Archived: HMP Chelmsford

We carried out an announced focused inspection of healthcare services provided by Health Care Resourcing Group (HCRG) Medical Services Limited at HMP Chelmsford on 10 August 2022 and between 15 and 17 August 2022.

Following our last joint inspection with Her Majesty’s Inspectorate of Prisons (HMIP) in August 2021, we found that the quality of healthcare provided by HCRG Medical Services Limited at this location required improvement. We issued a Requirement Notice in relation to Regulation 12, Safe Care and Treatment and Regulation 17, Good governance, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The purpose of this focused inspection was to determine if the healthcare services provided were meeting the legal requirements of the Requirement Notices that we issued in November 2021and to find out if patients were receiving safe care and treatment. At this inspection we found that some improvements had been made, however the provider continued to be in breach of the regulations and more work was needed.

We do not currently rate services provided in prisons.

At this inspection we found:

• Staff had not assessed risks to patients or developed adequate care plans.
• Medicines administration was not managed well for patients on the enhanced care unit. Staff did not always record sufficient detail when patients were not administered their medication in line with their prescription.
• Multidisciplinary meetings for patients on the enhanced care unit were not held regularly and staff had not adequately considered for the risks to patients who lacked capacity to make decisions for themselves.
• The service had enough pharmacy staff on the wings (prison wings are where the general prison population are housed) to ensure patients received their medication.
• Staff treated patients with compassion and kindness and respected their privacy and dignity.
• Managers were supportive of staff and provided clinical support when required.
• Significant improvement had been made to medicines reviews, with 98% of all prisoners now having a review within 72 hours of arriving.

The areas where the provider must make improvements as they are in breach of regulations are:

• The provider must ensure staff develop suitable risk assessments and care plans for patients in relation to their healthcare treatment needs.
• The provider must ensure that there are effective processes in place so that patients are administered essential medication as prescribed.
• The provider must ensure that when medicines are not administered to a patient, a narrative explanation is recorded.
• The provider must ensure that patients who lack capacity to make decisions about their care have a best interest meeting and specific decisions made on their behalf.
• The provider must ensure that patients with complex healthcare needs are discussed regularly at multi-disciplinary team meetings.

The areas where the provider should make improvements are:

• The provider should ensure that guidance on the administration of controlled drugs is reviewed and updated and that staff comply with the provider’s guidance.