Detention and custody
Detainee care
Police and Criminal Evidence Act 1984 (PACE) Code of Practice C sets out the statutory framework for custodial care and the rights and entitlements of a detainee in police custody.
- 1 Management and supervision
- 2 Monitoring, observing and engaging
- 2.1 Observation
- 2.1.1 Levels of observation
- 2.1.2 Checking of visits and rousing
- 2.1.3 Written record
- 2.2 Signs indicating increased risk
- 2.3 Medication
- 2.3.1 Managing medication
- 2.3.2 Quantities of medication
- 2.3.3 Detainees retaining medication
- 2.3.4 Unused medication
- 2.3.5 Responsibility for medication in custody
- 2.4 Medical documentation
- 2.4.1 Detained person medical form
- 2.4.2 Examination and assessment
- 2.4.3 Detained person medication form
- 2.5 Medical emergencies
- 2.5.1 Appropriate care
- 2.5.2 Case notes
- 2.5.3 Supervision and security in hospitals
- 2.5.4 Police supervision
- 3 Cell checks
- 4 Out of cell
- 4.1 Exercise
- 4.1.1 Reading materials
- 4.1.2 Visits to detainees
- 4.2 Interview
- 4.3 Detainee risk assessment while outside custody
- 5 Welfare and safety
- 5.1 Clothing
- 5.2 Bedding
- 5.3 Toilet and sanitary facilities
- 5.4 Food and drink
- 5.5 Choking
- 5.6 Cutlery and crockery
- 5.7 Smoking
- 5.8 E-cigarettes (vaping)
- 6 Diversion and referral
Management and supervision
Forces must establish clear lines of responsibility and accountability for supervising and managing custody staff, custody suites and detainees. Contracts that apply to police resources, contracted staff and training, and other professionals working within the custody environment are required to detail appropriate actions and liabilities in the event of an untoward incident. Section 1(2)(c) of the Corporate Manslaughter and Corporate Homicide Act 2007 specifies that its provisions apply to police forces. Forces must, therefore, ensure that there are clear lines of accountability in contracts for employment and services to custody.
Supervision by an inspector
The duty inspector or custody inspector is responsible for the supervision and support of all custody staff. At the beginning of each shift, the custody officer and, where practicable, the inspector should check:
- the welfare of all custody staff
- the number of detainees
- the custody records
- the detainees in cells
- that all risks, vulnerabilities and welfare needs of detainees are being adequately managed
- control measures against identified risks to ensure that they are both proportionate and effective
- review times
- if the staffing levels are sufficient for the safe and effective operation of the suite
- on any emerging issues
- the physical condition of the custody suite.
Section 40, section 40A, section 45A of PACE and section 15 of Code C provide detailed guidance on reviewing detention.
Maintaining custody records
Forces should implement audit and inspection regimes for custody records. These should include checking:
- the legibility, accuracy, appropriateness and quality of entries
- compliance with PACE and the codes of practice
- that all entries are signed, timed and dated
- that the condition of the detainee on arrival, at each check and on release or transfer is accurately recorded (including details of the detainee’s actions, mood and emotional state)
- that the waiting time for examination of detainee by a healthcare professional (HCP) is within acceptable timeframes and when escalation procedures were not followed
- that medical needs and administration of medication are being identified and met in accordance with instructions
- the quality of risk assessment and that control strategies are commensurate with identified risks
- that the detainee’s intelligence records reflect any vulnerability identified in the risk assessment
- that dietary or religious and cultural needs are being identified and met
- the needs of vulnerable or at risk detainees are considered and appropriate support is made available
- the level of detailed information provided on the person escort record (PER) form, where applicable.
- notes are contemporaneous, or recorded as soon as possible.
Handover procedures
It is essential that enough time is allowed for a full and effective briefing and debriefing between custody officers and staff when handing over responsibility for detainees, particularly at shift change over. This ensures that all relevant information is passed on and understood by the person taking over responsibility. If handover has to take place in or around the booking-in desks, the custody suite should be cleared of other personnel. Custody officers and other custody staff should carry out the handover together.
