DrPA Secure - 42 Kew Court

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• 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 assessed 3 quality statements from this key question. We found staff involved people in decisions about their care and treatment and provided them with advice and support.

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

The judgement for Assessing needs is based on the latest evidence we assessed for the Effective key question.

Patients with long-term conditions were offered an effective annual review to check their health and medicines needs were being met. For patients with the most complex needs, the GP worked with its partners to deliver a coordinated package of care.

The service could demonstrate how they identified patients with commonly undiagnosed conditions, for example diabetes, chronic obstructive pulmonary disease (COPD), atrial fibrillation and hypertension.

The service planned and delivered patients’ care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Systems were in place to ensure staff were up to date with evidence-based guidance and legislation

There were processes and procedures for escalating concerns and to ensure patients' needs were met.
The service worked with partners to benchmark performance against key performance indicators. Regular reviews were held where performance was discussed and changes made.

The service worked well across teams and departments to support people. We saw evidence of multi-professional meetings that included mental health and proactive multi-disciplinary meetings. This allowed for a collaborative approach to people’s care.

Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. The service worked with partners to ensure continuity of care, including where clinical tasks were delegated to others.

Feedback from partners demonstrated how the services worked together to support vulnerable patients. Partners told us staff were easily contactable and listened to their concerns about the people they supported and service delivery.

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

The provider completed a range of monitoring activities, including prescribing audits, key performance indicator (KPI) reviews, monthly and quarterly contract reviews, and reconciliation processes that ensured accurate oversight of service delivery. There was a governance structure and oversight by a governance lead who checked the quality of records relating to meetings and action.

Leaders also provided examples of quality initiatives they had contributed to. This included improvements to telephone triage systems, pain management pathways and the introduction of a medicine used to treat opioid dependence in partnership with the prison and Trust. The provider did not monitor clinical outcomes themselves, considering this the responsibility of Trusts, however there were processes to review incoming information.

Staff feedback we reviewed demonstrated the provider used evidence-based guidance, local multi-disciplinary team collaboration and templates on the clinical system to ensure good clinical practice. However, they described the challenge of prison operational constraints limiting the equivalence of care, contributing to delays and reduced access to treatment.

Learning from monitoring activities was shared in meetings with service leads, as well as informally in all-staff newsletters and ad hoc conversations. The provider acknowledged they could make internal quality improvement activity more visible to the wider clinical team. Plans were in place to support this.

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