Lincolnshire SARC

Background

Spring Lodge is a sexual assault referral centre (SARC) commissioned by NHS England and the Police and Crime Commissioner for adults. The SARC service is available 24 hours a day, 7 days a week (including public holidays) to provide advice to police and patients, deliver forensic medical examinations, provide support following recent and non-recent sexual abuse, and offer onward referrals to independent sexual violence advisors (ISVA) in the Lincolnshire area.

Lincolnshire police commission the forensic medical examinations which are undertaken by Forensic Medical Examiners (FME) who are employed by HCRG Medical Services Limited (the provider). For the purpose of this inspection we inspected HCRG Medical Services Limited’s provision of FMEs to perform the forensic medical examinations. At the time of inspection there were five FMEs providing forensic medical examinations.

The SARC is located on the outskirts of the city at the back of a business park. There was parking for police colleagues and patients outside the SARC, and a side entrance through a small garden to provide separate access to staff. The building is on one level and accessible to wheelchair users. There were two forensic medical rooms which included forensic showers and toilets. The building also had a pre examination waiting room, an aftercare room, a staff shower and toilets, a kitchen area, staff offices, store rooms, and a medical room utilised by the forensic medical examiner.

During the inspection we spoke with the clinical lead who is the registered manager at the Lincolnshire SARC, and two of the five FMEs. We looked at policies and procedures, reports, and eight patient records to learn about how the service was managed.

We left comment cards at the location the week prior to our visit but did not receive any feedback cards.

HCRG Medical Services Limited provide the forensic medical service and as a condition of registration 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 Lincolnshire SARC is the area manager for the provider.

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.

Our key findings were:

• The service had systems to help them manage risks presented to the service.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• FMEs 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 was effective.
• The FME service had a culture of learning and continuous improvement.
• Staff felt supported and had good joint relationships with co-located colleagues at the SARC.
• The provider encouraged staff and patient feedback about the services they provided.
• Complaints were managed and investigated efficiently.
• The provider had suitable information governance arrangements.
• The SARC environment was welcoming, appeared clean, and was well maintained.
• Infection control procedures reflected published guidanceand had been adapted with Covid-19 guidance to ensure services remained available to patients throughout the pandemic.

We identified regulations the provider was not meeting. They must:

• Ensure that a system is in place to be assured that safeguarding concerns have been reported and followed up in a timely manner.
• Ensure that patient records are complete and contemporaneous, and evidence the discussions with patients and/or their responsible adult to explain the clinicians decision making and the rationale for care and treatment provided.

We identified areas for improvement. The provider should:

• Ensure that all patients have the option to be examined by a female clinician.

Full details of the regulation/s the provider was/is not meeting are at the end of this report.