Officers and staff should communicate information verbally. Where CCTV exists in the custody area, handover should take place in sight and sound of an appropriate camera and microphone. If CCTV is not available, there should be written acknowledgement that all custody officers and staff have been fully briefed on the risks and needs on each detainee’s custody record.
The information entered should include the risks, disabilities, medical needs, vulnerabilities, emerging issues, control strategies and welfare needs of each detainee. It should also cover the status of each investigation, including the actions required to achieve effective and lawful resolution of the matter for which the person has been detained. The incoming shift of custody officers and staff must ensure that they are aware of all of this information.
Custody officers should ensure that rousing checks are completed on all detainees, during, or as soon as practicable after, handover.
Multiple custody officers on duty
Where multiple custody officers are on duty, each must be aware of their individual duties and responsibilities and ensure that this information is recorded and kept up to date. Local force policy may provide clarity about who is acting as the designated custody officer for each detainee at any given time.
Use of whiteboards and wipe boards
Wipe boards can assist in the handover process, but to comply with data protection legislation, they must be out of sight of non-custody staff.
Monitoring, observing and engaging
The custody officer is responsible for managing the supervision and level of observation of each detainee and should keep a written record in the custody record. They should specifically check that officers and staff are adhering to the timing of levels of observation and carrying out rousing.
The custody officer must take into consideration a detailed and up-to-date assessment of the risk that the detainee poses to themselves and others, and any recommendations an HCP has made following medical assessment. The HCP’s recommendations should be given both verbally to the custody officer and in writing. Identified risks can be mitigated by using the most appropriate and considered control measures, eg, CCTV monitoring, replacement clothing, supervised meals.
Custody staff are directly responsible for observing and supervising detainees. They should be aware of the risks that have been identified, and the purpose of the allocated level of supervision that is deemed necessary. Staff must note all visits and observations, including the detainee’s behaviour/condition, in the custody record. Multiple detainee cell checks should not be recorded in individual custody records. Each check and entry should be unique to that particular detainee. Staff must report any changes in the detainee’s behaviour/condition to the custody officer immediately and review and update the risk assessment as appropriate. The use of technology does not remove the need for physical checks and visits.
There are four levels of observation.
Observation
Levels of observation
Following full risk assessment, this is the minimum acceptable level of observation required for any detainee. It includes the following actions: Subject to medical direction, this is the minimum acceptable level for detainees who are under the influence of alcohol or drugs, or whose level of consciousness causes concern. It includes the following actions: If the detainee’s risk assessment indicates a heightened level of risk to the detainee (eg, self-harm, suicide risk or other significant mental or physical vulnerability) they should be observed at this level. It includes the following actions: The purpose of CCTV cell monitoring should be recorded in the custody record together with the name of the designated officer or member of custody staff who is responsible for the monitoring. Officers and staff must consider issues of privacy, dignity and gender. Detainees at the highest risk of self-harm should be observed at this level. It must include the following actions: Every officer or member of custody staff required to conduct close proximity supervision must be fully briefed by the custody officer with regards their role, the needs of the detainee and the risks presented by the detained person. They must be fully trained and equipped to respond accordingly. If there is a requirement to rouse, this must be done by a trained officer or member of staff. Any changes in the detainee’s condition must be brought to the custody officer’s attention immediately. HCPs may work across different forces and be familiar with different categories or levels of observation. Custody managers should ensure that HCPs working within their force are aware of local procedures. Forces should have auditable systems that specifically inspect that staff adhere to observation levels. This should include using recorded CCTV to check timing of visits and rousing. Officers and staff must make a written record in the custody record following each and every visit/check/rousing completed for each detainee. The custody officer must record the following in the custody record: HCPs should ensure that their recommendations for custody staff on the frequency of checks and/or any recommendations on the rousing of a detainee are written in the custody record, in addition to being verbally passed on. Officers and staff should not use the phrase ‘continue observations at the current level’. HCPs and custody sergeants should specify the level of observation precisely at each