Archived: City Health Care Partnership CIC - HMP Humber

We carried out an announced focused inspection of healthcare services provided by City Health Care Partnership CIC (CHCP) at HMP Humber on 10 December 2019. We last inspected the service in March 2019 when we judged that City Health Care Partnership CIC was in breach of CQC regulations. We issued a Requirement Notice on 24 May 2019 in relation to Regulation 17, Good Governance, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The purpose of this inspection was to determine if the healthcare services provided City Health Care Partnership CIC were now meeting the legal requirements and regulations under Section 60 of the Health and Social Care Act 2008. We found that improvements had been made and the provider was no longer in breach of the regulations.

We do not currently rate services provided in prisons.

At this inspection we found:

• The provider had implemented additional governance and quality assurance measures to ensure that patient care was appropriately monitored.
• There was effective partnership working with the prison to continually improve and develop health care services for patients.
• Managers had successfully recruited a range of new staff and had worked with CHCP community services to provide a variety of training and development opportunities, available to all staff.
• Staff were well supported with weekly team supervision sessions and regular managerial supervision.
• No alternative to methadone for treatment of substance misuse and dependency was yet available, however discussions with prison management and NHS England commissioners were ongoing as to how this could be facilitated.
• Improvements had been made to the oversight of medicines including a new system for compliance checks and regular audits to ensure that patient group directions were appropriately signed and authorised.

The areas where the provider should make improvements are:

• Clinical coding should be effectively embedded to improve data quality and monitoring of patient care.

We carried out an announced focused inspection of healthcare services provided by City Health Care Partnership CIC (CHCP) at City Health Care Partnership CIC - HMP Humber (HMP Humber) on 11 March 2019.

Following our last joint inspection with Her Majesty’s Inspectorate of Prisons (HMIP) in December 2017, we found that the quality of healthcare provided by at this location did not meet regulations. We issued one Requirement Notice in relation to Regulation 17, Good Governance, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

CQC also received concerns about patient care and whistle blowing allegations about health care services at HMP Humber between June 2018 and January 2019.

The purpose of this inspection was to determine if the healthcare services provided by CHCP 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. At this focused inspection we found:

• Governance arrangements around medicines management had improved.
• The provider had recruited additional clinical staff.
• The range of support and interventions for patients with substance misuse and mental health needs had increased.
• Staff and patient engagement had improved.
• Staff felt well supported by the new management team but supervision was not fully embedded in line with CHCP policy.
• Governance arrangements were not fully effective at identifying and mitigating risks to patient care.
• Managers had built links with local community services and were clearly sighted on improving the offender health service to be equitable with community provision.

There are areas where the provider MUST make improvements:

• Ensure that monitoring and governance arrangements identify and address risks to patients.
• Ensure that patient clinical records are accurate and up to date to support appropriate decision making.
• Ensure that patients are given relevant information about their care and any incidents pertaining to their care.
• Ensure that staff supervision is provided in line with CHCP policy.

There are also areas where the provider SHOULD make improvements:

• Ensure that the movement of medicines within the prison is risk assessed to take account of prison activities.
• Continue to develop local audit processes to improve the quality of care.
• Ensure prescribing options for substance misuse treatment and harm minimisation support for patients released reflects national clinical guidance.