Report of the Inquiry into the circumstances of the Death of Bernard ...

14.16 “Prisoners who are at risk of suicide and self-harm and are found guilty at
adjudication should, wherever possible, have sanctions applied that do not consist of
cellular confinement.” (PSO 2700, paragraph 8.6.18)
The ACCT plan
14.17 The F2052SH for prisoners identified as being at particular risk was replaced by
a new plan – ACCT (Assessment, Care in Custody and Teamwork). Key features are:
an individual assessment for every prisoner identified at risk of suicide/self-harm;
a team of staff trained to conduct semi-structured assessment interviews;
development of flexible and individualised care and management plans (called
CAREMAPS);
accountable management of care plans through case managers and naming
those responsible for specific actions;
agreed communication and referral protocols linking systems of care for
suicide/self-harm with systems for mental healthcare;
greater emphasis on supporting guidance and training.
14.18 Prison Service Instruction (PSI) 18/2005 which introduced the ACCT plan says
that it seeks to promote an emphasis on “people not processes”, and “individual care
(rather than ‘suicide watch’)” (PSI 18/2005, paragraph 5). It is noticeable that the new
procedures generally speak of “individuals” and “persons” where policies formerly said
“prisoners”.
14.19 As in the F2052SH system, the ACCT form is a booklet with a distinctive orange
cover containing guidance and prompts for staff completing it.
Assessment interview
14.20 When an ACCT plan has been opened, an immediate action plan is required for
the first 24 hours. The assessor team must be notified and an assessor must interview
the prisoners within 24 hours, using an extended interview form containing prompts for
the assessor to write notes on the individual’s perception of the cause of their distress,
recent or previous self-harm, current mental state, current suicidal thoughts and
intentions, reasons for living and coping resources, other matters and agreement on
action.
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