HMP Durham

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We looked at 2 quality statements in this key question. We found a mixed picture in relation to governance arrangements. Governance relating to incident management, training and supervision were effective. However, improvements were required in the EPCU and administration.

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

The judgement for Shared direction and culture is based on the latest evidence we assessed for the Well-led key question.

The judgement for Capable, compassionate and inclusive leaders is based on the latest evidence we assessed for the Well-led key question.

The judgement for Freedom to speak up is based on the latest evidence we assessed for the Well-led key question.

The judgement for Workforce equality, diversity and inclusion is based on the latest evidence we assessed for the Well-led key question.

Governance arrangements were variable. The provider had robust systems operating for incident management with learning identified and shared across services. Good working relationships with prison leaders and effective escalation processes had resulted in positive changes for healthcare.

Recruitment had improved and the service had a stable team of highly skilled staff. All staff received induction, mandatory training and supervision. An audit programme helped check the quality of services and support continuous improvement. Recent initiatives had improved patient care such as multidisciplinary ward rounds for patients in the EPCU.

However, we found a lack of clinical governance and managerial oversight of the EPCU. While the unit now had a dedicated nurse (during weekdays), we found in their absence, essential clinical work was not always completed, and managerial oversight was not adequate.

We found that systems and process were not effective in ensuring patient applications were reviewed efficiently. Despite the recent administration project to standardise administrative roles and functions, the recommendations did not include the need to develop standard operating procedures in relation to specific tasks associated with supporting essential clinical functions.

The judgement for Partnerships and communities is based on the latest evidence we assessed for the Well-led key question.

During our inspection, we identified several areas of improvement and innovation. For example, healthcare staff attended a prison led working group that aimed to review and improve the systems and processes associated with early days in custody.

The provider had liaised with local hospitals to develop initiatives that would improve patient care. For example, they had developed a consultation and advice pathway with the local community-based burns service. This meant they could share patients’ symptoms and images of their wounds electronically and discuss interventions.

The service had developed a virtual ward with the local NHS trust that managed the 2 local hospitals. A dedicated electronic application allowed staff to refer patients to the virtual ward for consultation and advice from the appropriate secondary care specialty. These initiatives helped patients receive timely and appropriate care and reduce the need to go to hospital.

Through audits, the provider had identified the need to improve their staff clinical supervision process. They had developed a clinical supervision improvement plan, which aimed to improve the quality and recording of supervision, and which included training for qualified staff on how to deliver supervision.

The provider had developed a new digital learning and development portal, and it was anticipated that staff will be able to use it as a repository for any additional training they had completed.