The Elms

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• 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.

Prior to attending the SARC, patients received an initial telephone assessment by a sexual offence’s examiner. This enabled staff to identify any urgent medical risks that required priority over the forensic examination and to determine any additional needs. This information was used to inform the planning and timing of the patient’s visit to ensure appropriate support was available.

All patients attending the service received a comprehensive assessment of their needs. This included a review of their medical and sexual history, mental health, and any safeguarding concerns. Patients were assessed for identified risk factors such as domestic abuse and non-fatal strangulation to ensure that appropriate interventions and support could be offered.

Recognised clinical screening tools were used to assess the risk of drug or alcohol withdrawal. Where required, a small amount of alcohol was held on site to manage acute withdrawal symptoms in line with relevant guidance. Staff also completed self-harm risk assessments to identify any ongoing risks and ensure patients were appropriately supported following discharge from the service.

Where patients attended the SARC on multiple occasions, specific management plans were developed to promote a coordinated and consistent approach to their care.

Additional assessments were completed for children and young people. These included consideration of social care involvement, household composition, education and their capacity to provide consent. The service was also able to provide on-site sexually transmitted infection (STI) testing for patients under 12 years of age.

Health risks associated with unprotected sexual activity were identified and managed in line with national guidance. This included assessments for post-exposure prophylaxis and emergency contraception in accordance with guidelines from the British Association of Sexual Health and HIV (BASHH) and the Faculty of Sexual and Reproductive Healthcare (FSRH).

The service had clear referral pathways to support patients’ wider health and wellbeing needs. Records demonstrated that appropriate referrals were made to partner agencies such as independent sexual violence advisors, general practitioners, counselling services and genitourinary medicine clinics. Staff routinely checked that referrals had been received by the appropriate services to ensure continuity of care.

A daily meeting was held to review each case and patient contact. This provided assurance that assessments had been completed comprehensively and that procedures had been followed correctly, supporting safe and effective care delivery.

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.

Staff received training in obtaining patient consent and demonstrated a clear understanding of the requirements of the Mental Capacity Act (MCA).

The service had developed an easy read consent form to support patients in understanding and agreeing their care and treatment.

Staff routinely assessed patients’ capacity to engage in their assessment and treatment and to make informed decisions, evidence of which we viewed in the files we checked. For children and young people, staff considered Gillick competence and ensured appropriate involvement of individuals with parental responsibility, in line with safeguarding and consent requirements.

During forensic examinations, staff checked regularly with patients to confirm their ongoing consent and willingness to proceed with the procedure.

Following examination, consent was sought again for referral to other healthcare professionals and support services to ensure patients remained involved in decisions about their ongoing care.