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Inspection Summary


Overall summary & rating

Updated 12 December 2018

The five questions we ask and what we found

Are services safe?

We did not inspect the safe domain in full at this inspection. We inspected only those aspects mentioned in the Warning Notice issued on 18 December 2017 and Requirement Notices issued on 14 March 2018, and to follow up on concerns raised by staff whistleblowers.

At this focused inspection we found that whilst some improvements had been made to the mental health service and in relation to the management of long term conditions, we identified new concerns about medicines management and found evidence that medicines were not managed properly and safely.

Are services effective?

We did not inspect the effective domain in full at this inspection. We inspected only those aspects mentioned in the Warning Notice issued on 18 December 2017 and Requirement Notices issued on 14 March 2018.

At this focused inspection we found that Care & Custody (Health) Limited had not taken adequate action to address the concerns identified during our last inspection, and staff still did not receive the appropriate support, training and supervision to enable them to carry out the duties they were employed to perform.

Are services caring?

We did not inspect the caring domain at this inspection.

Are services responsive to people’s needs?

We did not inspect the responsive domain at this inspection.

Are services well-led?

We did not inspect the well-led domain in full at this inspection. We inspected only those aspects mentioned in the Warning Notice issued on 18 December 2017 and Requirement Notices issued on 14 March 2018.

At this focused inspection we found evidence that insufficient improvements had been made and governance systems and processes did not effectively assess, monitor and improve the quality of services provided. A number of risks which we identified during our last inspection had not been acted upon, and we identified significant new concerns during this inspection.

Areas for improvement

Musts

  • Care & Custody (Health) Limited must ensure that medicines are managed properly and safely, in particular for responding to medical emergencies and in-possession medicines.
  • Care & Custody (Health) Limited must ensure that staff receive the appropriate support, training and supervision to perform their duties.
  • Care & Custody (Health) Limited must ensure that the pharmacy service is governed appropriately.
  • Care & Custody (Health) Limited must ensure that governance systems and processes assess, monitor and improve the quality and safety of services.

Shoulds

  • Care & Custody (Health) Limited should undertake a review of the substance misuse service to include the implementation of relevant policies, a treatment pathway, and increase clinical oversight to assess and monitor the safety of the service.

We do not currently rate services provided within prisons

Inspection areas

Safe

Updated 12 December 2018

Effective

Updated 12 December 2018

Caring

Updated 12 December 2018

Responsive

Updated 12 December 2018

Well-led

Updated 12 December 2018