HMP Lowdham Grange

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We did not inspect the safe key question in full as part of this focused inspection.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

The judgement for Learning culture is based on the latest evidence we assessed for the Safe key question.

At our last inspection we found that there was no safe system to manage patient applications and ensure patients received the care they needed in a timely manner. Only one administrator had access to the electronic system to view the applications patients had made, and only one hour per week was allocated to view the applications and action them which was insufficient. There was no process to review patient applications in the absence of the one staff member with access to the system, and we were not assured that patient applications were clinically triaged to manage patient risk effectively. At this inspection the management of patient applications had improved. We found that: • Most of the staff team had access to the patient application system rather than reliance on one staff member’s access. • Patient applications were reviewed daily. • Clinical staff triaged patient applications to ensure patients received an appropriate and timely response. • Daily checks were in place for managers to ensure patient applications were reviewed in a timely manner.

At our last inspection we found that patients with identified need for psychological therapy did not have their needs met. 72 patients were waiting for psychological interventions, and although the mental health team was unable to provide routine services due to operational safety concerns within the prison, no efforts had been made to support patients in alternative ways such as using in-cell telephony or bringing patients to the healthcare centre. A psychology assistant had been re-deployed, and a psychologist post was vacant. At this inspection the waiting list for patients awaiting psychological therapy had reduced and those patients waiting were monitored for signs of deteriorating mental health. We found that: • 43 patients were awaiting psychological therapy treatment with the longest waiting time approximately 15 weeks. This was in comparison to a waiting time of up to 1 year at our last inspection. • The provider had adopted their ‘waiting well’ policy which meant that patients were reviewed regularly during the waiting period. • Drop-in clinics were available on a regular basis for patients to access interim support. • A psychologist visited the service for 2 sessions per week to provide psychological therapy and 3 new staff members had joined the psychology team to offer group work, low level interventions and counselling. • Assistant mental health practitioners offered group sessions for patients awaiting or receiving psychological therapy such as art and games in the well-being centre.

The judgement for Safeguarding is based on the latest evidence we assessed for the Safe key question.

The judgement for Involving people to manage risks is based on the latest evidence we assessed for the Safe key question.

The judgement for Safe environments is based on the latest evidence we assessed for the Safe key question.

The judgement for Safe and effective staffing is based on the latest evidence we assessed for the Safe key question.

The judgement for Infection prevention and control is based on the latest evidence we assessed for the Safe key question.

The judgement for Medicines optimisation is based on the latest evidence we assessed for the Safe key question.