HMP Wymott

We carried out an unannounced comprehensive inspection of healthcare services provided by Greater Manchester Mental Health (GMMH) NHS Foundation Trust to follow up on a Section 29A Warning Notice that was issued as a result of a focused inspection looking at medicines on the 10 and 11 August 2022. You can find the report here:

HMP Wymott - Care Quality Commission (cqc.org.uk)

The purpose of this comprehensive inspection was to determine if the healthcare services provided by GMMH NHS Foundation Trust were meeting the legal requirements and regulations under Section 60 of the Health and Social Care Act 2008 and that patients were receiving safe care and treatment.

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.

How we carried out this inspection

We conducted a range of on site interviews with staff and accessed patient clinical records on 29 and 30 November 2022. We also had remote access to electronic clinical patient records which ceased on 12 December 2022.

Before this inspection we reviewed a range of information that we held about the service, including regulatory notifications.

During the inspection we spoke with staff including:

• Administration staff
• Pharmacy staff
• Head of operations
• Pharmacy technicians and locum pharmacist
• Nurses
• Healthcare assistants
• Prison officers
• Service manager

We asked the provider to share a range of evidence with us. Documents we reviewed included:

• Audits
• GMMH Risk register
• Supervision matrix and appraisal compliance records.
• Training compliance
• Local delivery board meeting minutes
• Policies and procedures

Our findings

We based our judgement of the quality of care at this service on a combination of:

• What we found when we inspected.
• Information from our ongoing monitoring of data about services.
• Information from the provider, patients, the public and other organisations.

At this inspection we found that:

• The trust had made significant improvements around medicine processes.
• Patients received effective care and treatment that met their needs.
• Staff supported patients with kindness and respect and involved them in decisions about their care.
• Patients could access care and treatment in a timely way.

However, we also found that:

• Not all staff were up to date with their appraisals and mandatory training.
• Supervision was not carried out in line with the trust policy for all staff.
• Despite an on-going recruitment campaign, the trust had been unable to recruit and continued to have vacancies

We found two breaches of regulations. The provider must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care (Regulation 17)(1).
• Ensure sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed to meet the fundamental standards of care and treatment (Regulation 18)(1).
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties (Regulation 18)(2).

In addition to the breaches the provider should:

• Continue to take action to ensure that all medication administration points have sufficient handwashing facilities.
• Improve the monitoring of daily fridge and room temperatures where medication is stored.
• All care plans should be reviewed within the expected review time scales.
• Staff completing 13-weeks reviews for patients on substance misuse pathways should be appropriately trained.
• Mental health appointments should be carried out in an appropriate environment; ensuring the patients’ privacy and dignity.
• Patients should have access to information about all the healthcare services available.
• Patients’ should receive timely immunisations and vaccinations.
• The trust should maintain clinical waste in line with their policy.