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Archived: HMP Lincoln

This service was previously managed by a different provider - see old profile

All reports

Inspection report

Date of Inspection: 18, 19 November 2013
Date of Publication: 14 December 2013
Inspection Report published 14 December 2013 PDF

There should be enough members of staff to keep people safe and meet their health and welfare needs (outcome 13)

Not met this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by sufficient numbers of appropriate staff.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 18 November 2013 and 19 November 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with staff, reviewed information given to us by the provider and talked with other regulators or the Department of Health.

Our judgement

There were not enough qualified, skilled and experienced staff to meet people’s needs.

Reasons for our judgement

We were told the prison accommodated a maximum of 729 males in 407 cells spread across four residential wings and a care and segregation unit. The daily health care staffing complement consisted of:

Four-six nurses which included two clinical leads and two-three health care support workers between 7:30am and 5:00pm

Two nurses and one health care support worker between 5:00pm and 9:00pm

One nurse and one health care support worker between 9:00pm and 7:30am

We were told the reception which screened new people arriving required a nurse for the health screen assessment. This was staggered over the day but core times were 7:30am-8:30am and 13:30pm-21:00pm. We were told by reception staff and clinical staff there could be delays in the screening process, which included the health screening process, when the nurse was not available to health screen people immediately. We were told, an evening the previous week, it had taken until 12:30am to get people to their cells as 40 people had required screening. Medication was issued by nurses on the four wings and they were in the treatment rooms on the wings until 9:15am. This included two wings that required four nurses to be involved in the administration of medication. This meant medication was not always issued in a timely way on the other two wings when only one nurse was available. It also meant staff duties were disrupted if there was a medical emergency and other qualified staff were not available to assist. This meant there were not enough skilled, qualified and experienced staff to meet people's needs to cover all the duties required by healthcare staff.

We were told the health care clinics operated from 9:30am -11:30 am and 2:00pm- 3:45pm. We observed staff were busy and tried to make themselves available in clinics, treatment rooms and reception in a timely way to deal with people's needs. Records and incident reports also showed there were people with complex needs who required care and treatment in a timely way. These included incidents of self-harm or death. We concluded from observation, staff comments and the comments of people who use the service and records looked at, that there were not enough staff to meet the needs of the people.

We saw there was one doctor who worked part time Monday and Tuesday mornings.

One medical officer who worked full days; Monday-Thursday.

This meant doctor cover was not available on Fridays or at any time over the weekends to write prescriptions or to attend to patient appointments. We were told people may have to wait a minimum of five days for a prescription when they arrived when doctors were not available. This included waiting for prescriptions for long term health conditions such as diabetes and epilepsy. This meant there were not enough staff to meet people's needs in a safe and timely way.

We were told by the senior healthcare management team that Lincolnshire Partnership Trust was undertaking a work force review. As a result healthcare staff provision within the prison was also affected. We were told one band six, clinical nurse was not being replaced. The band three health care support workers posts were being removed and this would affect two staff members.

We observed staff morale was low at the time of inspection and there were some justifiable concerns from staff that there would not be enough qualified, skilled and experienced staff to meet people's needs. We noted five staff had left and recruitment was taking place to fill some of the vacancies, we were told exit interviews were carried out. At the current time there was still continuous care and support provided to people who used the service. A concern would be that continuity of care to people who used the service would be disrupted as more people left or if morale remained low.