Archived: St Mary's Hospital

Background

We carried out this announced inspection on 17th August 2021 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist professional advisor.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we examine during the inspection.

The Treetops Centre SARC provides forensic medical examinations and related health services to people who have been victims of sexual assault and who live in the local authority areas of Southampton, Portsmouth, parts of Hampshire and The Isle of Wight. The service is an ‘all-age’ service; that is, for adults aged 18 and over, children and young people aged 13 and above and children under the age of 13. The service is accessible to male, female and transgender patients. We inspected this SARC as it had not previously been inspected by us.

The service is provided by Solent NHS Trust and The Treetops Centre is listed with CQC as a location aligned to St Mary’s Hospital, Portsmouth as part of Solent NHS Trust. It is commissioned by NHS England and the Hampshire police and crime commissioner.

The service is available 24 hours each day. Children and young people can be referred to the service via the police or children's social care. Adult patients can also self-refer into the service should they prefer to do so. Patients aged 13 and over can also self-refer, but this is subject to safeguarding procedures for younger patients as we have set out below.

The staff team includes a centre manager, Sexual Offences Examiners (SOE) which includes five doctors, four trainee SOE’s (all doctors) a qualified paediatric nurse, two substantive crisis workers, one male crisis and health promotion worker, five bank crisis workers and two Young People’s Independent Sexual Violence Advisors (YPISVA) and adult ISVAs. The substantive doctors were fellows of the Faculty of Forensic and Legal Medicine (FFLM) and examiners for Membership of the Faculty of Forensic and Legal Medicine examination processes. The paediatric nurse is also a qualified nurse prescriber and sexual health nurse.

Prior to our inspection, we spoke with the commissioner from NHS England. During our inspection, we spoke with the centre manager, two crisis workers, two SOEs and a YPISVA. We examined the records of nine people who had used the crisis and forensic examination service (one of these was a child under 13, six were young people aged 13 to 18 years and two aged 18 and over.

We left comment cards at the location in the week prior to our visit and received 13 responses from patients who had used services during that week. One of the responses was in ‘easy read’ format.

Throughout this report we have used the term ‘patients’ to describe people who use the service to reflect our inspection of the clinical aspects of the SARC.

Our key findings were:

• The service had systems to help them manage risk.
• The staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The service had thorough staff recruitment procedures.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• 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/referral system met clients’ needs.
• The service had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The service asked staff and clients for feedback about the services they provided.
• The service staff dealt with complaints positively and efficiently.
• The staff had suitable information governance arrangements.
• The service appeared clean and well maintained.
• The staff had infection control procedures which reflected published guidance.