Updated 14 May 2018
Her Majesty’s Prison Wayland is a category C training prison and holds just over 1,000 adult male prisoners. Virgin Care Services Limited is commissioned by NHS England to provide a range of primary healthcare services to prisoners. This includes nursing, GP, clinical substance misuse services and pharmacy services. Dental services and mental health are subcontracted. The location is registered to provide the regulated activities: Treatment of disease, disorder or injury and Diagnostic and screening procedures.
CQC inspected this location with HMIP between 26 and 30 June 2017. We found evidence that fundamental standards were not being met and a Requirement Notice was issued in relation to Regulation 18, Staffing, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The provider had produced an action plan outlining how they addressed the issues identified. We reviewed this alongside evidence, and the relevant recommendations made by HMIP and CQC in their joint report, as part of this focused inspection. We found that the provider had addressed the previous breach of regulations identified.
Why we carried out this inspection
We undertook a focused inspection under Section 60 of the Health and Social Care Act 2008. The purpose of the inspection was to follow up the Requirement Notice that we issued following a joint inspection with HMIP in June 2017, and to check that the provider was meeting the legal requirements and regulations associated with the Act.
The joint report published following the June 2017 inspection can be found by accessing the following website:
Summary of findings:
Are services safe?
We did not inspect the safe key question in full at this inspection. We inspected only those aspects detailed in the Requirement Notice, issued in October 2017, and the joint HMIP/CQC report recommendations that related to healthcare delivery.
- Since the last inspection, the provider had developed their recruitment pathway. There was a range of suitably qualified staff in post, including a deputy manager and lead nursing staff, and there were no vacancies at the time of this inspection. This ensured that there were adequate levels of staff trained in the management of long-term conditions to meet the needs of patients.
- Managers kept an up to date training log and supported staff to develop skills and qualifications which enabled them to support patients with complex needs.
- The provider had an up to date in-possession medication policy. Staff followed up on any missed medication that was deemed critical, which ensured patients were being offered critical medication in a timely manner.
Are services effective?
We did not inspect the effective key question in full at this inspection. We inspected only those aspects detailed in the Requirement Notice, issued in October 2017,and the joint HMIP/CQC report recommendations that related to healthcare delivery.
- Since the last inspection the provider had developed a long-term condition clinic list to enable staff to manage all patients’ needs effectively. Nursing staff were holding specific clinics reviewing patients’ care and treatment. This included clinics for epilepsy, diabetes, asthma and chronic Obstructive Pulmonary Disease (COPD).
- Since the previous inspection the provider had developed pathways for each long-term condition following National Institute for Care and Excellence (NICE) guidance. Staff followed a standard operating procedure so that when a medical condition was diagnosed or suspected, the patient was automatically referred to a clinic list to enable them to receive the correct care and treatment.
- The provider had developed an integrated health and wellbeing initiative, working with other services within the prison to promote health and mental health across the prison population.
- Staff we spoke with said they felt supported by management. They were positive about the leadership and felt they worked well as a team.
- The provider had developed a strategy involving the local NHS trust, to arrange for a qualified nurse to work alongside their staff to deliver epilepsy reviews and upskill staff.
Are services caring?
We did not inspect the caring key question in full at this inspection. We inspected only those aspects detailed in the Requirement Notice, issued in October 2017, and the joint HMIP/CQC report recommendations that related to healthcare delivery.
- Patients with long-term conditions had care plans to ensure they received the care and treatment that they required. Staff adapted these care plans to make them person centred. Care plans were up to date and copies given to patients, which helped inform them of their treatment.
Are services responsive?
We did not inspect the responsive key question in full at this inspection. We inspected only those aspects detailed in the Requirement Notice, issued in October 2017, and the joint HMIP/CQC report recommendations that related to the healthcare delivery.
- A qualified nurse triaged any healthcare requests daily to effectively prioritise appointments based on clinical need. Patients could also access healthcare advice by visiting the healthcare department or by asking an officer to call and ask for a nurse. This ensured patients were seen urgently if needed.
- The prison had supported healthcare staff by allocating a uniformed member of staff to assist with getting prisoners to and from healthcare, which improved access.
- A single confidential healthcare complaint system was in place. Patients had access to a Patient Advice and Liaison Service (PALS) clinic weekly. This ensured that patients were given the opportunity to be seen face to face to discuss their concerns.
Are services well-led?
We did not inspect the well led question during this focused inspection.