Scottish Prisons Assessment and Review of Outcomes for Women (SPAROW): full report

4. Vision and aspirations for the CCUs: a policy Theory of Change (ToC)

Background

As set out earlier in the report, a Theory of Change (ToC) is a description of how and why a desired change is expected to happen in a particular context. It outlines the stated goals of a desired change, the interventions or activities that are intended to effect change, and the conditions or circumstances that need to be in place (and how these relate to each other) to allow change to happen. This allows for the link between the intervention and the successful achievement of goals to be more fully understood and can help to highlight where the original programme theory is flawed in its conception or in its implementation.

This chapter presents our summary of the implicit CCU ToC. To develop this, we used the key policy documents pertinent to the CCUs (detailed earlier). This was discussed with our project Advisory Board in June 2024 and, it shaped our study design and data collection tools.

In addition, this chapter provides a policy perspective on some of the main strands (or ‘activities’) of the ToC in light of interviews conducted with four senior officials occupying strategic and/or operational roles within SPS. All were involved in development of the CCUs and provided detailed information on the conception of the CCUs, and their early stages of operation. Three of those interviewed contributed to the SPS Women's Strategy 2021-2025 which encapsulates the vision for gender-sensitive and trauma-informed working. Their insights provide important context for understanding the vision and ToC for the CCUs. Because the interviews were undertaken one year into the process of implementation, some of the data refer to perceptions of implementation as well as to aspirations of how the CCUs had been anticipated to operate. Figure 1 (overleaf) shows the SPAROW initial ToC.

Figure 1. SPAROW Initial Theory of Change

Assumptions:

• Gender- and trauma-informed approaches, combined with a commitment to empowerment, can shape relationships between women, staff, and delivery partners, and improve the care provided.

Context:

• SPS New Model of Custody for Women, 2019.

Activities:

• Establishment of Community Custody Units (CCUs) with appropriate and informed staff recruitment.
• Training for staff in gender- and trauma-informed care.
• Identification of target women and implementation of informed choice to move to CCUs.
• Delivery of care for women based on gender- and trauma-informed principles (including SPS Strategy 6 core values).
• Collaboration with delivery partners to support wellbeing, empowerment, life skills, and successful reintegration.

Short/medium-term outputs/outcomes:

• Facilities operational and full complement of informed staff recruited and in place.
• All staff trained and aware of the practice implications of gender- and trauma-informed care.
• Clear and transparent processes for identifying women to move to CCUs and women fully informed in decision-making to move.
• Women aware of and perceive the reality of gender- and trauma-informed care and SPS Strategy 6 core values; women feel supported in establishing/maintaining family links and preparing for successful integration in the community.
• Range and scale of delivery meets aspirations for supporting women’s health and wellbeing, empowerment, life skills, and reintegration. Delivery partners aware of the practice implications of gender- and trauma-informed care and feel supported by CCUs to deliver care in this way.

Longer-term outcomes:

• Women feel empowered, better informed, better supported by staff and better able to connect to the communities and social networks within which they will integrate.

Establishment of CCUs

It was generally agreed that the genesis of the CCUs lies in the Report of the Commission for Women Offenders (2012) and ideas about ‘one stop’ justice centres. These have their origins in the Corston Report (2007) published in England and Wales, and which were originally imagined as replacements for HMP & YOI Cornton Vale which was due to be closed when the ideas for CCUs were first discussed. The since-closed 218 Service was based in Glasgow and offered a comprehensive programme of support for women, as an alternative to a custodial sentence. It aimed to address the root causes of women’s offending, by offering a therapeutic, trauma-informed programme for women to actively engage in their own personal recovery journey and was mentioned by interviewees as a source of inspiration for the CCUs.

