Brook Manchester

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

This means we looked for evidence that people were protected from abuse and avoidable harm.
This is the first rating for this service. This key question has been rated good.

Good. This meant people were safe and protected from avoidable harm.

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.

Description: We have a proactive and positive culture of safety based on openness and honesty, in which concerns about safety are listened to, safety events are investigated and reported thoroughly, and lessons are learned to continually identify and embed good practices.

There had been no serious incidents or adverse events over the last 12 months at the service.

All staff knew what incidents to report and how to report them. They documented incidents on an incident form, and this was assigned to a manager depending on the type of incident recorded. This was broken down into clinical, safeguarding or incidents that were referred to estates after review for environmental works.

Staff reported all incidents that they should report. There were 15 incidents between July 2024 and July 2025. Lessons learned were shared to staff within the service and nationally

Staff understood the duty of candour. They were open and transparent and gave patients and families a full explanation if and when things went wrong.

Staff received feedback from investigation of incidents, both internal and external to the service. Senior staff met monthly to discuss incidents and identify lessons learned. Lessons learned were shared at team meetings to staff within the service and nationally to all staff.

Staff also met to discuss that feedback at monthly clinical and development meetings. There was evidence that changes had been made as a result of feedback. This included not using abbreviations in documentation in patient records

The manager told us that staff would be debriefed and supported in the event of a serious incident.

Description: We work with people and our partners to establish and maintain safe systems of care, in which safety is managed, monitored and assured. We ensure continuity of care, including when people move between different services.

Brook Manchester provided a service for young people under the age of 20. Young people could self-refer, have telephone consultations and walk in appointments were provided for most services. In some cases, patients needed to attend on a specific clinic day to access a particular procedure such as for an implant fitting. The service’s referral processes ensured that all essential information about the patient was received to determine if the patient’s needs could safely be met. Staff supported young people to provide as much information as possible about their concerns. In some cases, staff contacted children’s services to gather additional information.

Staff involved all the necessary healthcare and social care services to ensure patients had continuity of safe care, both within the service and post-discharge. Staff identified safeguarding concerns and escalated these to the local safeguarding team. Where patients required a service not provided at Brook, staff made a referral to the appropriate agency or the hospital to ensure that all patients needs were met.

Description: We work with people to understand what being safe means to them as well as with our partners on the best way to achieve this. We concentrate on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect, and we make sure we share concerns quickly and appropriately.

Nursing staff received training specific for their role on how to recognise and report abuse. There was a safeguarding policy in place and safeguarding level 1 and 2 training compliance was at 100%. Safeguarding level 3 children and young people was at 90% at the time of the assessment. Staff also had frequent safeguarding supervision sessions.

Staff could give examples of how to protect patients from harassment and discrimination, including those with protected characteristics under the Equality Act. All staff had received equality and diversity training. Examples of the protected characteristics that patients had included patients who had a disability, patients who were transitioning from one gender to another and patients from a whole variety of religious backgrounds. Staff had received chaperone training for those patients that required a chaperone during appointments. There was a privacy booth in reception so that patients could explain in confidence what they wanted, and staff used a laminated poster so that patients could point to a picture of what their main concern was.

Staff knew how to identify adults and children at risk of, or suffering, significant harm and worked with other agencies to protect them. Staff that we spoke with routinely made referrals to safeguarding, the police, schools, children’s services and hospitals. There were safeguarding leads within the service who provided advice and guidance to staff if required.

Staff followed safe procedures for the young people visiting the service. They knew how to make a safeguarding referral and who to inform if they had concerns. We reviewed the safeguarding referrals that had been made over the last 12 months and saw that staff were competent in identifying safeguarding concerns and that there were good links with the local safeguarding team.

Description: We work with people to understand and manage risks by thinking holistically so that care meets their needs in a way that is safe and supportive and enables them to do the things that matter to them.

We reviewed 6 risk assessments and 6 risk management plans during the assessment. Risk assessments and risk management plans were fully completed and updated if staff became aware that risks had changed or at a new appointment.

Staff involved patients in care planning and risk assessment. We saw good evidence of self-completed documents and safety netting systems in place. These were practices and protocols for managing diagnostic uncertainty, ensuring timely reassessment and maintaining patient safety.

Staff communicated with patients so that they understood their care and treatment, including finding effective ways to communicate with patients with communication difficulties. This included the use of a loop system, interpreters and picture posters.

Staff enabled patients to give feedback on the service they received. Patients were encouraged to give feedback on an iPad in reception after they had completed their appointment. Patients could also leave ‘I want great care’ reviews online and we saw that there were many reviews on the Brook website.

Staff used a nationally recognised tool to identify patients at risk and escalated them appropriately. The tool was called Spotting the Signs and was developed by Brook to help professionals to ask the right questions to identify potential abuse or exploitation in young people.

