AWARD WINNER 2012-13: Sandra, from the drugs charity Lifeline, has been manager of the multi-disciplinary substance misuse team at HMP Liverpool since 2009. Through her personal drive and dedication, she has transformed what was previously a failing area of the establishment in to a high quality, integral part of the prison regime, linked closely with outside partner agencies, to ensure that offenders receive the support they need, both in prison and after release. (This Award is supported by G4S Care & Justice Services).

IN THEIR OWN WORDS

[Sandra Dutton gives her account of the work for which she won her Award]

I led a substance misuse team in HMP Liverpool, encouraged joint working with both internal and external agencies, and developed systems to promote recovery orientated teamwork that enhanced the service user’s recovery journey, away from criminality and towards abstinence.

It was important that service delivery was established quickly, the team had the right work ethic and were dynamic enough to cope with change, be pro-active within their environment, and gain job satisfaction to give the best possible service to our service users at HMP Liverpool.

When I arrived it had been at the express request of my area manager who noted that I had special team building skills and the immediate need for the Liverpool team to have a strong leader. I took over a polarised and de motivated team with numerous personnel issues and inefficient working practices. As a multi-disciplinary team it was vital that I got the two elements of the contract partnership staff and Liverpool officers seconded to the group working harmoniously together.  I demonstrated my ability to get to the heart of the problem by identifying those destructive staff elements which were getting in the way of providing a real quality service to offenders in substance misuse recovery. There were additionally poor links with security and safer custody in relation to supply reduction, Mandatory Drug testing (MDT) and segregation governance and communication, also Integrated Drug Treatment System (IDTS) partnerships with clinical partners in drug dependency services were inefficient.

I immediately put in place formal agreed protocols between MDT and segregation, IDTS, and safer custody for ACCT to ensure the very best and safest levels of information sharing. I met with these partners and established good links based on trust and mutual interest in the best outcomes for offenders. Additionally and perhaps most importantly I worked very hard to build a solid working relationship with the clinical services side of substance misuse support at Liverpool and this transformed the service.

Liverpool is a very large inner city local prison serving the Merseyside courts and had recently also absorbed courts for Wigan and Blackburn. The prison population is generally at 1300 offenders and at any one time in excess of 360 of these offenders will be on the CARAT caseload, approximately 200 have an active substance misuse issue which involves the partnership of clinical services for detoxification and my team for psychosocial needs. The support of my team is often needed and felt long after detoxification has taken place and therefore, I established links within the community based drug interventions programmes in at least six areas to which offenders are released within and external to our footprint.

Further I established the recovery inclusion meeting where these community and prison partners meet with input from Sefton voluntary service, the probation trusts and clinical and psychosocial staff. The DIP teams are now established at Liverpool and, “Wing walk” having their own keys. This has created an invaluable culture where those offenders with substance misuse problems can engage immediately with those who will be caring for and supporting them on release. This also enables them to begin to make meaningful plans for their release with those who can make decisions and make a real difference to their recovery outcomes.

My team covered ten Lifeline substance misuse service staff and seven officers working collaboratively and constitutes the largest team in a North West prison. To give some idea of the scale of work involved my team in 2011-12 delivered on a monthly basis, around 1200 interventions, regularly received 160 new referrals for offenders needing help, case loaded around 350-400 cases, and also delivered over 200 structured one to one sessions with our offender service users Myself and the team have been pivotal in the introduction of the 3D unit, this is a drug free wing and started a Friday drop in with guest speakers from the community.

I grasped the opportunity to work collaboratively to introduce the short duration programme for substance users at Liverpool and a member of my team is a dedicated link worker for this. The SDP course has been an astonishing success which has exceeded expectations and is deeply valued by the offenders who have graduated from it.

The group work undertaken by my team has also been a fantastic success; in the last six months of 2011-12,   57 sessions were run to around 100 offenders each month. Myself and my  team ask participants to complete feedback sheets, here are some comments from those who took part in the triggers and cravings session in December 2011;

“Learnt to change the way I live an the way things trigger me to use drugs and drink”;
“it makes me more determined to stay clean”;
“You do a good job, people need to listen more”.

The MDT rate is consistently falling at Liverpool; there are no detoxification or lifeline substance misuse support waiting lists at Liverpool – if you need help you get it. Partnerships working with all teams at Liverpool and throughout the community services are imperative to create consistence and recovery focus offenders and to make real difference to real people’s lives.

