We carried out an announced comprehensive inspection on 7 December to Brierley Hill additional community services vasectomy clinic to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations.

Background

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

Additional Community Services Ltd provides this service, which comprises a one-stop shop approach for vasectomy for adult men in Brierley Hill. The service is funded through the NHS. This means the service offers a pre-procedure consultation, followed by the procedure on the day and a post-procedure consultation regarding aftercare. Men may wish to defer the procedure to another date if they feel unsure about going ahead on the day. The service offers 35 appointments per month, booked following a GP consultation on the electronic patient appointment booking system (choose and book). Appointments are available every Wednesday and one Saturday per month. A GP who is trained to carry out no scalpel vasectomy procedures runs the service, supported by health care assistants and an administrator.

The doctor carrying out the procedure is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Three people provided feedback about the service at the time of the inspection. They all said that they were happy with the information they had received, and the quality of the service on the day. Patients had not completed any comment cards.

Our key findings were:

• Safe one-stop procedures, including pre-procedure consultation, procedure and post-procedure education.
• Good infection control practices.
• Clear written and verbal information regarding consent and the procedure and outcomes.
• Good evidence of risk management being undertaken for each patient.
• Effective monitoring of patient outcomes.
• Good access with no waiting.
• No complaints and good monitoring of patient satisfaction.
• Well-led with a clear focus on service delivery.
• Good communication channels and governance processes.
• The doctor for the service was a trainer for other no-scalpel vasectomists

There were areas where the provider could make improvements and should:

• Review the recording of lidocaine stock to ensure a permanent record of all deliveries received.

We inspected Brierley Hill health and social care vasectomy service on a planned, announced visit. We had previously informed the manager we would be attending to ensure the service was open and to cause as little disruption to people’s appointments as possible. We were supported throughout the inspection by the manager who was also the doctor who undertook the procedures.

We found that people who used the service had their care and welfare needs met. People we spoke with told us they were completely satisfied with the service they had received. One person told us: “It’s been an excellent service”.

We looked to see if medication was managed safely. We found that the service required some improvement in the auditing of medication stored on the premises.

We saw that there was a system of monitoring the quality of the service provided to ensure people received care that was up to date and safe practice.

At our previous inspection in March 2013 we found that the services complaints procedure was not easily accessible to people to use. At this inspection we found that improvements had been made.

Brierley Hill Health and Social Care Centre provided a well run community based vasectomy service. People were able to book their own appointments using the, "Choose and book system." People we spoke with said that this was easy to use and worked well.

The vasectomy service provided an efficient, friendly and competent service to the local community. One person said, " I am perfectly happy with the service," Another person said, " The written information is very thorough and clear and the referral came through quicker than anticipated."

A consultation took place prior to the procedure where an informed consent was obtained. We observed that clear explanations about the pros and cons of the procedure are given to people. People we spoke with said that the doctor was kind and supportive and gave explanations that were easy to understand.

The procedure was carried out in a clean environment taking into account all current infection prevention control guidance. Staff were observed to be kind and reassuring throughout the procedure. We observed the doctor explaining the after-care to people in a clear and informative manner.

The service had not received any complaints in the past year. The complaints system could be improved by making it clear to people how to make a complaint if they wish to do so.

There was a system of quality monitoring of the service provided to ensure people received care that was up to date and safe practice.