Overview of key inspection and monitoring findings for the year NPM members (both individually and jointly) carry out a significant number of inspections and monitoring visits each year. An overview of the findings from these visits is provided below, followed by a summary of the thematic work undertaken by NPM members to explore and understand issues arising in detention in more depth. Some of the recommendations, proposals and observations made by NPM members (both individually and jointly) to address issues identified through inspection and monitoring work are included towards the end of this section. Prisons The picture in prisons across the UK continued to be varied, and NPM members reported concerns which were similar to those raised in previous years. The number of self-inflicted deaths in prisons in England and Wales fell during the reporting year. However, incidents of self-harm in the 12 months to March 2018 rose to 46,859, an increase of 16% on the previous year.6 Joint inspections of male prisons in England and Wales (carried out by HMI Prisons, CQC and Ofsted) and monitoring visits by the IMB noted some examples of good practice, but also serious concerns. Significant weaknesses in assessment, care in custody and teamwork (ACCT) case management for prisoners at risk of suicide or self-harm were noted in most of the prisons inspected. It was also of concern that recommendations made by the Prisons and Probation Ombudsman (PPO) following 6 investigations of deaths had not been adequately implemented in a significant number of prisons inspected. HMI Prisons reported that the living conditions it found during inspections of HMP Wormwood Scrubs and HMP Liverpool were some of the worst inspectors had ever seen, and living conditions in several other prisons were very poor. However, despite pressures on the system, most men reported that the majority of staff treated them with respect. The amount of time that men received out of their cells continued to be poor for many: 20% of men responding to HMI Prisons’ survey reported that they were out of their cell for less than two hours a day on weekdays, and only 16% reported that they were out of their cell for at least 10 hours. Thirty-eight per cent of those aged 18­–21 held in young offender institutions (YOIs) reported in the survey that they were unlocked for less than two hours a day. Inspections and monitoring found that staff shortages in some prisons impacted on time out of cell. As reported last year, outcomes in women’s prisons in England were generally better than those in men’s prisons. However, an inspection of Peterborough found that outcomes in relation to safety were not sufficiently good. This was the first time since 2008 that a women’s prison had been assessed as not providing sufficiently good outcomes for safety. Those held in women's prisons continued to present with complex needs and prisons were not always doing enough to support them. As in previous years, many prisoners in women's prisons were held far from home, which impacted Ministry of Justice, Safety in Custody Statistics, England and Wales: Deaths in Prison Custody to June 2018 Assaults and Self-harm to March 2018, July 2018, available at: https://assets.publishing.service.gov.uk/government/uploads/system/ uploads/attachment_data/file/729496/safety-in-custody-bulletin-2018-Q1.pdf, accessed 9 August 2018.