review, to prevent any ambiguities. Officers must endorse the custody record every time the detainee leaves or is returned to their cell. Custody officers and staff should be familiar with the signs or behaviours of a detainee that may indicate an increased level of risk and/or requirement for a higher level of monitoring. An increased level of risk, illness or change in behaviour should always be brought to the attention of the custody officer and included in the ongoing risk assessment of the detainee. Repeated or continual use of a vulnerability tool may assist in recognising changes. Where the custody officer is satisfied that the risk to the detainee has decreased, they should reduce the level of monitoring accordingly. They should carefully consider, apply and record this change. The custody officer must consult the appropriate HCP before a detainee takes or applies any medication that was prescribed prior to their detention. They should note this in the custody record. The custody officer is responsible for the safekeeping of the medication and ensuring that the detainee is given the opportunity to use or apply it as prescribed. If the medication is listed in Schedule 4 or Schedule 5 of the Misuse of Drugs Regulations 2001, the custody officer must consult the appropriate HCP (by telephone if necessary) for authorisation to distribute it to the detainee for self-administration. Both must be satisfied that self-administration does not expose the detainee, police officers or anyone else to the risk of harm or injury. If authorisation has been given, the custody officer may distribute the medication or authorise other custody staff to do so. No police officer or staff may administer or supervise the self-administration of medically prescribed controlled drugs (of the types and forms listed in either Schedule 2 or Schedule 3 of the Misuse of Drugs Regulations 2001). A detainee may only self-administer such drugs under the personal supervision of the appropriate HCP authorising their use. HCPs must provide clear written instructions for custody staff. These should be recorded on the detained person’s medication form (form 450a). Instructions should include: Forces must establish procedures for the safe storage and handling of medication. This should include systems for auditing, managing and appropriate reporting of successful interventions, errors and adverse events. All custody staff must be trained in these procedures. Custody staff must check that the correct medication is given in the correct dosage to the right detainee at the appropriate time. Two custody staff should undertake this task where practicable. This should be recorded in the custody record and medication form. Staff should take care to prevent the detainee hoarding medication. If a detainee refuses medication, staff should inform an HCP. Adequate quantities of medication should be available to cover the likely length of detention in police custody and any known transfer time. Where a detainee is being transferred to court, officers should transfer sufficient medication with clear instructions for the time spent in court custody. They must record details concerning this provision on the PER form or medication form as appropriate. Depending on the risk assessment, it may be appropriate for example to allow detainees with asthma to keep their inhalers and detainees with angina to keep their angina sprays so that they can administer them as necessary. A detainee may, in certain circumstances, self-administer drugs under the personal supervision of the HCP authorising their use. When the detainee is released, custody staff should ensure disposal of unused medication in accordance with the instructions provided, recording the method of disposal on either the custody record or medication form. The custody officer is responsible for: The medication may not be what the detainee, friends or family say it is, or what is recorded on the packaging, and it can be used to conceal other items. The medication should never be distributed to the detainee for self-administration before it has been physically checked by an appropriate HCP. In exceptional circumstances where a dosage may have been missed, to prevent any harm to the detainee, officers should consult with HCP before taking any action. Medical notes are not part of the custody record. Officers and staff must not disclose these to solicitors and independent custody visitors while they are examining a custody record. Forces may adopt the detained persons medical form (DPMF/form 450) and the detained persons medication form (450a). These forms have been produced to provide a minimum acceptable standard, but forces may decide to use a locally agreed version with additional detail. Existing copies of both forms should be made available to the HCP immediately on arrival. They should be available at all times to all custody officers, staff and HCPs involved with the care of the detainee while they are in police custody. This is particularly important at shift handover. Staff should provide copies to ambulance or hospital staff if the detained person is being transferred to hospital and record this in the custody record. HCPs should ensure, where practicable, that detainees sign a declaration form to give consent for sharing information relevant to their care and welfare. HCPs should endorse the forms as required in clear and unambiguous writing and bring the content and detail of their report to the attention of the custody officer before leaving the