HMP & YOI Styal

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

At our previous inspection, we found ineffective governance and oversight of the services provided. At this inspection, we found the provider had made improvements and was no longer in breach of regulations. The provider had developed a comprehensive improvement plan to address the issues in the service and make sustainable improvements. Governance and oversight had improved with systems and processes being effectively used to ensure good practice or identify areas for improvement. New and capable leadership had helped improve the staff culture and created a more cohesive team who took pride in their work.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

We found improvements in the culture and a more cohesive team who took pride in their work. Staff morale had improved since the arrival of the new interim head of healthcare (HoHC). Staff expressed trust and confidence in the HoHC and the cluster manager, who were instrumental in changing the culture and making improvements. In particular, there was a stronger focus on working as a team. Staff felt supported and listened to by managers. We found good working relationships between staff and managers and increased engagement from staff. They showed a renewed enthusiasm for their service and shared their thoughts for improving it. Staff also felt able to raise concerns. Managers listened to staff and responded to their suggestions and concerns, which was shown on a “you said, we did” board. While staff knew there were still further improvements to be made, they had a shared direction and showed greater commitment to the service. Staff we spoke to told us it was a lot better now and they enjoyed coming to work, “We no longer have to put up and make do.” Even though the service continued to face challenges associated with funding and resources, good leadership and cohesion in the team had resulted in benefits such as a more stable team, staff willing to work overtime, and staff willing to help each other out.

Since our last inspection, the health care service had appointed a new interim head of healthcare, who worked closely with the regional manager, to lead an improvement programme. They provided stable and consistent leadership, which had resulted in significant improvements in the service. Staff spoke positively about the managers and the changes that were happening, which benefited them and their patients. We received positive feedback about health care services from the prison governors. Prison governors told us that staff across the prison and healthcare now “pulled together” to deliver their respective functions safely and effectively. The prison referred to the “excellent leadership” of the interim head of healthcare. They commented on the positive difference in the culture in primary healthcare, better working relationships and communication, happier staff, and a more stable service. The prison had a dedicated health link governor who met with healthcare managers every 2 weeks. Good joint working had greatly assisted with some areas that needed improving, such as standards of cleanliness, refurbishment, and developing a new clinic room on Waite wing. Managers of other health care services on site also commented on the positive changes in primary healthcare, describing it as “more open” with better multi-disciplinary working and staff replicating the values of the “fantastic” head of healthcare.

The judgement for Freedom to speak up is based on the latest evidence we assessed for the Well-led key question.

The judgement for Workforce equality, diversity and inclusion is based on the latest evidence we assessed for the Well-led key question.

The provider had significantly increased its internal governance of the service with a range of local and regional level meetings, named leaders assigned to oversee improvement activities, and clear escalation processes for any risks, issues and challenges. In addition, the provider had strengthened its links with the prison governors, working with them regularly to discuss issues and identify solutions. Checks and audits were fit for purpose and effectively used to ensure good practice or identify areas for improvement. We reviewed a wide range of audits including those for patients’ care records, infection prevention and control, and reception screening and found they were completed appropriately with any issues identified resulting in remedial actions. The provider submitted statutory notifications (SNs) when required or checked with CQC if they were unsure whether an SN was required.

The judgement for Partnerships and communities is based on the latest evidence we assessed for the Well-led key question.

Following the failings identified in our previous inspection, the provider had developed a comprehensive improvement plan to address the issues and make sustainable improvements. The provider had developed specific action plans for more complex areas such as medicines management. The medicines improvement plan showed all the areas that needed addressing with associated actions, timelines, and owners. Staff had made good progress addressing the highest priorities on the plan. The provider had allocated additional multi-disciplinary resources where needed to support the improvement plan that included the patient liaison manager, professional practice lead, organisation development lead, chief pharmacist, HR manager, and medical director. The provider had ensured there were effective governance and oversight meetings in place to support the improvement programme, which involved executive leaders, specialists and local teams. The provider shared weekly progress reports with CQC.