The Glade Sexual Assault Referral Centre-Telford

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We assessed 5 quality statements under this key question.

We found safeguarding arrangements were embedded throughout the service, supported by strong clinical leadership and clear governance processes to protect patients from harm. The premises were well maintained, secure and designed to support the delivery of safe forensic and clinical care. Medicines were managed safely.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

The judgement for Learning culture is based on the latest evidence we assessed for the Safe key question.

The judgement for Safe systems, pathways and transitions is based on the latest evidence we assessed for the Safe key question.

The service had comprehensive safeguarding policies and procedures in place to support staff in recognising, reporting and responding appropriately to concerns about abuse and neglect. All staff had completed safeguarding training appropriate to their role and attended regular safeguarding supervision sessions. The manager had undertaken level 4 safeguarding training, together with additional training to enable her to provide specialist safeguarding supervision and support to staff.

Staff demonstrated a good understanding of safeguarding responsibilities and told us there was a low threshold for raising concerns. They provided recent examples of safeguarding referrals they had made to protect people from harm. We reviewed patient records and found evidence of effective safeguarding practice. Clinical records contained detailed assessments that clearly identified patients risks, vulnerabilities and the safeguarding actions required to protect them. Safeguarding considerations formed part of daily patient case review discussions to ensue referrals to partner protection agencies had been made.

The provider had introduced an electronic system that enabled the identification of people who attended the service frequently, including those who had accessed other SARC within the provider's portfolio. This allowed staff to link contacts across services and identify patterns of repeated attendance. Where a person had more than 3 contacts within a 6-month period, a bespoke care plan was developed to ensure their needs were met through a coordinated, consistent and person-centred approach. We reviewed an example of this in the case records sampled.

The service manager was new in post but told us she planned to strengthen partnership working by developing closer links with local safeguarding teams and the multi-agency risk assessment conference (MARAC) service, especially as SARC staff were not routinely invited to strategy meetings which concerned her.

The provider had established a network of Freedom to Speak Up Champions, providing staff with an independent route to raise concerns, seek advice and speak up about issues affecting patient safety and the quality of care. Information on how to raise concerns, both internally and through external channels, was readily available to staff via the provider's intranet.

The judgement for Involving people to manage risks is based on the latest evidence we assessed for the Safe key question.

Overall, the premises were well maintained, secure and designed to support the delivery of safe forensic and clinical care.

The exterior of the building was covered by CCTV to help maintain the safety and security of patients, staff and visitors. Appropriate signage was displayed at the entrance to inform people that it was in operation.

We reviewed records relating to fire safety, gas safety, portable appliance testing (PAT) and equipment maintenance. These demonstrated that servicing, testing and maintenance were undertaken at appropriate intervals to ensure the ongoing safety of the premises and equipment. Staff routinely flushed water outlets in accordance with local procedures to reduce the risk of legionella contamination and maintain water safety standards. The service had 2 trained fire marshals, and the newly appointed manager had recently introduced regular fire drills to ensure staff were familiar with emergency evacuation procedures.

Control of Substances Hazardous to Health (COSHH) information sheets and risk assessments were available for all hazardous substances used within the SARC, supporting the safe handling of these materials.

The manager completed comprehensive monthly health and safety inspections to provide assurance that the environment remained safe. These checks covered a wide range of areas, including fire safety, electrical fixtures and fittings, environmental temperatures and general building safety.

The premises had been designed to meet relevant ISO and forensic science regulatory standards). Access to the building was appropriately controlled, with measures in place to prevent unauthorised entry and maintain the security of patients, staff and forensic evidence.

The forensic examination room was secured when not in use, and the service maintained an audit trail of staff access to the area. Appropriate safety measures had been implemented throughout patient areas. For example, bathroom doors could be opened from the outside in the event of an emergency, such as a patient becoming unwell or collapsing. Some fixtures and furnishings had been specifically selected to reduce ligature risks, and the service had completed a ligature risk assessment to identify and manage any remaining risks. A ligature cutter was readily available should it be required.

Staff had access to dedicated facilities for donning and removing personal protective equipment A shower facility was also available to enable staff to decontaminate between cases where there was a risk of cross-contamination, including cases involving linked individuals.

Medical consumables were stored securely within a dedicated storeroom used exclusively for clinical supplies.

The service had arrangements in place to respond to medical emergencies. Staff were trained in basic life support, and some emergency equipment was readily available and subject to regular checking. However, we found that the contents of the emergency equipment did not fully meet the standards recommended by the Faculty of Forensic and Legal Medicine (FFLM). In addition, the SARC did not stock medicines commonly used to manage medical emergencies such as acute asthma attacks, seizures or chest pain.

The service had enough appropriately qualified, skilled and experienced staff to meet the needs of patients accessing the SARC.

