Investigation of the Department of Corrections in relation to an incident of self-harm at New Plymouth Prison and the Department’s disposable safety razor policy
In July 2009, I received notification from the Department of Corrections, of an incident of prisoner self-harm that had occurred in a Remand Unit of New Plymouth Prison.
A prisoner was found to have used a prison-issued razor blade to self-harm by cutting his wrist in his remand cell.
The prisoner required hospitalization and underwent surgery due to the severity of the cut.
Own motion investigation
Given that the Department’s “Disposable Safety Razor Policy” had been in operation for almost three months at the time of the incident, I decided to carry out an own motion investigation into the occurrence. My investigation was later expanded to include consideration of how the new policy had been implemented.
The principal objectives of the investigation were to:
establish the circumstances and events surrounding the incident at New Plymouth Prison;
examine the implementation of the Department’s Disposable Safety Razor Policy;
examine whether any change in the Department’s operational procedures, policy, and practice regarding the Disposable Safety Razor Policy needed to be considered.
The investigation was conducted by, among other things, carrying out inquiries at New Plymouth Prison regarding the self-harm incident, interviews with relevant departmental staff, viewing documentation relating to the policy and making inquiries at other departmental prisons concerning the implementation of the policy.
My investigation found no concerns as to the actions carried out by departmental staff in responding to the discovery of the incident at New Plymouth Prison, where a prisoner was found to have self-harmed in his cell.
My investigation did find inconsistencies in procedures adopted for the purpose of implementing the policy. I consider that the efficacy of the policy had been diminished by some of the variations in procedures adopted for the purpose of implementing the policy. I formed a view that the policy was implemented without sufficient practical guidance for departmental staff involved in executing the policy.
I found that:
- there were different variations at prisons in procedures adopted for the purpose of implementing the policy;
there were various errors and omissions in certain records that were kept, at prisons, where enquiries were made, regarding the policy;
there were supervisory failings in that errors and omissions were not noted;
any failures to implement the policy correctly and adequately were due to lack of guidance as to how the policy was to be implemented;
- that departmental staff executing the policy, were left to decide themselves what they considered constituted a dedicated disposable container;
- at New Plymouth Prison, lower-ranking staff had an inadequate understanding of the policy and what was expected of them;
the audit of the policy at New Plymouth was ineffective;
overall, insufficient specific operational procedural guidelines and instructions to assist staff in the implementation of the policy were provided.
On 24 May 2010, I advised the Department of Corrections of my findings, which were provisional at that time. It responded by letter dated 28 July 2010, the material parts of which are quoted in the body of the report.
The present final report reflects my consideration of the Department’s reply.
Various criticisms, are made in the report. However, these should not distract from the fact that most recent statistics indicate a significant reduction in incidents involving razor blades.