CARAT services in prisons
When I began working in prisons 10 years ago, CARAT services were very much tailored to the needs of individual offenders and workers could exercise a degree of professional autonomy in what would most benefit those individuals. Over the last couple of years,with the massive and costly expansion of the Interventions and Substance Misuse Group,CARAT services have been systematically changed to a one-size-fits-all, audit-friendly, target-governed process wherein every tiny detail of what we do is prescribed and controlled by ISMG. This has led to the current situation where a large part of a drug worker`s job is taken up by proving they are working - such is the level of monitoring required by the bureaucracy. My argument is that, far from improving the quality of services available to drug-using offenders, this has led to a decrease in standards. Apart from the huge expense of sustaining the ISMG, I would like to know how much money has been spent by the group on expensive business consultants. For the purpose of this review(if indeed the views of people working in the field are going to be valued), my overall point is this: at a time when prisons are being required to save huge amounts of money, how can the unnecessary existence of ISMG be justified?
HI Steve
I can empathise with your comments. As a SDP treatment manager I am also subject ot the seemingly never ending audit process. The one size fits all approach makes for easier auditing and quality control, though one has to question what is the quality that is being controlled. I do what I do because I believe that people can change. To do it in a prison environment I must agree to work withing the parameters that those who get the money set. It's not ideal. I don't know how much ISMG has expanded or if the percieved expansion is accounted for the amalgamation of NDPDU and OBU. To say that the existence of ISGM is unecessary is as useful as saying the same about the CARAT service if you don't like what they do. My experience has been that individual CARAT workers did what they thought was best for the client. That is in my view different to doing what was best for the client. It has been that difference in delivery nationaly that has brought about this standardisation. Yes it is not perfect, yes the audit process takes time and yes it would be great if we could do it our way. That is not what is going to happen, so for me the question is, "How can I deliver the best possible service to the client within the boundaries set?" It is a challenge and too much time is currently being used to complain about things outside our control. Better to enter into a dailogue with the review about what specifically is the issue rather than generalisations.
question is, "How can I deliver the best possible service to the staff client and yourself within the boundaries set?"
sounds like over recording and feeling like you are under achieving.
the recovery movements have a luxury of relational depth and then model it in there practice .
if the home office could see this ? things would change?
Thanks for that, John. I appreciate your reply and some of the points you make. However, I cannot go along with a couple of things you say. First, it is illogical to say that saying one thing is unnecessary is as useful as saying another thing is unnecessary when the function of the `things` is completely different. In this case, one thing provides a service to individuals; the other controls and dictates, monitors and measures. So, I don`t think your analogy stands up. Second, you seem very reluctant to challenge the status quo. Why is this? Standardisation is seldom achieved across the prison estate - just look at the huge variation in the delivery of IDTS. And, anyway, I struggle with `standardisation` in our setting being held up as the only way. Are you saying all drug-using offenders are to be seen as one homogeneous group? Surely not. We can see what `standardisation` has done to the probation service! For my part, I would rather continue to challenge and criticise than accept things as unchangeable and put up & shut up. All it takes for evil to triumph...I`m sure you can finish that one off! There are a couple of good articles in July`s Drink & Drug News you might like to read in conjunction with what I wrote. I thought what Paul Flynn MP and Lord Ramsbotham had to say was interesting.
Cheers, Steve
Thanks for that, SD74. I have just posted a reply to John, the SDP manager, if you want to have a look.
I know of one person in ISMG who used to be a CARAT worker, however, she was a CARAT worker before ISMG started to take over the world!!
Good luck,
Steve
i was doing some research in the prison visitors centre to engage substance missuse carers and to my shock a lot of carers told me that there CSO / PARTNERS
even though they had a drug problem alcohol was the biggest problem ..
they told me that it was the alcohol that they swapped to to detox of heroin or poly use and they end up drug free but still on alcohol and the carats team did not work with alcohol only drugs ....the carers just see the drugs and alcohol as something that hurts there loved ones them ,the children ,the community, and the mental health, and how thiamine (vitamin B1 to stop long term altzimeres for generations to come ..... stupid carers what do they know ?
we are the elite in addiction? we can tell them about synapse's in the brain mental health ....? HOW DARE THEY.....change gona come
First, it is illogical to say that saying one thing is unnecessary is as useful as saying another thing is unnecessary when the function of the `things` is completely different. In this case, one thing provides a service to individuals; the other controls and dictates, monitors and measures. So, I don`t think your analogy stands up. Second, .........stop the waffle ?
the carers how are they inclueded and why don't carats deal with the alcohol problem aswell .
i think a lot are addicted to funding pots and jockeying for there corners ....
just like the prisoners on the landings about trainers and drugs /tabacco..? ...
I SEE THE STAFF MODEL IT TO THE PRISONERS AND SO THE CULTURE SAYS IT OK TO ACT THIS WAY ........JUST GET ON THE TRAIN IGNORE THE SMOKE? THE MUSIC IS NICE , YOUR GOING TO DIE WHEN YOU SEE WHATS AT THE OTHER END ...THATS WHY WE ARE SO BUSY....HAVE YOU GOT YOUR STAR ANY COLOUR YOU WANT SO LONG AS IT IS YELLOW ....SUITS YOU ..! PHEW NEXT!
1. This Prison Service Order (PSO) is being issued to replace the Prison Service Instruction 3600. It contains updated instructions reflecting the issue of310-014 the amended CARATs (standing for Counselling, Assessment, Referral, Advice and Throughcare services) casework file and guidance notes.
2. The non-clinical treatment needs310-015 of the majority of prisoners with substance misuse problems is met through CARATs. CARATs is the foundation of the drug treatment framework and is available in every establishment.
3. The current CARAT casework file was310-016 developed with a theoretical understanding of how CARATs would work and a commitment was made to review and refine the file in the light of experience and reference to best practice. 310-019 The amended version has been produced following extensive consultation and will improve the quality of CARATs.
I have also been working within drug treatment services within prisons for about 11 years and unfortuantely I have to agree with Steve. ISMG do seem to more preoccupied with processes and audits than they do with prisoner care. There are rare individuals within ISMG who are very helpful but in the main the organisation are likened a general in australia who makes orders for the battlefield in england. When you do get "support visits" (audit prep visits)they can be useful if you can get past the audit side. But, In my experience any comments i have submitted High command with regards to concerns i have about the numerous changes that have been made to CARATS, P-ASRO etc have met with silence or outright hostilitiy. Numerous needs analysis exercises have been submitted to evidence the unsuitability of the treatment programme at my establishment and yet it has been persisited with in order to meet KPTs. ISMG need to listen more to the front line especially now we are loosing the ADCs. We do need a prison savvy policy group to instruct us and support us not some external non prison aware body but ISMG need to up their game to survive as everywhere i go nobody likes them. One thing they desparately need to sort out is access to "quality" training for staff. Given the size of ISMG maybe a few could spend some time on the front line get an insight into what goes on they may find that useful I have yet to meet a former CARAT worker within their ranks