HMP Thameside

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked at 1 quality statement in this key question. The provider had not made sufficient progress to address the regulatory breaches found at our previous inspection.

We found there had been no improvements to the management of patients who were triaged for a healthcare appointment. We also found patients with identified mental health needs and/or on the in-patient unit did not have completed care plans which provided sufficient information for their care and treatment needs.

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

Systems were not adequate to ensure staff maintained detailed clinical records for each patient. At the last inspection we found patient records were of mixed quality with some records lacking relevant detail. During this assessment we found there had been no improvement in the quality of records.

Triage

Patients requesting an appointment were not consistently triaged promptly or accurately to see a member of the healthcare team. At the last inspection an untrained member of staff assessed potential new patients when they were referred to the service, or requested an appointment using the electronic prison application system. During this assessment, paper applications were used due to access rights for the electronic software. Paper applications were collected from each wing and shared with administrators prior to being triaged by a qualified nurse. However, we identified delays in the applications being processed for some patients because they weren’t being processed promptly. We were shown some applications which had not been processed for several days and staff confirmed the process did not work consistently well. We also identified that the dietician waiting list was not triaged effectively. This meant some patients with high need were not seen promptly, or by other health care clinicians to manage their care and treatment safely, whilst they waited for an assessment from the dietitian.

Mental health

At the last inspection we found mental health care plans were inconsistent and did not always include details of an accurate diagnosis, goals and objectives. Patients were not

always seen in accordance with agreed timescales. During this assessment, we found

timescales were being adhered to however, there was no improvement in the completion of mental health care records. Records we reviewed lacked details of diagnosis, goals

and outcome objectives. In addition, there was limited evidence of patients being involved in the decisions about their treatment. This meant patients did not receive person centred care.

Primary care

At the last inspection we found primary care records varied in quality. During this assessment we saw some improvement in records, however, for some patient records the quality of information recorded was poor.

The quality of records varied. We reviewed a range of patient records for patients who had attended both GP and nurse appointments. Some GP records were well written, concise with a clear plan, whilst others it was not clear what the purpose or diagnosis was or what action was taken or advice given if required. Nursing records were inconsistent, some contained appropriate information whilst others lacked detail. This meant that staff may not have all the information they need to deliver safe care and treatment to patients.

At the last inspection we found most patients with a long-term condition did not all have an up to date or personalised care plan in place. During this assessment we found this had not improved. Patients either did not have a care plan in place or one had been created the week prior to the inspection, although the patient had not been seen and assessed by the nurse to develop the plan. This meant that in some cases, it was not clear how the patient should manage their condition effectively and that they were not involved in management of their care.

Inpatient Unit

At the last inspection we found patient care plans lacked pertinent information, were not personalised and patients were not provided with a copy. During this assessment we

found there had been no improvement. Care plans did not always state what the diagnosis was, if made, and what the goals and expected outcomes were. Care plans were generic and lacked sufficient detail about why the patient was on the unit, what their goals were, how staff could monitor improvements including the patients’ mental state.

The judgement for Delivering evidence-based care and treatment is based on the latest evidence we assessed for the Effective key question.

The judgement for How staff, teams and services work together is based on the latest evidence we assessed for the Effective key question.

The judgement for Supporting people to live healthier lives is based on the latest evidence we assessed for the Effective key question.

The judgement for Monitoring and improving outcomes is based on the latest evidence we assessed for the Effective key question.

The judgement for Consent to care and treatment is based on the latest evidence we assessed for the Effective key question.