The inappropriate use of pain-inducing restraint techniques in youth custody was brought into sharp focus by the BBC Panorama investigation into Medway secure training centre (STC) in 2016.
Four men were cleared last year of misconduct charges brought in response to the investigation.
A serious case review (SCR) published in January 2019 by Medway Safeguarding Children Board concluded that use of restraint techniques involving inflicting pain "appeared to enable an environment of increased risk of abuse to children".
The National Offender Management Service took over the running of the centre from G4S in 2016, but an inspection report published last month also found evidence that pain-inducing restraint is still being used inappropriately by officers.
This led to calls by children's rights campaigners for the "irredeemable" centre to be closed.
The former Medway STC senior manager who first raised concerns about the use of restraint at Medway has warned that even if the centre were to be closed - unlikely considering it has been earmarked as the site of the government's first secure college - it would not address the system-wide issues around custody culture and restraint use exposed by the SCR.
Instead, Nathan Ward, former deputy director at Medway STC and the Panorama whistleblower, says what is needed is a fundamental change to the way youth custody staff are trained, and an honest debate about when and how force should be used.
Ward is a long-time advocate for reform in the youth secure estate who had raised concerns about the use of restraint at Medway long before the Panorama investigation (see box). He says the latest review echoes findings from the first major evaluation of Medway STC published in July 2000, two years after the centre opened.
The evaluation by the Policy Research Bureau described a centre that was struggling to understand its role and had little success in reducing offending.
The authors of the evaluation - Ann Hagell, Neal Hazel and Catherine Shaw - concluded that essential components of good practice were youth custody staff having knowledge of the children they cared for, a child-centred ethos and a positive outlook.
Ward says the SCR and inspection findings suggest these messages were not heeded.
Read together, the SCR and inspection report describe a setting where pain-inducing restraint is still too readily used, procedures for monitoring restraint incidents are not always adhered to, and a culture existed where young people felt it was unsafe to complain.
"You have to ask how this culture emerges; what are its ingredients?," says Ward.
He believes its roots lie in the "huge trauma" that many of the young people that end up at Medway have experienced in their lives and the inability of staff to respond effectively.
"They are playing that out in the institution, with the result being that staff experience a secondary trauma which they have not been given the tools to deal with. The only way they can respond is to detach emotionally from the young people."
This schism between staff and young people creates a climate where force is more readily used instead of it being a last resort.
Ward says Medway staff in the Panorama documentary displayed signs of trauma. "It is too easy to demonise those who went over the top - we have to ask what has led them to behave like this?"
He rejects the notion that it was "a few rotten apples" and claims there were failings across the whole organisation, including among health, education and social care services, with the behaviour of custody staff "the gross manifestation of that".
In addition, Ward says the cultural issues raised by the case apply across the secure estate and public services generally.
"The debate has been narrowed to that of Medway, but it has everything to do with the wider system," he adds. "This is not something unique to youth justice - it's seen in failing prisons, care homes and hospitals."
The large number of young people cared for in STCs and other custody settings makes it harder for staff to form strong relationships with young people, says Ward, which in turn adds to the anxiety among children and staff.
Another aggravating feature is the tension between meeting the needs of children and delivering contractual obligations, he adds.
Wards says: "Managers must ensure they are delivering on the contract, but that dimension can sometimes take priority over everything. I'm not against privatisation, but it's very hard to have a dual focus."
Use of restraint
Ward has sympathy with campaigners who want an outright ban the use of restraint on children, but says a dose of realism is needed. "I don't believe any children should be locked up or physically restrained in an ideal world, but we don't live in that ideal world," he explains.
"All restraint is deeply problematic - there is no such thing as ‘safe' restraint. But when a young person is attacking another young person, what should you do to stop it? You need staff with the skills and authority to stop that happening, even if that includes using some degree of pain inducement."
He says the use of restraint in custody has become "bound up" in a debate about children's rights, but highlights that no such questions are being asked about methods used by police.
