Queen's Medical Centre

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. Staff had completed the appropriate level of training for their role and those we spoke with demonstrated comprehensive understanding of safeguarding practices for their role.

Staff obtained risk and safeguarding information at the point of referral to identify patients’ risks and vulnerabilities; including self-harm and mental health. Staff routinely attended safeguarding strategy meetings and had worked hard to build relationships with the numerous police forces across the counties the SARC served.

Staff received safeguarding supervision, and cases were routinely peer reviewed to identify learning. We also witnessed informal peer support between colleagues in post examination procedures and staff told us they felt well supported by each other and managers to discuss any concerns.

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 within Queens Medical Centre hospital, and 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.

All doors to clinical or forensic areas 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 was stored in the entrance to the SARC and was subject to regular checks. Emergency medicines such as adrenaline and inhalers were available for patients if required and were stored securely in a temperature controlled area.

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, unless using bathroom facilities where anti-ligature cords were in place and staff could unlock doors from the outside if required.

The SARC team was made up of a wide range of specialist staff with extensive experience in safeguarding and paediatric nursing. Specialist nursing roles had been introduced to increase outreach work from the SARC and support forensic examiners. The SARC manager and clinical lead knew their service well and they worked closely alongside crisis workers who were separately commissioned but were co-located in the SARC which provided good continuity of care for patients.

Staff recruitment was managed centrally by the Trust’s human resources department. Recruitment procedures were robust and ensured staff members had the appropriate pre-employment and vetting checks completed to ensure they were suitable for their role.

All new staff received an induction from the Trust including essential training such as infection control, safeguarding, and information governance. New starters then shadowed colleagues as part of their SARC specific induction until they felt competent to work alone and were assessed as competent to undertake the role by senior clinicians.

All staff received regular supervision and an annual appraisal to identify any training needs and ensure their practice met professional standards. Staff told us that they received excellent support from colleagues and managers, and an additional staff rest area provided a separate area for staff to have space away from the offices, especially after dealing with distressing cases. Staff had access to Trust wide welfare services.

Staff we spoke with told us they enjoyed their roles within the SARC and demonstrated passion and commitment to the work they did.

The Trust had appropriate policies in place in relation to infection prevention and control, and staff received training in this area. Daily cleaning was carried out by the hospital cleaning contractor and SARC staff carried out cleaning of clinical areas, including forensic cleaning of examination rooms after seeing patients, for which they had received additional specialist training.

Staff completed cleaning records for clinical areas and equipment which were subject to regular audits, and forensic examination rooms were deep cleaned quarterly. All staff were up to date with infection prevention and control training.

The SARC facilities were visibly clean and hygienic during our inspection including waiting rooms, offices, staff and visitor bathroom facilities, and the police interview room. Clinical areas were clean and tidy, free from clutter, and met infection prevention standards.

Staff showers were available in the SARC and there was a good supply of scrubs. Staff had access to the appropriate PPE, including face mask, gloves, and disposable aprons.

A bin was available for the safe disposal of sharps, which was dated when opened and not overfull.

Patients had access to emergency contraception, Hepatitis B vaccines and HIV post exposure prophylaxis (PEP) treatment. A small stock of medicines such as inhalers, antihistamines and pain relief was also available to give to patients if needed.

Medicines were stored securely and staff monitored fridge and room temperatures daily to ensure readings were within the required range to maintain the medicines integrity.

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

Medicines were subject to regular audits and any concerns raised were shared with staff during team meetings.