Updated 18 December 2019
We carried out this announced inspection over two days on 9 and 10 July 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. Two CQC inspectors, supported by a specialist professional advisor, carried out the inspection.
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.
Our key findings were:
- The service had systems to help them manage risk.
- The staff had suitable safeguarding processes and 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 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 clients’ needs.
- The service had effective leadership and a culture of continuous improvement.
- Staff felt involved and supported and worked well as a team.
- The service asked staff and clients for feedback about the services they provided.
- The service staff had procedures to deal with complaints positively and efficiently.
- The staff had suitable 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:
- Introduce procedures so that practitioners make a full written record documenting the risks and reason for referral when contacting social care about children for whom they have concerns.
- Offer, whenever possible, a choice of gender of forensic examiner to all patients, particularly for children and young people under 16 years old.
- Complete the planned programme of level three children’s safeguarding training, including multi agency sessions for all relevant staff.
- Consider how the communication needs of patients whose first language is not English are met.
Background
The Hazlehurst Centre is a sexual assault referral centre (SARC). The SARC provides health services and forensic medical examinations to anyone, of any age, in West Yorkshire who has experienced sexual violence or sexual abuse. The centre, which is used solely for the SARC service, is set back from a busy road in Dewsbury, Wakefield. The SARC has a discreet side entrance and car parking is available. The building is single storey and therefore offers some accessibility for people with limited mobility. The mobility needs of all patients are fully assessed on first contact with the service, before the patient attends the centre. Should a patient require a fully accessible building they are given an appointment at a sister centre within the region or in certain circumstances patients can be seen in their own home. The SARC currently has limited space, this is recorded on the organisation’s risk register as a concern and a new building is under construction. There are two examination rooms in use in the centre which are used to capacity.
The adult SARC service is jointly commissioned by NHS England and the Police and Crime Commissioners across Yorkshire and Humberside. Adult services are available 24 hours a day, seven days a week by appointment. The SARC welcomes adults and young people of any gender over the age of 16 either by police referral or by self-referral. The Hazlehurst Centre works closely with neighbouring SARCs to ensure adults access the service best suited to their needs and geographical location.
The paediatric service is jointly commissioned by NHS England and the West Yorkshire Police and Crime Commissioner. An acute paediatric clinic for children and young people, of any gender, aged 0 -15 from West Yorkshire operates during the day, seven days a week. Referrals into the paediatric service must be made by a professional, however if a young person under the age of 15 calls the SARC and requests help this will be arranged following the completion of a strict safeguarding protocol. Over weekends and bank holidays the centre is the regional paediatric on call SARC facility therefore children from across North Yorkshire and Humberside can access this service.
The staff team includes a centre manager, Forensic Nurse Examiners (FNEs), administration staff, adult crisis workers, paediatric crisis workers and paediatric Forensic Medical Examiners (FMEs). The Hazlehurst Centre team offer referrals to Independent Sexual Violence Advisors (ISVAs) and counsellors, these staff members are provided by victim support and were therefore not part of this inspection.
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 Hazlehurst Centre was also the medical director for Mountain Healthcare Limited. We have used the terms ‘registered manager’ and ‘centre manager’ to differentiate between the two roles.
During the two-day inspection we spoke with seven staff members, including the registered manager, the centre manager, a forensic medical examiner, a forensic nurse examiner, an adult crisis worker and a children’s crisis worker. We reviewed the records of 16 patients. We left comment cards at the location the week before we visited and received four responses from patients who had used 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’.
We looked at policies and procedures and other records about how the service is managed.