"We are not having the same discussions over the police's use of tasers or extendable batons, but when young people come into custody we're saying it is wrong to use pain to control."
Ward also points to the fact that under 2011 Department for Education guidance, school staff can use reasonable force to control or restrain pupils to prevent them hurting themselves or others, damaging property or causing disruption "with less scrutiny, oversight and training than in custody".
What is needed, he says, is a "serious, reasoned debate" about the use of force on children, with the focus being on the context in which it is used.
While Ward believes there is still a place for restraint, he argues for custody staff to have better training in non-physical interventions, so that this can be employed before restraint is even considered.
"We need to train and equip all of our staff in crisis negotiation and communication to the same degree as they get trained in physical restraint," he says, citing the New York Police Department as an example of an agency that has trained officers in this way.
"I'm a great believer in negotiation, but there does come a point where you need to stop talking and act."
Campaigners have called for STCs to adopt the policies of secure children's homes (SCH), which do not allow the use of restraint, but Ward is sceptical.
"They are successful with a certain cohort of young people, but it is not a utopia - there have been more deaths in SCHs than in STCs," he adds. "There's also no evidence that SCHs are effective in working with older and more violent children."
For Ward, the most important action policymakers could take would be to implement measures in Charlie Taylor's 2016 review of youth justice as this provided a blueprint to "overhaul the youth custody system" and deliver the "holistic approach" needed.
‘HAS ANYTHING CHANGED AS A RESULT OF THE MEDWAY STC INQUIRIES?'
By Nathan Ward, former deputy director at Medway STC and vicar at St Margaret's Church, Rainham
I began working at Medway secure training centre (STC) in 2001 as a chaplain following completion of my youth and community work degree in Durham. Soon after starting, I raised concerns with my line manager regarding some of the attitudes staff had towards the children.
My concerns grew over time to the extent that, by the end of 2004, I went to Professor John Pitts who wrote on my behalf to government ministers raising significant concerns and citing specific examples of abuse.
I had met with the Youth Justice Board monitor, local authority designated officer, Kent Police, inspectors, MPs and a bishop, as well as internal management, and yet nothing happened. I even called the internal whistleblowing hotline and was told by the call handler that he hadn't received the whistleblowing training yet and therefore could he take my name and number and get someone to call me back.
It was like being a whistleblower with a whistle that had no ball in it.
So, in 2007, after witnessing staff grab children by the neck while explaining "you will fucking respect me", I contacted a journalist at The Guardian newspaper to see if we could do something before someone died.
We worked together over nine years, which eventually led to the Panorama broadcast on 11 January 2016.
Following the broadcast, which was watched by 3.17 million people, the government set up an Independent Improvement Board. It made 25 recommendations which, on the whole, have not been implemented.
Kent Police launched a major criminal investigation, which utilised 40 officers taking 150 statements and identified 23 suspects and 39 victims.
In December 2016, Charlie Taylor's review of the youth justice system was published and made 36 recommendations for reform.
In January 2019, the final piece of the story was published in the form of the serious case review (SCR) making 40 recommendations.
After 18 years and 101 recommendations, are children any safer now than they were back in 2001?
The police investigation led to not a single person being found guilty of child abuse; the improvement board recommendations are largely unimplemented; aside from the secure college trial, Charlie Taylor's review recommendations remain on the shelf; and the SCR, like many of its predecessors, echoes themes of the past still unlearnt in practice.
The government trots out the phrase "the safety of all young people in custody is our absolute priority" and yet a simple online search of that phrase quickly shows how often and for how long it has been used.
Until we recognise that this is not about Medway STC, privatisation or ‘a few rotten apples', children will remain unsafe and stories of abuse will continue to emerge from all institutions that look after vulnerable people.
Instead, we need to rethink how we train social workers, health professionals, care workers and prison officers to have humanity as the primary context for their work and relationships, then support them in this so that the trauma they experience is held and not perverted into dehumanising, abusive practice.