HMP & YOI Styal

We carried out an announced focused inspection of healthcare services provided by Spectrum Community Health C.I.C. at HMP & YOI Styal on 5 February 2020.

Following our last joint inspection with Her Majesty’s Inspectorate of Prisons (HMIP) in April and May 2018, we found that the quality of healthcare provided by Spectrum Community Health C.I.C. at this location required improvement. We issued a Requirement Notice in relation to Regulation, 12, Safe care and treatment, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We carried out a focused inspection in April 2019 and we found that improvements were still required. We issued Requirement Notices in relation to Regulations, 12, Safe care and treatment, and 17, Good Governance, 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 by Spectrum Community Health C.I.C were meeting the legal requirements of the Requirement Notices that we issued in April 2019. We checked to see if patients were receiving safe care and treatment and that governance systems had improved. At this inspection we found that improvements had been made and the provider was meeting the regulations.

We do not currently rate services provided in prisons.

At this inspection we found:

• Checks of medicines fridge and room temperatures were carried out.
• Stock of homely remedies was appropriately managed.
• Emergency equipment and medicines were regularly checked.
• Patients’ medicines in-possession risk assessments were carried out when they arrived at the prison.
• There was a system to follow up patients not attending for their medicines, which was mostly effective.
• Governance systems had improved and there was regular assurance of staff practice relating to medicines management.

The areas where the provider should make improvements are:

• Follow up all patients who don’t attend for their medicines for three consecutive days.
• Amend the expiry date of certain medicines when required.
• Complete medicines administration records accurately to reflect the reasons why medicines were not administered to patients.

We carried out an announced focused inspection of healthcare services provided by Spectrum Community Health C.I.C. on Thursday 18 April 2019.

Following our last joint inspection with Her Majesty’s Inspectorate of Prisons (HMIP) in May 2018, we found that the quality of healthcare provided by Spectrum Community Health C.I.C. at HMP YOI Styal required improvement. We issued a Requirement Notice in relation to Regulation 12, Safe care and treatment, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The purpose of this inspection was to determine if the healthcare services provided by Spectrum Community Healthcare C.I.C were meeting the legal requirements of the Requirement Notice and that patients were receiving safe care and treatment. At this inspection we found that some improvements had been made but further improvements were required. We also found new areas of concern.

We do not currently rate services provided in prisons.

At this inspection we found:

• Patients accessed prescribed medicines in a timely way.
• All medicines trolleys were securely fixed to a wall in various treatment rooms located across the prison.
• Medicines were transported around the prison in secure bags and cases.
• Medicine key cabinet logs were still not consistently recorded.
• Maximum and minimum fridge temperatures were still not consistently recorded and when temperatures were not within the accepted range insufficient action was taken to resolve this.
• Out of hours medicines were not sufficiently monitored, dates were not recorded when an out of hours medicine was given and neither was a running total record of the number of remaining medicines.
• We found that records of room temperatures where medicines were stored were not consistently maintained.

We found some new areas of concern

• Checks of medicines and equipment in emergency bags were not consistently completed.
• Medication Administration Records (MAR) were not completed consistently and gaps in MAR records were not monitored.
• Patients sometimes did not collect prescribed medicines for several days; no actions was taken and the reasons for non-attendance were not recorded.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure that emergency equipment is safe to use
• Ensure that medicines are managed safely, administered appropriately and patients’ individual records are complete.
• Ensure that effective governance arrangements, assess, monitor the safety and quality of the service, including assurance and auditing systems or processes.

The areas where the provider should make improvements are

• In possession risk assessments should be completed promptly to support patients assessed as suitable to manage their own medicines.