As stated, five CCUs were originally envisaged, but the interviews with senior managers indicate a broad consensus that it was right to reduce this to two such Units. This was based on apparent need, to be pragmatic in terms of resources, and to reflect a wish to see how they worked out before making further commitment: ‘Start with two and test them out and then see where that takes us. We’ll review later’ (SSM 2). There were also concerns about ‘community fit’ – needing to be confident that each CCU would not provoke undue resistance from local residents and the wider community wherein they were located. They also needed to be close to amenities and services with knowledge and experience of working with women. Inverclyde had been considered as a possible site for a new large-scale women’s prison, for instance, but the location was considered to be without a good community fit. The importance of community fit was highlighted in the two chosen CCU sites of Glasgow and Dundee – as one interviewee stated:

“Things were easier in Glasgow – partly because of 218, partly because of the Scottish Working Group on Women. There wasn’t a model in Dundee and people there were less familiar with the debates and concerns for women.” (SSM 1).

Broader reservations largely revolved around community ‘pushback’, particularly in Dundee, but, through the local authorities in Dundee and Glasgow much effort was put into communications and reassuring the local communities that people would be safe in the community. Other complexities (availability/ownership of land and the Covid-19 pandemic) crept in, and delayed the building of the two CCUs. However, the aesthetic vision remained clear: “We wanted vision: light, garden, colour, connections between buildings.” (SSM2).

There was certainly agreement that bespoke design for the two CCUs was important. The architectural brief included the need for a trauma-informed design. As one strategic manager indicated:

“Much effort was put into the design of the centres to reflect women’s mental health needs, to promote independent living skills, to be trauma-informed. They were designed to look and feel like homes.” (SSM2).

In addition, it was clear that the vision for the CCUs was rooted in a clear recognition of women’s needs based on general research findings regarding women caught up in the criminal justice system. The vision was also based on what was known about women in the Scottish penal system in particular with a specific recognition of the role played by trauma. SSM 4, for example, commented:

“Ninety per cent of women in custody have mental health difficulties, anxiety, depression, and have also experienced childhood trauma, a third of our women meet the diagnostic criteria for PTSD.”

Linked to this evidence-based approach was a recognition of the importance of consultation with women who had lived experience of imprisonment, as well as research evidence on best practice.

“There was immense effort to consult with women about their experiences of the estate, what would help. And we looked for evidence regarding best practice and what works.” (SSM3).

Selection, training and support for staff

Interviewees commented on the recognition from the outset that staff for the CCUs would have to be carefully recruited and trained so that aspirations around gender- specificity and trauma-informed care delivery could be met. As one commented:

“We had values-based interviews with those who wanted to work in the CCUs; we wanted the right attitudes. All operational staff; we wanted those who knew about risk management but who were capable of a ‘lighter touch’.” (SSM1).

The recruitment process involved:

“Open competition and encouragement to apply. It was important to attract the right staff, those who would be able to adapt and respond… work in a different culture. It’s not just the facilities, it is the way the CCUs are run, what they ‘feel like’ that matters.” (SSM3).

Interviewees noted, however, that delays in opening the CCUs resulted in some recruited staff having lost interest or moved on. Thus, there was a shared sense that it was hard to maintain the momentum around a freshly trained and strategically selected workforce.

This said, it was clear from the interviews with the strategic managers that training was seen as an important way of setting out the expectations of working in a CCU. Training was to include content on operational matters, new processes, trauma, desistance, caring for women in custody, and working in a CCU. One mentioned ‘pain-free control’ training, as opposed to the regular ‘control and restraints’ training provided by the Scottish Prison Service (SSM 4). This was supported by other strategic managers:

“There’s a new restraint process, piloted in Stirling, and elsewhere. A UNCRC [United Nations Convention on the Rights of the Child] non-pain inducing approach. So training in the new control and restraint process is important. We need more emphasis on violence reduction management generally, CCUs included.” (SSM 3).

Ongoing training and supervisory support was recognised to be important in maintaining new ways of working.

“We can’t do things properly without appropriate supervisory practice. Staff need CPD [continuing professional development] and reflection space to reinforce ideas… think differently.” (SSM 3).

