The decision to withhold articles from the detainee must be based on a risk assessment of each individual and the guidance given in PACE Code C.

The custody officer should explain to the detainee why they are being searched and is responsible for the safekeeping of any property taken from the detainee. Where it is necessary for officers to restrain potentially violent or disturbed detainees, it is important that they are properly briefed on any known condition, the warning signs and risk factors for physical violence known about the subject. It is also necessary to have prior knowledge of any relevant medical conditions such as asthma or heart problems, so that detainees can be effectively monitored. The prone position and positional asphyxiaalcohol or drug intoxication (especially stimulants, for example cocaine, being on antipsychotic medication – some medications under certain conditions can cause abnormal heart rhythms) Crew size range: 7A – 3rd to 98th percentile; Q7A – 3rd to 98th percentile; GRUEA7 – 5th to 95th percentile; 7A – 5th to 95th percentile; Q7 – 5th to 95th percentile; H7 – 5th to 95th percentile Officers should take the following actions when inspecting cells and detention rooms for defects and potential ligature points (this list is not exhaustive):

All custody staff must receive training and refresher training in accordance with ACPO (2012) Personal Safety Manual of Guidance (available via College Learn to registered users only) and the National Custody Officer Learning Programme (NCOLP) (available via College Learn to registered users only). Custody officers should also be trained to supervise the searching of detainees in cells. This training should specifically cover thoroughness, control and restraint, and diversity issues. Documenting decisionsinduction training in General Forensic Medicine via a course following the FFLM syllabus and standards for this induction training For further information, see FFLM guidance on intimate searches. When might a strip search become an intimate search?

Where a detainee has menstrual products removed as part of a strip or intimate search, they should be offered a replacement without delay. Ministry of Justice (2008) The Mental Capacity Act 2005: Deprivation of liberty safeguards - Code of Practice to supplement the main Mental Capacity Act 2005 Code of Practice The initial risk assessment should be reviewed after the detainee has been placed in the cell (see Risk assessment). It should be repeated when and if the detainee has calmed down and is able to answer questions. Officers must record these procedures in the custody record. Review Injury or other effects caused by restraint In a preliminary decision on what constitutes an intimate search, it was held that an intimate search (defined by section 65 of PACE as ‘the physical examination of a person’s body orifices other than the mouth’) requires an act of physical intrusion into a body orifice.

For additional information on the use of restraints in a cell, see PACE Code C paragraph 8.11. Cell relocation a bespoke CED course approved by the FFLM and supported by the National Police Chiefs' Council (NPCC) Custody officers may (under section 54 of PACE) seize clothing on the grounds that they believe a detainee may use it to harm themselves. See also paragraph 4.2 of PACE Code C. With specific reference to restraint and drug use, restraint is significantly more likely to be used in a drug-related arrest than during a non-drug-related case. IPCC (2010) Deaths in or following police custody: An examination of the cases 1998/99 – 2008/09 found that of the 56 drug-related cases of death in or following custody, 43% had involved restraint of the individual. Most commonly, the restraint technique involved officers holding down the individual. Prolonged restraint and struggling can result in exhaustion, reduced breathing leading to a build-up of toxic metabolites. This, with underlying medical conditions such as cardiac conditions, drug use or use of certain antipsychotics, can result in sudden death with little warning. The best management is de-escalation, avoiding prone restraint, restraining for the minimum amount of time, lying the detainee on their side and constant monitoring of vital signs.