The Care Quality Commission
  • Prison healthcare

HMP Lowdham Grange

Old Epperstone Road, Lowdham, Nottingham, Nottinghamshire, NG14 7DA (0115) 966 9200

Provided and run by:
Nottinghamshire Healthcare NHS Foundation Trust

All Inspections

25 & 26 October 2023

During an inspection looking at part of the service

We carried out an announced focused inspection of healthcare services provided by Nottinghamshire Healthcare NHS Foundation Trust at HMP Lowdham Grange on 25 & 26 October 2023.

Following our last joint inspection with His Majesty’s Inspectorate of Prisons (HMIP) in April 2023, we found that the quality of healthcare provided by Nottinghamshire Healthcare NHS Foundation Trust at this location required improvement. We issued a S29A Warning notice as a result of breaches under 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 were meeting the legal requirements of the S29A Warning notice that we issued in June 2023 and to find out if patients were receiving safe care and treatment.

At this inspection we found that despite some improvements, there had not been sufficient progress and we found new concerns. As a result, we issued a Notice of Proposal to impose conditions for the provider at this location.

We do not currently rate services provided in prisons.

At this inspection we found:

  • Systems to manage patient applications were unsafe.
  • The management of medicines had improved since our last inspection.
  • Incidents were not always investigated in a timely manner and learning from incidents was not identified and shared with staff.
  • There was no oversight of patient complaints and staff followed different processes.
  • Patients did not receive timely responses to complaints.
  • Staff supervision and training rates had improved, and staff felt more supported than at our last inspection.
  • Patients with identified need for psychological interventions did not have their needs met.

3 July 2019

During an inspection looking at part of the service

We carried out an announced focused inspection of healthcare services provided by Nottinghamshire Healthcare NHS Foundation Trust at HMP Lowdham Grange on 3 July 2019.

Following our last joint inspection with Her Majesty’s Inspectorate of Prisons (HMIP) in August 2018, we found that the quality of healthcare provided by Nottinghamshire Healthcare NHS Foundation Trust at this location required improvement. 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 the inspection was to determine if the healthcare services provided by Nottinghamshire Healthcare NHS Foundation Trust were meeting the legal requirements of the Requirement Notices that we issued in January 2019 and to find out if governance systems had improved. At this inspection we found that improvements had been made and the provider was meeting the regulation.

We do not currently rate services provided in prisons.

At this inspection we found:

  • The provider had worked with prison colleagues and medicines suppliers to implement a safer way of delivering medicines to the prison.
  • Medicines were stored securely, and staff took appropriate action when medicines were exposed to excessive heat.
  • Records relating to medicines stock were maintained by staff and matched the items of stock that we checked.
  • New, tamper proof medicines disposal bins were now in place.
  • The waiting time for routine GP appointments had reduced and the provider intended to introduce further GP sessions. Emergency GP appointments were also available.
  • All applications to see the GP were triaged by a nurse, and patients also had access to an Advanced Nurse Practitioner.
  • Policies and procedures relating to medicines management required further review and updating. However, staff were working to the trust’s overarching policy.
  • Governance meetings relating to medicines had been implemented to provide oversight of medicines management in the prison.
  • Pharmacy staff carried out audits of medicines records and stock.

The areas where the provider should make improvements are:

  • Ensure that all medicines are stored in lockable cabinets.
  • Patients should have timely access to a routine GP appointment.
  • Local policies and procedures relating to medicines management in a prison setting should be reviewed and updated at the earliest opportunity.