One particular example of required training was in regard to professional boundary setting. As one manager put it, “Staff might disclose personal things to be helpful – in this more relaxed setting – without fully realising the dangers in this. It is a question of balance in the power relationship. So work on boundary setting is important.” (SSM 3).

Identification of target women and implementation of informed choice in move to CCUs

Through the developmental phases, strong consideration was given to which women might be suitable for transfer to a CCU and, in particular, the level of risk posed and whether moving to a CCU could be seen as part of prisoner progression. However, in terms of vision, there was also a strong sense amongst the strategic managers that equality legislation shaped what was realistic:

“One of the internal challenges was about equalities – you couldn’t have criteria that would be different from those relating to men – there had to be the same level of access to support, even if in a different format.” (SSM 3).

“There was lots of discussion on the selection criteria for the CCUs, especially on the issue of whether a move to a CCU should be seen as part of a progression model. We had to look at offence specific risks – specific risks before the CCUs could be opened up to a wider group.” (SSM 3).

Choice was also viewed as paramount with a recognition that some women may not want to leave a closed environment where they felt safe, and where they had established friendships and relationships:

“It’s a big step probably to go somewhere when you are settled and even though the opportunity is there to have home leaves or a work placement, a lot of the women feel comfortable in [the prison]; they feel quite safe.” (SSM 4).

When asked about criteria for admission to the CCUs since their inception it was clear that progression criteria had been reviewed, alongside escorted leave and temporary leave. However, there were challenging issues to do with comparisons and equality in treatment. Thus, the issue is conceived as how to give women access to the community without changing the SPS Prison Rules. Some women were thought to meet the criteria for being in a CCU, ‘but not the criteria for community access’ (SSM 4). At the time of the senior strategic manager interviews (January – March 2024), less than one third of the women had access to the community or home leave.

Summary

In this chapter we have identified the early aspirations for the CCUs at a strategic level – these fit with our depiction of the SPS Strategy for Women in Custody in Chapter 2. We have also identified that in the early stages of implementation, strategic stakeholders were aware of key barriers to be negotiated. These included identifying suitable locations for CCUs with appropriate community buy-in; the logistics of recruiting, training and retaining staff fitting the ethos of the model; and, the tensions between aspirations for CCUs and what is allowable under current equality legislation.

5. Gender-specificity and trauma-informed practice in a prison environment

The SPS Strategy for Women in Custody 2021-2025 emphasised the centrality of a gender-specific and trauma-informed approach within the CCUs:

“The strategy is founded on the principle that all aspects of the care of women in custody should be designed for women and take account of their likely experience of trauma and adversities. All aspects of the approach will therefore be both gender-specific and trauma-informed.” (SPS 2021)

The SPS Strategy for Women intended that these principles should underpin and inform a number of things. These include the skills and knowledge of SPS staff, the quality of the relationships between staff and women, the women’s health and wellbeing and the services, approaches and tools available to help to address the individual needs and risks of the women.

As previously stated, the strategy incorporates nine key gender-sensitive and trauma-informed principles. These, variously, focus on a recognition of:

• women’s distinctive needs and circumstances;
• women’s potential;
• the importance of positive relationships to support women’s journeys through the penal system;
• the effects of trauma and the potential for re-traumatisation;
• the development of women’s agency to encourage engagement and participation;
• the importance of an evidence-based approach to interventions known to promote desistance from crime and improve life chances;
• the wellbeing and rights of children with others in custody, and;
• a culture of continuous improvement based on evaluation, evidence and lived experience.

In this chapter we describe how, and the extent to which, gender-specificity and trauma-informed practice have been operationalised in the design intentions of the CCU environments. We also briefly outline the prison staffing arrangements and the statutory and non-statutory partner presence in the CCUs. Before doing so, we briefly highlight some of the recognised challenges of implementing these principles and practices in prison environments.

Challenges of implementation

Prisons are considered very challenging places to introduce and embed trauma-informed practice (Miller & Najavits 2012; Auty et al. 2022; Vaswani & Paul 2019; Thomas 2023). Research on trauma-informed practice within prisons highlights several obstacles preventing its operationalisation and delivery. For example, prison architecture and design with harsh, unnatural lighting, sterile spaces, loud unexpected noises and showers that lack privacy are physical features that can be re-triggering for those with histories of trauma.