INSPIRE ARTICLE

[The following article appeared in issue 5 of the Butler Trust’s magazine, Inspire]

Lifeline Substance Misuse Manager at HMP Liverpool, Sandra Dutton, has won an Award for ‘contributions to the treatment and care of prisoners with substance misuse problems.’

At any one time there is likely to be a large number of prisoners in the establishment with a substance misuse problem, requiring the involvement of clinical services for detoxification and Sandra’s team for psychosocial issues, and she has worked hard to build a solid relationship with clinical services colleagues as well as communitybased treatment services to ensure continuity of care after release. ‘At the moment we’ve got just under 400 on our case load,’ Sandra tells Inspire. ‘We’re working with around 150 who have a clinical intervention, with the rest it’s psychosocial.’

Sandra has been at Liverpool for three and a half years, taking over and transforming what was, according to colleagues, a ‘polarised and demotivated’ team. ‘We had to do a lot of recruitment and a lot of motivational work before it started to come together,’ she says. ‘We organised joint group work delivery and made sure referrals were coming in appropriately, and linked in with the agencies that we needed to, to make sure that the work was productive. I had to put a lot of systems in place, but within about six months, with new staff being trained by the old staff, it started coming together and case loads started becoming quite manageable.’

Sandra is employed by drug and alcohol charity Lifeline but based in the prison under a service level agreement, and her team of ten Lifeline staff and seven officers working collaboratively represents the largest of its kind in any prison in the North West. The team receives between 170 and 200 referrals a month on average – from internal and external sources, as well as selfreferrals – and carried out nearly 900 initial assessments between April and September 2012 alone.

Recovery peer support is a core part of the work, with Sandra’s team offering training and supervision, and Drug Intervention Programme (DIP) staff are now firmly established in the prison, creating a culture where offenders can immediately engage with the people who will be supporting them after release. ‘Continuity of care is paramount,’ she says. ‘The DIP teams come in for our local recovery inclusion meetings – all our DIP teams attend.’

The commitment to effective joint working is such that some DIP staff even have their own keys. ‘The Liverpool DIP and Wirral DIP hold keys so they can come on to the wings and work directly with offenders,’ she explains. ‘It’s a good piece of work because people can approach them. They might be coming in specifically to see two or three people, but before they’ve left they could have seen ten – for one-off advice or support, or taking away referrals if need be.’

The prison now has no waiting list for detoxification or treatment, and mandatory drug test rates have been falling consistently. Sandra has also been instrumental in setting up the prison’s 3D (Don’t Do Drugs) unit.

‘It was developed as a drug-free environment for people who are committed to make changes in their life and work towards abstinence,’ she says. ‘We set up a drop-in, which we run on a Friday afternoon in the offenders’ association time and it’s absolutely packed – they love it. We also get the recovery peer champions involved and outside agencies – in the last months we’ve had the dental department, the hepatitis nurse, other DIP departments, therapeutic community liaison workers, and we’ve run group work on steroid awareness, gambling, families – it’s very needs-led, and the peer support is fantastic as well. We virtually have to push people out of the door.’

Another drop-in centre has now been set up on the vulnerable prisoners’ wing, and her team has also established SMART recovery in the prison. ‘That’s just bedding in and I’m hoping we’ll have it on every wing. We’d also like to have more drop-ins on other wings, but that’s not always easy in the environment we’re working in – if there are no rooms available, for example. As new ideas come about, if I think it will work well in our establishment I’ll try to pilot it. We’re a local prison, with a transient population and people coming in on remand, but we’re actually finding that people want to stay,’ she laughs.

‘Sandra has, in short, transformed the substance misuse unit at HMP Liverpool,’ stated Governor John Illingsworth. ‘There is a high degree of need within HMP Liverpool and through her dedication and commitment, people management and organisational skills and sheer perseverance she has ensured that high quality services are now available.’

‘It’s fantastic,’ says Sandra of her award. ‘It’s lovely to feel that the work I’ve been doing here with my team has been recognised. It makes me feel really pleased, and humbled, really. I’m very recovery-orientated anyway, and I think any time you’re recognised for what you’ve achieved it’s going to encourage you to work that much harder, to keep going and keep having a positive impact.’

• Sandra Dutton’s award was supported by G4S Care and Justice Services.

For more information: contact HMP Liverpool