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.

      If a prisoner is entering an at-risk cell and they have already undergone a strip search on arrival to prison or from having a reasonable grounds search, and they have been supervised by an officer since the strip search was conducted, and an officer considers a further strip search is unnecessary then there is no need to strip search them again on entering an at-risk cell.

   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.
      3. Prisoner clothing inclusive of underwear will be determined case by case, in collaboration with health services with decisions recorded in the prisoner’s at-risk management plan.
      4. authorised property, unless in collaboration with health services there is reason to refuse or restrict certain property. These decisions must be recorded in the prisoner’s at-risk management plan.
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 general manager custodial 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 general manager custodial but must, as soon as possible inform the general manager custodial
   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 general manager custodial (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.
6. The general manager custodial or delegate must obtain the advice of the health centre manager or delegate within 24 hours following the initial at-risk assessment. After considering the advice, the general manager custodial or delegate must either reverse the at-risk assessment if they consider that the prisoner is not at risk of self-harm, or confirm the at-risk assessment if the general manager custodial considers that the prisoner is at risk of self-harm. If confirmed, an at-risk management plan must be established in consultation with the health centre manager or a health professional with relevant expertise or knowledge.

M.05.03.02 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.
4. All interactions by a registered healthcare practitioner with the patient must be documented and include a consideration of whether the ‘at-risk’ status remains appropriate.

M.05.03.03 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.05.03.04 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.

      The at-risk management plan must be completed within 24 hours of the prisoner’s assessment and following the general manager custodial 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. details of any restrictions on or denial of the opportunity of the prisoner to associate with other prisoners per a segregation direction made under [section 61CA of the Corrections Act 2004] by the general manager custodial
   2. type of risk and reason for at-risk status
   3. frequency of any observations
   4. prisoner clothing and underwear requirements

      Underwear will remain issued to a prisoner assessed as at-risk unless, after consultation with health services staff, it is determined underwear is not to be issued to assist with suicide prevention and maintaining the persons safety.

   5. prisoner’s access to authorised property, including any without property and/or requirements
   6. prisoner’s access to any support systems, programmes, or special requirements, including spiritual, cultural, social, religious, mental health, special or personal needs
   7. 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]), of the restrictions on association and the reasons for those restrictions.)
   8. 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.
   9. times when the prisoner’s at-risk status is to be reviewed
   10. 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 general manager custodial, after consulting with and obtaining advice from the health centre manager, revokes the at-risk status of the prisoner.

M.05.03.05 Reviews and revocation of the confirmed at-risk assessment

1. The general manager custodial must regularly consult with the health centre manager to discuss the prisoner’s needs, including whether (based on the required daily health checks) the prisoner’s at-risk status should be reviewed and/or revoked, and whether any direction to restrict or deny association should be reviewed and/or revoked.
2. Where there is agreement that a prisoner who has been assessed as being at-risk of self-harm remains at-risk of self-harm despite support and intervention after a period of 28 days, a complex review meeting will be held with the general manager custodial or delegate and health centre manager present to provide information or advice where relevant.
3. Where the health centre manager advises the general manager custodial that a prisoner is no longer at-risk of self-harm and the general manager custodial is satisfied that the prisoner is no longer at risk of self-harm, they must remove the at-risk status. Following this, the general manager custodial must ensure that the prisoner is moved out of an at-risk cell.
4. If a general manager custodial considers that a prisoner assessed as at-risk and with a direction that denies or restricts their association with other prisoners is no longer needed for their safety, then in consultation with the health centre manager, they may revoke that direction so that the prisoner may associate with other prisoners. Following this revocation the prisoner’s at-risk management plan must be updated.
5. The RISK OF SELF HARM alert on IOMS is deactivated before the prisoner is moved of the Intervention and Support Unit (ISU).
   Note: The review date for the alert should be the sentence release date for sentenced prisoners or remand end date for remand / accused prisoner. If the prisoners 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.