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

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There is insufficient evidence to conclude whether the gestures of Officer Bowcock or Sonny Lodge were the more threatening. There is insufficient evidence to determine whether the use of force on Sonny Lodge was justified and lawful. An adjudication about a related charge against a prisoner is not a sufficient investigation of the use of force. Prison managers should have ensured that use of force records were completed and, as a matter of routine, that an incident involving use of force was investigated. 155
Chapter 21: THE ADJUDICATION AND PUNISHMENT Introduction 21.1 The inquiry undertook to examine whether the conduct and conclusion of the adjudication was in accordance with Prison Service guidance. This chapter considers the conduct of the adjudication and the supervision of Sonny Lodge in the segregation unit. It also refers to the assessment of fitness for adjudication and cellular confinement but that has been considered more extensively in Chapter 13. Administrative background The Prison Discipline Manual 21.2 The Prison Discipline Manual contains instructions and guidance on the discipline system. The 1995 edition of the manual (PDM 1995) was in use in 1998. Among other things, the manual said that: 156 The adjudicator must come to the adjudication afresh with an uncluttered mind (this is called the de novo principle) and without bias which might arise from prior knowledge or personal interest. The manual says that a general good knowledge of the prisoner’s history would not be sufficient to amount to bias. The adjudicator must determine the case solely on the evidence presented at the hearing and the proceedings should be started without access to the prison record of the prisoner accused or record of any previous disciplinary offences in prison (PDM 1995, paragraphs 3.12-3.13, 9.10-9.11, 10.1, 10.2 and Appendix 4 paragraph 5 and 20). If an allegation is made by the accused against staff that is relevant to the charge, the adjudicator should consider what steps need to be taken to allow a full investigation. The manual says that it will often be the case that the adjudicator can thoroughly investigate the allegation at the adjudication by calling witnesses and questioning the prisoner making the allegation. In these cases, the adjudication may be concluded without a separate investigation (PDM 1995, paragraphs 5.18-5.19). On the day of an adjudication hearing and before the hearing starts the accused will be examined by a medical officer who will note on form F256 (the record of
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Report of the Inquiry into the circ
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Crown Copyright 2009 The text in th
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Reports from HM Prisons Inspectorat
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The report makes 48 findings but on
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CONTENTS PART ONE: WHAT LED TO THE
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viii
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Chapter 1 SONNY LODGE AND AN OUTLIN
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denied the charge. He admitted push
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and to Sonny’s wing. A health car
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was not aware of Sonny’s history
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The Court said that any failure to
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structure the inquiry’s considera
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2.25 At the hearings, the solicitor
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or recognition. Their actions may b
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18 In inquiries of this kind it ma
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Chapter 3: RISLEY: 15 TO 26 JUNE 19
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0820 Appeared to be OK when unlocke
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Chapter 4: THE INCIDENT AT WHISTON
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admitted pushing the officer and ga
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Officer Brownley’s injury 4.20 Dr
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was required to resume wing duties
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would not be a problem. He said he
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Chapter 5: 27 JUNE TO 9 JULY 1998:
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continued assessment and recording
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4 July 0630 1650 1930 5 July 0630 1
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Table 3 40 9 July 1335 1400 1609 17
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point on the history sheets kept on
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working prison occupied mainly by c
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privileges over and above the facil
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the actual memory of many of its st
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with officers in the kitchen for go
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H wing: 25 July to 1 August 7.37 In
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7.48 On Sunday 16 August, an entry
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Chapter 8: SUNDAY 23 AUGUST TO THE
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Wing officer 8.8 Officer Sanderson
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chaplains to see him. Ms Lorimer to
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Thursday morning 8.21 Captain Palme
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9.5 Officer Downs told the inquiry
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visit before time and that there wa
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ecollection of the incident and mus
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9.34 Mr Bowcock was asked about the
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Chapter 10: AFTER THE SEARCH: THE I
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and now they’re doing three years
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Mr Lodge’s account of the inciden
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HCOs advised staff to loosen their
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punishment for the altercation in t
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82 The diagnosis of dissocial pers
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11.6 Back in the chaplains’ offic
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take his clothes off for a search a
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Subsequent statements to the Prison
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Evidence to the inquiry SO Knight 1
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going to happen to him. She was als
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11.53 In his final letter to his gi
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Chapter 12: ISSUES RAISED IN THE CL
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should not routinely be used. But i
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impulsivity; difficulty forming rel
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any underlying paranoid illness as
Page 115 and 116: Chapter 13: ISSUES RAISED IN THE CL
Page 117 and 118: Changes to assessing fitness 13.10
Page 119 and 120: 13.20 One of the mental health nurs
Page 121 and 122: Chapter 14: SAFEGUARDS AGAINST SUIC
Page 123 and 124: Meeting the prisoner’s needs. Thi
Page 125 and 126: 114 Prison culture The policy stat
Page 127 and 128: 14.16 “Prisoners who are at risk
Page 129 and 130: Closing a Plan 14.25 The form says
Page 131 and 132: 14.36 In oral evidence to the inqui
Page 133 and 134: CHAPTER 15: PREVENTING SUICIDE AND
Page 135 and 136: mind in the last week of his life i
Page 137 and 138: colleague to see Sonny Lodge on Thu
Page 139 and 140: 15.21 ACCT also requires a risk ass
Page 141 and 142: Chapter 16: THE INQUIRY’S CONSIDE
Page 143 and 144: Despite these findings, there is in
Page 145 and 146: 16.17 The inquiry was told that pri
Page 147 and 148: Chapter 17: TRANSFERS, WING AND CEL
Page 149 and 150: punishment, there is no evidence th
Page 151 and 152: held safely; Respect - prisoners ar
Page 153 and 154: Chapter 18: WAS SONNY LODGE VICTIMI
Page 155 and 156: surgeon at Whiston Hospital found S
Page 157 and 158: fact that, as he sees it, injustice
Page 159 and 160: that it was made at all. However, i
Page 161 and 162: forcefully, but for prison staff, i
Page 163 and 164: Chapter 20: THE SEARCH AND THE INCI
Page 165: However, like the various reports o
Page 169 and 170: 21.4 PSO 2000, which came into effe
Page 171 and 172: 21.13 In order to find the charge a
Page 173 and 174: Chapter 22: COMMUNICATIONS AND RECO
Page 175 and 176: opportunity when the senior officer
Page 177 and 178: prompted special protection. Conseq
Page 179 and 180: Manchester prison now 23.4 In evide
Page 181 and 182: Safety 23.13 I have described in pa
Page 183 and 184: ehaviour, achievements, interaction
Page 185 and 186: prison. Many prisoners carry a host
Page 187 and 188: PART FOUR FINDINGS, RECOMMENDATIONS
Page 189 and 190: Information was not always recorded
Page 191 and 192: opportunities for social interactio
Page 193 and 194: 41 Governor McColm did not explore
Page 195 and 196: LIST OF RECOMMENDATIONS I have exer
Page 197 and 198: LIST OF OBSERVATIONS ABOUT INQUIRY
Page 199 and 200: ANNEX 1 TERMS OF REFERENCE 1 1. To
Page 201 and 202: 9. Communications and record-keepin
Page 203 and 204: helpful. The chronology will not fo
Page 205 and 206: Notice of matters requiring explana
Page 207 and 208: ANNEX 3 LIST OF LEGAL REPRESENTATIV
Page 209 and 210: PSI Prison Service Instruction PSI
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