HMP YOI Rochester

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• 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 assessed 1 quality statement for this key question. The provider had not made sufficient progress with the identified regulatory breaches. A temporary management team had recently been drafted in to make improvements in the team. The team had responsibility to improve the running of the department as well as undertaking a deep dive into its challenges. The team were tasked with reviewing and amending processes to align with healthcare systems at other prisons. This was in its early stages and whilst this had not translated into improved outcomes for patients in some areas, foundations in some systems had been strengthened.Some areas still required improvement, including reporting of incidents and oversight of appointments, audits and risks.

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.

Managers spent time upskilling staff to improve future performance. Managers provided group and 1:1 training sessions for staff on a range of clinical care priorities including medicines, wound care management and long-term conditions. Staff told us they found the newly introduced processes worked well and provided better clarity, but that until very recently they were short staffed, they felt stretched and did not feel well supported during these times.

The service had a process in place to report safety incidents. Staff recognised incidents but these were not consistently reported.

At the last assessment we found staff had improved on the quality of detail written for incidents reported and this had been sustained. However, we found that not all incidents were reported. During this assessment we found that some medicines incidents and staffing shortages were still not reported. Some of the staff we spoke with told us they did not have time to report all incidents because of staffing pressures.

There was a planned audit cycle, although this was not consistently followed to ensure improved patient outcomes and audits not always completed due to staffing shortages.

At the last assessment we found that staff participated in local audits; however, audits were not utilised to improve patient safety or performance. During this assessment we found there was an improved audit function, however, progress to make improvements was slow, audits were also not completed in-line with the schedule due to short staffing.

The service had identified risks and documented mitigating controls. However, these were not consistently being monitored to ensure they were put into practice.

At the last assessment we found monitoring compliance of the risk register was inconsistent and that staff had not escalated identified concerns when they arose.

During this assessment, we found that staff escalated concerns, although there was no meaningful discussion around identified risks at committee meetings. For example, minutes of the quality management meeting in October and November 2025 stated there were 7 live risks and that a copy of the report was attached. There was no evidence the content of the risk register had been discussed or considered.

There was no oversight of how long patients waited to see a member of the primary care team.

At the last assessment we found that there was no oversight of how long patients waited for an appointment when there had been a cancellation for any reason. During this assessment we found that whilst the way the system function had been changed, there was still no oversight and outcomes for patients waiting to see healthcare had not improved.

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

The judgement for Learning, improvement and innovation is based on the latest evidence we assessed for the Well-led key question.