Assisted Living Unit ALU Presented by Paul Goodridge HMP/ YOI Parc Introductions My name is Paul Goodridge, and I am an operational manager at HMP/ YOI Parc in Bridgend. I have worked at HMP/ YOI Parc for 18 years, in various ranks and roles, and currently I am the Older Prisoner and Disabilities Manager, and also manage the Assisted Living Unit. I have lead the development and implementation of Palliative & End of Life Care and Dementia Pathways, locally, member of Steering Group Committee (OHRN & NHS project) on older prisoner social and clinical needs assessment and Training facilitator in ‘Best Practice in Dementia Care’ with DSDC, Stirling University, but that’s enough about me.

What is the ALU What was the Need? Challenges and Milestones Sharing Practice Measuring Success Objective The ALU (Assisted Living Unit) is designed to meet the needs of an ageing population with complex clinical and social needs i.e. Palliative and end of life, various types of dementia, Parkinson’s etc. whilst providing support and care within a proactive and socially inclusive environment. But this is the end result, and getting there was an interesting journey

What was the Need? At Risk Population Impact At Risk Population The prison was experiencing an explosion of older prisoners, who were found to be disengaged. An increase in complex clinical and social care needs. An increase in hospital escorts and bedwatches – resource implication. Impact Operational staff were overwhelmed, due to a lack of knowledge, understanding. Staff believed that prisoners with such needs should be managed clinically, clinical teams believed that it was a social care matter. Service provision and application was patchy, inconsistent and failed to meet the needs of this population cohort Resulted in the most vulnerable at a greater risk Older prisoner's reported that they felt isolated and withdrew themselves Impacted on their mental health Increase in negative self worth

Challenges and Milestones (Key Aspects) Buy-In Service Development & Care Planning Training Internal Alignment Buy-In From the ‘top’ – to preserve its aims and objectives Departmental – to ensure that the role of the unit is understood. Prisoners – initial engagement help to align expectations but also understand their experiences. ALU Staff selection – critical area, correctly selected for their enhanced skills, willing to learn and develop Service Development Bringing together key external groups who have the knowledge and appetite to develop services within the custodial environment. Adopting a Person Centred approach to care, which led to the introduction of Supported Living Plans and after trialling was extended to the whole prison. “a symbiotic approach to social and clinical care”, to connect staff to individuals’ care and keep their “voice at the heart of all matters.” Work with those who’s lives you want to improve – what works what doesn't. Working with the older prisoner population gave an insight into their fears, expectations and needs. Review – test that processes and procedures are fit for purpose. For those who were end of life, we invited Macmillan in to examine service provision. Training Staff sent to work in a care home for a day Age training with AgeCymru Macmillan Alzheimer's Society DSDC Internal Alignment The introduction of the CVOP – which included Chaplaincy, ALU staff, OMU staff, GP’s and other Healthcare staff as mandatory, with external experts (Macmillan etc.), Security and the prisoner's family on a case by case basis.

Sharing Practice Evaluation & Planning Third Sector The Family Important to understand the needs of the older prisoner population, if you group older prisoner’s together just on age they are more likely to age quicker than those who have access to a multi-generation population group. Proven research. Always have in mind that we must ensure that the purpose is to meet the needs of the individual rather than duplicating an example of good practice Understand and compare service provision with community based models which should compliment and integrate into current care planning and provision Be realistic – Rome wasn’t build in a day. Examine resource implications – probably the biggest hurdle. We were fortunate that the majority of work was provided free, including some health training ie. Syringe Driver training Third Sector Wealth of knowledge and expertise in the community – who have proven willing to engage with the prison. Foster relations – this can take time, so please be patient but remain determined. The Family Involving the family and loved ones in care planning (CVOP), particularly those who where palliative or end of life is a key aspect in communication, understanding what care provision is in place and that placing the prisoner into a hospital surrounded by strangers rather than being with friends that they know. Clear Vision & Goals Whilst you may develop a pathway with an end goal – break down your plan into ‘bite-size’, evaluate and adjust whilst keeping your focus. This will help you to adapt any plan which is developing and maintain your sanity!

Measuring Success Butler Trust Award Care Wales Awards The Individual Silver Award for Excellence in Palliative and End of Life Care Spirit of Care Award The Individual One prisoner returned from hospital to die among people he knew, and who cared not just for but about him – this is the greatest compliment and achievement we could have hoped for.