Thematic report on inspections of Managed Isolation and Quarantine Facilities under the Crimes of Torture Act 1989

Executive Summary

This report outlines my key observations and recommendations in relation to six MIQ Facilities inspected between October and December 2020. I made 27 recommendations across the six MIQ Facilities, all of which MBIE has accepted.

Each Facility had its own unique set of operating circumstances, and associated challenges, in providing managed isolation and quarantine for detainees. Despite the variations, I found the Facilities to be consistently responsive in seeking to improve the treatment and conditions for detainees. My inspections were guided by expectations outlined in Appendix 1 and summarised below.

In responding to my provisional thematic report, MBIE has stated, ‘The evolving and dynamic nature of the COVID-19 situation has presented complex, never previously experienced operational challenges. MIQ remains a cornerstone of the Government’s elimination strategy and operates in an environment of continuous improvement. I would like to acknowledge the role of independent inspection, and the efforts of your office, in contributing to the development of improved systems and outcomes for returnees and workers in MIQ.’

Health and safety

I expect Facilities to provide all detainees with access to fresh air and sunshine, and time outside of the room in which they sleep. Each of the Facilities had an outside area for detainees to use, however, those areas varied in their availability and suitability. I was pleased that Facilities made changes in response to my advice that they improve these areas, including by dedicating some space to children and family groups. One Facility established a new, much larger exercise area following my inspection. Two other Facilities added ablution facilities to their offsite outdoor exercise area, after I expressed concern about their lack of availability there.

Facilities also responded promptly when I suggested improvements to infection prevention and control (IPC) measures, which are important to ensure a safe environment for detainees and staff in MIQ facilities. In particular, my Inspectors observed four instances across three Facilities where staff did not comply with personal protective equipment (PPE) requirements. Facility staff acted promptly when my Inspectors raised concerns, and I recommended that Facilities ensure staff wear personal protective equipment in accordance with Facility requirements at all times. I was also pleased that, during the inspection period, MBIE introduced an electronic sign-in system across all MIQ facilities to improve the quality of the data being collected from all workers and contractors who visit the Facilities.

Health care should be available and accessible for those in detention. In general, Facility staff displayed a proactive attitude to monitoring and responding to detainees’ health needs. However, there was inconsistent practice across Facilities regarding whether detainees had access to free medical advice. Although detainees at one Facility could access free medical advice from a General Practitioner (GP), not all Facilities provided this. I would like to see this inconsistency in practice addressed. In responding to my provisional thematic report, MBIE has informed me, ‘The Ministry of Health also notes your concerns about access to free medical advice across facilities, and is investigating the issue.’ I am pleased to learn this.

I was also concerned that another Facility had potentially re-occurring shortages of health staff. This presents a health and safety risk to detainees, staff, and the wider public. I recommended this be addressed. MBIE has responded to my provisional thematic report advising, ‘Pressure on the health workforce ebbs and flows in response to a range of complex factors, some caused by temporary circumstances and others which are sustained demands on the system. The Ministry of Health recognises the particular pressure for the health workforce, and works with District Health Boards on strategies to alleviate these pressure points (in the short and medium term) as a matter of priority. MIQ continues to work closely with the Ministry of Health and the District Health Boards to ensure that the health workforce capacity can match, and is responsive and resilient to, evolving and variable demand in the system.’ I appreciate the efforts of MBIE, the Ministry of Health, and the District Health Boards in this challenging area.

Detainees may enter MIQ Facilities during difficult periods of their life, which can increase stress and affect their wellbeing. I commended Facilities that took proactive measures to support detainees’ mental health and wellbeing, such as by providing regular wellbeing checks for detainees, and putting together individual support and education packages for detainees.

Contact with the outside world

Although physically prevented from interacting with the outside world while in MIQ facilities, detainees should be able to connect and communicate with people through other means, such as the internet. When inspected, two Facilities had unstable Wi-Fi, which prevented detainees from making video calls to their families and loved ones, continuing their education, and maintaining employment arrangements. I was pleased to learn that following my inspections the Wi-Fi at both Facilities had been improved. I was pleased that Facilities also took other measures to connect detainees with loved ones, such as allowing physically distanced visits with family and friends at the Facility’s perimeter fence.

