Lower level social care needs in prison: Constructing a theory of change

People living in prison have a complex mix of physical / mental health and social care needs. However, in the past there has been a lack of social care support in prisons.

It has now been made clear, in law, that local authorities in England must provide social care for people in prison. However, people have to have certain types and levels of social care needs to get help from these agencies.

Studies suggest that as many as one in ten men in prison have difficulty bathing,
getting dressed and/or getting around the prison. Lots of people do not have employment or activities whilst in prison. Many also have problems with their relationships, childcare, accommodation, and money. However, research also suggests that many of these individuals will not meet the existing criteria to get social care support. This is despite the fact that such needs can cause distress and may develop into bigger problems. When people first come in to prison, they often have lots of complex needs and it can be a very difficult time for them and so this is when we will focus our study.

In this situation (where people have ‘lower level’ needs that they will not get help with from the local authority) the law states that local authorities must still consider how to improve people’s wellbeing – to prevent the development of further difficulties in the future. That is, they have a duty to help reduce, prevent, or delay the need for future care and support. However, previous research and discussions with professionals suggest that little attention has so far been given to the services required by these individuals.

This study will:

i. Explore the nature and level of the social care needs of people on entry to prison who at that time are deemed not-eligible for support from the local authority;
ii. Find out what services are needed to address these lower-level problems; and
iii. Identify who is best placed to provide these services (e.g. the local authority, other prisoners, third sector providers such as voluntary organisations, or a combination of these).

To do this we will:

i. Review literature on the full range of social care needs of people on entry to prison and potential ways of meeting these;
ii. Interview a number of prisoners and the staff that care for them about their social care needs on entry to prison, the help they get, and the support they need.

Working together with a group of people with different expertise we will then use this information to design a model of care to meet these needs. We will also apply for further funding to test this model in another study. As such, this research is the first step in a longer programme aimed at helping people in prison access the social care they need.