Updated 23 April 2019
Background
The Emerald Centre is a SARC situated in the Bedford Health Village in the north of the centre of the town of Bedford. The SARC provides forensic medical examinations and related health services to people who have been sexually assaulted who live in the local authority areas of Bedford, Luton and Central Bedfordshire (referred to collectively in this report as Bedfordshire). The service is an ‘all-age’ service; that is, for adults aged 18 and over, children and young people aged 13 and above and children under the age of 13. The service is also accessible to male, female and transgender patients.
The service is provided by a limited company and as a condition of registration they 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 Emerald Centre was also the medical director for Mountain Healthcare Limited.
NHS England and the Bedfordshire Police and Crime Commissioner jointly commission this SARC. This is the only SARC in Bedfordshire although the location shares some of its functions with the SARCs in the neighbouring local authority and police areas covering Hertfordshire and Cambridgeshire. These include the sexual offence examiner (SOE) staff rotas and the single point of access known as the pathway support service.
The service is available 24 hours each day and has a one-hour call-out time throughout the day and night. Patients can be referred to the service through the police, or children's social care for children and young people. Patients aged 13 and over can self-refer but subject to safeguards for younger patients as we have set out below.
The staff team includes a centre manager, pathway support staff and SOEs. The provider sometimes refers to SOEs as forensic nurse examiners (FNE) and paediatric forensic medical examiners (FME). We have used the term FNE and FME in this report for consistency There is one full-time crisis worker who also carries out business support functions, and three crisis workers on an on-call rota. There are also two independent sexual violence advisers (ISVA) attached to the service but who are based off site.
During our inspection we spoke with the registered manager who is also the provider’s medical director. We also spoke with the centre manager, a crisis worker, both ISVA workers, two FNEs and a paediatric FME. We looked at the records of 12 people who had used the crisis and forensic examination service (four of these were children under 13 and two were young people aged 13 and over) and a further four records of people who had used the ISVA service.
We left comment cards at the location in the week prior to our visit and received four responses from people who had used the service in that period.
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.