Improvements in healthcare at Shropshire prison recognised by inspectors

A new report by the Care Quality Commission (CQC) said the category C facility, near Market Drayton, had implemented a number of positive changes since it was issued with a requirement notice following its last full inspection.

A desktop inspection – based on submitted evidence and conversations with prison managers rather than a follow up visit – found that concerns raised in the previous inspection had been addressed.

The requirement notice was issued by the CQC after a joint inspection with the prison and probation inspectors and Ofsted in November 2018.

It said the prison did not do “all that was reasonably practicable to mitigate risks to the health and safety of patients”.

The notice said bosses did not ensure the proper and safe management of medicines, with no stock audits and medicine being administered unsafely to prisoners in the segregation unit.

It also said a significant injury to a prisoner had not been escalated or reported, and there was only one full emergency bag on the site, which could delay emergency treatment being administered.

Since the previous inspection, Shropshire Community Health NHS Trust has taken over as the main healthcare provider at the facility.

The CQC’s follow up inspection, carried out in October 2019, found there was more emergency equipment and new protocols had been introduced to improve safeguarding.

Significant

It said: “We saw examples around safeguarding reporting and support to demonstrate that the new safeguarding processes were now equivalent to that in the community, which was a significant achievement for a prison site.”

The report also acknowledged improvements in mental health support and dental services, with waiting times in both areas reduced.

On the management of medicines it said: “An interim process for the administration of medicines in the segregation unit was implemented immediately after the last inspection to ensure safe administration of medicines.”

Inspectors praised the prison’s “highly effective engagement with patients, staff and partners”.

This included adoption of the Health and Wellbeing Champions (HAWC) scheme, in which a number of prisoners had undertaken a public health accredited course to provide peer support and work with the healthcare team.

The CQC report said the model had been used at other prisons but Stoke Heath had taken it further.

It said: “A HAWC representative now attended the start of weekly multi-disciplinary meetings to share their concerns about individual patients.”

The report made one recommendation: “Review governance arrangements to ensure new processes are appropriately monitored and formally recorded to help inform continuous improvement.”