Archived: Brook Tipton

Updated 8 June 2017

We carried out this inspection 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 service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Brook Tipton is part of the Brook organisation that provides sexual health advice and support for people under the age of 25, across the United Kingdom.

The Brook Tipton management team also manage Brook West Bromwich and Brook Dudley and consists of a clinical lead, who is the registered manager and a service manager, for all three sites.

The clinical lead is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

Brook Tipton serves the community in the area around the town of Tipton in the West Midlands. Geographically it is set between West Bromwich and Dudley and has a diverse local population within its community.

The clinic is small and shares some facilities with an after school and holiday club within the local youth centre. It serves as an annex to the West Bromwich clinic, which is commissioned to provide sexual heath and outreach service for the borough of Sandwell. Brook has provided services in Sandwell since 1993.

Brook Tipton provides free and confidential sexual health services, support, and advice to young people under the age of 18 and between 18 and 25. Services included contraception (condoms), emergency contraception, pregnancy testing, chlamydia testing, termination referrals, and counselling.

During the period between January 2016 and October 2016, Brook Tipton had 483 visits to the clinic.

Brook also runs satellite clinics in schools and colleges in this region (for pupils only) and can provide domiciliary services in homes and other settings. Young people could attend the service at a time suitable for them. Brook Tipton was open three days a week from 6pm until 8.30pm on a Tuesday and Thursday and 11am until 2pm on a Wednesday. Brook Tipton provided all services on a walk-in basis.

We gathered information from a variety of sources including data provided by Brook Tipton. During the inspection, we spoke to staff that worked within the service and we talked with people who used services, both in the clinic setting and those in the waiting areas.

Updated 8 June 2017

We carried out an announced comprehensive inspection on 26 October 2016 to ask the service the following key questions; Are services safe, effective, caring, responsive and well led.

Our Key findings:

We found that this service provided the following:

• Staff were caring and passionate about their work in supporting young people using the service.
• Staff were responsive and flexible in their approach to helping young people.
• Staff knowledge of the service was good.
• Patients were positive about the service provided.
• Information provided to patients was up-to-date and appropriate to this patient group.

However:

• Mandatory training in safeguarding level 3 was not fully completed for all staff
• Infection, prevention and control (IPC) training on chlamydia testing was not completed annually
• Procedures for learning from incidents and audits were not robust
• Some contingency planning was not evident in case of emergency
• Maintenance schedules and provision for building repair was missing
• Facilities for staff training were not ideal at this site
• General lack of facilities for staff/patients (hot drinks)

We identified regulations that were not being met and the provider must:

• The provider must ensure that all clinical staff who contribute to assessing, planning, and evaluating the needs of a child or young person are trained to safeguarding at level three as recommended in the Safeguarding children and young people: roles and competencies for health care staff’ by the Royal College of Paediatrics and Child Health, March 2014.
• The provider must ensure all staff that provide direct clinical care and involved in specimen collection and transportation complete infection control training.
• The provider must ensure there is a local risk register in place to provide overview of local risks.

There were areas where the provider could make improvements and should:

• The provider should ensure that staff are up-to-date with their annual mandatory training and appraisals.
• Ensure incidents are consistently recorded and their severity assessed when they meet incident reporting criteria, across the three sites.
• Review the contingency plans if a break-in should occur at the Tipton site. This should include cooperation from other agencies using the facility
• Review the arrangements for general repair and upkeep of the facilities, again with the cooperation from others using the building.
• Review procedures for learning and communicating with all staff following incidents, audits and complaints.
• Ensure audit results are communicated to all staff and are supported with an action plan, review date and person responsible.
• Ensure any local risks are clearly identified and have a documented timeframe for review.
• Ensure the backlog of patient records is scanned onto the new database within an agreed period.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements.

We also issued the provider with three requirement notice(s) that affected Brook Tipton. Details are at the end of the report.

Updated 8 June 2017

The clinic accommodates the needs of a diverse population in the area and offers advice in languages other than English. The staff were capable of using translation services provided, when required.

All staff at the clinic were observed treating the patient with compassion, understanding and dignity. The communication was appropriate to the individual and the care given was patient centred, with staff going the extra mile to make sure the patient was comfortable with the procedures and the environment.

Staff gave young people treatment in accordance with national guidelines and staff appeared competent in all areas of sexual health for children and young adults, however we saw no evidence of monitoring the staff competencies. Communication with the young people was very good and staff always sought consent before they gave treatment or care.

Staff demonstrated a good knowledge of the visions for Brook Tipton and were passionate about their work with young people.

The clinic areas were visibly clean and staff followed infection prevention and control procedures.

However, we also found the following issues that the service provider needs to improve:

Mandatory training in infection, prevention and control (IPC) was not completed annually for all staff despite undertaking Chlamydia screening as part of their role.

The service shared the building with other organisations. Some facility management risks had not been identified, for example, staff were unsure who was responsible for events such as emergency repairs after a break in.