Archived: HMP Hewell

When we revisited in February 2015, following the provider's submission of an action plan, we found that improvements had been made. The waiting times to see a healthcare professional had improved and staffing levels had been addressed to ensure that general practitioners were available. Mental health services, smoking cessation and managing drug and alcohol detoxification had been improved. The services available were more comparable to those in the community and reflected national guidance.

Prompt referrals were made for the assessment and management of patients' health needs. Individual care plans were reviewed periodically. However, care and treatment was not always delivered in a way that ensured patients' safety and welfare. Patients could not access timely appointments as expected in the wider community. They told us that obtaining GP appointments was particularly difficult. Care and treatment did not always reflect relevant research and guidance.

The trust worked effectively with partners to deliver primary and secondary care and treatment to patients. However, the effectiveness of partnership working with prison staff was variable. The recent withdrawal of prison staff from some areas had been detrimental to the healthcare provider's capacity to provide timely and appropriate care and treatment to prisoners.

Healthcare staff received appropriate training, supervision and appraisal to enable them deliver care and treatment to patients safely and effectively.

Our inspection of 5 November 2012 found that people had restricted access to healthcare advisory information. This had the potential for people not to fully understand their care, treatment and support options open to them. There were also long waiting times where people had to wait to see a medical practitioner. We also found poor medication administration, which meant that the arrangements were not sufficiently robust to keep people safe.

We received a comprehensive action plan on 12 June 2013. We reviewed the action plan, which explained how the staff have improved the areas we highlighted to ensure compliance. We recognise that some improvements are the subject of further work by HMP estates staff, and have taken this into consideration when judging compliance at this location.

We found that disabled people had restricted access to upper floor of the healthcare building, and there was a general lack of written healthcare information throughout the prison. We also found that people had longer to wait to see a General Practitioner than in the general community. People had good access to nurse prescribers which lessened the overall impact of waiting times. Medication administration could be improved with more security around dispensing times and people holding their own medication. Staff were also seen secondary dispensing medication which is not good practice as it has the potential to lead to medication errors.

We found a number of staff vacancies had an impact on the drug treatment service, though staff training, supervision and appraisal were found to be in place, and regularly undertaken. Where people had complained we found that they received a written reply to their concerns. Clinical governance was good with good communication between the commissioning board healthcare staff and prison.