police station. Any requests made by the HCP (such as collection of prescribed drugs) should be recorded in the custody record. Custody officers should record subsequent actions or decisions taken as a result of the request in the custody record (and PER form and/or detained persons medication form 450a as appropriate). The purpose of the detained person’s medical form (DPMF/form 450) is to highlight areas of medical concern to custody staff, and to provide, where necessary, a chronological medical report relating to a detainee’s period of detention. The information contained in the form is required for the detained person’s welfare and is disclosed only to hospital and ambulance staff. If, however, the detainee has been assessed as being at risk of suicide or self-harm, the DPMF should accompany the detainee when they are transferred to court, hospital or prison. The DPMF is completed for any person who is detained or brought to a station who: Where none of the above conditions apply, a form need not be used. Detained persons are not obliged to submit to a medical examination and assessment or to supply information. If, however, the detainee chooses not to cooperate fully, or there is any suspicion that they are not being truthful in their responses to questioning, this should be recorded on the DPMF and in the custody record. This applies particularly to assessment, which is when the detainee may try to conceal injuries from self-harm or hide the fact that they may be a suicide risk. The recommendations section (section 12) of the DPMF deals with the HCP’s overall assessment of the detainee’s fitness to be detained and interviewed and, if they are not, gives an estimate of when such fitness may be expected. It also allows for medical opinion on whether an appropriate adult may be required, which helps the custody officer make this decision. Staff should note recent self-inflicted injuries that become apparent during the detainee’s assessment on the body map section of the form. This helps to identify any new injuries that occur after the form has been completed, at a later assessment, or on transfer to hospital, court or prison. Staff should record the time the assessment was completed on the form. The HCP should add the proposed time of any further examination or assessment if they believe one is necessary. This should also be noted in the custody record (and PER form if appropriate). The HCP who conducts the further examination or reassessment should read and consider the original DPMF and complete a new DPMF that relates to the later assessment. The unique reference number of the new form should be recorded on the original form and the custody record. The DPMF should not include any confidential observations or notes. Such notes or observations should be recorded separately and kept by the HCP. The purpose of this form (form 450a) is to detail the prescribed medication and clarify how to administer it to the detainee. The form is self-explanatory and includes sections for single ‘once only’ prescriptions and sections for repeated or regular administration of prescribed drugs. More specific instructions on the general provision of drugs can be given to custody staff. The final section allows for an explanation of the reasons why prescribed drugs were not administered as required. The form also includes the HCP’s authority to transfer prescribed drugs to prisoner escort custody services personnel or to the detained person on release. The information contained in form 450a must only be disclosed to hospital and ambulance staff for the purpose of the detained person’s welfare. See also medical emergencies during transport. In medical emergencies, officers should call an ambulance immediately to convey the detainee to hospital as soon as possible. If an appropriate HCP is available at the police station, they should be asked to attend the detainee while awaiting the ambulance. Where forces do not have HCPs permanently based within custody suites, they must ensure that arrangements are in place to enable prompt access to an NHS triage service, which can help to alleviate well-intended but potentially inappropriate accessing of specific medical services The custody officer must ensure that a PER form is completed to accompany the detainee to hospital. In emergencies, however, there may not be sufficient time to do this. In this situation, the escorting officers should be verbally informed and the PER form passed to them at the hospital as soon as practicable. The detainee must be searched again on return to police detention from hospital, to ensure that they have not acquired items that could be used to cause harm to themselves or others, or to damage property. The police retain a duty of care for detainees who are refused admission to hospital or treatment by ambulance staff. They must make every effort to have the detainee examined and assessed. The Mental Health Crisis Care Concordat makes it clear that violence and/or intoxication should not be an automatic bar to admittance to a health establishment. However, if healthcare services still refuse to accept the detainee, they may be taken into custody at the police station. Officers should request clear instructions about their care, ongoing treatment and transportation from healthcare staff. This should preferably be in writing and include the reasons for refusal of admission or treatment. An HCP should reassess the detainee if the custody officer has any doubt about whether a detainee is fit to be detained