We spoke with two people who used the service. One person said that he was given appropriate information about the service and his treatment. The other person said that staff told him that he could not see a psychiatrist because there were no arrangements for this to occur. Staff we spoke with denied that the person would have been told this because there were arrangements for detainees to see a psychiatrist when appropriate.

A satisfaction survey amongst detainees in February 2012 showed that 100 percent of respondents felt that their privacy and dignity was respected during treatment by the mental health in-reach service.

People we spoke with told us that they were satisfied with the quality of the care and treatment they received. One person said that staff treated him well and made him feel better.

This inspection concerns the mental health services at Elmley Prison.

Elmley is a purpose built local Prison serving all courts in the county of Kent. It is the largest of the three prisons comprising the Sheppey Cluster. It is a male prison. There are 6 House Blocks holding between 183 and 240 prisoners each in single, double and treble cells. The total capacity is 1234 people.

Mental health services are provided by Oxleas NHS Foundation Trust. The trust supplies an “in reach” team. This comprises three Registered Mental Nurses (RMN) and three psychology grade staff, one of whom is part time at the prison. There is a full time psychiatrist.

There other mental health staff deployed at the prison who are employed by Her Majesty’s Prison (HMP) Service. There is an in patient facility which is run HMP staff.

Prisoners who used the services said that they were very satisfied with the quality of care provided. They said their consultations had been help privately. Comments made to the inspector included ‘the best (mental health care) I have known’ and ‘… good over here (Elmley)’. Comments made in the trust’s surveys included,’ (care has been) … a positive inspiration’ and ‘(staff name) … deserves a pay rise!’.

This inspection was carried out alongside an HM Inspectorate of Prisons (HMIP).

We spoke to four people who were prisoners in receipt of a service from the Prison In-Reach

team.

There was a mixed response from people about the service they receive. Two people were very satisfied with the service and the remaining two people were dissatisfied with it.

One person said that the support and help he has received has “transformed” his life. He added that this has helped him stabilise his mental health and allowed him to keep in touch with the psychiatric services he had before entering prison. Another person described helpful appointments with a health care worker from the in-reach team for anxiety and that this involved the use of self help guides. He said that the mental health professional he saw at the sessions was respectful, commenting: “She doesn’t judge me.”

Each of the four people we spoke to said that they are treated with respect by the mental health service professionals.

Each person said that their privacy was acknowledged and that they are always seen in private.

None of the people we spoke to were aware if they had a care plan or other documents setting out the type of support they receive .Two of the four people said that the mental health professional explained the support being provided. One of these people said that this was done in a way that he easily understood. The remaining two people said that there was no explanation of the help being provided.

None of the people we spoke to were aware if they had been given any written information about the mental health in-reach team, although one person said he may have received this.

Two people said they were given letters with future appointment times and two other people said they were not.

One person aid that he had completed two satisfaction survey forms about the mental health in-reach team. The remaining three people said that they had not been given a survey form.

This inspection was carried out alongside an HM Inspectorate of Prisons (HMIP) inspection.

We spoke to 6 people who were prisoners in receipt of a service from the Prison In-Reach team. People told us that they receive a range of services including ongoing support with mental health needs as well as appointments to monitor any symptoms. People said that the appointments were always held in private and that staff explained the services’ policy on confidentiality. The Prison In-Reach team were said to treat people with respect and dignity. Comments included the following: ‘They treat me well and treat me with respect. They don’t judge me.’ Another person said, ’It means a lot to be treated in the way they treat me. It’s the only place in the prison where I feel I can go to for support.’

People also told us that the staff explain the purpose of each appointment and any treatment. People also said that they had opportunities to agree to care and felt that their views were listened to if they disagreed. People said that they received information about the service either in the form of a leaflet or verbally at their appointment.

People gave mixed views about the service they received, the overwhelming majority being positive. One person made the following comments about the individual sessions he had: ‘Very supportive. They are honest and make me acknowledge my problems. I know that if I want to see them I can see them straight away. The sessions are well structured and cover my health needs. There is time to talk. They listen to what I think and help me through those thoughts.’ Another person commented about the staff therapeutic listening skills saying, ‘They listen. They don’t just nod, but respond in a constructive manner and ask questions about what I am saying.’ One person commented that whilst he was in agreement with his appointments with the Community Psychiatric Nurse he did not feel he needed any help and another person thought the input hadn’t helped him, but, that the individual sessions gave him an opportunity to raise any problems or personal issues.

People said that they had been given a survey form to complete, which asked for their views on the service provided by the In-Reach service.

We spoke to the Senior Practitioner at the service and to the provider’s Operational Manager. We spoke to one person who was in receipt of secondary care and treatment and observed the Senior Practitioner assessing three people. We also spoke to a member of the Immigration and Removal Centre staff who had worked with Bracton Community Psychiatric Nursing Team regarding the care and treatment of people.

People said they were satisfied with the support they received. We observed that the Senior Practitioner responded flexibly to referrals made by the health centre. People were interviewed in private by the Senior Practitioner and were addressed in a calm and polite manner.

We saw there was a system for taking referrals regarding people’s mental health care which included a system for allocating assessments and ongoing support. This involved decisions about the level of intervention, which was outlined in the provider’s procedure called ‘Stepped Care Model.’

Assessment of people’s mental health needs and care plans were well recorded. People had signed to acknowledge their agreement to their care plan and the assessment included people’s views.

The service worked with other providers of health care and the officers from the Immigration and Removal Centre so that needs were monitored and the appropriate care and support given.

The provider had policies and procedures regarding the safeguarding of vulnerable adults. Staff were trained in the safeguarding of vulnerable adults.

Staff received regular training and supervision.

The service had a procedure for processing and dealing with any complaints.