HMP Wakefield

We carried out an announced focused inspection of healthcare services provided by Practice Plus Group Health and Rehabilitation Services (PPG) at HMP Wakefield between 17-18 October 2023.

Following our last joint inspection with HM Inspectorate of Prisons (HMIP) in October 2022, we found that the quality of healthcare provided by PPG at this location required improvement. We issued three Requirement Notices in relation to Regulation 12, Safe Care and Treatment, Regulation 17, Good Governance and Regulation 18, Staffing, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The purpose of this focused inspection was to determine if the healthcare services provided were meeting the legal requirements of the Requirement Notices that we issued in February 2023 and to find out if patients were receiving safe care and treatment.

At this inspection we found the required improvements had been made in relation to Regulation 12, Safe Care and Treatment. However, the provider remained in breach of Regulation 17, Good Governance and Regulation 18, Staffing.

We do not currently rate services provided in prisons.

At this inspection we found:

• Systems and processes were not effective in monitoring and managing risk to patients. Audits relating to long term conditions, in-possession medicines and fridge temperatures did not identify concerns relating to quality and safety.
• The provider did not provide guidance to staff about when to report medicine related incidents and the mental health team did not report incidents related to availability of staff.
• The mental health team did not provide any therapies in relation to the wellbeing of patients due to the availability of staffing.

However;

• Staffing levels for the primary care team, pharmacy and in-patient services had improved.
• Effective processes and systems had been established relating to in-possession medicines, the safe and secure transportation of medicines to the segregation unit and the use of the out of hours medicines cupboard and emergency medicines cupboard.
• The service now had a critical medicines policy, and this was embedded into practice.
• Staff clinically triaged all healthcare applications in a timely way.
• Quality assurance meetings had taken place regularly. The quality of recording for these meetings had improved and minutes were easily accessible for all staff on the shared drive.
• Healthcare staff meetings took place regularly, meeting minutes evidenced a wide range of information sharing with the staff team, however learning from local quality assurance meetings was not included.
• The central database used to record information for all staff to access was well organised with clear files to identify the categories of information available to staff.
• Managers used data to identify and understand patient safety concerns, gaps in service provision and opportunities for service improvement, especially in relation to medicines and repeated complaints.
• The number of complaints had reduced, particularly in relation to medicines.
• All patients with end of life needs or social care needs had a good quality care plan in place, specific to their needs and preferences.

• Staff received monthly clinical supervision and recording of this had improved.