The Emerald Centre SARC

Background to the inspection

The Emerald Centre SARC provides forensic medical examinations and related health services to people who have been victims of alleged sexual assault and who live in the local authority areas of Bedford, Luton and Central 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 accessible to male, female and transgender patients. We inspected this SARC due to its move to a new, purpose-adapted premise since our last inspection of 22 and 23 January 2019.

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.

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 and, in some instances, but more rarely, Essex. The SARC shared 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 target. Patients can be referred to the service via the police or children's social care for children and young people. Patients aged 13 and over can self-refer, but this is subject to safeguarding procedures for younger patients as we have set out below. Where people prefer or if circumstances dictate, they can also access the linked SARCs in Hertfordshire and Cambridgeshire.

The staff team included a centre manager, seven crisis workers including a paediatric crisis worker and SOEs. The provider sometimes refers to SOEs as Forensic Nurse Examiners (FNE) and 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. The service would, where appropriate, refer service users into the Independent Sexual Violence Advisers (ISVA) service who work independently of The Emerald Centre SARC.

During our inspection, we spoke with the centre manager, two crisis workers, one FNEs and two FMEs. We examined the records of nine people who had used the crisis and forensic examination service (one of these was a child under 13, six were young people aged 13 to 18 years and two aged 18 and over.

We left comment cards at the location in the week prior to our visit and received five responses from patients who had used the service during 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.

Our key findings were:

• The service had robust systems in place to ensure that people accessing the service were kept safe and risks were managed.
• Clinical staff provided care and support in line with current guidelines.
• Leaders and managers-maintained oversight of service provision to ensure quality care continued to be given.
• The service had effective leadership and maintained a culture of continued improvement.
• Staff worked together to provide a holistic service across all age groups, reducing risks to people using the service.
• The service had thorough staff recruitment procedures in place.
• Areas seen during our inspection were clean and well maintained.
• Established policies and procedures were in place to ensure effective multi-agency and multi-disciplinary working.
• Infection control procedures were in place that staff followed and these reflected published guidance.