Updated 8 November 2022
Summary findings
We carried out a focused inspection of healthcare services provided by Norfolk Community Health and Care Trust (NCHCT) at The Harbour Centre Sexual Assault Referral Centre (SARC) on 13 September 2022.
We carried out this focused inspection using our inspection powers under section 60 Health and Social Care Act 2008. The purpose of this focused inspection was to determine if the services provided by NCHCT were meeting the legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 following an earlier inspection in January 2022 where a breach of regulation 17, ‘Good Governance’ was found. The inspection was led by a CQC inspector who was supported by another CQC inspector.
During this inspection we only focused on the following question:
Are services well-led?
We found that this service was providing well-led care in accordance with regulation 17.
We do not currently rate services provided by SARCs.
Background
The Harbour Centre is a sexual assault referral centre (SARC) based in Norwich. NHS England (NHSE) and Norfolk Police and Crime Commissioner commission the service. The SARC is available 24 hours a day, seven days a week (including public holidays) for patients over 13 years of age.
The children’s service (under 13 years of age) is available Monday to Friday (9-5 pm inclusive). Access to this service is by police or social worker referral only and following a strategy discussion. The service offer is to provide advice to police and patients, deliver acute forensic examination, provide support following recent and non-recent sexual assault and violence, and onward referrals to Independent Sexual Violence Advisors (ISVA).
The Harbour Centre has two health providers: Norwich Community Health and Care Trust (NCHCT) providing Forensic Medical Examiners (FMEs) for children and Mountain Healthcare Limited providing Forensic Nurse Examiners (FNEs) for those over the age of 13 years, including adults. The Police provide crisis workers and Independent Sexual Violence Advisors (ISVAs) and are responsible for the overall running of the SARC building including the forensic cleaning and maintenance.
This report will focus solely on the health provision for the children’s service provided by NCHCT. During this inspection we spoke with the Quality Assurance Matron for NCHCT, two consultant paediatricians who are FMEs and the Clinical Quality Director. We also reviewed the following documents:
- Competency tracker
- Quality assurance report of the SARC environment
- SARC quarterly report to commissioners
- Emergency equipment documentation
- Record keeping audit from June 2022
- Proposed SARC specific record keeping audit for October 2022
- Leaflets for children, parents / carers and leaflets in easy-read format
- Lone worker policy
- Disclosure and barring service (DBS) policy
During our inspection in January 2022, we identified that the provider was in breach of CQC regulations. We issued a Requirement Notice in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulation Activities) Regulations 2014; Good Governance.
For more details, please see the full report which is on the CQC website at:
https://api.cqc.org.uk/public/v1/reports/05eda7c0-31d2-4e79-b5ee-4ef9504eff3f?20220510070043
At the revisit inspection we found the trust had ensured:
- Paediatric life-saving equipment was onsite, and all staff were trained in intermediate life support.
- Assessment templates met the requirements set by the Faculty of Forensic and Legal Medicine (FFLM).
- Staff undertook record keeping audits to demonstrate that documentation was legible, complete and included discharge planning and onward referrals.
- There is a training competency framework in place.
- Staff have access to changing and shower facilities whilst working in the SARC.
- Children and young people and their parents/carers attending the SARC, received age-appropriate leaflets including an easy read format option.
- The trust had reviewed risks for staff and were confident that no one was working alone in the SARC.