Ultrasound-Care Bromsgrove

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

Effective

Effective – 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.

At our last inspection we rated this key question requires improvement. The service was in breach of legal regulation in relation to staff appraisals not completed. The service has made improvements and is no longer in breach of regulations. We saw risk assessments clearly detailed actions to be taken. At this assessment the rating has improved to good.

This meant the effectiveness of monitoring patient’s care was not always robust. Clinical audits and appraisals were not routinely completed. However, risks were identified prior to appointments which meant there were limited cancellations. Consent was clearly recorded for all appointments and there was cohesive and flexible working across all staff groups.

Due to the type of service outcomes were not routinely monitored and there was limited focus on supporting patients to lead healthy lives.

The service was in breach of legal regulation in relation to people’s safe care and treatment and governance at the service.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing, and communication needs with them.

Staff completed scanning as per referral or request. Women and patients either self-referred or were referred by another clinician. Scans were planned and delivered in line with evidence-based guidance, standards, and best practice.

The service had local ultrasound scanning protocols which had been approved for different pathways, which were in date. The lead sonographer regularly reviewed all clinical policies to ensure they reflected best practice and national guidance, ensuring clarity of actions and responsibilities.

Staff would assist patients into comfortable positions for imaging wherever possible. Patients had access to drinking water as needed or required. There was a water dispenser for patient use.

We reviewed 24 patient care records which included the preadmission terms, the conditions assessment and the scanning reports. The preadmission assessment included details of any allergies, condition, previous pregnancy information (including number of miscarriages), along with details of the service planned and cost. All assessments were signed and dated by the patient attending. Scan reports included pregnancy dates, details of sonographer and chaperone, confirmed consent and then the details of the scan. Where anomalies were identified, there was clear written and verbal advice on what the patient should do.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. However, audit processes and appraisals were not established for all staff.

Staff followed up-to-date policies to plan and deliver high quality care according to best practice and national guidance. All policies we looked at contained a creation and review date, and clear references to current national guidelines. There were systems to communicate changes in guidance through meetings and team updates. We saw notice boards displaying up to date guidance to staff.

Policies and processes took account of changes to the Royal Colleges guidelines and National Institute of Care and Excellence (NICE) guidelines.

We reviewed 15 patient records for evidence of completion of risks assessment prior to appointments and saw that risks were identified and clearly recorded within the preadmission paperwork.

The lead sonographer was in the process of introducing an audit of clinical skills for all trained staff. This included retrospectively auditing scans and observing practice to ensure competence and quality. If any issues were identified, the individual was spoken with or provided with additional support to ensure competence.

The team included or had access to the full range of specialists required to meet the needs of patients in the service. Sonographers and healthcare support workers worked within their roles and were able to support each other. We saw that the team used a secure social media site to share updates or learning.

Staff were experienced and qualified and had the right skills and knowledge to meet the needs of the patient group. This was checked prior to employment.

Managers provided new staff with appropriate induction. Healthcare support workers completed an induction with the senior managers. This could be extended if staff felt they needed additional support or confidence. Sonographers were required to work with a “buddy” and to shadow other staff as part of their induction.

Senior managers provided substantive staff with supervision. This included meetings to discuss care management and reflect on and learn from practice. They also supported personal and professional development and appraised staff performance. Managers ensured that staff had access to regular team meetings and shared meeting minutes. Meetings were completed monthly and staff were encouraged to share any ideas or concerns. Senior managers were available on site and could also assist with any concerns at the time.

The service did not provide evidence that substantive staff had annual appraisals completed. All staff had an appraisal completed by the provider, and sonographers confirmed they had appraisals as part of their NHS work within local trusts.

The percentage of substantive staff that received regular supervision was 100%. Sonographer supervision had been introduced in January 2026 and was not embedded. The aim was to complete quarterly reviews of practice.

Managers identified the learning needs of staff and provided them with opportunities to develop their skills and knowledge. Staff had been encouraged to take on new skills for different scans or phlebotomy to support the development of the service.

Managers dealt with poor staff performance promptly and effectively. Any concerns were addressed directly with the individual and if necessary, additional support given.