At the time of our inspection, the service employed 5 sexual offence examiners (SOEs), 2 crisis workers and a SARC manager. The service had experienced some recent staffing pressures; however, recent recruitment had strengthened capacity, and the service expected to be fully staffed from September 2026 following the appointment of new staff.

Staff told us that patient care and critical forensic examination timescales had not been adversely affected by staffing shortages. They explained that patients could, where necessary, be seen at other SARCs within the region to ensure timely access to care and forensic services. Senior managers met with police colleagues on a fortnightly basis to review staffing levels, discuss operational pressures and maintain oversight of any emerging risks.

Recruitment processes were robust. We reviewed the personnel files of 2 recently appointed staff members and found that appropriate pre-employment checks had been completed before they commenced employment. These included verification of identity, police vetting, satisfactory references and Disclosure and Barring Service (DBS) checks, providing assurance that staff were suitable and safe to undertake their roles.

All staff completed a comprehensive induction programme. The provider had received formal accreditation from the Faculty of Forensic and Legal Medicine (FFLM) for its induction course. Staff told us they felt well supported when joining the service and were given sufficient time to develop the knowledge, skills and confidence required for their role.

Staff maintained their competence through regular refresher training, continuing professional development and peer review activities. Training records showed that staff were up to date with mandatory training, including health and safety, infection prevention and control, female genital mutilation, information governance and medicines management. All SOEs had received training in statement writing and giving evidence in court to support their role within the criminal justice process. However, none of the SOEs held FFLM status, as recommended in national guidance.

Staff competence was monitored and assessed regularly. Each year, the associate head of healthcare observed SOEs undertaking a complete end-to-end forensic examination to assess their ability. Staff also had access to instructional videos and learning resources through the provider's intranet to support procedures that were undertaken less frequently. Where an SOE had not performed a particular procedure for a period of 3 months, their competency was reassessed.

Staff received regular supervision to support their professional development and wellbeing. This included quarterly safeguarding, management and clinical supervision sessions. Staff also received an annual appraisal, which they described as meaningful and beneficial in supporting their ongoing development and performance.

The provider had comprehensive infection prevention and control (IPC) policies and procedures in place to support the safe delivery of care and maintain forensic integrity. Records demonstrated that staff were up to date with mandatory IPC training and understood their responsibilities for maintaining a clean, safe and hygienic environment.

Effective cleaning and monitoring processes were in place. Daily, weekly and monthly cleaning schedules were completed, and the premises underwent a monthly deep clean. Regular IPC audits were undertaken to provide assurance that standards were being maintained and to identify opportunities for improvement.

To support forensic standards, environmental DNA monitoring was carried out on a quarterly basis. This provided assurance that cleaning processes were effective in removing residual DNA and minimising the risk of contamination within the forensic examination environment.

Cleaning equipment and materials were colour coded and stored separately from forensic consumables, helping to reduce the risk of cross-contamination. Clinical waste was stored securely in locked external containers pending collection and disposal in accordance with relevant waste management requirements.

At the time of our inspection, the service did not have an on-site laundry facility. Patient towels were transported to a neighbouring SARC in Bransford for laundering. However, arrangements were in place for the installation of a dedicated laundry facility shortly after our visit, which would further strengthen local IPC arrangements.

During our inspection, we found all areas of the SARC, including the waiting area, toilet facilities, storage areas and corridors, to be visibly clean, tidy and well maintained. The forensic examination room had been designed to support both effective infection prevention and forensic practice. It was fitted with sealed flooring, coved edges and smooth, non-porous work surfaces, enabling thorough cleaning between examinations. Handwashing facilities within the examination room met recognised standards and were readily accessible to staff.

Following each examination, crisis workers completed a comprehensive cleaning process to ensure the room was safe for subsequent use and to remove any potential DNA contamination.

The provider had comprehensive medicines management arrangements in place to support the safe storage, handling, prescribing and administration of medicines. Patient Group Directions (PGDs) were in place, enabling registered nurses to supply and administer specified medicines safely within their scope of practice.

The service maintained a limited formulary of medicines relevant to the needs of patients attending the SARC, including emergency contraception, HIV post-exposure prophylaxis (PEP) medication and the Hepatitis B vaccine. Appropriate refrigerated storage facilities were in place for temperature-sensitive medicines, and systems were established to monitor and record refrigerator temperatures. Staff carried out regular stock checks, and records we reviewed demonstrated that stock levels were accurately maintained and reconciled.

Staff maintained accurate and comprehensive records of all medicines supplied or administered to patients. Clinical records included details of the medicine provided, dosage, date of administration and batch numbers, ensuring full traceability. We reviewed a sample of patient records and found this documentation had been completed consistently. Records also demonstrated that clinicians routinely assessed patients for the need for HIV PEP and supplied these medicines in accordance with current national guidance and best practice.

National safety alerts and other relevant safety notices were disseminated promptly to staff. This ensured staff remained informed of emerging safety issues and any actions required to protect patient safety.