This inspection was an announced focused inspection carried out on 4 December 2017 to confirm that the provider had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection between 20 and 23 March 2017. The March 2017 comprehensive inspection was carried out in partnership with Her Majesty’s Inspectorate of Prisons (HMIP) in accordance with our published methodology.

This report covers our findings in relation to those aspects detailed in the Requirement Notices dated 28 July 2017 and the joint HMIP/CQC report recommendations that related to healthcare delivery. We do not currently rate services provided in prisons..

Our key findings were as follows:

• There were positive relationships between trust staff, the prison and service commissioners, which were contributing to service improvements.

• Significant improvements had been made to the way medicines were managed that improved patient safety, patient experience and the effectiveness of medicines. There was good oversight and monitoring by a pharmacist.

• The safety of the dental service was monitored and risks were being addressed. The planned refurbishment of the dental suite had not commenced and there were concerns about the reliability of ageing equipment.

• Actions to improve services to patients with mild to moderate mental health needs were well advanced but not yet complete.

• Patients’ general health was being more actively promoted and a joint wellbeing strategy was being developed with the prison.

• Trust staff were no longer providing personal care to prisoners. Proper formalised arrangements were in place to ensure prisoners’ personal care needs were met.

  However, there were also areas of practice where the provider needs to make further improvements.

The provider should:

• Implement additional recommendations from the NHS England Pharmaceutical Adviser’s report (September 2017) to ensure best practice in medicnes optimisation

• Continue to work proactively with the prison and NHS England commissioners to ensure that the planned dental suite refurbishment is completed as soon as possible.

• Complete the planned recruitment of nursing staff intendedto ensure that patients’ needs are consistently met.