Safeguarding arrangements had significantly improved and new policies had embedded well. Effective measures were in place to support women with complex needs and those who were the most at risk.
Security was well managed and the systems in place to identify and manage risks were good. Security meetings were well attended, and there were excellent links to relevant outside agencies. Women considered to require specific management arrangements were dealt with particularly well and any curtailments in their regime were reasonable and justified. The availability of drugs in the prison was limited. A competent and proactive security team organised the prison drug supply reduction strategy. A good action plan was in place and issues were addressed proactively.
Living conditions in the separation and care unit (SCU) were good. Cells were clean and adequately furnished. Case management on reintegration planning had significantly improved and all the women had individual care plans. Relationships between staff and women were excellent. There were good plans in place to develop further the management of some women in the SCU who had complex needs.
Clinical and psychosocial care was very good for those with substance misuse issues and the range of interventions was comprehensive. However, in our survey women were less satisfied than in the comparator with the support offered. The peer support scheme was well organised. The substance misuse recovery unit provided a secure and well managed environment that met women’s first night, stable stabilisation and ongoing recovery needs.
Living conditions were mainly very good. Staff prisoner relationships were excellent and resettlement work was well supported. Equality and diversity provision had developed, and some positive outcomes had been achieved for prisoners with protected characteristics. Complaints were well managed. Legal services were well developed. Health services were reasonable overall and a good range of mental health support was available. Outcomes for women were good against this healthy prison test.
At the last inspection we found that outcomes for women in Mayfield were reasonably good against these healthy prison tests. We made 27 recommendations in the early of respect. At this follow up inspection we found that 13 of the recommendations had been achieved, 4 have been partially achieved and 10 had not been achieved.
Living conditions and the overall design of the prison were very good. Outside areas were very pleasant. Most cells were in good condition but some double cells they were too small and toilets were not screened effectively enough. Women appreciated the in-cell telephones. Electronic information kiosks or pods were useful and encouraged women to take responsibility for many aspects of their own lives. Staff prisoner relationships remained very good. Most women, although fewer than at the last inspection, said staff treated them respectfully, and that there was a member of staff they could turn to if they had a problem. What we saw bore this out and the staff culture had an emphasis on decency.
Good leadership ensured diversity and inclusion are high priorities. The diversity and inclusion action team provided an effective forum, enabling women to hold staff accountable for carrying out the required actions. The discrimination incident reporting form process was well managed and independently quality assured. Despite some negative responses in our survey, consultation arrangements and support for all protected characteristics were well developed.
Women from black and minority ethnic backgrounds were generally positive about equality. The prison had an independent immigration advice service offered women who were foreign nationals good accessible support. Women with disabilities generally receive good care and a new approach to social care had recently been introduced. This new approach had the potential to help women with their personal care needs. Support for younger and older women and those who are transgender was very good. Arrangements to manage gay women in relationships were reasonable. The mother and baby unit was excellent. Women wishing to practise a faith had access to a wide variety of opportunities and take up of these opportunities was high. Women of no faith had access to other activities designed to provide support.
Women could make a complaint via an easily accessible system, and this system was generally efficient. Around 20 per cent of complaints were upheld and systems were in place so lessons could be learned. Women had access to a good legal rights service, which included visits from the Women’s Advice Service.
Prisoners remain very negative about health services, particularly waiting times for prescription medicines. Despite this, we thought health services were reasonably good overall. Access to a female General Practitioner had improved. Waiting times for most services were equivalent to those in the community and attendance had improved. However, there were shortcomings in physiotherapy, podiatry and lifelong conditions management, but these were being addressed. The sexual health services and antenatal services were impressive. The inpatient unit was reasonably good but its therapeutic role was compromised because some women were admitted for non-clinical reasons.
Pharmacy services had generally improved, but some aspects of medication security and administration and controlled drug management remained poor. The supervision of medical administration was good. The dental suite had improved and access was reasonably good, but governance was inadequate. Despite limitations in primary mental health services, a good range of support was available for the very large number of women with mental health needs. This support was provided by the mental health team. Although we found the range and standard of food to be satisfactory, in our survey, only 19 per cent of respondents said that it was good. Mealtimes were reasonable and women could eat together. Women could get their first canteen promptly and make subsequent orders efficiently through the electronic pod system.