HMIP Report – Health Summary: HMP Ashfield, Mar-Apr 2019

This report was on an unannounced inspection of HMP Ashfield between 25 March to 12 April 2019, and was published in July 2019.

General Points of Note.

Low levels of violence and bullying incidents, with just one fight and seven assaults recorded in the previous six months. There were six incidents of use of force for the same period.

In the previous six months, there had been only 25 self-harm incidents and 39 ACCT documents opened for prisoners at risk of suicide or self-harm. There have no self-inflicted deaths since the prison was re-roled in 2013.

95% officers had undertaken mental health awareness training.

At the time of the inspection, there were 338 Enhanced regime prisoners under the Incentives and Earned Privileges (IEP) Scheme. This represents approx 84% of the population. None were on Basic regime.

Healthy Prison Outcomes:

2015 2019
Safety 4 4
Respect 4 4
Purposeful Activity 2 4
Rehabilitation & Release Planning 3 2

Outcome Ratings:

Rating Outcomes for Prisoners
4 Good
3 Reasonably Good
2 Not Sufficiently Good
1 Poor

Key Points of Interest: Health, Well-Being and Social Care:

In the survey, 84% of respondents said that the overall quality of health care was quite or very good. There was a well-established health care improvement group, which met every six weeks and enabled prisoner representatives to consult on services.

95% prison staff who had regular prisoner contact had been trained in first aid and the use of the automated external defibrillators (AED).

Nurses worked from 7.30am to 6pm every day, Monday to Sunday. Leadership of the team was strong and all staff were supported. Managerial and clinical supervision was established and systems to learn lessons were embedded.

Prisoners could request appointments using the touchscreen information kiosks on the wings.

The number of prisoners who failed to attend health care appointments was low. Patients requesting a routine GP appointment had to wait up to three weeks. Urgent appointments would be facilitated the same day.

A monthly social care drop-in centre was an excellent initiative, where caring, dedicated staff, including a social worker, occupational therapist and health care worker, listened to prisoners’ support needs and helped to ensure that they were fully met, so far as was possible.

In the previous six months, the Mental Health team had received 84 referrals. MH practitioners offered one-to-one interventions to 17 patients, and prisoners could also participate in groups focusing on low mood and anxiety, which was a positive development. In the same period, only six patients had presented with severe and enduring mental health problems. There had been no transfers under the Mental Health Act in the previous 12 months.

In the previous six months, 52 prisoners had been assessed for substance misuse support. The current caseload for structured one-to-one work (mainly relapse prevention), stood at 12. Only two prisoners had required opiate substitutes (OST) in the previous two years.

Substance Misuse and Mental Health practitioners were co-located, shared patient records and co-facilitated groups, which benefited patients.

Most prisoners were on in-possession medication, and for all of the records sampled by inspectors, there was an up-to-date in-possession risk assessment stored on SystmOne.

Recommendations: Health, Well-Being and Social Care:

  • There should be an up-to-date health and social care needs analysis.
  • Trained and supervised peer workers and health trainers should offer health information and support to prisoners.
  • All prisoners with long-term health conditions should have a care plan.
  • Trauma-informed psychological support should be available for prisoners.

Good Practice: Health, Well-Being and Social Care:

  • The monthly social care drop-in service was an excellent initiative, allowing prisoners to discuss issues with a social worker, occupational therapist and health care worker.

CQC Requirement Notices Issued:

None.


Links/Resources:

Full Report Here – HMP Ashfield