Archived: The Brandon Centre

Updated 8 February 2018

The Brandon Centre is commissioned by Camden and Islington Public Health along with two other providers as part of the Camden and Islington Young People and Sexual Health Network (CAMISH) to deliver level one and level two contraception and sexual health services (CaSH) to people aged 12 to 24 in Camden and Islington. As a level 2 CaSH service, The Brandon Centre provided contraception, asymptomatic screening, treatment for sexually transmitted infections and prescriptions and health promotion.

The Department of Health national strategy for sexual health and HIV defines the three levels of service, including levels of sexually transmitted infection (STI) management. Levels increase in the scope of complexity and range of care from basic advice at level 1 to testing and treatment at level 3.

The service also provided:

• Outreach and sex and relationship education (SRE) services to secondary schools and colleges.
• Delivery of the national ‘c-card’ programme, which aims to improve young people’s use of condoms and safer sex practices. This involved providing condoms and self-test kits for sexually transmitted infections.
• A workforce development specialism that delivers training to the children’s workforce to ensure they are competent in supporting young people with SRE.

Psychotherapy and counselling services were provided on the same premises. Although our inspection did not include these services as they are not regulated by CQC, we spoke with staff to gain a better understanding of the patient journey and experience.

In the period of October 2016 and September 2017, the service saw 3120 patients and delivered 4183 individual appointments.

We last inspected the service in August 2013 and found it to be compliant with all the fundamental standards we inspected.

There was a registered manager in post.

Updated 8 February 2018

We do not currently rate community sexual health services.

The Brandon Centre provides contraception and sexual health services to young people aged 12 to 24 in the London Boroughs of Camden and Islington. We carried out an announced inspection of the service on 14 and 15 November 2017.

We found the following areas of good practice:

• The service demonstrated how learning took place from incident investigations, including from near misses and the review of individual cases.
• Staff understood and adhered to the principles of the duty of candour.
• We saw excellent safeguarding practices including multidisciplinary working and a rapid response for urgent safeguarding concerns.
• Staff achieved a balance between appropriate risk management and meeting the sexual health needs of young people who presented with complex or high-risk behavioural needs.
• Staffing was provided by an experienced and competent multidisciplinary team. Clinical staff practiced at other services and demonstrated their commitment for children and young people. The service had good systems in place to ensure continuity of care when patients were seen by different members of the team.
• The service ensured that when something goes wrong, young people received a sincere and timely apology. We saw that young people were told about any actions taken to improve processes to prevent the same happening again.
• Staff gave sufficient priority to the safeguarding of vulnerable adults, children and young people and focused on early identification.
• The service monitored patient outcomes regularly to improve care including treatment for sexually transmitted infections and care plans for pregnant patients.
• There were extensive opportunities for staff to undertake continuing multidisciplinary professional development and to progress in their clinical competencies. Each individual also had access to regular supervision and appraisal to support the effective delivery of care and treatment.
• Multidisciplinary working was embedded in practice and staff used a range of established links with social services, safeguarding teams and genitourinary medicine providers to ensure patients received coordinated care. We saw examples of excellent proactive work from clinicians when patients were under the care of multiple doctors in different specialties.
• The centre team invested considerable time and resources in developing health promotion interventions and strategies that met individual needs. This included highly individualised contraception, sex and sexual health advice for people based on their identity, experience and age. The service monitored outcomes from health promotion work and used this to further develop the service and identify unmet need.
• Staff used consent and mental capacity assessments in line with legislation and guidance for patients based on their age and level of need, such as the Fraser guidelines.
• Patient survey results and feedback from patients was consistently good and all of the patients we spoke with were passionate about the service. There was evidence of long-term care for patients and individuals frequently cited the individualised and confidential service as important factors in their decision to go there. Individuals gave examples of significant levels of support staff had provided that had improved their lives for the better.
• Staff recognised and respected the totality of young people’s needs.The service adapted care and advice options to the changing needs of the patient population and local young people. This was an ongoing process and we saw substantial evidence the service was proactive in ensuring individual needs were understood and met.
• Staff used rapid access pathways and partner services to ensure patients who were vulnerable received coordinated care, including in urgent circumstances such as suspected sexual exploitation.
• Facilities and premises are appropriate for the services being delivered.
• There was a consistent, demonstrable focus on improving the service for patients and improving work processes for staff that paid attention to detail. The service ensured a consistent focus on this through structured clinical governance and a programme of meetings that enabled all staff were involved in the running of the service.
• The overall culture of the service was demonstrably passionate and positive and this was reflected in all elements of the operation.
• The leadership team was highly respected and demonstrated how they engaged with staff in the running of the service, including for development and improvement.

This was a dynamic service led by a motivated team of experienced specialists and professionals keen to develop their career in sexual health. The service went above and beyond the expectations of young people and meeting the needs of its local community.

Updated 8 February 2018

The Brandon Centre provides contraception and sexual health services to young people aged 12 to 24 in Camden and Islington.