Kelman et al. (2024) note that creating trauma-informed settings is a dynamic process which is somewhat complicated by prisons being inherently triggering environments for women. Pat-downs, strip searches and other unwanted physical contact can be extremely distressing for survivors of abuse (Elliot et al. 2005). A physical environment that is designed in such a way that embodies and reflects the care required to deliver and sustain trauma-informed practice is essential.

Trauma-informed and gender-specific work also require organisational support and strong and demonstrable buy-in from prison leadership. The knowledge and approach of prison staff is crucial. There is very limited work on the role, implementation, and impact of trauma-informed practice approaches within prison contexts in Scotland. A notable exception is Vaswani and Paul’s (2019) research undertaken with 200 prison officers in a Scottish Young Offender Institution (YOI); they concluded that whilst prison staff may support and endorse the role of a trauma-informed approach in prisons, this is significantly constrained by their organisational purpose, which is fundamentally to punish.

Against the known challenges of meaningful implementation, the vision for the CCUs to both embody and deliver trauma-informed and gender-specific work is indeed ambitious. In what follows we describe how the CCUs attempt to meet this ambition.

Reflecting the SPS Strategy for Women: a gender-specific and trauma-informed approach?

The intention for the CCUs was that they embody an organisational shift to be more gender-specific and trauma-informed, in their physical design, their organisational ethos, and in the approach of staff and partners delivering services into them.

Physical design of the CCUs

Particular attention has been paid to the physical design and layout of the CCUs, to promote feelings of safety and afford an element of privacy for women. Each CCU consists of two storey ‘shared houses’ of which there are three in HMP Bella and four in HMP Lilias. Each house has individual bedrooms, each with an en-suite shower room and toilet, to accommodate individual women. Each shared house also has a large communal kitchen with cooking and food storage facilities, a living/dining room area, and a shared bathroom. The houses incorporate trauma-informed design principles, with simple but comfortable furniture, and with large, un-barred windows letting in lots of natural light. The aim is to create a ‘residential feel’ and women are provided with good quality bedding and bedroom fittings, hairdryers and toiletries.

The shared houses are situated a short walk away from another larger single-storey building. These contain the CCU reception area, staff/administrative offices, small rooms used by educational providers and nursing staff and a very small gym with some items of strength conditioning equipment. They also contain a large ‘Hub’ which can be used by women, their visiting families and delivery partners providing services into the CCUs.

The ‘Hub’ is a large communal area with comfortable couch seating, several tables and upright chairs which can be used as dining areas and for various activities. There is also a large open-plan kitchen area intended for women to use. It has doors leading out into a garden adjacent to a small children’s play area, for use by the women’s children and other family members when visiting.

The SPS Strategy for Women in Custody states that it seeks to reduce the damaging impact of a mother’s imprisonment on her children. This includes ‘using best practice in design, facilities and provision that relate to children while they are in custodial settings – family rooms, mother and child facilities, and CCUs’. Both HMP Lilias and HMP Bella have accommodation which could be used to house a mother with her baby. During the course of the research, however these spaces were not in use.

All buildings are situated in landscaped garden grounds with attractive herbaceous planting, short paths for walking and places to sit. The CCU buildings reflect trauma-informed design principles (Jewkes et al. 2019). For example, the buildings are of a clear design and offer a simple lay-out; there are a range of spaces that can be used by the women. The Hub is a flexible and easily adaptable space with lightweight furniture that can be re-configured in different ways and used for a range of purposes. For example, it can be used for learning events and drop-in sessions organised by service providers. A key intended use of the Hub was for family visits. Once through the reception area, there is a child and family-friendly environment, with a garden space and the ability to move around freely. This differs markedly from traditional prison visits that take place in a very controlled environment.

