Recurring concern

Failure to reliably make protective-order conditions available to responsible staff

First to latest report 3 Aug 2021 — 26 Jul 2024

Reports that mention this concern
3
Times this concern has been raised
5
Stated actions linked to this concern
8

What this concern includes

Includes failures of dedicated processes or systems to receive, record, transfer, highlight or make protective-order conditions and associated enforcement powers available to staff responsible for safeguarding, offender management, risk assessment or enforcement.

What is not included
  • Excludes generic information-sharing, record-keeping or alerting deficiencies not specifically concerning protective orders or their conditions.
  • Excludes failures to impose, vary or enforce a protective order where the order information was reliably available and the concern is a substantive legal or operational decision.
  • Excludes probation recall-process failures that do not involve making protective-order information available to responsible staff.
  • Excludes general offender intelligence or licence-condition information unless the assertion specifically concerns protective-order conditions or associated powers.

Reports and published responses 3 reports

See individual reports that have raised this concern, and the actions taken in response

  1. East London

    AI-generated summary

    Zara Natasha Aleena · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Zara Natasha Aleena died at the Royal London Hospital on 26 June 2022 after sustaining a severe traumatic brain injury during an unprovoked attack while walking home in Ilford. The report identifies concerns about understaffing, risk assessment, information sharing, supervision, recall procedures and coordination across the Probation Service, police and other agencies, as well as concerns about training and reporting of predatory behaviour.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure of alert systems to highlight restraining orders

    Wider context from the report

    “(8) The globe system and alert systems did not work effectively in this case. A restraining order had been put in place against the offender, but this was not highlighted, as it should have been. Key staff involved in assessing and managing the offender were unaware of the restraining order. ”

    Source location

    Zara Natasha Aleena · Prevention of Future Deaths report
    Page 4 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Prompt OASys assessors to identify Civil Orders and incorporate their implications into risk assessment and management.

    Verbatim wording from the response

    “8.1. We recognise the importance of probation staff being aware of restraining orders and they are expected to record them in a globe in the case record system (i.e., an alert) with the start and end date, with explanatory notes. We also recognise that the globe system requires staff to look for and record relevant information. To ensure that staff are expected to consider whether there is a restraining order and to use the information to inform the management of the case, in April 2023 HMPPS made a change to the OASys tool to prompt assessors to state if people under their supervision are subject to Civil Orders. This means that practitioners are supported to include behaviours which have resulted in the courts imposing a Civil Order in their risk assessment even if they were not convicted of an offence.”

    Source location

    Response from HMPPS and MoJ
    Page 7 · response
    Published 2 August 2024

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Deliver the Civil Order e-learning package and complete relevant staff training by the target date.

    Verbatim wording from the response

    “8.2. To further strengthen practice and ensure that practitioners do not miss the significance of a restraining order or any other Civil Order, in May 2024 we released a new Civil Order e-learning package to provide HMPPS staff with an overview and awareness of Civil and ancillary Orders and why they are important in probation work. Our target is that all staff in relevant roles will have completed this by the end of March 2025.”

    Source location

    Response from HMPPS and MoJ
    Page 8 · response
    Published 2 August 2024

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Review practice guidance on recording Civil Orders and adding or removing globe alerts.

    Verbatim wording from the response

    “8.3. We will review practice guidance by December 2024, including when to add and remove a globe to ensure that HMPPS staff are clear on the need to record Civil Orders. We are also committed to a review of the globe system by March 2025 with the purpose streamlining and to make information more accessible to staff. We are committed to identifying whether digital solutions are available to improve the review, updating and termination of information on the globe system. However, this will have multi-system impacts and will need to be embedded alongside other changes as systems are developed, rather than be progressed in isolation. This will impact on timescales for this aspect of the solution.”

    Source location

    Response from HMPPS and MoJ
    Page 8 · response
    Published 2 August 2024

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Review the globe system and identify digital solutions to improve accessibility, updating and termination of Civil Order information.

    Verbatim wording from the response

    “8.3. We will review practice guidance by December 2024, including when to add and remove a globe to ensure that HMPPS staff are clear on the need to record Civil Orders. We are also committed to a review of the globe system by March 2025 with the purpose streamlining and to make information more accessible to staff. We are committed to identifying whether digital solutions are available to improve the review, updating and termination of information on the globe system. However, this will have multi-system impacts and will need to be embedded alongside other changes as systems are developed, rather than be progressed in isolation. This will impact on timescales for this aspect of the solution.”

