HMP Humber (Prison Healthcare)

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked at 1 quality statement in this key question. The provider had made sufficient progress to address the regulatory breaches found at our previous inspection and was no longer in breach of regulation 12 safe care and treatment.

We found improvements in the identification, assessment and management of patients with a long-term health condition. Patients had access to a dedicated long term conditions nurse and clinic appointments. Staff had received training, and plans were in place to offer some staff more specialist training.

Patients received appropriate risk assessment in relation to falls.

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

At the previous inspection we identified ongoing issues in relation to the management of long-term health conditions (LTC) including ineffective care pathways from reception, poor care planning and no dedicated LTC clinics. Managers completed audits to maintain oversight of care, but these were ineffective.

During this inspection we found staff had made significant improvements to ensure patients received safe care and treatment for their health condition. The service now had a dedicated LTC nurse in post and they had established several new ways of working. Staff had received some training in LTC to develop their knowledge and understanding. A training plan was in development to provide some staff with more specialist training.

Effective care pathways from reception were in use and staff routinely made referrals to the LTC nurse. Dedicated LTC clinics were operational, this included 2 clinics per week on the induction wing to review patients that were new to the prison. This ensured patients were assessed and reviewed at the earliest opportunity. Four additional clinics were available each week to assess and review patients from across the prison.

Staff had introduced the use of the recall function in the electronic clinical record system; this meant patients were automatically recalled into an appointment on a scheduled date. This strengthened the approach to effectively manage annual patient reviews and reduced the number of patients not attending, as they were aware of what their appointment was for. This approach also ensured patients with poor management of their LTC could be recalled earlier in response to their changing needs.

Staff had introduced a new model for completing care plans. We reviewed 8 care records for patients with different LTC. The quality of care plans had significantly improved, each providing a complete record of individual patient need, current physical observations and a record of prescribed medicines. Staff confirmed that all patients are offered a copy of their care plan on review.

Managers monitored and maintained oversight of LTC through regular audit. Outcomes for the last 4 months demonstrated an improving picture; compliance ranged between 77-86%.

At the previous inspection we identified that staff did not always complete falls risk assessments in line with the provider’s guidance.

During this inspection we reviewed 4 care records and found that staff had appropriately completed falls risk assessments and followed up on these as required. We saw that staff reviewed and updated risk assessments when patient need changed. Care plans were in place and staff made onward referrals to the physiotherapist to support ongoing care.

To improve staff awareness and understanding of the risk of falls, a GP had developed a slide deck for inclusion in the induction pack for new members of staff. Additional training was being planned for existing staff.

The judgement for Delivering evidence-based care and treatment is based on the latest evidence we assessed for the Effective key question.

The judgement for How staff, teams and services work together is based on the latest evidence we assessed for the Effective key question.

The judgement for Supporting people to live healthier lives is based on the latest evidence we assessed for the Effective key question.

The judgement for Monitoring and improving outcomes is based on the latest evidence we assessed for the Effective key question.

The judgement for Consent to care and treatment is based on the latest evidence we assessed for the Effective key question.