26, 27 & 28 April 2022
During a routine inspection
We carried out an announced comprehensive inspection of healthcare services provided by Practice Plus Group Health & Rehabilitation Services Limited (PPG) at HMP Stafford. We also followed up on Requirement Notices issued after our last inspection in March 2021. At the last inspection in March 2021, we found the quality of healthcare provided by PPG at this location required improvement. We issued Requirement Notices in relation to Regulation 12, Safe care and treatment, Regulation 17, Good governance and Regulation 18, Staffing.
The purpose of this comprehensive inspection was to determine if the healthcare services provided by PPG were meeting the legal requirements of the Requirement Notices that we issued in April 2021, and to determine if the provider 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.
At this inspection we found the required improvements had been made and the provider was meeting the regulations. We took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering how we carried out this inspection. We therefore undertook some of the inspection processes remotely. The provider consented to our remote activity to reduce inspection activity carried out on site and minimise infection risks due to the coronavirus pandemic.
We do not currently rate services provided in prisons. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.
At this inspection we found:
- Staff identified any urgent clinical need and acted appropriately to safeguard patients.
- Medicines management had improved, and most patients received their medicines in a timely way.
- The quality of care plans for patients with long-term conditions was varied. Some were very detailed, however other care plans required review and updating. Patients with diabetes did not always have clear care plans in place.
- The staffing of healthcare teams was more stable and there were generally sufficient numbers of staff to meet patients’ needs.
- Staff received regular supervision and felt supported.
- We observed staff to be kind, caring and compassionate in their interactions with patients.
- The service was responsive to patients’ needs and anything urgent was prioritised. However, there were extended waits for routine appointments with the GP and Advanced Nurse Practitioner.
- Governance systems had improved, and regular audits were carried out, identifying where improvements could be made. Staff and patients were able to provide feedback about the service and felt listened to.
- Staff told us there was a more open culture and they felt able to confidently report incidents. However, there was a backlog of incidents requiring review.
The areas where the provider should make improvements are:
- The provider should review diabetes care plans and ensure patients are supplied medicines in line with those plans.
- Ensure that staff are aware of and follow the required procedures for the administration of medicines.
- Ensure that mechanisms are used and embedded for monitoring and following up on omitted doses.
- Managers should have enough time allocated to review and investigate incident reports.