Archived: HMP Whatton

Updated 6 August 2019

HMP Whatton is a Category C training prison in Nottinghamshire with an operational capacity to hold 841 convicted male prisoners. It fulfils a national function to provide services that seek to address the offending behaviour of men mainly convicted of sexual offences. More than 90 per cent of Whatton’s population are serving sentences in excess of four years, with just under three-quarters of these serving indeterminate or life sentences. Prisoners held at HMP Whatton come from across the country, and about two-thirds are aged over 40. The prison is operated by Her Majesty’s Prison and Probation Service.

Care & Custody (Health) Limited is commissioned by NHS England to provide primary health care, mental health and substance misuse services at the prison. The provider is registered with the CQC to provide the following regulated activities at the location: Treatment of disease, disorder or injury and Diagnostic and screening procedures.

CQC has not previously inspected this location. It was last inspected by Her Majesty’s Inspectorate of Prisons between 15 to 26 August 2016.

The HMIP inspection report can be found at:

https://www.justiceinspectorates.gov.uk/hmiprisons/wp-content/uploads/sites/4/2016/12/HMP-Whatton-Web-2016.pdf

We announced our intention to undertake a comprehensive inspection of healthcare services provided by Care & Custody (Health) Limited, on 29 May 2018. The inspection took place from the 11 to 13 June 2019.

Updated 6 August 2019

We carried out this announced inspection on 11 June 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

•Is it safe?

•Is it effective?

•Is it caring?

•Is it responsive to people’s needs?

•Is it well-led?

These questions form the framework for the areas we look at during the inspection.

We do not currently rate services provided in prisons.

At this inspection we found:

• Healthcare managers had identified staffing levels needed to meet the needs of patients, and recruitment had taken place in the last year to address this.
• The monitoring system to ensure that emergency equipment was suitable for use, was not effective as it did not identify out of date items. We raised concerns about this at the start of the inspection, however no immediate action was taken to replace out of date items.
• Records of personal care were not completed contemporaneously and care plans were recorded inconsistently.
• The provider had safe systems in place to manage and respond to safeguarding concerns.
• The provider carried out regular infection prevention control audits, identifying areas of non-compliance and were taking action to address them.
• Medicines were appropriately stored, transported, administered, and disposed of safely.
• Staff understood their responsibilities to raise concerns and record and report safety incidents internally and externally.
• Staff reviewed patients’ long-term conditions. However, care plans were not always recorded in the same place, which compromised staff’s access to up to date information.
• Nurses ran regular clinics for patients with long-term conditions, such as, epilepsy, diabetes and Hepatitis and patients care plans were updated in accordance with national guidance.
• Waiting times were reasonable, Patients could see the nursing staff and were triaged on the same day.
• Staff said that they worked in a supportive environment, they enjoyed working as a team and worked well together.
• The provider’s audit schedule was being developed to ensure it covered all aspects of the service.
• There was an effective process in place to evaluate patient feedback to develop the service. Patients were mainly positive about the healthcare they received.
• The recording and oversight of some data relating to medicines was ineffective
• The provider was not analysing their non-attendance rates, which would help develop the service.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure the monitoring of emergency equipment is effective.
• Ensure that care records are completed consistently and contemporaneously so that staff have access to up to date information.

The areas where the provider should make improvements are:

• Ensure that the supply of medications to prisoners on arrival is timely.
• Ensure that monitoring of prescribed medicines is effective including, medicines supplied to patients prior to transfer, medicine reviews and in-possession risk assessments.
• Ensure managers monitor clinic attendance rates to develop the service.