HMP Wormwood Scrubs

We carried out an announced focused inspection of healthcare services provided by Care UK Health & Rehabilitation Services Limited (Care UK) at HMP Wormwood Scrubs between 30 September and 4 October 2019, alongside a comprehensive joint inspection of health and social care services at the prison with Her Majesty’s Inspectorate of Prisons (HMIP).

During a focused inspection by CQC in October 2018, we found that the quality of healthcare provided by Care UK at this location did not meet the fundamental standards. We issued a Requirement Notice in relation to Regulation 17, Good governance, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The purpose of this focused inspection was to determine if the healthcare services provided by Care UK at this location were now meeting the legal requirements of the above regulations, under Section 60 of the Health and Social Care Act 2008.

We do not currently rate services provided in prisons.

At this inspection we found:

• Oversight of medicines management had improved since our last inspection. This included more regular audits and recorded checks of medicines storage and administration processes.

• Staff received regular training to support them in managing medicines safely.

• The local operating procedure for administering medicines was signed by all relevant staff.

• All medicines administration that we observed was conducted safely, including the administration of controlled drugs.

• Controlled drugs were stored safely and in line with relevant legislation.

We carried out an announced focused inspection of healthcare services provided by Care UK Health & Rehabilitation Services Limited (Care UK) at HMP Wormwood Scrubs on 29 and 30 October 2018.

Following our last joint inspection with Her Majesty’s Inspectorate of Prisons (HMIP) in July and August 2017, we found that the quality of healthcare services provided by Care UK at this location required improvement. We issued a Requirement Notice in relation to Regulation 12, Safe care and treatment, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The purpose of this focused inspection was to determine if the healthcare services provided by Care UK were 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.

We do not currently rate services provided in prisons.

At this inspection we found that while some improvements had been made, medicines were not always managed safely and consistently:

• Oversight of medicines management had increased, including greater input from pharmacy technicians and further training for staff.
• Two new local operating procedures supported staff in moving and administering medicines.
• Arrangements for the safe management of medicines on the wings had generally improved, although some controlled drugs were not stored safely.
• Medicines for men who had moved or left the prison were no longer retained in wing cabinets.
• Regular stock reconciliation was now completed on every wing.
• Staff checked each patient’s identity before administering medicines.
• A safe process for patients self-administering treatments was not embedded.
• Staff transported medicines around the prison securely.

The areas where the provider must make improvements as they are in breach of regulations are:

• A safe process to support men self-administering medication must be fully embedded.

The areas where the provider should make improvements are:

• Storage of controlled drugs should be secure to ensure safety and comply with relevant legislation.

• Local Operating Procedures should be read and signed by all staff responsible for administering medicines.

• Compliance checks of the wing treatment rooms should be routinely recorded.