We carried out an announced focused inspection of healthcare services provided by Bridgewater Community Healthcare NHS Foundation Trust (Bridgewater) at Bridgewater CHCFT HMP/YOI Hindley (HMP YOI Hindley) on 14 December 2018.

Following our last joint inspection with Her Majesty’s Inspectorate of Prisons (HMIP) in December 2017, we found that the quality of healthcare provided by Bridgewater at HMP YOI Hindley did not meet regulations. We issued one 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 Bridgewater were now 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 the trust had made a range of improvements to the management structure and governance processes to monitor and improve patient care and safety.

• Infection prevention and control was appropriately monitored and staff had been given appropriate training to carry out their roles.
• Local patient concerns were appropriately monitored and complaints were no longer recorded in patient clinical records.
• Managers had arranged additional training for all staff in the incident reporting and management system and the reporting and investigating of incidents had improved significantly.
• There was a range of engagement with patients to help improve the quality of the service and responses to patient surveys were positive about the service.
• Access to routine GP appointments was generally within two weeks.
• There had been a number of staffing changes in the pharmacy team and a lead pharmacist for the prison health service had oversight of pharmacy services at HMP YOI Hindley.
• Two pharmacy technicians had been recruited to support nurses with medicines administration and management and there were clear plans in place to provide further pharmacy input into HMP YOI Hindley.
• Local managers were working effectively with prison management to drive forward a range of improvements to prisoner health and wellbeing.

This inspection was an announced focused inspection carried out on 4 May 2017. The purpose of the inspection was to confirm that the service provider, Bridgewater Community Healthcare NHS Foundation Trust had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous joint inspection with Her Majesty’s Inspectorate of Prisons (HMIP) between 11 and 14 July 2016 and in the Requirement Notice that we issued on the 12 December 2016. This report covers our findings in relation to those requirements.

Our key findings were as follows:

• The management of controlled drugs had significantly improved.
• Patients received their medicines on time or within an agreed time frame.
• We found that the trust was operating an effective and accessible complaints process that upheld patient confidentiality.

We carried out this inspection alongside Her Majesty's Inspectorate of Prisons (HMIP).

The Care Quality Commission and HMIP routinely coordinate inspections of prisons and

healthcare providers.

One young person said: "Health care is good."

Another young person told us: "I’ve had my vaccines while I’ve been here. I’m up to date with them now."

The young people we spoke with told us they were very satisfied with the care and treatment they had received. One young person said. “I haven’t made a compliant, I know how to complain, but there’s nothing to complain about. I'm treated well.” We found that the Trust operated a confidential complaints system.

We found that young people received co-ordinated care and treatment when one or more providers were involved in their care.

We observed health care staff interactions with young people. We saw that these were appropriate at all times and staff were caring and sensitive in the way they spoke with and approached young people.