The wide internal corridors and smaller rooms used by the women in the larger building are also of simple design, uncrowded by furniture or other obstacles, and avoiding any sensory overload. The use of colours – mainly pastel shades throughout – seek to alleviate any negative emotions associated with trauma. All of the areas used by the women were designed to create a sense of normality.

From the outset, the CCUs and the staff working within them were expected to operate in a trauma-informed way which also took into account women’s gender-specific needs. So, for example, as a means of supporting agency and responsibility women were expected to maintain their personal and communal living spaces. They are given a weekly shopping allowance of £38.50 and are expected to budget, shop, and prepare their own meals. Personal Officers (POs) sit with the women as they work through shopping lists to ensure that they have enough planned food for three meals a day across the week. The POs and the women work together to develop a weekly meal plan. The plan is then uploaded to a shopping order sheet (created by SPS), the food is then ordered and delivered weekly.

The women all carry a key card that enables access to their bedroom, their house, and other areas of the CCU, such as the Hub and the gym space, depending on their regime. Unless they are on a cleaning work party, women cannot access the CCU reception areas or the staff offices. They must stay in their house at night, and houses are locked each evening at 8pm. However, women do not have to go into their bedrooms at that time and are free to associate with the other women who live there.

Another key intention of the SPS Strategy for Women is to encourage the women to contribute to their individualised case management plan, developed in conjunction with their PO. Through this collaborative process, women are encouraged to identify their specific needs, as well as their skills and assets and the types of support services and interventions that may be helpful to them.

There are minimal overt signs of security in the CCUs; however all staff carry radios which also act as an alarm.

SPS officers in the CCUs

In each CCU there are a combination of residential and operational officers, along with up to six line managers. Officers in the CCUs have different remits and responsibilities according to their job role. Residential officers work closely with the women residents on a day-to-day basis to provide support and care and longer-term case management. Key skills sought by SPS in a residential officer are the ability to offer and provide support in a non-judgmental and encouraging way. Residential officers are also dedicated POs who work directly with individual women.

Operational officers are responsible for the overall security and functioning of the CCUs. They are the first point of contact for visitors and have responsibility for screening, searching and facilitating entry and exit. Operational officers monitor security systems (CCTV, alarm and communication) and are responsible for ensuring the safety of staff and the women residents and any visitors to the CCU. They are also a key point of contact for family support and are responsible for observing and supervising family visits. They manage the entry and release of the women and also accompany them to, for example, hospitals, dentists, court hearings, as required.

First Line Managers (FLMs) are responsible for monitoring and auditing of risk management of the women, and the scrutiny of case management activities. They also provide oversight and support to staff. Each CCU has a Unit Manager who has overall responsibility for the day-to-day running of the CCU and reports to the Governor of HMP Stirling under whose remit the CCUs lie.

Each CCU has a staff contingent of between 30 and 36. However, staff work a shift pattern in line with a set roster so are not all in the CCU at the same time. Shifts cover a variety of working patterns: early shift, day shift, back shift and night shift. Given the variety of shifts, officers tend only to see those who share the same shift patterns; as such they see their other colleagues very infrequently, if at all.

As discussed in more detail in Chapter 8, there is variability in the level of experience of officers working in the CCUs. Most have past experience of working for the prison service, either in Scotland or in England, before transferring into a CCU. At the time of the research interviews, officers’ length of service ranged from almost three decades to three weeks. Most had experience of working in men’s prisons before transferring to a CCU. For others, the CCU was their only experience of working in a prison.

Although it was originally intended that around 70-75 per cent of prison officers working in the CCUs would be female, at the time of the research this had not yet been fully achieved. Nevertheless female officers are currently in the majority and their proportion increased over the fieldwork period. Most of the residential officers who were interviewed had only ever worked in the male prison estate. All but one had only ever worked in closed conditions. Just a small number of those interviewed had experience of working in the women’s prison estate.

Training for SPS Officers

In order for the SPS to meet their vision and goals for the CCUs, it is crucial that the training delivered to officers who are deployed within them is comprehensive and ensures that they feel equipped to do the job expected of them.