or interviewed following their return from hospital. If the escorting officers do not agree with hospital staff that a detainee should be released from hospital, the following actions should be considered: If an appropriate HCP is not available, the detainee should be taken to another hospital for a second opinion. Officers should pass any case notes or items of information from hospital medical staff relevant to the continuing treatment of the detainee to the HCP at the police station. They should obtain the results of any tests, such as CT scans in the case of head injuries, information on how to care for the detainee and any care plan in writing. The escorting officers should return the PER form to the custody officer and inform them of any additional risks identified. Forces should establish local protocols with hospital trust managers that specify how responsibility for security is assigned between police officers and hospital trust security staff. A supervisor should also contact them at least once during each shift of duty to ensure that: Officers supervising detainees in hospital must be fully briefed. This should include: Where practicable, the person who carried out the last visit should conduct the next check. Continuity in checking allows evaluation of any changes in the detainee’s condition and potential risks involved. Officers and staff undertaking visits or observations must: When cell checks and visits are carried out, it is not sufficient to record ‘visit correct’ or ‘checked in order’ in the custody record. More detail is required. A check through the cell spyhole does not constitute an acceptable welfare check under any circumstances. Checks are required even where the detainee is awake and has been engaging in conversation. If custody staff are unable to clearly see the face of a sleeping detainee because their view is obscured by a blanket, the blanket should be adjusted so as to allow an adequate welfare check. Where a decision has been made to monitor the detainee’s welfare using continual CCTV cell observation, officers should record the reasons for taking this measure in the custody record along with the name of the person(s) responsible for the monitoring. CCTV monitoring does not negate the need to make regular physical checks of the detainee and update the custody record accordingly. If it is decided that the detainee needs to be roused on each visit, officers must do so and record the detainee’s responses in the custody record. Accurate entries in the custody record are essential, including a record of who has conducted each check. Where a detainee has persistently used the cell call system to gain attention with no genuine need, the custody officer responsible for that detainee may decide to switch off the call system for that cell for a short and limited time. When this course of action is taken, the custody officer must mitigate the increased risk by implementing control measures. These may include moving the detainee to a cell with CCTV where they can be continuously monitored or increasing the level at which they are being monitored. Officers must record all such actions and justifications for them in the custody record. Rousing is one of the key measures designed to protect detainees in custody. Rousing must be carried out properly. The purpose of rousing is to determine whether a person who appears to be sleeping is slipping into a more unconscious state. It therefore requires careful application of the principles outlined below. In particular, officers must personally see the detainee in the cell, question them and elicit and record specific responses. Police forces should adopt procedures to ensure that custody officers and staff adhere to the rousing procedures outlined in Annex H of PACE Code C. Forces must have audit procedures in place to monitor these checks regardless of whether CCTV is in use. Rousing involves the use of a stimulus designed to elicit a response from the detainee. Only when the detainee has given a comprehensive verbal response can they be considered as adequately roused. If a detainee cannot be roused, they should immediately be treated as a medical emergency. Officers and staff should adhere to the frequency of rousing advised by an HCP, unless the custody officer directs that rousing should be more frequent. Where an HCP is working in a custody suite, and it is practicable, they should accompany custody staff on cell visits to those detainees presenting any risk or identified vulnerability. There is a risk of death in custody where the use of alcohol and drugs has masked another medical condition. The following actions may help to avoid this: Can they be woken? Response to questions – can they give appropriate answers to questions such as: Officers must record the specific answer(s) to the question(s) in the custody record. Response to commands – can they respond appropriately to commands such as: PACE Code C Annex H requires that ‘If any detainee fails to meet any of the criteria’ (as stated above), ‘an appropriate healthcare professional or an ambulance must be called’. This is the law. However, the College recommends a more cautious approach. The College advice is to treat the incident as a medical emergency and call an ambulance if a person cannot be roused. If an appropriate HCP is available at the police station, they should also be asked to attend the detainee while waiting for the ambulance. Officers must remember to take into account the possibility or presence of other illnesses, injury