The provider worked well across teams and services to support people but had limited access to other organisations due to the nature of the business, often seeing patients for limited periods of time.

Sonographers and other professionals worked together as a team to benefit patients. They supported each other to provide good care. Staff worked with senior managers to ensure scans and investigations were completed in a timely manner with appointments made within 24 hours of referral.

Staff reported healthy working relationships across staff groups, with chaperones and sonographers working well together, ensuring appointments went smoothly. We heard examples of effective team working which was based on mutual respect and trust.

Staff worked closely with the referrers to enable patients to have a prompt appointment, aiding diagnosis, and treatment pathway. All reports and results were directed to the referrer for onward care planning. If concerns or abnormalities were identified, staff escalated them to the referrer or signposted to the appropriate service. For example, anomalies on pregnancy scans, such as incorrect location or foetal deformities were referred to the early pregnancy unit, midwife, or GP. This ensured staff could share necessary information about the patients and provide holistic care.

The teams had effective working relationships and although the sonographers were self-employed, we were told they often worked together within the NHS. This meant that staff were familiar with each other and knew the individuals’ skills and competency, which promoted shared learning and mutual respect.

The provider supported people to manage their health and wellbeing to maximise choice and control. Due to the nature of the service, information was limited to that appropriate to the scans/ treatments offered.

The service had a range of health promotion information available via the provider website. This included promoting healthy eating, caffeine consumption and conditions such as pre-eclampsia and asthma in pregnancy.

The service had a range of information leaflets for different scans undertaken, which detailed what patients should expect during their visit and how patients should prepare for their scan.

The provider routinely compared the business model against their peers and identified areas for growth and development. This included the development of additional scanning services and phlebotomy. The provider was focused on providing a positive experience for people attending the centre and captured feedback about what could be improved. This included enabling women to pick their own image to take home.

The provider had recently introduced sonographer audits to ensure compliance and quality as outlined above, but these were not established at the time of inspection. Senior managers assessed substantive, non-sonography staff regularly to ensure that their practice was in line with the companies expected standards. This included working alongside managers during induction to ensure correct terminology and effective communication. They were supervised monthly to ensure good practice was maintained and compliance against policies.

Service managers compared treatments available and costings with peers to ensure they were in line with similar providers. However, audits and national reporting was not routinely completed due to the type of service being provided.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff supported patients to make informed decisions about their care and treatment. They followed national guidance to gain patients’ consent and this was clearly recorded in the patient record.

Staff knew how to support patients at risk of sensory overload or were experiencing mental ill health. Additional time was allocated, or appointments were allocated to a quieter part of the working day, to promote a positive experience.

Staff understood how and when to assess whether a patient had the capacity to make decisions about their care. Staff followed the services policies related to consent, and restrictive practice, as relevant.

Where possible, staff gained consent from patients for their care and treatment in line with legislation and guidance. Consent for scanning was sought, and this included discussion about the benefits, potential complications, the risks, and alternative options. Consent was clearly recorded within the assessment phase.

Staff gained verbal consent before providing care or treatment and patients signed to confirm they understood what they were agreeing too. People were involved in decision making at all levels.

Interpreters were used to support patients to give informed consent, including for BSL and face to face interpreting when necessary. Staff routinely accessed telephone interpreting services to assist with appointments. The need for interpreters was discussed at the point of referral.

Staff sought permission before sharing patient information with family or friends. Patients attending confirmed that those accompanying them could be included in the appointment. We were told how some women chose to have large groups at appointments and this was facilitated where possible.

The service had a consent policy which was up-to-date and provided patients with written information about the consent process prior to attending for appointment. The service only provided scans for people over the age of 18 years.

Patients were given information explaining what to expect from the appointment and how the results would be shared. Patients we spoke with confirmed they had completed a safety questionnaire and had given their consent for the procedure for which they had attended. Patients were not pressurised into purchasing other products or treatments.

All staff received and kept up to date with training in the Mental Capacity Act and Deprivation of Liberty Safeguards and knew where to access the current polices. There was 100% compliance with Mental Capacity Act and Deprivation of Liberty Safeguards training.