The York Hospital

We carried out this announced inspection over two days on 18 and 19 February 2020 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. Two CQC inspectors, supported by a specialist professional advisor carried out this inspection. 

The North Yorkshire Child Sexual Assault Assessment Service (CSAAS) is situated in The York Hospital. The service operates from a discrete set of rooms accessed via a paediatric ward. The CSAAS is accessible for people who use wheelchairs. 

The service is jointly commissioned by NHS England and the Police and Crime Commissioner for North Yorkshire and is provided by York Teaching Hospital Foundation Trust. The CSAAS offers health services and forensic medical examinations to children and young people, aged 15 and under, who have been sexually assaulted or abused. The service can also see older young people aged 16 to 18 who have additional vulnerabilities, this is decided on a case by case basis in conjunction with the local adult sexual assault referral centre. The service does not accept self-referrals. All referrals must be made by police or social care staff. The North Yorkshire CSAAS is available Monday to Friday from 9am to 5pm excluding bank holidays. Children and young people requiring care outside of these times are referred to other services in the region. 

The unit is accessed via an intercom and consists of a waiting room, a forensic examination room, a bathroom and an office which is used by CSAAS staff as well as the hospital safeguarding team. The CSAAS is staffed by a full-time lead nurse, a part time nurse and a part time administrator. Four paediatric consultants cover the service on a rota basis. Play therapists, who are employed on the neighbouring paediatric ward, can offer support to children and young people who are attending the unit. The service does not employ Independent Sexual Violence Advisors (ISVAs) or counsellors directly and refers children and young people into these services. The ISVA and counselling services, therefore, were not part of this inspection. 

During our inspection we spoke with staff members including the lead nurse, the lead play therapist and a Forensic Medical Examiner (FME). We looked at 14 patient records and three staff recruitment files. We looked at policies and procedures and other records about how the service is managed.