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. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.
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.
Background
HMP Whatton is a Category C training prison in Nottinghamshire holding 838 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.
Time for Teeth Limited is sub-contracted by the primary healthcare provider at the prison, to provide dental services to men held at the prison. Time for Teeth Limited is registered with the CQC to provide the following regulated activities at this location: Treatment of disease, disorder or injury, Diagnostic and screening procedures, and Surgical procedures.
CQC has not previously inspected this location. It was last inspected by Her Majesty’s Inspectorate of Prisons (HMIP) in 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
The dental team includes a dentist, dental nurse and dental therapist. The service has one treatment room. Four dentist sessions are run over two days every week, and two therapist sessions are run on one day a week. The dental nurse is on site Monday to Friday. The dental suite was located in the main healthcare department, which was on the ground floor of a building accessible to patients with mobility issues.
During the inspection we spoke with the clinical team, the location’s compliance lead, and Time for Teeth Limited’s clinical lead. We looked at policies and procedures and other records about how the service is managed. We also spoke with four patients.
Our key findings were:
- The facilities appeared clean and well maintained.
- The provider had infection control procedures which reflected published guidance.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
- The service had systems to help them manage risk to patients and staff.
- The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults.
- The provider had thorough staff recruitment procedures.
- The clinical staff provided patients’ care and treatment in line with current guidelines.
- Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
- Staff were providing preventive care and supporting patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- The provider had effective leadership and culture of continuous improvement.
- Staff felt involved and supported and worked well as a team.
- The provider asked staff and patients for feedback about the services they provided.
- The provider dealt with complaints positively and efficiently.
- The provider had suitable information governance arrangements.
There were areas where the provider could make improvements. They should:
- Work with the main healthcare provider to establish formal monitoring arrangements to ensure effective oversight of infection control, equipment maintenance, patient access and complaints.
- Undertake a specific sharps risk assessment, to be updated annually.
- Consider adjusting the timetabling of dentist sessions to ensure that patients requiring urgent treatment could be seen by a dentist more promptly.