New SPS prison officers undergo an 8-week Officer Foundation Programme, which incorporates a mix of classroom instruction, practical skills training, and learning assessments. This is delivered at the Scottish Prison Service College (SPSC), Polmont. In addition to this basic training, which includes a module on working with women, CCU staff are expected to undergo trauma-informed training sessions. These were developed by National Health Service (NHS) Education Scotland for use by NHS employees, social workers, criminal justice employees and other sectors (NHS Education for Scotland 2017).

Health and social care services for women within the CCUs

There is an NHS presence in each CCU. In terms of medical staff, there are one or two nurses in the CCUs each week from Monday to Friday and an occupational therapist once or twice a week. A doctor visits once a week. There is a dedicated medical room in each CCU where the NHS staff are based. They conduct examinations, prescribe and dispense medication and make referrals to other NHS services where necessary. Women can self-refer to the NHS nursing team and are not dependent on officers doing it for them, as may be the case in closed conditions.

There is also a clinical psychologist in each of the CCUs, who will typically spend one to two days a week there. The psychologists are part of the NHS Clinical Psychology Intervention Service who work across other Scottish prisons. They conduct assessments, deliver therapy and treat mental health problems of the women in an equivalent way to that provided by clinical psychologists in the community. The psychologists do not accept self-referrals direct from the women, but receive them from SPS officers or the NHS medical staff in the CCUs. The psychologists also work with the CCU officers. They offer a weekly staff forum for them to understand the women’s presentations, and to provide the staff with informal support.

Social workers are frequent visitors to the CCUs, providing one-on-one support for the women throughout their sentences, assessing their risks and needs and, where feasible, connecting them with other resources. They also participate in Integrated Case Management Case Conferences, and provide reports for Parole Boards in relation to individual women. Social workers in the CCUs also play a role in supporting family contact for the women.

A housing officer works with women to plan for sustainable accommodation and support as part of a case management approach. Housing officers facilitate advice and planning regarding accommodation including financial or debt issues such as arrears payments.

Multi-disciplinary working across the health and social care partners is strongly encouraged in the CCUs, to ensure a holistic approach to working with the women there.

SPS delivery partners

Delivery partners provide a service to prison establishments/prisoners and are an important feature of all Scottish prisons. They provide a range of services across the prison estate and have a significant role in the CCUs, representing as they do, a direct link between prisons and the community.

Statutory services (such as social work and health services) work in partnership with SPS and are funded to do so. Other services (notably third sector and voluntary groups or individuals) do not receive SPS funding to deliver their services. Hence they need to generate their own funding through trusts and/or charitable bodies. Third sector, voluntary groups and individuals delivering services into the CCUs variously include addiction support, arts and craft groups, jewellery making, and reading groups. Such groups (those that are funded independently from SPS) are required first to complete a Partnership Agreement. This aims to support collaborative working between SPS and organisations delivering independently funded services in Scottish prisons.

They are also required to complete and submit a lengthy Partnership Pack detailing key information about the partner, their services and delivery details. This involves completing a lengthy and detailed application form which requires sign off by various SPS personnel at different stages in the process. An outline proposal is completed initially which is sent to the Head of Offender Outcomes (HOO) at the relevant prison. A Service Demand and Due Diligence section is then completed by the HOO within one month, indicating if the service/intervention is of interest to the prison. If there is a need for, or interest in, the service, then a meeting or series of meetings will take place between the third sector organisation and the prison. This will involve discussion of operational details and any potential challenges or practicalities that may need to be addressed.

If, at this point, there is agreement between SPS and the third sector organisation, a Partnership Agreement will be signed off by both organisations. The service will subsequently be reviewed by the SPS based on this agreement and the proposed plans and outcomes.

If a service is going to be delivered in several prisons, then this will require a separate Partnership Agreement to be signed for each prison, to ensure that any specific arrangements can be put in place as appropriate. The experiences of CCU Delivery Partners are discussed in more detail in Chapter 9.