HMP Humber (Prison Healthcare)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We assessed a total of two quality statements from this key question. We found the provider was not providing safe care in accordance with the relevant regulations. Managers had not developed a local process to guide staff in the management of stock and required audits for the use of the out of hours and emergency medicines cupboard. However, the management of clinical waste, sharps bins and audits of fridge temperatures had improved. In addition, staff were able to undertake clinical assessments in an appropriate environment.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

The judgement for Learning culture is based on the latest evidence we assessed for the Safe key question.

The judgement for Safe systems, pathways and transitions is based on the latest evidence we assessed for the Safe key question.

The judgement for Safeguarding is based on the latest evidence we assessed for the Safe key question.

The judgement for Involving people to manage risks is based on the latest evidence we assessed for the Safe key question.

The judgement for Safe environments is based on the latest evidence we assessed for the Safe key question.

The judgement for Safe and effective staffing is based on the latest evidence we assessed for the Safe key question.

At the previous inspection we found issues relating to infection prevention and control (IPC). Staff were undertaking clinical assessments and interventions in cells; sharps bins were not assembled correctly, and clinical waste was not disposed of appropriately. At this inspection leaders told us they had taken action to improve issues related to IPC. Staff now offered clinics in healthcare to appropriately undertake clinical assessments, including urine testing and wound care. Although clinic space remained a significant challenge, staff were able to provide two clinics each week for the substance misuse team and daily clinics were available to provide wound care. We also visited each clinical area to check on the management of sharps bins and clinical waste. All sharps bins were assembled as required and all clinical waste was disposed of correctly.

At the previous inspection we found that systems and processes were not effective in the proper and safe management of medicines. During this inspection, staff and leaders told us practice had improved; regular checks and audits were in place; however, we found that improvement was still required in relation to the out of hours and emergency medicines cupboard.

At the previous inspection we found that staff did not regularly check all clinical fridges as required and some patient specific medicine was not individually labelled. During this inspection we found that staff checked and recorded fridge temperatures daily and took appropriate action when temperatures were out of range. Patient specific medicine, such as insulin was labelled correctly. Managers maintained oversight through regular audits and action planning through the registered managers tool kit. However, processes relating to the use of the out of hours and emergency medicines cupboard needed to improve. Spectrum had updated their procedure in June 2024; however, staff were still using the previous version from September 2022. This meant staff were not following the latest local guidance, which included the need to develop a local process to ensure that medicine was stock checked and date checked. Staff were not able to provide a copy of this during our inspection; however, confirmed they would write this procedure. We found little improvement in the records and audits of the use of the out of hours and emergency medicines cupboards. Staff did not always record when they had used a medicine, such as antibiotics, for a patient. Staff did not routinely check the stock in the out of hours and emergency medicines cupboards. Managers told us checks had been increased to weekly, to maintain oversight. However, we found this did not happen; in some months there were no checks completed. Audits were ineffective; they did not identify that stock checks were not regular, that staff were not recording details of patients issued medicines and records were of poor quality. Staff recorded the audit in the registered managers tool kit, despite poor audit compliance; there was no associated action plan to improve the process.