Patients felt that individual healthcare staff treated them with respect. Comments we heard from patients in the mental health intervention unit (the Brunel Unit) included,” they always talk to me like an equal” and “they do respect my privacy and I trust them to respect it”.

Patients said they were well cared for and comments included,” … they are very patient with me”, “they do their very best here and there are some very difficult people” and “ I find the groups (therapeutic group work) very good … found the (relaxation) group very helpful”.

We found that there was a strong commitment to co-operative working between the different providers of care and treatment and between the providers and the prison staff.

Staff were trained and supported to deliver the services and meet patients’ needs. There were systems in place to assess and monitor the quality of care.

This inspection was an announced focused inspection on 26-27 June 2018, under Section 60 of the Health and Social Care Act 2008. The purpose of the inspection was to follow up on Requirement Notices that we issued following a joint inspection with Her Majesty’s Inspectorate of Prisons (HMIP) in March 2017, and to check that the provider was meeting the legal requirements and regulations associated with the Act.

This report covers our findings in relation to those aspects detailed in the Requirement Notice dated 25 July 2017 in the joint HMIP/CQC report, in respect of Regulation 9 Person Centred Care.

Our inspection team

This inspection was completed by two CQC health and justice inspectors.

During the focused inspection, we reviewed the action plan created by Avon and Wiltshire Mental Health Partnership NHS Trust (AWP), which demonstrated how they have worked to achieve meeting compliance with the requirements. We spoke with staff and looked at a range of documents and records relating to clinical practice and governance. 

Background

HMP Bristol is a category B local prison holding male prisoners. The prison is a mixture of Victorian and later 20th-century buildings, situated in a residential area of the city.

AWP provides a range of primary healthcare services to prisoners at HMP Bristol, comparable to those found in the wider community. The location is registered to provide the regulated activities: Treatment of disease, disorder or injury and diagnostic and screening procedures.

CQC inspected this location with HMIP between 13 and 16 March 2017. We found evidence that fundamental standards were not being met and issued a Requirement Notice in relation to Regulation 9, Person Centred Care, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The joint report published following the March 2017 inspection can be found by accessing the following website:

https://www.justiceinspectorates.gov.uk/hmiprisons/wp- content/uploads/sites/4/2017/07/Bristol-Web-2017-2.pdf

We subsequently asked AWP to make improvements regarding the breach. We checked these areas during this focused inspection and found the provider had addressed the previous regulatory breach identified.

In our Requirement Notice issued in July 2017, we referred to the “Brunel unit” as an “in-patient unit”. The Brunel unit is an area of the establishment where the prison accommodates some prisoners with more complex needs, it is not an inpatient-unit and the healthcare team do not independently place people onto this unit. However, healthcare staff do routinely visit prisoners on the unit.