Brook Manchester

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first rating for this service. This key question has been rated Good

Good: This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We maximise the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

We reviewed 6 patient records during the assessment. Staff completed an assessment of the patient during the appointment. There was a comprehensive identity checking system in place that staff used to confirm who patients were.

Patients were able to access assessment templates online which allowed them to record symptoms and concerns, and these were then reviewed by staff.

Staff assessed patients’ physical health needs and created individual plans according to the needs of the patient.

There was good evidence of safeguarding plans, diagnosis, follow up and safety netting systems in place which were routinely monitored and updated.

We plan and deliver people’s care and treatment with them, including what is important and matters to them and in line with legislation and current evidence-based good practice and standards.

Staff followed up-to-date policies to plan and deliver high quality care according to best practice and national guidance. This included the National Institute for Care and Excellence (NICE) and the British Association for Sexual Health and HIV (BASHH).

There were rarely patients who were subject to the Mental Health Act. In cases where young people had additional needs they were supported by the relevant external professional during the appointment. This included key workers and social workers.

Staff ensured in all cases that they obtained patients’ consent to treatment. Children under the age of 16 can consent to treatment without parental consent if they have the maturity to understand the advice given and it is in the young person’s best interests to receive the advice and treatment without parental consent. This is known as the Fraser Guidelines.

Staff routinely assessed the psychological and emotional needs of patients and would handover this and any other important information at shift changes or prior to the commencement of clinic sessions.

Staff did not provide pain medication but would advise young people to take analgesia prior to a coil or implant fitting.

Staff were experienced, qualified and had the right skills and knowledge to meet the needs of patients. Qualified nurses were required for certain procedures, including the implant and coil clinic.

Managers gave all new staff a full induction tailored to their role before they started work. All new staff were given an induction plan to work through. It included mandatory training, shadowing, familiarisation with policies and procedures and was reviewed by the supervising staff. New staff were given time and support to complete their induction before commencing work with patients.

Managers supported staff to develop through yearly, constructive appraisals of their work. Appraisal compliance was at 100% at the time of the assessment.

Managers supported nursing staff to develop through regular, constructive clinical supervision of their work in line with the supervision policy. There were different supervision sessions for safeguarding and for clinical issues. Supervision compliance was at 100% at the time of the assessment.

Managers made sure staff attended team meetings or had access to full notes when they could not attend.

Managers identified any training needs their staff had and gave them the time and opportunity to develop their skills and knowledge. There were examples of additional staff training included neurodivergence, domestic violence and clinical support competence for health care assistants to inform their sexual health knowledge and core skills to deliver clinical interventions.

Managers made sure staff received any specialist training for their role. Staff could access a dedicated learning and development page to inform them of learning and development, provide information about upcoming events, and overviews of the impact of Brook’s internal learning and development work.

Managers identified poor staff performance promptly and supported staff to improve. They created a personal improvement plan to assist with this.

We work effectively across teams and services to support people, making sure they only need to tell their story once by sharing their assessment of needs when they move between different services.

Staff held regular and effective meetings to discuss patients and improve their care. These were attended by nurses, HCA’s and external professionals in some cases. There were effective referral pathways for example into the level 3 services for issues such as for gonorrhoea or HIV testing and treatment. Staff routinely made referrals and liaised with other services to support patients to get the care and treatment that they needed.

Staff worked across health care disciplines and with other agencies when required to care for patients. Staff routinely made referrals and liaised with other services such as the sexual assault referral centre (SARC) domestic violence services, children’s social care and safeguarding teams and school nurse services. Staff also worked closely with young peoples’ mental health teams, and we saw Child and Adolescent Mental Health (CAMHS) referral forms at the service.

Staff referred patients for mental health assessments when they showed signs of mental ill health and/or depression. Staff told us that they worked closely with young peoples’ mental health teams

Patients had their care pathway reviewed by staff and staff used prompts on the recording system to remind them of when reviews were required.

We support people to manage their health and wellbeing so they can maximise their independence, choice and control, live healthier lives and where possible, reduce their future needs for care and support.

Staff supported patients to live healthier lives for example, through participation in smoking cessation schemes, healthy eating advice, screening for cancer, and dealing with issues relating to substance misuse. Staff used traffic light system to establish the levels of risk in relation to sexual behaviour. There was a team of educators who provided outreach services to schools, colleges and GP surgeries. They provided information on healthy sexual relationships as well as healthy lifestyles.

Staff made sure patients had enough to drink and there was a water cooler in the reception area.

The service had relevant information promoting healthy lifestyles. There were posters and leaflets in the reception area to promote this.

Staff assessed each patient’s health when admitted including recording their height weight and blood pressure.

We routinely monitor people’s care and treatment to continuously improve it and to ensure that outcomes are positive and consistent, and that they meet both clinical expectations and the expectations of people themselves.

The service audited patient records locally and participated in the national peer review system for of all Brook patient records. Other audits included sexually transmitted infection testing and treating, infection control, emergency contraception, coil and implant fitting and referrals for the termination of pregnancy.

Outcomes for patients were positive, consistent and met expectations, such as national standards. Staff worked towards a set of key performance indicators. Leaders added targets to individual staff workplans, along with the national business plan goals at the start of each financial year. These were reviewed quarterly at the staff members’ appraisal and at team meetings.

Managers and staff used the results to improve patients' outcomes. There was a focus on ensuring that the service was accessible and a clinic was provided on Saturdays for those patients who could not attend on weekdays. There was a change in the referral process whereby for some results an automatic referral was made to a level 3 sexual health service for onward care and treatment to ensure that patients received a more effective seamless service.

Managers and staff carried out a comprehensive programme of repeated audits to check improvement over time. They made sure that staff understood the information from the audits. All audit outcomes were discussed at national senior meetings and locally at staff team meetings.

Improvement was checked and monitored and discussed at supervision and at fortnightly clinical learning meetings.

The service worked to the British Association of sexual health and HIV (BASHH) Guidelines for sexual health.

We tell people about their rights around consent and respect these when we deliver person-centred care and treatment.

Staff took all practical steps to enable patients to make their own decisions. The service had a consent policy; this was in line with national guidelines.

For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. Staff clearly recorded consent in all the patients’ records reviewed.

Staff made sure patients consented to treatment based on all the information available. The service spent extra time with the young people to ensure that they had fully understood the information and treatment options provided. If there were concerns staff consulted colleagues to assist them with consultations and in some cases, they sought support from carers or other professionals if this was appropriate.

Staff understood Gillick Competence and Fraser Guidelines and supported children who wished to make decisions about their treatment.

Staff received and kept up to date with training in mental health awareness and compliance was at 100 % at the time of the assessment.

Staff understood the relevant consent and decision-making requirements of legislation and guidance, including the Mental Health Act, Mental Capacity Act 2005 and the Children Acts 1989 and 2004 and they knew who to contact for advice. There were mental health and safeguarding champions within the service whom staff could consult for advice and guidance.

Staff could describe and knew how to access policy and get accurate advice on the Mental Capacity Act which was stored on the staff intranet.

Managers monitored how well the service followed the Mental Capacity Act and made changes to practice when necessary.