Care and Support for People with Social Care Needs on Release from Prison.

Introduction
Following the introduction of the Care Act (2014) local authorities are now responsible for identifying, assessing and meeting the social care needs of people in prison, and people released from prison, with a package of care and support. This legislation was designed to address longstanding concerns about a lack of social care in prisons and to ensure continuity of care when people are released into the community. However, although release from prison is associated with high rates of mortality, homelessness, social isolation, unemployment and debt, most authorities initially focused on people in custody. Little is known about the number of people released from prison with social care needs, the nature of these or how best to meet them. There are also concerns about the release planning process, including insufficient notice of release, gaps in communication, problems establishing which authority is responsible for certain prisoners, and difficulties transferring assessments between authorities.

Objectives
This study will build on NIHR SSCR-funded research on the social care needs of people in custody, and will focus on the social care needs of people on release, including individuals with both high and low level needs. The aim is to provide local authorities with evidence to facilitate the delivery of better social care and support for this client group, enabling them to implement the Care Act reforms in an efficient manner.

Methods
The study forms part of an ongoing collaboration between Social Care and Society (SCS) and the Offender Health Research Network (OHRN) and has four main strands.

* Identify what is known about the social care needs of people released from prison via a review of the social care practice, policy and academic literature
* Estimate the number of people with identified social care needs released from prison, and explore the ways they are identified, prepared for release and supported post-release by means of national surveys of prison and local authority staff
* Improve understanding of the problems with the release planning process and how to resolve these through interviews with staff and service users at four sites across England
* Highlight practice implications of the findings by means of two validation workshops.

Within the literature there was scant information on the number of people with social care needs on release from prison. The existence of formal systems for identifying people who developed social care needs post-reception also appeared rare, with work indicating most authorities relied on prison and healthcare staff recognising such people in routine interactions. This dearth of data was also a prominent theme in survey responses received from local authorities. Only a minority (32%) of authorities reported collecting data on the number of prisoners with eligible social care needs released to the community, whilst some did not know if their authority collected such data. Authorities reported often lacking sufficient notice to make adequate plans for release. Further challenges related to the nature of the person’s crime, health status, social situation, and sentence length, with many prisoners having multiple and overlapping needs. Specific initiatives to prepare people with social care needs for release however appeared rare. Interviews with staff and stakeholders indicated little formal planning for when an individual is due to be released from prison with social care needs. Overall, processes for individuals needing social care support on release appeared ill-defined and inadequate. The combination of this and the prison system’s rigid and time-limited pre-release planning meant any support provided to these individuals is typically too little, too late. Finally, release processes often relied upon the collaboration of different local authorities, which data indicated was often suboptimal. It appeared that governmental-level decisions and funding concerns also combined to hamper delivery of care.