HMP Peterborough Prison

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We assessed 2 quality statements for this key question. We found the service had made sufficient progress to address the regulatory breaches found at our previous assessment. The frequency of observations for patients detoxing from alcohol and drugs now aligned with the provider’s policy and national guidance. An improved referral and triage system allowed more effective and timely oversight of patients awaiting a mental health assessment.

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

The judgement for Assessing needs is based on the latest evidence we assessed for the Effective key question.

At our last assessment, the frequency of observations for patients detoxing from alcohol and drugs was not in line with the provider’s policy and national guidance.

At this assessment, we found there had been improvements. We found the frequency of observations was now in line with the trust policy, with twice-daily physical observations and twice-nightly visual observations. The night-time visual observations were scheduled for early evening and early morning to minimise disruption to patients’ sleep, while still maintaining safety. Records we reviewed confirmed that patients had received all 4 planned observations.

Assurance processes included a daily review of patients undergoing detox to ensure planned observations took place, a weekly review of the scheduled observations and a monthly compliance audit. Staff escalated any concerns appropriately and the results were discussed at a senior leadership meeting. Managers used the audits to ensure compliance as well as identify areas for improvement. For example, they told us about their plans to reduce the use of paper records and to enhance the standards and consistency of information recorded in electronic entries about physical observations.

Managers we spoke with described a team that has been working hard to reduce risk and improve outcomes for patients. They had worked with the prison to ensure patients were located on a specific wing to ensure safety and efficiency. While this was not always possible, priority was given to those at highest risk during the critical first 24 hours, or at minimum, placed within the same houseblock. The team closely monitored the location of patients and checked the electronic system to ensure records were accurate.

The judgement for How staff, teams and services work together is based on the latest evidence we assessed for the Effective key question.

The judgement for Supporting people to live healthier lives is based on the latest evidence we assessed for the Effective key question.

At our last assessment, we found the mental health triage list was too long. Staff did not clinically review the list based on risk or prioritise patient need.

At this assessment, we found that an improved referral and triage system allowed more effective and timely oversight of patients awaiting a mental health assessment.

A mental health manager was now in post who had worked to develop and improve processes. They had removed the triage lists and now held a single mental health referral list. At the time of our visit, 27 patients were waiting for assessment, with the longest wait being 2 weeks and most patients were waiting 4 to 5 days. A duty worker triaged the waiting list throughout the day to monitor for any urgent referrals or alerts of deteriorating patients waiting for assessment. The team were also invited to the daily huddle, which meant they could receive or share information and discuss concerns with staff from multiple departments. Assurance processes were in place to ensure any issues or concerns were escalated and actioned appropriately.

Patients awaiting assessment were supported with self-help materials and given clear information on how to contact the mental health team if their circumstances changed.

At our last assessment, the mental health team were unable to complete assessments in line with national guidance.

At this assessment we found an improving picture. Although staff worked hard to review and improve processes, staff vacancies or long-term leave hindered some progress. However, regular audits were taking place and funding for additional nurses had been approved.

A redesigned referral process and form had been introduced, significantly reducing incorrect “urgent” allocations that previously impacted assessment waiting lists.

Patients on the mental health referral list were discussed weekly and prioritised as needs changed. The assistant director and head of healthcare maintained weekly oversight of this list. For patients waiting more than 5 days, a desktop harm review was carried out with the clinical team to ensure safety. They also visited patients and attended ACCT reviews where appropriate (an Assessment, Care in Custody and Teamwork review isa process in prisons to support and monitor individuals at risk of suicide or self-harm).

Due to being a remand prison, this meant they had a very high turnover of prisoners. Therefore, to maintain the accuracy of the waiting list, the team administrator routinely checked to confirm patients were still in the prison and had not been transferred or released.

The judgement for Consent to care and treatment is based on the latest evidence we assessed for the Effective key question.