Archived: HMP Brixton

We considered our inspection findings to answer questions we always ask:

.Is the service safe?

.Is the service effective?

.Is the service caring?

.Is the service responsive?

.Is the service well-led?

This is the summary of what we found.

Is the service safe?

Individual risk assessments and environmental risk assessments were in place. Audits were carried out to look at accidents and incidents and the necessary action was taken to keep people safe. We were told nursing staff were not available after 6:30pm. This meant people may not receive their required medication within the appropriate timescales. Information was available to show that the service worked with other agencies to help ensure people's health needs were met.

Is the service effective?

We spoke with ten people who used the service who told us they were happy with the service they received. One person said; "The staff are very good." Another person said; "The healthcare is good." Most people we spoke with said staff were friendly and supportive.

Staff we spoke with were knowledgeable about people's health care needs. We saw there were some opportunities for staff training but this needed to be further developed to include developmental training. This was to ensure staff were able to understand and support the different health care needs and also to progress their health promotion role.

Records we looked at did not show a regular review or evaluation of any long term health conditions. This was necessary to ensure people's health needs were being met. Staff were observed to be patient and supportive as they worked with people.

Is the service caring?

People spoken with were positive about the health care provided by staff. One person said; "The staff are friendly and helpful." Another said; "The nurses are kind." We found people were encouraged to be involved in decision making.

Is the service responsive?

Information was collected by the service with regard to the person's healthcare and support needs when they started to use the service. Various assessments were completed by the staff of the service with the person to help make sure staff could meet their health care needs.

Referrals for specialist advice were made when staff needed guidance to ensure the health needs of people were met. People's individual needs were taken into account and they were involved in decision making with regard to their health care and treatment.

Information was not always available to help people understand the care and treatment choices available to them.

We saw there was not an effective publicised complaints procedure in place that gave people information about their right to complain. There was not a health care complaints system separate to the prison complaints system to enable a person to make a complaint confidentially about the healthcare provision.

A health care forum was in place for representatives of people who used the service to discuss the running of the service and to ensure the service was responsive in meeting the changing needs of people. One person we spoke with said; "I know the healthcare rep on my wing, he's very helpful."

Is the service well-led?

Staff told us if they needed to raise any concerns they felt they would be listened to. They said they felt well supported by managers.

People who used the service told us they felt able to speak to the manager and staff about any issues. We saw there were opportunities for people to comment about the service they received and action was taken as a result of the surveys.

We spoke with six people who used the service who told us they were happy with the service they received. One said "this is better than most places I have been to". Another said "most of the nurses are good, it is okay". Some said there were delays in receiving treatment. During our visit we could find no evidence to support this. All those we spoke with were impressed with the dentist. One said "I can't complain, I was seen straight away".

We spoke with ten nursing staff who worked at the prison. They told us they enjoyed their work. They said they felt well supported and trained to carry out their role. We looked at the records for the service, including quality assurance audits, surveys, staff records, policies and training documents and found them to be correct and up to date.