HMP Manchester

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We assessed 2 quality statements in this key question. The provider had made sufficient progress to address the regulatory breaches found at our previous inspection and was no longer in breach. We found the provider had made improvements to the management of patient applications and waiting lists. Although some care pathways had been introduced to guide and support staff, staff should ensure other key care pathways are established and embedded to support the safe delivery of patient care.

Managers had introduced a new safeguarding process and staff knew how to raise a concern. However, staff should ensure they use the correct process to report safeguarding incidents to the prison’s safer custody team.

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

The judgement for Learning culture is based on the latest evidence we assessed for the Safe key question.

At the previous inspection, we found staff did not review patient applications for healthcare appointments daily or as a priority. During this inspection we found staff routinely reviewed all patient applications and allocated them to a clinic appointment or waiting list with a suitable clinician. In addition, there was capacity within the clinic schedules to facilitate urgent same day appointments with GPs and nurses. This meant patients did not experience delays in having their needs assessed and managed.

At our last inspection, we found staff heavily relied upon the use of waiting lists in the prison clinical system, and staff could not confirm how accurate they were. We found significant improvements had been made following a data cleansing exercise. The number of waiting lists had reduced and staff were successfully managing patient waits and follow up care more effectively. In addition, managers met monthly to review all waiting lists; this ensured managers had oversight of any emerging risks.

We previously found there was a lack of care pathways and procedures in place to guide staff and inform decision making. At this inspection we found some care pathways had been implemented in relation to dementia and falls. We found evidence in care records that these were routinely used. There were still some areas for development, but it was evident that staff were working hard within the primary care team to address this; evidence was shared in relation to reception, long term conditions, urgent care and medicines administration.

At our previous inspection, we had concerns in relation to safeguarding. Although staff were trained, most staff spoken with did not know how to raise a safeguarding alert.

At this inspection, we found the provider had developed a safeguarding process for prison sites. This set out expectations and clarified staff responsibilities for identifying and reporting abuse or alleged abuse.

Staff we spoke with knew the safeguarding process and reported their concerns on the trust’s incident reporting system. Staff also reported safeguarding concerns to the prison, for example, the safer custody team who were responsible for safeguarding in the prison, security officers, and the healthcare link governor. However, these reports were not always logged as incidents on the prison’s system for various reasons such as staff not having active system access, or staff wanting to avoid duplication having used the trust’s system.

The judgement for Involving people to manage risks is based on the latest evidence we assessed for the Safe key question.

The judgement for Safe environments is based on the latest evidence we assessed for the Safe key question.

The judgement for Safe and effective staffing is based on the latest evidence we assessed for the Safe key question.

The judgement for Infection prevention and control is based on the latest evidence we assessed for the Safe key question.

The judgement for Medicines optimisation is based on the latest evidence we assessed for the Safe key question.