Herts SARC

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• 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.

Patient records we reviewed were detailed, contemporaneous and clearly outlined the care and treatment given by staff.

Patients attending the SARC received a comprehensive assessment of their needs including their mental and physical health. Patients were fully assessed for risk factors such as domestic abuse and non-fatal strangulation so that any concerns could be identified, and support offered.

Patients who attended the SARC frequently had specific care plans implemented to ensure a co-ordinated and consistent approach to their needs. Self-harm risk assessments were also completed for patients to identify support needs when they left the service. Additional assessments were undertaken for children and young people in relation to their social care history, household composition, education and ability to give consent.

Recognised screening tools were used to identify anyone who might be experiencing withdrawal symptoms from drugs or alcohol. A small amount of alcohol was kept on site to address any acute withdrawal needs in line with guidance. However, the exact amount given was not always recorded, just an estimate.

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 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 services and genitourinary medicine clinics had been made. All patient referrals were checked by staff to ensure they had been received.

All patients received a booklet following their attendance at the SARC outlining the care they had received, the medicines given and a list of referrals that had been made on their behalf. This booklet also contained helpful information about sources of support for both patients and their advocates.

A meeting was held every day to review each case that had been seen at the SARC and to ensure patients’ needs had been fully assessed, and the procedures had been followed correctly. In addition to this, regular peer reviews were undertaken, allowing for a more in-depth review of the case notes and treatment delivered to patients.

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

We found staff understood the importance of seeking informed consent from patients. Patients’ capacity to give informed consent was actively assessed, with clear guidelines in place for staff about what to do if this was in doubt.

Signed consent for examination, treatment and the taking and the storage of images was obtained for every patient. For children when appropriate, consent was obtained from their advocates or carers in accordance with FFLM guidelines at the beginning of their visit. An easy read consent form had been designed to ensure young people understood the process, and a doctor told us they always signposted children and their carers to an on-line video which explained what they could expect to happen when they visited the SARC. Staff repeatedly checked with patients throughout their forensic examination if they were happy to continue with it.

Parental responsibility was recorded on the records we viewed, and staff also considered Gillick competence when supporting children and young people.

With consent, staff also shared information with other health professionals such as GPs, mental health services and sexual health services.