HMP Guys Marsh was found to be a safer prison and the overall impression from the inspection team was of a calmer, more settled institution. Putting this into perspective, HMIP also noted that the levels of violence as being higher than that of similar prisons.
This inspection of Guys Marsh evidenced tangible progress for the first time in many years, and the Health service was described as being very good overall.
Some notable statistics from the prison for the six period prior to the inspection were that 202 prisoners had required medical intervention due to suspected new psychoactive substance use in the previous six months. 27% of prisoners had tested positive in random mandatory drug tests.
Additionally, there had been 211 reported incidents of self-harm, and at the time of the inspection, only 70 men (18%) were on the mental health team caseload. There had been five deaths since the previous inspection, one of which had been self-inflicted and three that appeared to have a connection to the use of new psychoactive substances (NPS).
Date of publication: 21 May 2019
Report type: Prison and YOI inspections
Location: HMP Guys Marsh
Healthy Prison Outcomes:
- Safety = 2 (1)*
- Respect = 3 (2)*
- Purposeful Activity = 2 (2)*
- Rehabilitation and Release Planning = 3 (1)*
Note: *Previous inspection (Dec 2016) outcomes in brackets.
Summary: Health, Well-Being and Social Care:
Staffing levels were good and the team told us they felt supported. The health care team was well trained and further relevant training opportunities were available. Clinical supervision was available to all staff and recent supervisor training for primary care staff had prompted further development, which was good.
Staff were well trained in emergency response. Senior prison officers had recently undertaken the custody officer intermediate life support training and were well supported by health care staff.
Health care services were well embedded with the developing a rehabilitative culture project. Health care staff had supported well-being initiatives as part of this work.
Health information was available across the prison, and health promotion material was widely displayed. We noted innovative, imaginative initiatives which included a mental health and well-being calendar and identification of monthly health promotion themes.
A release and well-being coordinator had recently been employed, which was a good initiative. The role included oversight of peer workers, further development of health promotion and provision of pre-release support.
An initial health care screen was undertaken and appropriate referrals made. Rates of attendance for a timely secondary health screen were very poor. An initiative to address low uptake had recently been implemented but it was too early to assess its impact.
Telemedicine had been used to support provision on site. Patients were also offered the opportunity to register with Socrates, the health care smart phone software application.
There was a high level of mental health need. In our survey, 57% of men said they had a mental health problem against the comparator of 43% and 58% said they had been helped with their mental health.
A daily MH duty worker screened referrals, responded to urgent cases and participated in ACCT reviews when appropriate. Standard templates were used to support mental health triage and reviews.
Opiate substitution treatment was administered from a dedicated treatment room on Saxon/Gwent units, and other controlled drugs were administered from the health care department.
All other administered medicines were available three times a day from two medicine administration points in the health care centre, one of which was in the health care waiting area. This resulted in medicines being administered among prisoners waiting for appointments. When we raised this, the appointments were rescheduled and the problem of prisoners crowding around the hatch was resolved. Supervision of medicines queues by prison officers had improved since our last inspection, with the allocation to health care of a dedicated prison officer.
Recommendations: Health, Well-Being and Social Care:
- Health care services should be informed by an up-to-date health needs analysis.
- All prisoners should receive secondary health screening within seven days of arrival at the prison.
- All patients should receive advance notification of their health care appointment.
- Patients requiring mental health inpatient care should be transferred without delay. (repeated recommendation)
- The clinical management of substance dependent prisoners should be strengthened by consistent specialist nurse input.
- All prisoners should have lockable cabinets in which to store their prescribed medicines. (repeated recommendation)
- Staff training and competency assessments relating to medicines administration should be reviewed to help ensure all staff administering medicines maintain their competency.
- The governance of in-possession risk assessments should be reviewed to ensure that the assessments reflect the current risks for the prisoner.
Good Practice: Health, well-being and social care:
- The care of prisoners who were self-isolating ensured that current and emerging health needs were quickly identified and managed.
CQC Requirement Notices Issued: