National Preventive Mechanism Second Annual Report 2010–11 Nonetheless, HMIP reported that the extent and seriousness of self-harm among women prisoners remained a major concern. Health care, and particularly secondary mental health care, had improved but there was insufficient primary mental health care provision. Resettlement services were not always aligned to the specific needs of women prisoners. Overall, HMIP noted commendable work in most women’s prisons but a prison environment simply could not meet the needs of many of the women being held. Children and young people under the age of 18 may be held in young offender institutions (YOIs) run by the Prison Service.14 In recent years, there has been concern that custody is not always being used as a last resort for under-18s; however, HMIP was pleased to note that there had been a large reduction in the number of young people being held in prison. While the fall in the number of young people in custody was welcome, one inevitable consequence was that some establishments had been closed and young people were being held even further from home than before. In 2010–11, HMIP inspected six YOIs holding those under the age of 18. Three of these inspections were unannounced follow-ups, in which HMIP found that more than threequarters of its previous recommendations had been achieved or partially achieved. While noting improvements in many areas, HMIP nonetheless had concerns about a number of areas, including searching, staffing and a lack of purposeful activity. HMIP noted that, while the majority of reception staff dealt sensitively with young people, arriving in custody remained a daunting experience. At some YOIs, routine strip-searching marred efforts by staff to reassure new arrivals; at others, stripsearching was intelligence led. A stable and experienced staff team has a vital role to play in ensuring that an establishment is safe and HMIP found that one YOI with a history of violence between young people and towards staff had been badly affected by a recruitment freeze. This had resulted in a number of posts being filled on a temporary basis, and bullying and the use of force by staff were high. HMIP also found that young people did not have enough time out of cell and had limited access to the open air. More positively, however, it found that the majority of young people undertook some form of accredited education and training, and for many, this was their first experience of educational achievement. HMIP also conducts thematic inspections. In 2010–11, it published several thematic reports, including reports on: • training planning for children and young people • the management of gang issues among children and young people in custody and in the community, in conjunction with HM Inspectorates of Constabulary and Probation • offender management, jointly with HM Inspectorate of Probation • commissioning health care in prisons, jointly with CQC. 14 Children and young people under the age of 18 may also be detained in secure training centres or secure children’s homes. These detention facilities are not run by the Prison Service and instead are described below in the section on ‘Children in secure accommodation’ (page 32). 20