The Shores – Dorset SARC

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We assessed 2 quality statements under the effective key question. Patients’ needs were systematically assessed, and their care and treatment were delivered according to standards and evidence-based practice. Staff understood the importance of seeking informed consent and always carefully explained to patients what their rights around consent were.

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

Patients over 16 years of age were examined by either one of the provider’s doctors or one of the nurses, patients between the ages of 13 and 15 years were seen by one of the provider’s doctors; and all patients under the age of 13 were seen jointly by one of the provider’s doctors and a paediatrician from the local hospital.

Prior to attending the SARC, patients underwent an initial telephone screening by staff. This helped identify medical risks that needed to take priority over the forensic examination and any additional patient requirements to inform the planning and timing of their visit to the SARC.

Patients attending the SARC received a comprehensive assessment of their needs, including their medical and sexual history, mental health and any safeguarding concerns. Staff used standardised templates in assessing and examining patients that reflected current guidance from the Faculty of Forensic and Legal Medicine (FFLM) and other health standard bodies. Patient records we reviewed were detailed, legible and clearly outlined the care and treatment given by staff.

Recognised clinical screening tools were used to identify anyone who might be experiencing withdrawal symptoms from drugs or alcohol. Health needs arising from exposure to unprotected sexual activity, such as the need for post exposure prophylaxis and emergency contraception, were identified through assessment that met guidelines issued by the British Association of Sexual Health and HIV (BASHH) and the Faculty of Sexual and Reproductive Healthcare (FSRH) respectively. The service did not provide testing for sexually transmitted infections but made referrals to local sexual health services if needed.

Staff worked with police and social care colleagues to support patients who attended the service frequently to ensure a co-ordinated and consistent approach to their needs.

The SARC had clear referral pathways in place to support patients’ holistic needs and records showed that appropriate onward referrals to other agencies such as independent sexual violence advisors, GPs, counselling and substance misuse services had been made.

The judgement for Delivering evidence-based care and treatment is based on the latest evidence we assessed for the Effective key question.

The judgement for How staff, teams and services work together is based on the latest evidence we assessed for the Effective key question.

The judgement for Supporting people to live healthier lives is based on the latest evidence we assessed for the Effective key question.

The judgement for Monitoring and improving outcomes is based on the latest evidence we assessed for the Effective key question.

Staff received specific training in patient consent and those we spoke with demonstrated a sound knowledge of the Mental Capacity Act (MCA) and its requirements. One sexual offences’ examiner (SOE) gave us an example of where they had used the MCA effectively to ensure an older patient living with dementia received a forensic examination. This had led to forensic evidence being collected and a successful prosecution.

A crisis worker reported they spent considerable time explaining forensic procedures to ensure patients fully understood what would happen during the examination and emphasised that they could withdraw their consent at any point.

Signed consent was obtained from all patients at the beginning of their visit, evidence of which we viewed in the notes we reviewed. Patients had to actively consent for the use of specialist equipment to record sensitive images, for forensic samples to be taken and for medical notes to be shared with police and legal representatives.

For children, consent was obtained from their advocates or carers in accordance with FFLM guidelines. Parental responsibility was documented and staff told us of the additional measures they had taken to ascertain who held the parental responsibility for one young person who had recently attended the SARC. Staff also considered Gillick competence and Fraser guidelines when supporting children and young people, although this could be better documented on the patient case notes.

Following an examination, patient consent was actively sought again for referral to a range of healthcare professionals and aftercare services.