We carried out this visit in partnership with Her Majesty’s Inspectorate of Prisons (HMIP). As part of the visit we attended a focus group of prisoners with HMIP. We also spoke to prisoners in the healthcare centre and on different wings of the prison.

We asked if people felt they were able to be involved in making decisions relating to their care and treatment.

We were told, “Yes they did a health screen when I first got here and asked what I needed.” Another prisoner told us, “They always explain things to me so I know what is happening.” We were also told, “The staff do listen and take the time to help me.”

We asked prisoners for their views of the care and treatment they had received. We received mixed feedback, “I had a blood test recently and it was fine.” Another person said, “The waiting lists are too long. You have to wait weeks to see the GP, even longer for the dentist.” Another person said, “The healthcare service here is not as good as in the community, they take too long to do anything.”

The trust was supporting some prisoners to become “health champions”. They would then be a representative for a group of prisoners and take any issues from the prisoners to healthcare meetings. The health champion could also promote healthcare services to other prisoners and provide information. The prisoners we spoke with felt this was a good innovation, “The health champions are a great idea. They have given me good advice and I have asked questions through them I wouldn’t have asked anyone else.”

We carried out this announced inspection on 13 and 14 November 2018 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 carried out by two CQC inspectors who were supported by a specialist professional advisor off site.

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

Serenity SARC is in Northamptonshire and was commissioned to provide services to adults and children within the Northamptonshire area and to children under 18 within the Leicestershire and Rutland area, who have experienced sexual abuse or sexual violence, either recently or in the past.

The service is provided from dedicated, secure forensic premises owned and maintained by Northamptonshire Healthcare NHS Foundation Trust (NHFT) with all areas accessible for patients with disabilities. Accommodation includes forensic waiting rooms, forensic medical rooms with adjoining bathrooms, quiet counselling rooms in which they provide emotional support and have a family waiting room.

The service was commissioned to provide Independent Sexual Violence Advisors (ISVA). The support provided by an ISVA will vary from case to case, depending on the needs of the victim and their circumstances. The main role of an ISVA includes providing emotional support and to signpost for counselling and other services available. Making sure that victims of sexual abuse have the best advice on what counselling and other services are available to them and the process involved in reporting a crime to the police, and journeying through the criminal justice process, should they choose to do so.

The team includes 11 doctors, 10 crisis workers, 4 independent sexual violence advisors, 2 other staff.

We looked at policies and procedures and other records about how the service was managed.

The service was provided 24 hours, seven day a week.

Our key findings were:

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

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

Ensure any clinical audits carried out are effective and continue to improve the Independent Sexual Advisor’s (ISVA) paperwork.