This inspection was an announced focused inspection carried out on 2 May 2018 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 31 July and 4 August 2017. The July – August 2017 comprehensive inspection was carried out in partnership with Her Majesty’s Inspectorate of Prisons (HMIP) under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions in accordance with our published methodology. CQC issued two Requirement Notices under regulations 12 and 17 of the Health and Social Care Act to G4S Health Services (UK) Limited. These can be found in Appendix 2 of the joint inspection report. The joint inspection report can be found at:

https://www.justiceinspectorates.gov.uk/hmiprisons/inspections/hmp-northumberland-2/

This focused inspection report covers our findings in relation to those aspects detailed in the Requirement Notices dated 21 November 2017. We do not currently rate services provided in prisons.

Our key findings were as follows:

• Medicines were now transported safely around the prison.

• Fridge temperatures were now monitored to ensure the integrity of medicines

• The local policy for the completion of electronic in possession risk assessments was not being followed, however, where paper risk assessment templates were completed they were scanned into clinical records promptly.

• Staff received regular supervision.

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

The provider should:

Improve governance arrangements to provide adequate assurance that the service is being assessed and monitored and that improvements to the quality and safety of the service are being made including:

• Reviewing medicine storage arrangements and monitoring in line with relevant guidance.

• Monitoring the embedding of new systems and processes, progress against action plans and taking appropriate action where progress is not as expected.

• Ensuring that managers have sufficient knowledge and understanding of new processes, regulations and national guidance to effectively support staff and monitor the safety and quality of the service.

• Working cohesively with other registered healthcare providers to ensure shared governance and audit arrangements are fully effective around areas of joint responsibility.

Background to HMP Northumberland

HMP Northumberland is a category C training prison which was formed in 2011 from the amalgamation of HMP Acklington and HMYOI Castington. The site covers several square miles with health services delivered from several locations across the prison. During our visit HMP Northumberland was holding around 1,340 male prisoners.

Health services at HMP Northumberland are commissioned by NHS England. The contract for the provision of primary healthcare is held by G4S Health Services (UK) Limited. This report covers our findings in relation to those aspects detailed in the Requirement Notices issued to G4S in November 2017. We do not currently rate services provided in prisons.

CQC inspected this location with HMIP between the 31 July and 4 August 2017. We found evidence that fundamental standards were not being met and two Requirement Notices were issued:

• Regulation 12, Safe care and treatment

• Regulation 17 Good governance

These were for breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We subsequently asked the provider to make improvements regarding this breach.

How we carried out this inspection

This inspection was carried out by one CQC health and justice inspector and one CQC pharmacist specialist with guidance from a CQC specialist clinical advisor.

During this inspection we reviewed the action plan submitted by G4S to demonstrate how they would achieve compliance with. We reviewed documentary evidence including minutes of meetings, reports generated from the electronic patient clinical record system and made observations of the areas of risk identified at the last inspection. We reviewed patient clinical records and spoke with healthcare staff, managers and the prison governor.