HMP Wymott Prison

We carried out this announced inspection on 30 November 2022 under section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a Care Quality Commission (CQC) inspector. To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

We found this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice did not always provide well-led care in accordance with the relevant regulations.

Background

Redbridge Associates Limited run and provide Smart Dental Care who have a dental suite located in the healthcare centre at HMP Wymott. The suite includes a surgery and decontamination area and patients can use the main healthcare patient waiting room area.

The dental team included a dentist, a dental manager/nurse, and a dental therapist. The dentist was the clinical lead for the Smart Dental Care surgeries in the region. The practice is owned by two individuals from Redbridge Associates Ltd who have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. There was no CQC Registered Manager in place at the time of our inspection and a registered manager application was made by the provider following our inspection.

During the inspection we spoke with the dentist and dental manager/nurse. We looked at practice policies and procedures and other records about how the service is managed. The practice is open from Monday to Thursday between 8:00am and 5:00pm.

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The provider had infection control procedures which reflected published guidance.
• The provider had systems to help them manage risk to patients and staff. However, sharps risk management protocols were not effective in ensuring staff were appropriately trained and familiar with local risk assessments.
• Staff ensured facilities and equipment were safe, and that equipment was maintained according to manufacturers’ instructions.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults. All staff had completed training.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider asked staff and patients for feedback about the services they provided.
• Wait times for routine treatment were up to 14 weeks.
• The provider dealt with complaints positively; however, there was no service specific policy to inform timescales for investigation.
• Governance arrangements were not always effective in ensuring policies and procedures were service specific, reviewed within agreed timeframes, and had been seen and understood by staff.
• Not all incidents were reported in accordance with policy, and systems and processes were not always effective in ensuring learning was routinely shared with staff.
• There was a culture of continuous improvement and learning; however, systems and processes did not ensure there was an effective system for the communication regarding policies and procedures and learning from incidents.

There were areas where the provider must make improvements.

They must:

• Implement a system to ensure incidents are reported and investigated in line with policy, and that learning from incidents at local and regional level is shared with staff.
• Implement a system to ensure that policies, guidance and risk assessments are reviewed within timescale and are service specific.
• Implement a system to ensure policies, guidance and risk assessments are reviewed by staff including, within induction, and as required.
• Implement a system to ensure that eligible staff receive sharps handling training.

There were areas where the provider should make improvements.

They should:

• Ensure there is always a registered manager in place.