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Inspection carried out on 5 and 6 March 2019

During a routine inspection

Background

Services for the support and examination of people who have experienced sexual assault are commissioned by NHS England and Merseyside Police and provided by Manchester University NHS Foundation Trust through Safe Place Merseyside based in Liverpool city centre. The service is part of the St Marys Hospital Manchester provider services.

Forensic Physicians (FPs) and Crisis Workers (CWs) work on an on-call rota to cover daytime, nights and weekends and are available to respond to adults and young people(16-17yrs) over a 24-hour period. The service for children under 16yrs is provided by The Alder Hey Hospital and does not form part of this inspection. Any professional can refer to the Safe Place service. Self-referrals, for safety reasons, are seen during the daytime only. The staff are supported by a full-time administrator.

Safe Place Merseyside has 15 FPs and 10 CWs, both disciplines have two staff currently in training, all staff are permanent. There are two managers who work across both Safe Place Merseyside and the SARC based at St Marys Hospital Manchester.

The centre is a self-contained unit within a service building which also hosts a walk-in centre and community sexual health services. The centre meets the needs of the patients, it is discreetly signposted, and the entrance has access for people with physical disabilities. Accommodation includes a forensic medical room, bathroom, a forensic waiting room and a non-forensic waiting room.

Safe Place Merseyside are not commissioned to provide counselling or talking therapies and referrals are made to a number of local services commissioned to offer follow on care.

During the inspection we spoke with the clinical director, clinical lead, operational manager, forensic physician, two crisis workers, ISVA worker, talking therapies worker and a police officer.

Prior to and during the inspection we looked at policies and procedures and other records about how the service is managed.

Patients spoke positively about the service and the quality of care that was provided.

Our key findings were:

  • The provider had adequate systems and processes in place to identify where quality and safety were compromised.
  • The service had effective leadership and staff told us they felt well supported.
  • The premises appeared clean and well maintained.
  • The staff used infection control procedures which reflected published guidance.
  • Staff knew how to deal with emergencies.
  • Appropriate medicines and life-saving equipment were available.
  • The staff followed suitable safeguarding processes and knew their responsibilities for safeguarding adults and children.
  • Systems were in place to support multi-agency working.
  • The clinical staff provided patients’ care and treatment in line with current guidelines.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • The appointment and referral system met patient’s needs.
  • The provider asked patients for feedback to obtain their views about the services provided.
  • The staff had suitable information governance arrangements.
  • The provider had thorough staff recruitment procedures.

We identified an area of notable service.

The majority of forensic practitioners are members of the Faculty of Forensic & Legal Medicine (FFLM) or working towards membership.

There were areas where the provider could make improvements. They should:

  • Formalise an audit programme of activity including an environmental infection control and prevention audit.
  • Risk assess bathroom areas for ligature risk to patients
  • Continue to ensure policies and paperwork reflect the Safe Place Merseyside service and local partnerships processes and procedures.

Inspection carried out on 2nd October - 8th November 2018

During a routine inspection

We had not previously rated this hospital. We rated services as good because.

  • We rated maternity services as good for safe, effective, caring, responsive and well-led.
  • We rated neonatal services as good for safe, effective, responsive, well- led and outstanding for caring.
  • Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness.
  • Services took account of patients’ individual needs.
  • Services controlled infection risk well. Staff kept themselves, equipment and the premises clean. They used control measures to prevent the spread of infection.
  • Staff received appropriate education and training to enable them to provide safe care and treatment.
  • The service planned and provided services in a way that met the needs of local people. People could access the service when they needed.
  • Staff gave patients enough food and drink to meet their needs and improve their health.
  • Managers across the services had the right skills and abilities to run a service providing high-quality sustainable care.
  • Staff were committed to improving services by learning from when things went well and when they went wrong, promoting training, research and innovation.

However:

  • Not all mandatory training particularly for medical staff met trust targets.
  • Staffing was a challenge: although most shifts, over the period reviewed, met the national guidance from the British Association of Perinatal Medicine, there remained gaps in staffing on occasions.