The Saturn Centre SARC

Summary findings

We carried out this announced inspection on 1 and 2 October 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by two CQC inspectors who were supported by a specialist professional advisor.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Background

We carried out this announced inspection on the 1 and 2 October 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by two CQC inspectors who were supported by a specialist professional advisor.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection. The Saturn Centre SARC is a sexual assault referral centre (SARC). The service provides health services and forensic medical examinations, on an appointment only basis, to patients aged from 14 years old upwards who have experienced sexual violence or sexual abuse. It does not offer a walk in service. However, if a patient was to attend the SARC unannounced staff would endeavour to see them in a timely manner. The SARC is situated in Crawley Hospital, run by Surrey and Sussex Healthcare NHS Trust. The layout of the premises is spread over one ground floor. There is one examination room in use, which is used to capacity. The service is jointly commissioned by NHS England and the Police and Crime Commissioner. Services are available between 9am and 5pm seven days a week. There is an out of hours phone number that operates 24 hours a day, seven days a week and staff go in on an ‘on call’ basis. The staff team consisted of a centre manager, forensic nurse examiners (FNEs) and crisis workers who also work as administrators.

The service is provided by a limited company and, as a condition of registration, the company must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run. The registered manager at the Saturn Centre SARC was also the medical director for Mountain Healthcare Limited who is a member of the Faculty of Forensic and Legal Medicine. There was a centre manager on site and we have used the terms ‘registered manager’ and ‘centre manager’ to differentiate between the two roles.

Comment cards were sent to the service prior to our visit and we received two responses from patients who accessed the service. Throughout this report we have used the term ‘patients’ to describe people who use the service to reflect our inspection of the clinical aspects of the SARC. During our inspection we toured the premises and reviewed the care and health records for 16 patients who had used the service and the records for the management of medicines. We spoke with the registered manager, the centre manager, and three directors, two FNEs and two crisis workers. We checked five staff recruitment files, minutes of meetings, audits and information relating to the management of the service.

Our key findings were:

• The service had adequate systems in place to help them manage risk.
• Safeguarding processes were not always followed, though staff knew their responsibilities for safeguarding adults and children.
• The service had thorough staff recruitment procedures.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment/referral system met patients’ needs.
• The service had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The service asked staff and patients for feedback about the services they provided.
• The service staff dealt with complaints positively and efficiently.
• The staff had clear information governance arrangements.
• The service appeared clean and well maintained.
• The staff had infection control procedures which reflected published guidance.

There were areas where the provider could make improvements. They should:

• Follow up safeguarding referrals for children and adults within 72 hours of sending the referral.
• Carry out follow up calls to patients to check the outcome of referrals to Independent Sexual Violence Advisors (ISVAs) services and other health referrals into services that require follow up.
• Update paper and electronic records to ensure they match and that repeat attendances by the same patient are attributed to their unique patient number.