Brook Brixton is part of Brook Young People, which provides sexual health services, support, and advice to young people under the age of 25. Brook Brixton (Brook Young People) is the registered provider for Brook Brixton. The service is jointly funded by the London Borough of Lambeth and the London Borough of Southwark.

They provide the following services:

• Caring for adults under 65 years of age
• Caring for children up to 18 years of age

They provide the following regulated activities:

• Family planning
• Treatment of disease, disorder or injury
• Diagnostic and screening procedures

As part of the inspection, we spoke with young people attending clinics, spoke with staff working at the service, and viewed documentation of six client care and treatment records.

Our findings are as follows:

• Staff were encouraged and supported to report incidents. The system for escalating incidents was simple and streamlined, and actions and outcomes were shared with staff.

• The service had strong safeguarding systems in place to protect children and young adults. Staff were able to identify and report safeguarding concerns quickly and there was good collaborate working with local support services to ensure children and young adults received the right care. Care and treatment was based on national guidelines and the service participated in national and local audits, using outcomes to improve the quality of their service.
• The environment was visibly clean and equipment had been tested in line with appropriate guidelines. There was a good selection of personal protective equipment available for staff to use.
• Medicines were managed well and good patient group directives were in place.
• Records were kept safe and there were good notes to provide a clear pathway of care for the young person.
• Consent was monitored and managed well. Staff were provided with training and understood when to apply Gillick competence and Fraser guidelines to those young people under 16 years of age.
• The service was accessible at suitable times and several locations, which meant young people, could be seen quickly.
• The service recognised waiting times were an issue and had introduced a texting queue system to help alleviate the problem.
• Brook Brixton worked well with the local borough and other sexual health services to offer the best care for young people.
• The service acted upon local issues, which concerned young people and did their utmost to understand and provide the best care. For example, staff had participated in a safeguarding course aimed at understanding the culture within ‘youth gangs’ and the difficulties young people experienced.
• Young people were involved in shaping and evolving the service. There was a participation group where young people met regularly and Brook provided volunteering opportunities for young people.
• Young people had good access to a selection of information and were able to ask questions through their website.

We saw examples of outstanding practice:

• There were robust safeguarding systems to protect vulnerable young people. Staff knew how to escalate concerns, ensuring the best supportive services were used to help young people.
• The service continuously monitored their safeguarding practices to make sure they kept vulnerable young people safe.
• Staff were kind and caring and placed young people’s health and wellbeing at the heart of their service. They listened to their clients and were prepared to make changes and put in place ideas raised by young people.

However:

• Staff shortages meant 61 shifts were unfilled for the reporting period of July 2016 to October 2016. There was a national shortage of sexual health nurses and staffing was placed as a high risk on local and corporate risk registers.