminal justice processes carried out by custody sergeants was largely robust, there appeared to be limited intrusive supervision by sergeants of the care for detainees in ancillary centres, supplementary to the initial booking in process.
• There was a lack of available appropriately sized anti-harm clothing at the centres visited. This can impact on the dignity and safety of female or small stature detainees that are regularly provided with oversized garments.
• We found some delays in the timely input of detainee observations and cell checks onto the NCS, as the police officers operating in the ancillary centres often had to manage other emerging police business in their area. This was present across all centres, except from our sample of records from Fort William.
• We found several gaps in NCS records regarding the provision of meals, drinks and a wash being offered. These gaps may be recording errors, and while we expect this to be the case, recording gaps cannot provide full assurance that care and welfare practices are robust.
• We found that criminal justice decisions were often accompanied by detailed rationales, but care plan rationales were often weak or omitted. There were weaknesses in the recording of some care plan rationales particularly when they were subject of review or change.
• We found that on some occasions, detainees would be transferred from rural ancillary centres to Inverness, often very late in the evening, to free up officer resources at one of the ancillary centres due to competing operational requirements. This could result in long trips for detainees.
• There was a lack of inspector oversight on the NCS regarding records for children in custody. Our review of the NCS found that four children were held in cells overnight for social work pick up the next day regarding, what inspectors considered to be, relatively minor crimes. No child detention certificates were on record.
• The ancillary centres operated with low officer numbers, and the custody function is often secondary to their core duties. When a detainee is held, there is a drive towards single officer care to allow two officers to manage other operational demands.
• The retention of police officers based on the Islands remains a particular challenge. Often officers will leave the Islands following conclusion of probationary periods or seek development not available locally.
• Information for detainees on how to provide feedback or make a complaint regarding healthcare provision was only visible in Inverness and Wick custody centres.
• In Fort William, Stornoway and Kirkwall, while (Personal Protective Equipment (PPE)) for healthcare related use was available, it was not stored appropriately – i.e. close to point of use and in a clean, dry area to prevent contamination.
• Sharps bins used for disposing of used sharps were available at all centres. These were correctly labelled in Inverness and Wick but not in the other custody centres we visited.
• No HAI-Scribe^[1] assessment had been completed prior to the commencement of the works at Inverness, the treatment room was temporarily closed, and healthcare delivery was relocated to an alternative area. A retrospective HAI-Scribe was subsequently completed.
• There was a programme of local infection prevention and control (IPC) audits being carried out to provide assurance in Inverness and Kirkwall’s custody centres but not in the others we visited.
• At Wick, we observed that custody staff were the second signatory when controlled drugs were being checked. No formal training was in place to support custody staff to carry out this role.
• Across Highland, mental health joint working was often ineffective, resulting in delays in assessment and hospital admission, and patients continuing to face multiple assessments, long waiting times, and reluctance from secondary mental health care services to engage or provide timely support.
• In Lerwick, we learned that healthcare recommendations, including those relating to medications, were recorded directly onto the Police Scotland NCS system by healthcare staff. Whilst this approach reduces the risk of healthcare information being missed or wrongly transcribed, NHS Shetland and CJSD should ensure that appropriate governance systems are in place to support this approach.
• In Stornoway, healthcare recommendations were given verbally to custody staff. A more robust system should be introduced to reduce the risk of healthcare information being missed or recorded incorrectly.
• Custody staff told us that they can be advised by a healthcare professional over the phone to administer a detainees own ‘over the counter’ medication. Some centres, officers dispensed medication without dispensing aids. This will require more robust oversight and governance.
• General Practitioners (GPs) and Advanced Nurse Practitioners attending the custody centre in Lerwick would bring their own emergency equipment. Out of hours (OOH) vehicles also contained oxygen if required. While we were told that OOH equipment was checked as part of the OOH healthcare staff duties, records of these checks were not kept.
• At Lerwick, healthcare staff dispensed medication into multi-compartment compliance aids to enable custody or GEOAmey staff to administer medication. However, there was no training in place for GEOAmey staff in the use of compliance aids to support medicines administration.
• When controlled drugs were required in Lerwick custody centre, they were transported from the hospital emergency department to the custody centre by healthcare staff in their own or NHS cars. We were told these medications were not securely stored in a lockable container during transfer.
• The medical service in Kirkwall had no policies or SOP in place to support staff with the supply, storage, dispensing and safe destruction of medicines at the police custody centre.
• We were told that the out-of-hours GP service in Kirkwall occasionally placed medication into multi-compartment compliance aids to enable custody staff to administer medication. However, there was no training in place for custody staff in the use of compliance aids to support medicines administration.
• From our sample of NCS records, arrest referral was accepted in eight instances and declined in 28. Forty five records had been updated to the effect that services were not applicable. However, some detainees were not offered a referral despite presenting with what inspectors considered to be appropriate needs.

[1] HAI-SCRIBE (Healthcare Associated Infection Systems for Controlling Risk in the Built Environment) is an online risk management tool designed to identify and assess for potential hazards in healthcare establishments. The goal of HAI-SCRIBE is to reduce infection hazards within the built healthcare environment.