Archived: Brook West Bromwich

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. This was a planned inspection to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The clinical lead is currently 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 service was established in 1964; Brook has over 50 years of experience working with young people and currently hasservicesin England, Scotland, Northern Ireland and Jersey as well as a digital‘Ask Brook’service. Brook provides free and confidential information, contraception, pregnancy testing, advice and counselling, testing and treatment for sexually transmitted infections.

Brook West Bromwich provide support services and programmes to help young people make positive and healthy lifestyle choices and improve their well-being.

Brook provides sexual health services and advice for young people under 25, between January 2016 and October 2016 Brook West Bromwich saw 1072 of young people under the age of 18 and 1606 of 18 and above. Brook is a charity service that work across the UK and Channel Islands that specialise in working with young people to promote their sexual health in the wider context of health and well-being.

Brook provides educationwork in schools and community venues, with specific programmes that address the needs of vulnerable young people, In addition to schools and community venues the education and wellbeing team offer training for professionals. In 2012, Brook undertook organisational structural change becoming one organisation. This change enabled joining up of services and ensured a robust management and governance structure of A National Board –made up of expert volunteers and including client representatives.

Brook West Bromwich is commissioned by Sandwell local authority to provide Sexual Health services to young people. In Sandwell, Brook operates a hub and spoke model, with the hub located in West Bromwich and spoke clinics across the six localities.

The service operates from a main clinic in West Bromwich town centre with outreach support providing a range of community venues in addition to schools, training providers and supported housing.

Brook West Bromwich had 17 staff working at the time of our inspection – this included Receptionists, client advisors, Nurses, Counsellors, Health and Wellbeing workers, Education and Wellbeing Specialists, Nurse Manager and Service Manager.

The clinic operated on Mondays, Wednesdays, Thursdays and Fridays from midday to 7pm and from midday until 4pm on Saturdays. The patients were also able to attend weekly drop in clinics based in a Training Providers, Colleges, Community locations, Supported housing.

Updated 8 June 2017

We carried out an announced comprehensive inspection on 24 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 aware the requirements of being open and honest.
• Staff protected young people from avoidable harm.
• Staff recognised early signs of abuse.
• Clinical staff were provided with support from the clinical manager based at Brook West Bromwich.
• Care and treatment for young people were planned and delivered in line with up-to-date national recommendations and legislation.
• Staff reviewed consent practices and records to ensure young people were involved in making decisions about their care and treatment in line with relevant legislation.
• Staff were committed to working collaboratively with external organisations in order to deliver joined up care for young people.
• Staff completed a Fraser guideline assessment for all young people under 16.
• Staff had access to a regular clinical newsletter with up to date information.
• The privacy, dignity, and confidentiality of young people attending the service was protected and staff treated them respectfully at all times.
• Staff treated young people as individuals and there was a strong visible young person centred culture within the service.
• The feedback from young people who used the service was consistently positive.
• Young people gave clear examples, which demonstrated the value they placed upon the service and how staff supported them.
• The service was planned and delivered in a range of locations and at suitable times, to ensure the service was convenient and accessible to the local population.
• The facilities and premises were suitable for the delivery and effectiveness of the service.
• Young people had access to reception staff by telephone to obtain advice regarding local clinics and to book appointments.
• There was a proactive approach to understanding the needs of young people and to deliver services in a way which supported them and demonstrated equality.
• Brook West Bromwich had vision and values, which were embedded within the service.
• There were a number of policies and procedures accessible to staff on the intranet.
• Managers completed general risk assessments in relation to the service.
• Staff were aware of their responsibilities and were knowledgeable within their role.
• Young peoples' opinions were valued and acted on; there were comment cards available for young people to complete.
• The management team recognised future priorities.

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 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 infection control training is completed by all staff providing direct clinical care and involved in specimen collection and transportation.

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 that training documentation is consistent, up-to-date and easily accessible to all members of the management team.
• Ensure that all incidents are recorded and their severity assessed when they meet Brook young people’s incident reporting criteria.
• The provider should ensure that all staff have access to training on Mental Capacity Act 2005 and how this applies to young people under 25’s.

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

Updated 8 June 2017

The clinic at Brook West Bromwich was visibly clean and staff were open and honest.

Staff worked to support children and young people using evidence based care and treatment including counselling and there was an overall focus on the mental and physical well-being of children and young people attending the clinic. There was multi-disciplinary working with a range of agencies and organisations. Staff sought the opinions of the people using the service and made changes appropriately.

There was a strong vision for the organisation to support children and young people in a holistic way and this underpinned all the work that took place at the clinic.

The organisation had a quality assurance system that assessed the quality and effectiveness of the services provided.

However, we also found:

All clinical staff who contribute to assessing, planning, and evaluating the needs of a child or young person must be trained to safeguarding at level three.

All staff providing direct clinical care are required to complete infection control training.

To ensure there is a local risk register in place to provide overview of local risks

All staff are required to be up-to-date with their annual mandatory training and appraisals.

Training documentation were not consistent, up-to-date or easily accessible to all members of the management team.

All incidents to be recorded and their severity assessed when they meet Brook young people’s incident reporting criteria.