Archived: HMP Oakwood

We considered our inspection findings to answer questions we always ask:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is the summary of what we found.

Is the service safe?

There had been improvements in the management of people's medicines. Medicines were generally safely stored, although this was not consistent across all areas. Medicines were recorded and staff responded to people's queries about their medication.

Is the service effective?

People's consent was obtained before treatment was provided. Arrangements were in place to protect people's rights when there was a doubt about their capacity to make a particular decision.

People had access to a wide range of physical health, mental health and substance misuse services. Waiting times were generally reasonable, however waits to access mental health services were long.

Working relationships with the prison and other service providers were generally effective, however the system to book external hospital appointments was not always sufficiently flexible.

Is the service caring?

People were cared for and treated by staff who took the time to listen to them and people were offered different choices.

Is the service responsive?

The provider responded to people's feedback and complaints about the service appropriately and put in place actions to improve the service when possible.

Is the service well-led?

People and staff were able to provide feedback about the quality of the service and this feedback was used to inform improvements.

There were effective systems in place to regularly monitor and assess the quality of the service provided, for example through regular audits and analysis of incident reports.

Improvements had been made to the way that medicines were managed. Other initiatives were in progress. Over all, people had better access to medicines. However, people expressed to us variable views on the availability of their medicines. We followed this up and found that in most cases they did receive their medicines in a timely way. The trust had systems in place to record and monitor when people's medicines were missed and the reason for these omissions.

People's complaints were fully investigated and resolved. Staff were aware of their responsibilities in relation to complaints management. Staff's responses to complaints were being monitored to ensure that individuals received an appropriate response. People were also able to raise their concerns informally with healthcare staff.

Changes to the leadership and quality monitoring arrangements within the service provided a more robust framework for improvement. The information that people received about the service had been improved, as had how staff engaged with people. New arrangements were in place to ensure that people received safe and effective care and treatment. However, some actions to effectively address areas of identified non-compliance required further development. Whilst significant work had been undertaken in these areas, improvement was insufficient to assure us of compliance in relation to the management of medicines and complaints.

People we spoke with told us that healthcare staff treated them with respect. One person said that nurses were 'polite.'

People that used the service had been made aware of service developments and were asked for their views and suggestions with regard to improvements. Positive discussions took place at prisoner forums and prisoner representatives were well informed. However, the feedback we received from people was mixed, with negative views that focussed mainly on medicines.

Medicines were not managed safely, or in accordance with appropriate policies and procedures. People often experienced delays in obtaining their medicines. They made comments such as: 'I went three weeks without meds'; 'Difficult to get repeat prescriptions even if you give a week's notice'. Medicine stocks were not well managed, leading to duplication and wastage.

Staff received appropriate training, supervision and appraisal to ensure they were competent in their roles. We saw examples of effective joint working with other prison teams to meet the complex needs of individual people. The provider's arrangements to monitor the quality of the service and to make improvements where necessary were not effective. The procedures to manage complaints did not ensure that people received a response that was timely and appropriate. One person said: 'The complaints procedure is not followed. They do not answer your complaint by the times set out'.