Dignity and respect

I expect MIQ Facilities to communicate with detainees about their stay in an open, clear, and consistent way. The majority of surveyed detainees reported they were satisfied with Facility communication on topics such as COVID-19 testing procedures and results, how to access services, the length of their stay, and their rights. However, some surveyed and interviewed detainees at several Facilities identified a number of instances where unclear communication caused them confusion or distress, and I made it clear in one Facility’s provisional report that I would like this to change. In responding to that report the Facility advised me that since my inspection, material to inform detainees had been improved and onsite wellbeing navigators contacted detainees within the first few days of their arrival. I was pleased such action had been taken.

I also expect detainees to be able to communicate through interpretation services if needed, in situations other than formal medical interactions. I made several recommendations to Facilities to ensure professional interpreter services are available and accessible 24 hours a day. I also encouraged one Facility to implement signage using symbols to improve basic communication with detainees.

People staying in MIQ facilities have a range of physical, mental, and psychosocial needs. Facility staff told my Inspectors they do not generally receive prior notice of a person’s particular needs until they arrive at the Facility. Despite this challenge, detainees generally had positive feedback about how staff managed their particular needs. I made several recommendations across Facilities to improve how those Facilities meet the needs of children, young people, and people with disabilities.

Protective measures

Protective measures such as complaints mechanisms and good communication channels are especially important in places of detention where detainees are subject to the restrictions and rules of the facility.

People in detention should be clearly informed about how they can make a complaint, and any complaints they make should be dealt with in an equitable and consistent manner. There is a description of the complaints procedure in the Welcome Pack[1] for detainees, which includes an online complaints form and email address covering all MIQ facilities. However, at the time of my inspections, none of the six Facilities had a formal, facility-based internal complaints system or register in which to record complaints and how they were addressed. Rather, individual agencies at each Facility separately recorded any complaints detainees made to them. Staff often reported they responded informally and immediately to complaints, but did not record the actions taken in response.

Although the practice of informal resolution of complaints where possible is to be encouraged, the failure to record and track internal complaints and the corrective actions taken creates risks that detainees may experience inconsistent or delayed responses. Having a formal process for receiving and responding to complaints also assists a facility to identify patterns of issues arising, address what is causing them, and take corrective action in a timely manner, rather than having complaints dealt with in an ad hoc manner that is potentially inequitable for detainees. Therefore, in provisional reports I indicated each Facility should review, or establish, a formal, complaints system that is accessible, well-communicated and includes the recording of complaints, corrective action taken, and a clear pathway of escalation.

I am pleased to learn that, since my inspections, staff at three Facilities have started using an electronic internal complaints register. I consider it important Facilities ensure that detainees are made aware of the complaints process.

Staffing

MIQ Facilities bring together staff from a number of agencies who are required to work together in a new, and ever-changing environment. In this context, I would like to acknowledge the professionalism and commitment of the staff my Team encountered during the inspections. MBIE has responded to my provisional thematic report stating, ‘I am pleased to note that throughout the provisional thematic report their efforts are recognised, as our staff are pivotal to the success of MIQ.’

I was concerned that the frequency of staff rotations at several Facilities made it challenging to maintain continuity of knowledge about the facility and consistency in care for detainees. As such, I made two recommendations in this area. In responding to my provisional thematic report, MBIE has advised, ‘MIQ is continuing to stabilise its workforce; a new workforce strategy is under development, which includes reviewing the overarching operating model. As noted in recent report responses to your office, this includes the consideration of implementing permanent MIF [managed isolation facility] managers. This review will assist in ensuring a sustainable MIQ system for as long as it is required, and identify any roles that can be transitioned to appropriately skilled civilian staff.’ I will follow the review with interest, and continue to look at the impact of staff rotation on the conditions and treatment of detainees in my inspections.

Concern about the need to ensure adequate levels of healthcare staff also led me to make one recommendation about health staff resourcing.