Maudsley Hospital

Updated 18 March 2022

HMP Wandsworth is a local Category B prison in inner West London. It is a designated resettlement prison holding up to 1368 adult men and some young adults. The prison is operated by Her Majesty’s Prison and Probation Service.

SLAM is contracted to provide mental health care for patients. SLAM is registered with CQC to provide the following regulated activities from its trust headquarters: Treatment of disease, disorder or injury, and Diagnostic and screening procedures.

Our last inspection of HMP Wandsworth was a joint inspection with HMIP in September 2021.

The reports from these inspections can be found here:

https://www.justiceinspectorates.gov.uk/hmiprisons/wp-content/uploads/sites/4/2022/01/Wandsworth-web-2021.pdf

Following the inspection in September 2021, SLAM have agreed to hand over the management of mental health services to another provider from 1 April 2022.

Updated 18 March 2022

We carried out an announced focused inspection of healthcare services provided by South London and Maudsley NHS Foundation Trust (SLAM) at HMP Wandsworth on 1 and 2 February 2022.

Following our last joint inspection with Her Majesty’s Inspectorate of Prisons (HMIP) in September 2021, we found that the quality of healthcare provided did not meet the fundamental standards. We issued a Section 29A Warning Notice. We also issued a Requirement Notice in relation to Regulation 18, Staffing of the inpatient unit as well as the Assessment and Liaison Service (The Assessment and Liaison service forms part of the Outpatient Mental Health provision) under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The purpose of this focused inspection was to determine if SLAM was meeting the legal requirements and regulations under Section 60 of the Health and Social Care Act 2008, and that patients were receiving safe care and treatment.

We do not currently rate services provided in prisons. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.

This was a focussed inspection, we looked at a range of areas, for staffing, we concentrated on the Inpatient unit as well as the Assessment and Liaison Service which forms part of the outpatient provision for Mental Health, having identified concerns with these two distinct areas as part of our September 2021.

At this inspection we found:

• Patients waiting to be assessed by mental health professionals were reviewed and welfare checks made for most patients.
• Staff understood and applied the Mental Capacity Act.
• Referrals were reviewed thoroughly by a team of clinicians.
• Staff understood the needs of patients they supported and helped them manage their treatment or condition.
• The service continued to have high staffing vacancy rates for the inpatient unit, although there had been some improvement in covering unfilled shifts.
• There had been a slight improvement in staffing of the Assessment and Liaison Service, which supported an improved referral and waiting list management process, however, more staff were needed to ensure the full range of therapeutic services were available to patients.
• Therapy cover was inadequate and therapeutic interventions had been stopped for new patients and significantly reduced for existing patients. There were no short-term crisis interventions available to patients, although welfare checks were made as required.
• Governance systems needed strengthening, performance monitoring was not comprehensive and some information was not accurately reported. Incidents were not always reported in line with policy.
• Patients who required transfer to secure mental health inpatient services waited too long.

The areas where the provider should make improvements are:

• Deploy sufficient numbers of suitably qualified, competent, skilled and experienced staff.
• Ensure all incidents are reported in line with its incident reporting policy.
• Produce accurate performance reports which contain meaningful information.
• Ensure all patients receive a welfare check and/or assessment as needed.
• Ensure therapeutic interventions are available for patients as needed.
• Ensure crisis intervention is available for patients as needed.
• Ensure all patients who require transfer to a secure mental health inpatient service are transferred in line with national timescales.