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

14 Sonny Lodge’s behaviour in the waiting area at Whiston hospital was truculent
and challenging (paragraph 16.8).
15 Officer Brownley’s determination to enforce instant compliance with the hospital
‘no smoking’ policy was overzealous and he sought to enforce his instruction
without the skill and sensitivity that could reasonably be expected of a
professional officer (paragraph 16.8).
16 The inquiry finds on the balance of probabilities that Mr Lodge pushed Officer
Brownley away in reaction to the officer’s unjustified and inappropriate movement
towards him (paragraph 16.8).
17 The inquiry is unable to conclude from the evidence available whether or not
Officer Brownley laid hands on Mr Lodge before he was pushed (paragraph
16.8).
The Prison Service’s response to the incident at Whiston Hospital
18 Notwithstanding the police investigation, prison managers should have ensured
that use of force records were completed and, as a matter of routine, that an
incident involving the use of force was investigated (paragraph 16.20).
19 The information about Officer Brownley’s past disciplinary offence and the
rumour circulating in the prison were material considerations that the prison
ought to have disclosed to the police investigating Officer Brownley’s complaint
that Sonny Lodge assaulted him (paragraph 16.20).
Transfers, wing and cell moves and the wing based disciplinary system
20 The punishment imposed at the adjudication increased Sonny Lodge’s
vulnerability through confinement without means of occupation or distraction
(paragraph 17.20).
21 To go back on the decision to return Sonny Lodge to E wing after the seven days’
punishment was either a mistake or it was a deliberate decision for which
reasons should have been recorded (paragraph 17.20).
22 The regime on K wing was unsatisfactory. It increased Sonny Lodge’s alienation
and distress (paragraph 17.20).
23 The wing-based disciplinary system gave unfettered authority to individual
officers to impose penalties without due process that reduced prisoners’
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