or mental ill health/learning disabilities. A person who is drowsy or who smells of alcohol may have one of the following conditions: Sometimes detainees decide to foul their own cells. In such cases, the detainee should be extracted from the cell for it to be cleaned and placed in another cell. It is for the custody officer to determine whether this action is proportionate. The custody officer should take specialist advice from an HCP and tactical adviser as to the best course of action using the NDM. They must record their considerations and decisions in the custody record. Technology can assist in monitoring vulnerable detainees, but officers and staff should still make physical checks and visits. Over-reliance on CCTV monitoring creates an increased risk to the health and safety of detainees. Technology must only be used to enhance the monitoring of a detainee’s welfare. CCTV and monitoring devices installed in cells may be effective in alerting staff to self-harm or suicide attempts, but officers cannot rely on them to monitor a detainee’s medical condition. Custody staff must always observe the detainee through the spyhole or cell hatch prior to opening the cell door. Whenever a detainee is allowed out of a cell, officers must adequately supervise them at all times to prevent them from obtaining an item or doing anything that could: If there are concerns that a detainee has not been adequately supervised outside a cell, for example, during consultation with a solicitor, officers should thoroughly search the detainee before returning them to the cell. Officers should endorse the custody record when a detainee leaves and returns to their cell. Detainees are entitled to brief, daily outdoor exercise where practicable. Exercise should be provided individually and be adequately supervised. Officers should thoroughly search exercise areas for any potential hazards prior to use. Constant supervision may be necessary depending on the design of the exercise area, the nature of the exercise and the detainee’s risk assessment. Officers should give consideration to the appropriate arrangements necessary to meet the needs of men, women and children, for example, by providing adequate clothing. Staff should offer reading material to detainees where appropriate. The available selection of literature may include text in an easy-read format and a suitable range of languages. Children and vulnerable adults likely to be detained for over 24 hours (or overnight) should have the opportunity to have visits from parents or carers. The custody officer handing over the detained person for interview should check: The interviewing officers must accept responsibility for the detained person and make an appropriate entry in the custody record. This is signed (warrant number only) by the custody officer who delivers the detainee to the interviewing officers. At the conclusion of the interview, the detainee is returned to the custody officer by the interviewing officer. Any irregularities are noted in the custody record and signed by all officers concerned. For information on the use of electronic note taking in interviews, see ACPO/The Law Society (2011) Mobile Telephones and Laptops being taken into Custody Suites by Solicitors. Officers and staff should tell detainees how to make a complaint and enable them to do so if they wish. There should be systems in place to facilitate complaints and officers should take detainees’ complaints at the earliest practicable time. The custody officer must be informed if the detainee makes a complaint during the course of interview in relation to any aspect of their arrest and detention. The custody officer should then escalate the complaint by reporting it to an officer of at least inspector rank who is not connected with the investigation. Please see PACE Code C 9.2. Forces may find it useful to identify and track patterns and trends that occur in complaints to focus training and resource management. Detainees are at an increased risk of inflicting self-harm in the period immediately following an interview, especially if they have been arrested for a serious offence or rearrested for further offences. All staff must be aware of this and watch for changes in a detainee’s demeanour, such as their becoming quiet and withdrawn. This also applies to detainees who have been refused bail. When a decision is made to charge a person and bail has not been granted, the detainee may be kept in custody until the next available court sitting, with notable exceptions such as transfer to local authority care in the case of a child or young person. Officers must review the risk assessment at this point because the detainee is at a higher risk of suicide or self-harm. They should, therefore, monitor the detainee for changes in behaviour that may indicate an increased risk of self-harm or suicide. Access to external support, such as calling the Samaritans, can be effective at this stage. All staff involved in investigating offences have a duty to inform the custody officer of any further information they discover which may affect the detainee’s risk assessment. This includes any statements the detainee makes during interview, while on escorted visits outside the police station, or any made about the detainee by others who know them. If investigating staff take a detainee out of the police station for any reason, they must supervise the detainee at all times and fully comply with the relevant PACE codes of practice. Staff must also monitor the detainee’s