Care for elderly prisoners is inconsistent and the lack of planning for an ageing population is a serious defect, say inspectors

The prison service and local authorities are failing to plan for the future needs of a growing population of elderly, ill and frail prisoners, according to a report on social care in jails by HM Inspectorate of Prisons and the Care Quality Commission.

Many older jails are ill-equipped for prisoners in wheelchairs, or with mobility problems. Some prisoners struggle to wash and look after themselves and others who have fallen cannot get help during the night. The quality of care is inconsistent across prisons. The number of people in prison aged 50 and over was 13,522 in December 2017 – 16% of the total adult prison population aged over 18. Projections show this number is likely to increase. Reports have suggested that factors in prisoners’ lives, in and out of jail, lead to a faster ageing process.

The responsibility for social care in prisons falls on 58 English authorities with jails and five in Wales. The joint report by the two inspectorates says: “The ageing population within prisons, coupled with increasing frailty and incidence of dementia, has accelerated the need for prisons to address social care needs. In addition, a significant proportion of prisoners also have learning disabilities, autism, mental health disorders or difficulties which may also inhibit their ability to cope with life in prison.”

The report shows that there have been some improvements in care for older and disabled prisoners since new legislation three years ago in England, and separately in Wales, required authorities to assess prisoners’ care needs. Some prisons show good practice and there are many caring staff and fellow prisoners.

However, troubling evidence gathered from individual prison inspections by HMI Prisons and the CQC have led to some key conclusions:

  • At a national level, Peter Clarke, HM Chief Inspector of Prisons, and Steve Field, CQC Chief Inspector of General Practice, say: “We are concerned that developments in social care in prisons are only related to current need. We are not convinced that there is adequate consideration of what will be required in the very near future, such as the obvious needs that will flow from the projected growth in the older prisoner population. This, in our view, represents a serious and obvious defect in strategic planning.
  • At a prison level, the report notes, “there continue to be wide variations between social care services in prisons, so that as yet they are neither equitable nor consistent. Gaps remain in provision of services in English prisons. Gaps also remain in the provision of support for those prisoners requiring assistance with personal care who do not meet the eligibility threshold for social care. There are clear signs that the disparity in services between prisons is disadvantaging prisoners in their ability to be rehabilitated, because transfers to suitable establishments cannot be effected when receiving prisons are unable to offer services that can adequately respond to the individual’s social care needs.”

Peter Clarke, HM Chief Inspector of Prisons, said:

“Even the most psychologically robust and able-bodied man or woman finds being imprisoned to be a disturbing experience. And for those men and women who are imprisoned, but who need assistance with their social or personal care, it is especially challenging and daunting. Prisons were designed to accommodate physically fit and mentally stable individuals, with prison life being arranged to address the needs of the many. Prisoners with social care needs – unable to fully care for themselves, needing help in getting around the prison or in participating socially – are at a significant disadvantage.”

Professor Steve Field, Chief Inspector of General Practice and Integrated Care at the Care Quality Commission said:

“People in prisons can have complex and varied health and care needs, which can be exacerbated through incarceration. This will only become harder to address if they are not given access to good care, and if settings do not make the necessary adjustments to support prisoners with varied capacity to care for themselves. As the prison population ages and becomes more likely to develop new conditions while in prison, it is extremely important that services are equipped and managed in a way that offers the high-quality care that everyone has the right to.”

– Ends –

Notes to editors

  1. A copy of the full report, published on 16 October 2018, can be found here.
  2. Under the terms of the Care Act 2014, and the Social Services and Well-Being (Wales) Act 2014, local authorities have a legal obligation to assess the need for and provide social care to people whose needs make them eligible to receive it.
  3. As at December 2017, the number of people in prison aged 50 and over was 13,522, representing 16% of the total adult prison population (those aged over 18). Projections indicate that the number of people aged 50 and over held in custodial settings is likely to increase.i As such, needs are changing, impacting provisions and raising questions about the suitability and training of staff to care for an increasingly older population.ii,iii
  4. This report draws on inspection reports and additional data collection conducted in eight establishments. Evidence from all sources was triangulated to strengthen the validity of our assessments. Primary fieldwork was conducted in eight establishments in January and February 2018. These establishments were selected to include a range of the different functional types of establishment and local authority social care delivery models. Primary fieldwork was conducted at the following establishments:
  • HMP Peterborough (men)
  • HMP & YOI Peterborough (women)
  • HMP Exeter
  • HMP Channing’s Wood
  • HMP Littlehey
  • HMP Cardiff
  • HMP Wakefield
  • HMP Low Newton

About Her Majesty’s Inspectorate of Prisons

HM Inspectorate of Prisons is an independent inspectorate, inspecting places of detention to report on conditions and treatment, and promote positive outcomes for those detained and the public.

Please contact John Steele at HM Inspectorate of Prisons on 020 3334 0357 or 07880 787452, or at, if you would like more information.

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England. We make sure health and social care services provide people with safe, effective, caring, well-led and responsive care, and we encourage care services to improve. We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.

Please contact the CQC press office on 020 7448 9401 or for more information.

i Ministry of Justice, 2017. Prison Population Projections 2017 to 2022, England and Wales. Available at <> accessed 5 September 2018.
ii Turner, J. M. (2016). ‘Improving palliative care for prisoners: the ‘both sides of the fence’ study’. Prison Service Journal, (224).
iii Peacock, M., Turner, M., & Varey, S. (2017). ‘‘We Call it Jail Craft’: The Erosion of the Protective Discourses Drawn on by Prison Officers Dealing with Ageing and Dying Prisoners in the Neoliberal, Carceral System’. Sociology.