HMP Dovegate

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We did not inspect the safe key question in full as part of this focused inspection. We looked at 2 quality statements for this key question and reviewed the breaches from the last inspection. We found the provider had addressed the previous breaches and were now compliant with the relevant regulations. We found that patients were seen by a member of the healthcare team for a health screening on arrival regardless of their arrival time at the prison. Additionally, there had been improvements to out of hours arrangements to reduce delays for patients receiving prescribed medicines.

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

The judgement for Learning culture is based on the latest evidence we assessed for the Safe key question.

At our last inspection we found when patients were not able to receive a full healthcare screening on arrival at the prison, not all measures were taken to identify and address immediate risks and prescribing requirements. We also found patients with identified risk were not always monitored during their first night in custody for signs of deteriorating health.

During this inspection we reviewed records for 12 patients who had recently arrived at the prison. We found patients were seen by a member of the healthcare team for a health screening on arrival regardless of their arrival time at the prison. Night staff completed an ‘exceptional safety assessment’ which identified immediate risks and prescribing requirements for patients if a full health screening was not possible. Additional funding had been agreed with NHS England commissioners to increase staffing levels to cover the evening period when a high number of new receptions arrived at the prison. The provider was in the process of recruiting to these additional positions. Managers carried out routine audits to ensure all patients arriving at the prison received a reception screening or emergency safety assessment. The night shift rota ensured a minimum of 1 staff member was available per night to monitor patients during their first night in custody where risks had been identified.

At our last inspection, staff relied upon the good will of off duty staff to prescribe medicines out of hours remotely. This resulted in some patients not receiving their prescribed medicines on their first night in custody. We also found remote prescribers were not always given the level of information required to prescribe, which also resulted in delays to patients receiving medicines.

At this inspection, we found there had been improvements to out of hours arrangements to reduce delays for patients receiving prescribed medicines. Records we reviewed during the inspection did not show any delays to patients receiving prescribed medicines. We found that a prescriber was scheduled on the staff rota to cover reception daily until 8pm. Managers had developed a relationship with the out of hours provider to improve communication and agree an algorithm for staff to follow where remote prescribing was required. The out of hours algorithm had been shared with all staff and the out of hours contracted provider offered remote prescribing to any patients arriving at the prison after 8pm.

The judgement for Safeguarding is based on the latest evidence we assessed for the Safe key question.

The judgement for Involving people to manage risks is based on the latest evidence we assessed for the Safe key question.

The judgement for Safe environments is based on the latest evidence we assessed for the Safe key question.

The judgement for Safe and effective staffing is based on the latest evidence we assessed for the Safe key question.

The judgement for Infection prevention and control is based on the latest evidence we assessed for the Safe key question.

During our last inspection, we found staff did not always follow the provider’s patient group direction (PGD) for Diazepam when patients presented with mild withdrawal symptoms. We also found the provider’s Diazepam PGD had expired for a brief period, which was only identified when a staff member was unable to use it to prescribe out of hours.

At this inspection we did not identify any cases where the Diazepam PGD was not followed when appropriate. In addition, the on-site pharmacist had implemented a new process on the electronic record system to flag any PGDs which were due for review to reduce the risk of a PGD expiring without review.