welfare and ensure that the detainee does not gain access to items that could be used to harm themselves or others or to facilitate an escape. Meeting the welfare needs of detainees involves providing various items, some of which are routinely taken into cells but can be used to self-harm. Detainees who are determined to self-harm can adapt items in unusual ways. Detainees should be able to remain clean and comfortable while in custody. Changes of clothing, especially underwear, should be facilitated as required. Forces should ensure that alternative clothing is readily available within their custody suites. Officers must justify removal of clothing for safety or investigative purposes and record this in the risk assessment and custody record. Any item of clothing can be used as a ligature. Belts, ties, cords and shoelaces are obvious and more readily available. Officers should make the decision to remove such items after conducting a risk assessment. The custody officer must balance any risk with the need to treat detainees with dignity. If a detainee is believed to be at risk of suicide or self-harm, seizing and exchanging clothing may not remove the risk but may increase the distress caused to the detainee and, therefore, increase the risk of them self-harming. Leaving a detainee in their own clothing can help to normalise their situation. Constant observation or observation within close proximity (level 3 or 4) may be a more appropriate control measure in these circumstances. Clothing may be taken from a detainee in the course of an investigation as evidence or for hygiene purposes. In all cases replacement clothing must be provided. There are various alternatives to the paper suits that are marketed as being safe for detainees who are at risk. No suit is totally safe, although some are more difficult to use in self-harm attempts than others. Mattresses, pillows and blankets supplied to a detainee should be in a clean and sanitary condition. They should be checked and cleaned prior to being used by another detainee. Mattresses should be checked for damage and cleaned as required when a cell is vacated. No blanket is totally anti-tear and must be checked for signs of damage when being issued, to prevent it being used as a ligature. Staff should collect blankets when the detainee no longer requires them. Blankets should never be left in a cell when a detainee is moved or released. A worn or damaged mattress can be torn into strips for use as a ligature or could be used to conceal items. Worn and damaged mattresses must be removed from use immediately. Detainees should be able to access and use a toilet in privacy. Forces should provide hand washing facilities. A decision to provide or withhold toilet paper should depend on the detainee’s risk assessment. The default position should be that detainees are supplied with toilet paper unless there is evidence that they may try to harm themselves. The potential risk posed by toilet paper is that detainees may either plait long rolls of paper to make a strong ligature, or soak the paper and force it down their throats causing death by choking. Risk can be minimised by not supplying rolls of toilet paper and supplying a number of single sheets of toilet paper when required. Hygiene packs should be routinely offered to women on arrival and a variety of menstrual products must be available on request (detainees must be advised they are free). Staff should take into consideration the additional needs of detainees who, for example, are menstruating or have an additional medical need on an individual basis. The manufacturer’s instructions for each product should be followed, including replacement timeframes, unless changes are requested more frequently by the detainee. Forces should ensure they have prompt, hygienic and safe means available for the disposal of used items. Detainees who require a shower should, where appropriate, be offered the opportunity to do so. Staff should offer adequate food to detainees as required in a timely fashion. The calorific value of meals should be reasonable and sufficient to meet the dietary requirements of detainees. Staff should carefully manage the temperature of food. Providing very hot food and drinks to a detainee risks scalding the detainee and can cause severe injury if thrown at staff. The design of most custody suites means that food and drinks are delivered to cells via the custody area. Additionally, the food container should not provide an easy source for self-harm. Preparing and supplying food to detainees can carry the risk of food poisoning. Custody staff should take all appropriate measures to eliminate these risks by ensuring that hot meals are properly heated. Forces should establish a policy on providing and preparing food to detainees from external sources. They should also consider preventing food being provided to a detainee from an external source, other than for strict dietary or religious requirements (except when sourced by the police). Drugs are commonly smuggled in by these means and items such as cigarettes, matches and lighters can also be concealed in this way. Where a decision has been made to allow relatives or friends of a detainee to bring food or drink into the custody suite, officers should thoroughly search it before offering it to the detainee. See PACE Code C paragraph 8.6 and note 8A. Choking on food can happen by accident or it can be a deliberate attempt to self-harm. This condition can be difficult to diagnose and may not always be