    Source location

    Response from HMPPS and MoJ
    Page 8 · response
    Published 2 August 2024

    Open published response

  2. Cheshire

    AI-generated summary

    Angela Vanessa CRADDOCK · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Angela Vanessa Craddock died on 11 April 2018 after an offender attended her address and inflicted survivable injuries. Concerns included failures to identify and share information about breaches of a restraining order, incomplete risk assessment and recall information, and ineffective deployment of police resources to enforce the recall notice.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to include restraining order breach information in OASys risk assessments and prison recall reports and reviews

    Wider context from the report

    “During the 39 days between conviction and release the offender phoned Angela Craddock on 160 occasions. Most of the calls did not connect. The offender also wrote several letters to Angela Craddock from prison in breach of the Restraining Order. Details of the Restraining Order were sent to HMP Altcourse and on receipt a paper copy of the conditions were placed in an envelope to be delivered to the Public Protection Department. This was never received so the relevant staff were not aware of the Restraining Order. Consequently, upon release on licence the community rehabilitation service were unaware of the breaches of the Restraining Order and were unable to include this information in the OASys risk assessment or the prison recall report and review, ultimately sent on to the police for the enforcement of the recall notice. ”

    Source location

    Angela Vanessa CRADDOCK · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to ensure receipt of restraining order conditions by relevant staff

    Wider context from the report

    “During the 39 days between conviction and release the offender phoned Angela Craddock on 160 occasions. Most of the calls did not connect. The offender also wrote several letters to Angela Craddock from prison in breach of the Restraining Order. Details of the Restraining Order were sent to HMP Altcourse and on receipt a paper copy of the conditions were placed in an envelope to be delivered to the Public Protection Department. This was never received so the relevant staff were not aware of the Restraining Order. Consequently, upon release on licence the community rehabilitation service were unaware of the breaches of the Restraining Order and were unable to include this information in the OASys risk assessment or the prison recall report and review, ultimately sent on to the police for the enforcement of the recall notice. ”

    Source location

    Angela Vanessa CRADDOCK · Prevention of Future Deaths report
    Page 1 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Operate a single Probation Service to simplify information sharing between releasing prisons and receiving probation areas.

    Verbatim wording from the response

    “At the relevant time, the post sentence supervision was being delivered by the Cheshire & Greater Manchester Community Rehabilitation Company Limited (CRC) and the separation of the delivery of probation supervision had added to the complexity of arrangements to share information between prisons and probation. The CRCs ceased to hold contracts to deliver probation services on the 25th June 2021 and there is now one Probation Service. This has simplified and therefore improved the sharing of information between releasing prisons and the receiving probation service area.”

    Source location

    Response from HM Prison and Probabtion Service
    Page 2 · response
    Published 1 June 2023

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Establish a documented workflow for copying court documents, identifying risks, applying restrictions, updating custody warnings, and obtaining approval for monitoring requests.

    Verbatim wording from the response

    “A series of actions were then put in place to ensure we had assurance of no future reoccurrence. Those actions were:”

    Source location

    Response from Sodexo Government
    Page 1 · response
    Published 1 June 2023

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Provide staff conducting public protection risk assessments with access to live probation and court information through digital casework systems.

    Verbatim wording from the response

    “Since 2018 the Prison has gained access to probation and court documents via N Delius, Digital Prison System and the Common Platform (Courts). These systems give us significant information to allow staff completing Public Protection risk assessments to have access to live and up to date information.”

    Source location

    Response from Sodexo Government
    Page 2 · response
    Published 1 June 2023

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Scan restraining orders to the relevant safeguarding mailbox and retain an evidence trail of transmission.

    Verbatim wording from the response

    “As further assurance the Custody Department upon receipt of a restraining order will scan the order and email it to the functional mailbox for OMU/Public Protection Unit and an evidence trail is kept of those sent documents. This was put in place to prevent any internal mail failures or the Public Protection Team not collecting items from Admissions.”

    Source location

    Response from Sodexo Government
    Page 2 · response
    Published 1 June 2023

    Open published response

  3. Inner South London

    AI-generated summary

    Emma Day · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Emma Day died in the street on 26 May 2017 from multiple stab wounds and was found to have been unlawfully killed. The report describes a history of domestic violence, coercive and controlling behaviour, threats to her life and protective orders that had expired shortly before her murder. Principal concerns included failures to share and record risk information, inadequate domestic-violence training and guidance, and a system failure in handling reports of domestic violence within the Child Maintenance Service.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to record the duration and conditions of protective orders

    Wider context from the report

    “1. The Gaia Centre did not record the length or conditions of either the Non-Molestation Order or the Prohibited Steps Order, nor did there appear to be any safety netting if the situation escalated. ”

    Source location

    Emma Day · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to hold or know protective-order conditions and arrest powers

    Wider context from the report

    “2. Lambeth Children’s Social Care (CSC) had no copy nor knew conditions of either Order, nor that there was a power of arrest. There seem to be steps taken by the CSC to consider action to mitigate the risk posed by the perpetrator in light of these Orders. ”

    Source location

    Emma Day · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

Actions and positions describe what organisations say in published responses. Implementation is not independently verified.

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Data last updated 7 September 2026