Hey Baby 4D Northampton

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

The service had processes in place to manage person safety incidents, which were rare. The provider shared learning from incidents across its national network as part of an embedded learning culture. When things went wrong, staff apologised and gave people honest information and suitable support. Staff had the required levels of training to safeguard vulnerable adults and children and took action to keep people safe from avoidable harm and abuse. Risk assessments ensured a safe environment and systems of care. There was continuity of care when people moved between different services and a clear focus on supporting people with mental health needs. The design, maintenance and use of facilities, premises, and equipment kept people safe. The service had enough staff with the right skills, training and experience who received effective support, supervision, and development. Staff worked together effectively to provide safe care that met person’s individual needs. Staff controlled infection risk well. Staff kept equipment and the premises visibly clean.

This service scored 84 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff facilitated the learning culture in line with the provider’s national policies and procedures. Staff maintained good standards of day-to-day safety and there had been no incidents in this clinic related to clinical practice or errors. Staff understood how to document and report incidents, and the provider had an up-to-date incident management policy. Staff tracked referrals to NHS services where they found no foetal heartbeat or evidence of a miscarriage.

Managers had access to learning from incidents and near misses across other locations. Managers shared learning and reviews from other locations in team meetings and risk monitoring to make sure staff were aware of this information.

Sonographers worked as peer reviewers nationally to address any complaints or concerns about scan image quality or processes. This reflected good practice and meant locations across the provider network had access to learning and tools to standardise practice.

Staff used person feedback to make improvements. For example, staff improved their mental health assessments and did training in how to meet the needs of an increasingly diverse population. This meant more people were able to access the service.

Staff checked people age before scanning them to make sure only people aged 18 or older were scanned. Some types of scans had minimum pregnancy term limits before the service could safely offer them. For example, the service required people asking for a gender scan be at least 15 weeks into their pregnancy and to meet certain foetal measurement requirements.

Early pregnancy gender diagnostic tests and scans could be offered from 6 weeks of pregnancy however this was confirmed by evidence of an NHS scan. Early pregnancy gender diagnostic tests involved a blood test to confirm the baby’s gender at an early stage of pregnancy.

When people could not provide identification to confirm their age, staff signposted them back to their GP for care. This ensured the service provided care safely and helped staff act with caution where they found people may be vulnerable.

When sonographers diagnosed a miscarriage, they contacted the nearest NHS emergency department (ED) and arranged for the person to attend there for a second opinion.

In other urgent situations, sonographers arranged for the person to attend the nearest NHS gynaecology assessment unit or early pregnancy assessment unit for immediate care. The service had established links with local NHS providers to facilitate this as part of the care pathway.

Sonographers used the national ‘pause and check’ safety system during scans. Designed to reduce errors during scanning, the system incorporated checks for accuracy into each stage of the scan. Quality assurance audits indicated 100% compliance with expected standards.

All staff were trained to level 3 adults and child safeguarding and in the recognition of female genital mutilation (FGM). The service had an up-to-date safeguarding policy based on national guidance specific to pregnant women and their families. The team demonstrated compassion and attention to detail when recognising potentially vulnerable people. Staff documented safeguarding vulnerabilities in each person’s record.

The service had an established protocol in place to support people who were experiencing domestic abuse. Discreet information instructed people how to seek help from staff without attracting attention. Staff were trained to provide immediate support while providing a safe space for the individual.

Staff knew how to make safeguarding referrals to the local authority and to link with NHS services when they had welfare concerns. For example, staff acted quickly to address the needs of a person who presented for a scan while intoxicated. The sonographer used a mental capacity protocol to check the person’s mental capacity and worked with their regular gynaecologist to coordinate care. The fast action of staff, including a safeguarding referral, kept the person safe and ensured their broader needs were addressed.

The team acted on shared learning from a safeguarding incident at another clinic. As a result, where staff identified signs of risk during conversations with people, they obtained more detailed contact information to help local authorities and police follow up. Staff had developed a form to record relevant information which meant quicker information sharing with the local authority or police in such cases.

Staff were trained to support people with a history of self-harm and suicidal ideation. They avoided stigmatising people and recognised the difference between historic cuts and new evidence of self-harm. Sonographers provided care with as little risk as possible and were skilled in facilitating difficult conversations. They liaised with other agencies where they had concerns about a person such as to local non-profit specialist support agencies. Staff used risk assessments in such cases.