Staff completed risk assessments for each patient on arrival and updated this if new risks emerged during engagement with the service.

Staff knew about and dealt with any specific risk issues, such as a safeguarding concern and safeguarding plan or follow up diagnosis and treatment.

The service referred to specialist mental health support (if staff were concerned about a patient’s mental health). Staff referred on to safeguarding or specialist child and adolescent mental health services (CAMHS) or adult mental health teams, for patients thought to be at risk of self-harm or suicide.

Staff shared key information to keep patients safe when handing over their care to others, including the police, children’s services or safeguarding teams.

Shift changes and handovers included all necessary key information to keep patients safe.

Description: We detect and control potential risks daily in the care environment and make sure that the equipment, facilities and technology support the delivery of safe care.

Staff did daily risk assessments of the care environment and there were good systems in place for the repair and maintenance of all areas, décor and furnishings. The provider had a national maintenance service that provided upgrading and repair of the facilities.

The service layout did not allow staff to observe all parts of the service. However, the alarms in the interview rooms were linked to reception to ensure staff and patient safety. There was also an alarm in reception and a safety procedure that staff used when they needed immediate support from colleagues.

Clinic rooms were fully equipped with accessible resuscitation equipment. that staff checked regularly.

Staff carried out daily safety checks of specialist equipment such as resuscitation equipment.

The service had suitable facilities to meet the needs of patients’ families. There was a bright and spacious seating area in which patients’ families or friends could wait. There was access to fresh drinking water and cups in reception. There was also free access to the internet.

The service had enough suitable equipment to help them to safely care for patients. Staff disposed of clinical waste safely. This included the collection of sharps bins by an outside agency.

Description: We make sure there are enough qualified, skilled and experienced people, who receive effective support, supervision and development and work together effectively to provide safe care that meets people’s individual needs.

Brook Manchester employed 4 permanent qualified nurses and 2 permanent healthcare assistants to staff the service. There were 3 part time sexual health educators who provided an outreach information service.

The service had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. Managers regularly reviewed and adjusted staffing levels and skill mix and gave bank nurses the same induction as permanent staff.

Staff had received and were up to date with appropriate mandatory training and compliance rates were at 98%.

The registered manager could adjust staffing levels daily according to the needs of patients. We reviewed the staffing rotas for the 2 months prior to inspection. Cover requirements were identified in advance of shifts and the number of nurses and healthcare assistants matched the planned numbers.

The service had no vacancies at the time of the assessment and the turnover rate over the last 12 months was 0%.

There were low staff sickness rates and there had been no use of bank staff over the last 6 months.

Brook Manchester was a level 2 service and did not employ medical staff (doctors). They provided testing and treatment for chlamydia only. In the event that patients may have a different sexually transmitted infection they were referred to a level 3 service for ongoing testing, care and treatment.

There was an emergency out of hours rota and a process by which staff could escalate urgent and non-urgent concerns to senior team members for advice and support.

Qualified nurses received fortnightly clinical learning sessions. There were (patient group direction) PGD development sessions in place with a minimum attendance requirement of 1 session per quarter.

All staff completed training on recognising and responding to patients with mental health needs, learning disabilities and autism. The compliance rate for learning disability and autism training was at 100% at the time of the assessment.

Description: We assess and manage the risk of infection, detect and control the risk of it spreading and share any concerns with appropriate agencies promptly.

The service performed well for cleanliness. Cleaning records and cleaning audits were up-to-date and demonstrated that all areas were cleaned regularly. We saw that the service was clean and well maintained.

Staff followed infection control principles including the use of personal protective equipment. (PPE).

Staff cleaned equipment after patient contact and labelled equipment to show when it was last cleaned. Staff carried out cleaning audits daily to ensure that there was oversight of this.

Description: We make sure that medicines and treatments are safe and meet people’s needs, capacities and preferences by enabling them to be involved in planning, including when changes happen.

Staff followed systems and processes in line with the service’s medicines management policy to prescribe and administer medicines safely.

Staff reviewed each patient’s medicines at appointments and provided advice to patients about their medicines.

Staff completed medicines records accurately and kept them up to date. We reviewed 6 patient records and saw that medication records were reviewed and updated.

As this was a level 2 service, staff administered medication for chlamydia only. Staff stored and managed all medicines and prescribing documents safely. Medication was kept in a locked cupboard. The service did not use controlled drugs and did not provide painkillers.

Staff followed national practice to check patients had the correct medicine when they accessed the service. Staff carried out peer reviews of casework to ensure that practice was appropriate and up to date.

Staff learned from safety alerts and incidents to improve practice. These were discussed and shared across all of Brook services.