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Inspection carried out on 14 and 15 November 2017

During a routine inspection

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.

Inspection carried out on 13 August 2013

During a routine inspection

We inspected the service on the 13 August 2013. We spoke with the registered manager and some members of staff. We looked at the health records of a number of people using the service, records relating to staffing and health and safety issues and written policies and procedures.

There were no appointments during our inspection. However, we contacted some people by phone to discuss their experience of using the service. We also looked at a number of feedback questionnaires, which people used to comment on the service. A person told us they were very pleased with the service, saying that the staff were “friendly and very supportive.” Another said “I’ve had really positive experiences” with the service.

People’s needs were appropriately assessed and care and treatment was planned and delivered in line with their individual care plan. Choices were offered and sufficient information was provided so that people could make informed decisions about their care and treatment. One person in their questionnaire response had said that one of the best things about the service was the “range of options given to you.” Another person said, “I don’t know what I would have done without this centre being available.”

Staff members told us they were well supported to deliver people’s care and treatment and they were given appropriate on-going training.

There was an effective system for monitoring the quality of the service and involving people in how the service was provided.

Inspection carried out on 13 February 2013

During a routine inspection

There were no young people or parents available to discuss the service with us during the inspection. We used the results of the providers surveys of people using the service.

People who use the services are highly satisfied with the level of care and treatment they receive. People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. The staffs are trained to deliver the services provided to the young people.

The provider carries out regular reviews with people using the service to measure their satisfaction levels. The provider also uses these reviews to improve the service or to broaden access for people needing the services.

Inspection carried out on 6 January 2011

During a routine inspection

People who use the range of services provided at the Brandon Centre are happy with the care and treatment they receive. They praise the staff for providing them with the help they need in a friendly and non-intimidating manner. Staff ensure that people are involved with their care and influence the way the services are delivered.

Reports under our old system of regulation (including those from before CQC was created)