All staff were involved in risk assessment so risk could be reduced. Managers updated risk assessments annually or more frequently to reflect learning from an incident or a change to good practice guidance.

Sonographers assessed each person for risks associated with high blood pressure, acute bleeding, pain, gestational diabetes, and mental health symptoms. Staff used specific risk assessments to reduce the risk of miscarriage and ectopic pregnancy.

Staff followed national guidance when assessing levels of risk where sonographers suspected an ectopic pregnancy. They asked people to disclose information such as history of pelvic inflammatory disease, abdominal surgery, smoking status, and whether they were sexually active. Sonographers used this information to assess risk more accurately and we saw detailed risk assessments completed appropriately.

The service had changed how they worked to allow more time to assess mental health concerns and needs. Staff discussed person expectations and reasons for scans in advance with each person. Sonographers used a mental health pre-assessment to ensure the person had the capacity to consent and understand potential outcomes. Staff ensured people understood this was a non-diagnostic service and did not replace NHS clinical care. Staff made it clear to people that blood tests were processed by an external company that was responsible for any diagnosis and follow-up advice, guidance, or treatment.

Staff facilitated the learning culture in line with the provider’s national policies and procedures. Staff maintained good standards of day-to-day safety and there had been no incidents in this clinic related to clinical practice or errors. Staff understood how to document and report incidents, and the provider had an up-to-date incident management policy. Staff tracked referrals to NHS services where they found no foetal heartbeat or evidence of a miscarriage.

Managers had access to learning from incidents and near misses across other locations. Managers shared learning and reviews from other locations in team meetings and risk monitoring to make sure staff were aware of this information.

Sonographers worked as peer reviewers nationally to address any complaints or concerns about scan image quality or processes. This reflected good practice and meant locations across the provider network had access to learning and tools to standardise practice.

Staff used person feedback to make improvements. For example, staff improved their mental health assessments and did training in how to meet the needs of an increasingly diverse population. This meant more people were able to access the service.

The senior team planned and maintained safe levels of staffing based on service demand. A team of 4 non-clinical staff, 2 sonographers and 1 locum sonographer staffed the service. The locum sonographer completed the same level of training and supervision as permanent colleagues, which ensured people had assurance of consistent care. Baby scans do not require fully qualified sonographers and so the service’s standard practice of sonographer-led care reflected a high standard of practice from qualified, experienced staff.

Sonographers were registered with the Health and Care Professions Council (HCPC) and were members of the British Medical Ultrasound Society. Such registrations provided assurance of competent practice and access to the most up to date national guidance and continuing professional development. All staff were trained to act as chaperones.

Staff completed a provider induction followed by a role-specific induction as well as a programme of mandatory training, which consisted of up to 26 modules depending on their role. They maintained a record of the policies and standard operating procedures (SOPs) read as part of their induction. The provider required staff to update this record as policies were updated.

At the time of our site assessment all staff were up to date with mandatory training. All clinical staff additionally completed care skills training and venepuncture training.

This clinic was linked with another location in Derby and shared resources to avoid disruption during periods of staff absence. Local procedures, policies, and equipment were identical between clinics, enabling staff to cross cover seamlessly.

The provider operated a no lone working policy to maintain staff safety and ensure support was available for people in the event they received bad news.

Staff maintained consistently good standards of infection prevention and control (IPC) in the clinic. They cleaned and sanitised equipment in line with manufacturer guidance and used daily, weekly, and monthly checklists for cleaning of the environment. We found high standards of IPC and cleanliness during our site assessment in all aspects of the environment, including in good decontamination processes for vaginal probes.

Sonographers were trained in venepuncture and followed good practice when taking bloods for screening such as non-invasive prenatal testing (NIPT), including appropriate use of personal protective equipment (PPE) and sharps disposal.

Staff carried out monthly hand hygiene audits that included all colleagues and assessed their practices against the World Health Organisation’s (WHO) international guidance. The team performed well and achieved 100% compliance in the previous 12 months. The service displayed the WHO hand washing guidance adjacent to each sink to encourage good practice.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.