Archived: HMP Gartree

Updated 12 December 2018

HMP Gartree is a high security category B lifer centre holding adult males. The prison is located in the village of Market Harborough in Leicestershire and accommodates up to 707 prisoners. The prison is operated by Her Majesty's Prison and Probation Service.

Care & Custody (Health) Limited is commissioned by NHS England to provide primary health care and clinical substance misuse services at the prison. Care & Custody (Health) Limited is registered with CQC to provide the regulated activities of Diagnostic and screening procedures and Treatment of disease, disorder or injury at the location HMP Gartree.

There is no registered manager for this location

Our last joint inspection with Her Majesty’s Inspectorate of Prisons (HMIP) was completed in November 2017. During that inspection we found breaches of Regulations 17, Good governance and 18, Staffing and issued Requirement Notices on 14 March 2018. We also identified a breach of Regulation 9, Person centred care and took enforcement action in the form of a Warning Notice issued on 18 December 2017. The joint inspection report can be found at:

https://www.justiceinspectorates.gov.uk/hmiprisons/inspections/hmp-gartree-2/

We undertook an announced focused inspection on the 21, 22 & 23 August 2018. This inspection was carried out in order to follow up on the regulatory breaches found during our last inspection.

The purpose of the inspection was to determine if the registered provider, Care & Custody (Health) Limited, was meeting the legal requirements and regulations under Section 60 of the Health and Social Care Act 2008 and that prisoners were receiving safe care and treatment.

Our key findings were as follows:

• The management of patients with mental health issues and long term conditions had improved since our last inspection.
• Medicines were not managed properly or safely.
• Staff did not receive appropriate support, training or supervision.
• Social care was not consistently provided in accordance with service users’ care plans.
• Governance systems to assess, monitor and improve the quality and safety of the service remained poor.

Before this focused inspection we reviewed a range of information that we held about the service, including action plans we had received from the provider in response to the Warning Notice issued on 18 December 2017, and the Requirement Notices issued on 14 March 2018.

During the inspection we asked the provider to share with us a range of information which we reviewed. We spoke with healthcare staff, prison staff and people who use the service, and sampled a range of records.

Updated 12 December 2018

The five questions we ask and what we found

Are services safe?

We did not inspect the safe domain in full at this inspection. We inspected only those aspects mentioned in the Warning Notice issued on 18 December 2017 and Requirement Notices issued on 14 March 2018, and to follow up on concerns raised by staff whistleblowers.

At this focused inspection we found that whilst some improvements had been made to the mental health service and in relation to the management of long term conditions, we identified new concerns about medicines management and found evidence that medicines were not managed properly and safely.

Are services effective?

We did not inspect the effective domain in full at this inspection. We inspected only those aspects mentioned in the Warning Notice issued on 18 December 2017 and Requirement Notices issued on 14 March 2018.

At this focused inspection we found that Care & Custody (Health) Limited had not taken adequate action to address the concerns identified during our last inspection, and staff still did not receive the appropriate support, training and supervision to enable them to carry out the duties they were employed to perform.

Are services caring?

We did not inspect the caring domain at this inspection.

Are services responsive to people’s needs?

We did not inspect the responsive domain at this inspection.

Are services well-led?

We did not inspect the well-led domain in full at this inspection. We inspected only those aspects mentioned in the Warning Notice issued on 18 December 2017 and Requirement Notices issued on 14 March 2018.

At this focused inspection we found evidence that insufficient improvements had been made and governance systems and processes did not effectively assess, monitor and improve the quality of services provided. A number of risks which we identified during our last inspection had not been acted upon, and we identified significant new concerns during this inspection.

Areas for improvement

Musts

• Care & Custody (Health) Limited must ensure that medicines are managed properly and safely, in particular for responding to medical emergencies and in-possession medicines.
• Care & Custody (Health) Limited must ensure that staff receive the appropriate support, training and supervision to perform their duties.
• Care & Custody (Health) Limited must ensure that the pharmacy service is governed appropriately.
• Care & Custody (Health) Limited must ensure that governance systems and processes assess, monitor and improve the quality and safety of services.

Shoulds

• Care & Custody (Health) Limited should undertake a review of the substance misuse service to include the implementation of relevant policies, a treatment pathway, and increase clinical oversight to assess and monitor the safety of the service.

We do not currently rate services provided within prisons