• Doctor
  • Urgent care service or mobile doctor

Archived: Devon Sexual Health - Exeter

Overall: Good read more about inspection ratings

31D Sidwell Street, Exeter, EX4 6NN (01392) 403785

Provided and run by:
Northern Devon Healthcare NHS Trust

Important: This service was previously managed by a different provider - see old profile
Important: This service is now managed by a different provider - see new profile

All Inspections

01 December 2021

During an inspection looking at part of the service

We carried out a focused inspection of healthcare services provided by Northern Devon Healthcare NHS Trust (NDHT) at Devon Sexual Health- Exeter (Exeter SARC) on 1st December 2021.

The purpose of this inspection was to determine whether Northern Devon Healthcare NHS Trust was meeting the legal requirements and regulations under Section 60 of the Health and Social Care Act 2008. During this inspection we focused on compliance with the requirement notice issued on 1 June 2021 relating to:

Are services well-led?

We found that the provider was compliant with Regulation 17 (1), of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We do not currently rate the services provided in sexual assault referral centres.

Background

NHS England commission Northern Devon Healthcare NHS Trust (NDHT) to deliver a dedicated paediatric service based at Exeter Sexual Assault Referral Centre (SARC) for children and young people up to their 18th birthday. This service provides forensic medical assessments for children and young people from across Devon, Cornwall and the Isles of Scilly following recent sexual assault. The Exeter SARC also provides medical assessments of children and young people from Devon, Torbay, Plymouth and Cornwall following non-recent sexual assault.

We last inspected the service on 18 March 2021 when we judged that NDHT was in breach of CQC regulations. We issued a Requirement Notice on 1 June 2021 in relation to Regulation 17, Good Governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The report on the inspection can be found on our website at https://www.cqc.org.uk/location/RBZ72

The purpose of the inspection was to determine if the registered provider was meeting the legal requirements and regulations under Section 60 of the Health and Social Care Act 2008 and that patients were receiving safe care and treatment.

This desk based review was conducted by one CQC health and justice inspector and included a review of evidence and telephone calls with staff. Before this review we reviewed the action plan submitted by NDHT to demonstrate how they would achieve compliance, and a range of documents submitted by NDHT.

Documents we reviewed included:

  • Service action plan
  • Four patient records
  • Information gathering proformas used for all patient groups
  • Paediatric review meeting minutes
  • Case notes audits

We did not visit the SARC to carry out an inspection because we were able to gain sufficient assurance through the documentary evidence provided and telephone calls with staff.

Key findings

At this inspection we found that the provider had addressed concerns highlighted in the requirement notice issued in June 2021, and were now compliant with the relevant regulation.

18 March 2021

During a routine inspection

We carried out this announced inspection on 18 March 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 look at during the inspection.

Background

NHS England commission Northern Devon Healthcare NHS Trust to deliver a dedicated paediatric service based at Exeter Sexual Assault Referral Centre (SARC) for children and young people up to their 18th birthday. This service provides forensic medical assessments for children and young people from across Devon, Cornwall and the Isles of Scilly following recent sexual assault. The Exeter SARC also provides non-recent medical assessments of children and young people from Devon, Torbay, Plymouth and Cornwall following non-recent sexual assault.

The SARC is situated on a business park outside of Exeter town centre with a staff office in a separate building, but close by, to the patient environment. The SARC is spread over the ground floor of the premises with disabled access, a discreet entrance to the rear of the building and car parking outside. The SARC is available for forensic medical assessments between 9am and 5pm Monday to Friday, and between 10am and 2pm Saturday and Sunday. A 24 hour telephone advice line is staffed by clinicians and available to professionals 365 days a year.

The SARC facilities, situated within a building leased by police with police offices adjoining, include two examination rooms, one for non-recent and one for recent examinations. There are two waiting rooms; one forensic and one non-forensic, as well as an aftercare room, storage room and small kitchen area. Bathroom facilities including showers are available within the forensic suites, and a visitors bathroom is accessible in adjoining police offices. The staff office, leased by the provider, consists of a large open plan staff office with kitchen and bathroom facilities, a disabled toilet, meeting room and two smaller therapy rooms.

The SARC team are overseen by a specialist services manager, with a SARC general manager and SARC service manager, and a specialist nurse carrying out the crisis worker role for all children and young people attending the SARC. The paediatric clinical lead is a consultant paediatrician supporting four forensic medical examiners (one of whom is currently on maternity leave). Three clinical staff are members/licensee of the Faculty of Forensic and Legal Medicine.

On the day of inspection we spoke with four staff members and reviewed eight patient records. We reviewed policies and procedures and other records about how the service is managed. We also spoke with three staff members via virtual meetings in advance of the site visit.

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:

  • Staff understood their responsibilities for safeguarding adults and children.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • There were good working relationships with police colleagues.
  • There was a culture of continuous improvement.
  • Staff showed care and passion for their work and felt well supported in their roles.
  • Patient feedback was positive about the support received from the SARC, and there had been no complaints.
  • The environment was clean and included age appropriate rooms and equipment with toys and visual distractions for children.
  • The provider had infection control procedures which reflected published guidance and had adapted quickly to COVID-19 guidelines to ensure services remained available to patients throughout the pandemic.

We identified regulations the provider was not meeting. They must:

  • Ensure that patient records are complete and contemporaneous, and evidence the discussions with patients and/or their responsible adult to explain the clinicians decision making and the rationale for care and treatment provided.

Full details of the regulation the provider was not meeting are at the end of this report.

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

  • Ensure that assessment proformas evidence how a clinician has determined capacity to consent.
  • Include the Gillick Competence assessment for staff to complete with under 16’s if applicable.
  • Evidence the voice of the child in assessments.

1 March 2017

During a routine inspection

Letter from the Chief Inspector of General Practice


We carried out an announced comprehensive inspection at Sidwell Street Walk In Centre on 1st March 2017. Overall it is rated as good.

There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. There was a genuinely open culture in which all safety concerns raised by staff and people who use services were highly valued as integral to learning and improvement.

Risks to patients were assessed and well managed. The walk in centre had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse.

Patients’ needs were assessed and care was planned and delivered in line with current legislation. Arrangements had been made to support clinicians with their continuing professional development.

Staff had received training appropriate to their roles. There were systems in place to support multi-disciplinary working with other health and social care professionals in the local area. Staff had access to the information and equipment they needed to deliver effective care and treatment.

Learning was celebrated and the centre was proactive in using opportunities to improve services by seeking and acting upon feedback from staff, patients and other stakeholders.

People’s individual needs and preferences were central to the planning and delivery of tailored services. We saw several examples of this. For example in order to meet patient needs, nurses had received extra training in traumatic wounds, infections and mild cellulitis; dental pain; animal and human bites protocol and patients presenting with minor ailments protocol. Health Care Assistants (HCAs) had received further training in areas such dementia awareness, learning disabilities, tissue viability, anaphylaxis, duty of candour and end of life care.

There was high patient satisfaction, with all nine patients we spoke with and the seven patient comment cards received, confirming they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.

The centre had good facilities and was well equipped to treat patients and meet their needs.

The provider was aware of and complied with the requirements of the duty of candour.

The leadership, governance and culture at the walk in centre was used to drive and improve the delivery of high-quality person-centred care.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice