Date of publication 08 May 2019
Report type Prison and YOI inspections
Location HMP Swaleside
Report on an unannounced inspection of HMP Swaleside (3-13 December 2018)
Main Points: Health, well-being and social care.
Health services had improved and were reasonably good but a few areas were still concerning. The chronic staffing shortages had started to reduce. Prisoners could access an appropriate range of primary care services and visiting specialists. Waiting times for primary care services were reasonable but too many prisoners did not attend their appointments. The in-patient unit provided good care for patients with very complex needs. A lack of escorts led to the cancellation of too many hospital appointments, long delays and risks to prisoners’ health. The social care referral pathway was not sufficiently well promoted. Mental health services were good but waiting times for counselling were too long – at up to 32 weeks in some cases. The emotional well-being mentors scheme was excellent, and an example of good practice. Substance misuse services were reasonably good, with flexible prescribing and a range of psychosocial support. Inconsistent supervision of medicine queues by custody staff compromised confidentiality and increased the risk of medicines being diverted. Some tradable medicines, such as dihydrocodeine (an opiate-based painkiller), were prescribed in-possession. In-possession risk assessments were too infrequent. Some prisoners waited up to 11 months for a dentist appointment, which was very poor.
Recommendations: Health, well-being and social care.
- 5.23 Prison officers should ensure that health service areas, including queues for medication, are safely and effectively managed. (2.57)
- 5.24 Professional telephone interpreting services should always be used for confidential consultations when a prisoner does not speak good English. Information should be available in a range of languages. (2.62)
- 5.25 The number of missed appointments should be reduced further, to ensure that patients receive prompt treatment within effective use of clinical resources. (2.72)
- 5.26 Arrangements for prisoners convicted of a sexual offence attending health care appointments should be safe and respectful. (2.73)
- 5.27 There should be sufficient escort staff available to ensure that prisoners’ treatment at outside hospitals is not delayed. (2.74)
- 5.28 Patients on the in-patient unit should have access to a range of therapeutic activities to support their well-being and recovery. (2.75)
- 5.29 The referral pathway should ensure that all prisoners with social care needs are identified and supported. (2.77)
- 5.30 Prisoners should have timely access to counselling services. (2.87)
- 5.31 The in-possession policy should be followed, to ensure that the prescribing of medicines is suitable for patient treatment in a secure environment, overseen by the medicines management committee. (2.102)
- 5.32 All medication that cannot be held in possession should be administered at times that ensure clinical efficacy. (2.103)
- 5.33 Risk assessments for in-possession medicines should be regularly reviewed and updated when a prisoner’s circumstances change. (2.104)
- 5.34 Prisoners requiring routine dental appointments should receive them within six weeks. (2.106)
Good Practice: Health, well-being and social care.
- 5.53 The ‘Well-being for all’ action group promoted health activities and provided relevant guidance. (2.63)
- 5.54 The emotional well-being mentors scheme encouraged better understanding and awareness of mental health issues. (2.88)