observed until it is too late. Where practicable, visiting the detainee when they are eating may reduce the risk of them choking to death. Crockery must be safe for hot food but provide the least risk of being misused. All items connected with meals and drinks should be removed from cells immediately after use to prevent them from being used to cause injury or damage. Kitchen areas must be kept secure. Staff should keep items of crockery brought into the custody suite for personal use secure to prevent detainees using them as weapons. No smoking should be allowed in custody. Local force policy and procedure should direct custody officers and staff on the use of appropriate nicotine substitutes. Where a decision has been made to allow smoking within a designated area of the custody suite (eg, the exercise yard) officers and staff should monitor detainees in line with their risk assessment. Any such decision must take into consideration the safety and welfare of custody officers, staff and other detainees and meet with the requirements of the Health Act 2006. The main concern with e-cigarettes is that there are no regulatory requirements on the composition of the product. This, together with the different countries of origin, makes it difficult to regulate the various products. There is still the potential for other chemical by-products to be given off as part of the vapour. Employers are under a legal duty to protect their staff from the risk of exposure to harmful chemicals, including all forms of cigarette smoke, within the workplace. It also has a legal obligation to evaluate the by-products under Control of Substances Hazardous to Health regulations. Detainees should avoid using e-cigarettes in any internal areas. The e-cigarette contains a battery product – officers should carefully consider detainee’s possession and use of the product as part of the risk assessment process. This APP supports the definition of diversion used in Lord Bradley’s review of people experiencing mental ill health or who have a learning disability in the criminal justice system, The Bradley Report (2009): Diversion is a process whereby people are assessed and their needs are identified as early as possible in the offender pathway (including prevention and early intervention), thus informing subsequent decisions about where an individual is best placed to receive treatment, taking into account public safety, safety of the individual and punishment of offence. The term diversion is predominantly used in the context of those suspected or convicted of criminal offences and can apply at different stages in the criminal justice response. For example: Diversion at the first two stages involves decisions by the police and the CPS, but may involve other agencies. Diversion from prison involves decisions by the court, which should be supported by information from the police, the CPS and other relevant agencies. The main triggers for referral include: Others include: The duty of the police to act on foreseeable risks can extend beyond the person’s release. Referral to another agency following the issue of a conditional caution, or release or transfer from police custody may prevent deaths following police contact, or incidents of self-harm. It can also help to break the reoffending cycle. Information obtained by the police while dealing with a detainee is confidential. Recording, retention and deletion of this information must be in accordance with PACE Code C paragraphs 3.8 to 3.10 and the Data Protection Act 1998. Provisions are made for sharing information in specific situations in the Crime and Disorder Act 1998. There are a number of agencies which assist people needing help or support on release from police custody. These may include statutory agencies such as community mental health teams and general practitioners, or voluntary agencies such as the Samaritans and local alcohol and drug diversion workers. Forces can make arrangements with local agencies to provide alcohol and drug awareness or support programmes on release from custody. Agency referral is also possible through the use of conditional cautions. Both of these methods require consent and a level of commitment on the part of the detainee to be successful. Forces should also consider: Staff should use templates and provide directories of suitable agencies for referral (eg, local NHS directories) and make these directories readily available in custody suites. Templates for agency referral should:
Page last accessed 21 April 2021
Checking of visits and rousing
Written record
Signs indicating increased risk
Medication
Managing medication
Quantities of medication
Detainees retaining medication
Unused medication
Responsibility for medication in custody
Medical documentation
Detained person medical form
Examination and assessment
Detained person medication form
Medical emergencies
Appropriate care
Case notes
Supervision and security in hospitals
Police supervision
Cell checks
Misuse of the cell call system
Rousing
Checklist: rousing procedure
Dirty protests
Using technology
Out of cell
Exercise
Reading materials
Visits to detainees
Interview
Detainee complaints
Increased risk of self-harm post-interview
Detainee risk assessment while outside custody
Welfare and safety
Clothing
Bedding
Toilet and sanitary facilities
Food and drink
Food provided by external sources
Choking
Cutlery and crockery
Smoking
E-cigarettes (vaping)
Diversion and referral
Triggers for referral
Benefits of diversion
Care pathways out of custody
Use of templates