Cocoon Harrogate

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This is the first assessment for this service. This key question has been rated good. This meant women’s needs were met through good organisation and delivery.

We looked for evidence that women were always at the centre of how care was planned and delivered. We checked that the health and care needs of women were understood, and they were actively involved in planning care that met these needs. We looked for evidence women could access care in ways which met their personal circumstances and protected equality characteristics.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

The service made sure women were at the centre of their care and treatment choices and they decided, in partnership with women, how to respond to any relevant changes in women’s needs.

Women told us staff went the extra mile to ensure gender scan results were accurate. Staff offered repeat scans, if required, a few hours or days later, depending on the woman's availability and preferences, to confirm the baby's gender and provide reassurance the result was correct.

Staff did not record detailed information in women’s scanning records about their individual needs, and the records did not show how staff tailored care to women’s needs and preferences.

Staff described having sufficient time to support women and develop positive relationships with them, particularly where individuals returned for multiple scans throughout their pregnancy. They stated this continuity contributed to women feeling safe and reassured.

The service was described as providing emotional support during difficult situations and ensuring women experiencing pregnancy loss were not left without information regarding further support.

The service understood the diverse health and care needs of women and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service provided private scans with women booking appointments themselves.

The Registered Manager told us there was good relationships established with local maternity and early pregnancy services, which supported effective referrals.

The service had no direct access to women’s NHS records, however, patients regularly brought their ante-natal records with them when going for their scans.

The service provided private wrap around community midwifery support both antenatally and postnatally. There were effective relationships established with NHS health visitors and social services.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Women told us staff provided information in a way they could understand. Staff signposted women to other local services which could offer additional support during pregnancy and after birth, helping them access the information and care they needed.

We observed staff providing information to women about their scans as they were undertaking the scan, then provided a report and copy of the scan on the same day.

Leaders told us the organisation provided information governance safeguards through its Data Storage Policy and Records Management Policy. These policies ensured the collection, storage, access, sharing, retention, and disposal of information aligned with the UK GDPR (General Data Protection Regulation) and the Data Protection Act 2018.

The data and systems governance lead had completed GDPR in Health and Social Care Level 2 and the service was registered with the Information Commissioner’s Office.

All clinical staff completed annual Information Governance and Data Protection training and ensured confidentiality of women’s records. Staff shared information through secure systems to ensure confidentiality. The service had a clear process in place to ensure staff saved previous scans and reports onto a secure electronic system.

Leaders told us staff locked physical records in filing cabinets. We did not observe any physical notes lying unattended whilst on site.

The service made it easy for women to share feedback and ideas, or raise complaints about their care, treatment and support. They involved women in decisions about their care and told them what had changed as a result.

There were posters and information available on the company internet site advising women how to feedback to the service including complaints. We did not see any alternative formats for those with additional needs.

A complaints policy was in place with clearly defined response times. The policy outlined the investigation process, and stated staff would offer an apology where appropriate. The policy detailed the escalation process for complainants who were unhappy with the services response. However, the service had not implemented an audit process to ensure staff managed complaints in line with the policy, and leaders had not identified how they shared learning from complaints with staff.

Leaders told us there had been two complaints in three years, which they responded to instantly, with apologies offered.

The service had many examples of thank you letters and reviews from women who had used the service.

The Registered Manager told us positive service users feedback was consistently received and used as an indicator of service quality.

The service made sure that women could access the care, support and treatment they needed when they needed it.

Women told us the service offered appointment times to fit in with their own needs and not that of the service.

Leaders told us, once a woman had self-referred to the service, staff assessed equality, diversity, and inclusion needs as part of the initial assessment and ongoing interactions, however, we saw no evidence of these assessments.

Leaders told us staff took into consideration such things as emotional distress or anxiety (particularly in the context of pregnancy or previous loss), communication differences, neurodivergence, cultural or religious considerations, safeguarding concerns, and physical accessibility needs. However, we did not see evidence of this in women’s scanning notes.

Leaders and staff told us about the processes they would undertake to provide individual care to women who had mobility issues. If the service were unable to provide the access required they would signpost women elsewhere.

Women with neurodivergent needs could visit the service and meet staff prior to scans to reduce anxiety and increase familiarity.

The service offered bespoke packages to women with anxiety providing medical screening with dedicated mental health and wellness care to women

Staff and leaders actively listened to information about women who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff had all received training in equality and diversity.

Most staff told us they had not encountered women requiring interpreters, those with reduced mental capacity, or women with significant cultural or religious needs. However, they demonstrated awareness of the need to respond appropriately to individual circumstances and support requirements.

Leaders told us they would like to offer more marginalised groups the same service as private women but were unable to at present owing to the lack of funds to support women who do not have the finances to pay for the service themselves.

Women were supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

Women told us that staff supported them compassionately when scan results did not bring the news they had hoped for, giving them the confidence to return to the service when they needed it again.

The service trained all staff to communicate bad news effectively to women. Staff could refer women to private bereavement services for further support.

The service planned to move into larger premises to support larger wrap around provision for women, by providing GP services in site.