Hull Royal Infirmary

On this page

• 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. Safeguarding was firmly embedded within the SARC and referrals made when required. Care was provided in a way that kept patients safe from avoidable harm. The environment was well maintained and kept clean. Medicines were safely prescribed.

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 Trust had child safeguarding policies and procedures which provided information to staff about how to identify, and report suspected abuse. Most staff had completed the appropriate level of training for their role, and the manager was addressing those staff whose training required updating. Medical and nursing staff within the team had dual roles, working within the SARC and across the Trust as part of the safeguarding team. The SARC manager and a consultant paediatrician were the Trust’s named lead nurse and doctor for safeguarding children.

A comprehensive safeguarding and risk assessment was completed for all patients prior to them attending the SARC, which identified risks and vulnerabilities; including self-harm, for both the patient and carers. Arrangements were in place with the mental health liaison team to support patients with immediate concerns regarding mental health or suicidal thoughts. Staff regularly attended safeguarding strategy meetings alongside police colleagues and the 4 local authorities. The SARC manager had identified differences in data held by the police and the SARC in relation to the number of strategy meetings attended by staff. The manager had escalated this to the Humberside Strategic Delivery Group meeting for further exploration.

Staff received safeguarding supervision, and cases were routinely discussed by staff following examinations. Staff told us the SARC manager had an open-door policy, and this provided staff with prompt support.

Freedom to Speak Up Champions were available if staff wanted to raise any concerns and staff were aware of this.

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

The SARC was located on the Hull Royal Infirmary site, and therefore essential premises and safety checks such as fire, portable appliance testing, legionella management, and equipment maintenance were completed regularly by the hospital estates department to ensure a safe environment.

To allow for changes that were needed to meet the new standards for UKAS ISO accreditation for forensic services, all acute forensic examinations from the 01 October 2025 were now completed at the regional hub in Sheffield. Only follow up appointments and non-acute examinations were completed at the SARC.

All doors to clinic rooms in the SARC were fitted with specialist locks, allowing them to be opened easily in the event of an emergency. Essential medical equipment for emergency situations in the SARC was available in the nearby children’s outpatients’ department. Some emergency medicines were available in the SARC; including adrenaline and inhalers, these were stored securely.

Staff undertook mandatory training in life support, health and safety, and fire safety. All children and young people were always supervised during their time at the SARC, this mitigated the risk regarding potential ligature points; such as the shower. Patients’ dignity was maintained by using a portable privacy screen. Staff had access to a ligature fish cutter in the event of an emergency.

CCTV was installed at the SARC following an incident in 2024, notices were on display to inform visitors, and the clinical room was not covered by CCTV. Personal safety alarms were installed in the SARC, and staff would respond to these when required.

The SARC service was staffed by a well-established and experienced team, consisting of 3 paediatric consultants, 3.5 whole time equivalent (WTE) nurses and a small administrative team. At the time of our visit there was 1.6 (WTE) nurses on maternity leave and only 0.64 (WTE) cover was in place. The impact on the service was minimal, as staff worked together to ensure the service was covered and that patient care had never been compromised due to shortages.

Staff recruitment was managed centrally by the Trust’s human resources department. Information we reviewed for the most recently recruited staff members demonstrated that appropriate pre-employment and vetting checks had been completed to ensure they were suitable for their role.

All new staff underwent the Trust’s induction which covered essential training in moving and handling, infection control, safeguarding, and information governance. They then shadowed colleagues as part of the SARC induction (up to 12 weeks) until assessed as competent to undertake the role. Figures provided to us by the Trust showed that 89% of SARC staff were compliant with mandatory training requirements and 93% with role specific training.

Most of the paediatric consultants had completed training in sexual offences medicine, additional training had been completed in relation to child sexual abuse and trauma informed care.

All staff received regular supervision and appraisal to identify any training needs and ensure their practice met professional standards. Staff reported to us that they received good support from colleagues and managers, especially after dealing with distressing cases. Staff had access to Trust wide welfare services.

Staff spoke positively about their role, and it was clear staff were proud of the service and how they supported children and vulnerable young people.

There were appropriate policies in place in relation to infection prevention and control, and staff received training in this area. The hospital cleaning contractor provided a daily cleaning service, and the clinical room and equipment was cleaned by the nurse following examinations. Records were maintained regarding cleaning the clinic room, equipment and children’s toys, and staff audited these on a quarterly basis. The clinic room was deep cleaned, but the frequency of this was unclear. All staff were up to date with infection prevention and control training.

We observed that all areas of the SARC were visibly clean and hygienic, including the waiting area, bathroom, and interview room. The clinical examination room surfaces including walls, floors and cupboard doors were free from dust and visible dirt. The room had sealed flooring so it could be cleaned easily.

Scrubs were available for staff to use, and laundry facilities were available on site in the SARC. A bin was available for the disposal of sharps, which was dated when opened and not overfull. This was stored in a locked cupboard when not in use.

Staff wore appropriate PPE, including face mask, gloves, and disposable aprons.

Paediatric consultants prescribed medicines individually to patients which included emergency contraception and Hepatitis B vaccines. A small stock of medicines such as inhalers, wart treatment and pain relief was also available to give to patients if needed.

As the SARC no longer completed acute forensic examinations, they did not hold any stock of HIV post exposure prophylaxis (PEP) treatment. We found follow up appointments had been made for patients to receive Hepatitis B boosters if needed.

Staff routinely monitored the fridge temperature to ensure medicines were stored safely. Staff had identified out of range temperature readings, this was escalated and equipment was replaced.

Prescription pads were stored securely and appropriate records kept of their use.

Staff completed regular audits of medicines; including monthly checks and quarterly audits. Outcomes were shared with staff during team meetings.