Hey Baby 4D Middlesbrough

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

We looked for evidence that people and communities had the best possible outcomes because their needs were assessed. We checked that people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

This is the first inspection for this service. This key question has been rated good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We have not awarded this service a score for Effective.

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

The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The service had a clear inclusion and exclusion criteria. All staff including receptionists were aware of the criteria. Prior to each clinic taking place staff would check the booking forms for any risk information. Staff gave examples of when they would contact people to discuss whether an appointment was appropriate. For example, if a person had recently attended for an NHS scan or was noted to be under 18 years of age.

Individual risk assessments were carried out taking historic and current information into account, for example past miscarriage or ectopic pregnancy, current hypertension. There were clear actions for staff to follow depending upon the issue identified. Staff would signpost to appropriate other services when needed.

The electronic booking form was set up to highlight repeat bookers in different colours so that staff could easily check for the frequency of appointments. Staff would speak to people regarding reasons for appointments before confirming an appointment if they could see they had made multiple appointments in a short space of time.

We reviewed care records and saw examples of completed documentation including where people had been referred to other services. Record audits were completed and we saw scores were improving over time.

The evidence showed a good standard. The service 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.

Staff assessed and met peoples’ needs according to the scan being carried out. For example, water was offered for those who needed a full bladder.

The service followed the ‘ALARA’ (as low as reasonably achievable) principles. Staff also adhered to the nationally recognised ‘Pause and Check’ checklist, designed to remind staff of checks to complete before carrying out a scan. We saw posters displayed on walls in appropriate areas within the scan room detailing this information.

Staff reviewed National Institute for Health and Care Excellence (NICE) guidance and made changes to practice in line with guidance. For example, the process for making onwards referrals when there was no heartbeat detected had been changed to meet NICE guidelines. This supported joined up working relationships with the local NHS maternity unit. Referrals were not made unnecessarily.

The sonographer was a member of the British Medical Ultrasound Society (BMUS) and received regular updates regarding guidance. The sonographer was also working towards registering with the Society and College of Radiographers (SCoR) although this was not a legal requirement for this role.

The registered manager received updates regarding guidance from the national Hey Baby 4D franchise team and shared these with staff through regular team meetings. Any changes to guidance were recorded on an electronic system available for all staff.

The registered manager identified the learning needs of staff and provided them with opportunities to develop their skills and knowledge. For example, time to carry out bank shifts in the NHS to gain a wider range of experience.

The registered manager told us appraisals would take place annually and had begun to have the first conversations with staff regarding appraisals since opening. No appraisals had been formally documented at the time of inspection, however, staff understood the appraisal process and reported having appraisal conversations with clear objective setting opportunities tailored to their individual needs and in line with the wider service development. We saw evidence of these conversations through 1:1 meeting notes.

The sonographer had opportunity for peer review of scans with a sonographer identified in another service setting where a second opinion was required. There was also an additional formal annual peer review by an external experienced sonographer. The Audit Policy stated clinical observations would take place and peer reviews would be carried out on a regular basis.

The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff worked consistently well together. They allowed time prior to the start of each clinic to communicate any concerns about people attending during the clinic.

Staff communicated well with people and would ensure people did not attend unnecessarily when a scan could not be carried out. For example, text reminders were sent to people aged around 18 years to remind them to bring ID.

The team had built up a working relationship with the local NHS maternity and early pregnancy assessment teams and had made changes to practice to ensure they only referred when it was appropriate. Staff were able to articulate a clear process for handing over information to the local NHS services.

The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

People were able to identify individual health conditions and concerns at the point of booking and during their time with the sonographer. The sonographer was able to direct people to appropriate support services.

Posters were displayed with Quick Response (QR) codes linking people to recognised NHS healthy start websites for information on promoting healthy lifestyles during pregnancy and beyond.

The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service used data to monitor outcomes and plan for improvements. For example, numbers of complaints were reviewed month by month and themes were looked for. We heard an example of how factors would be taken into consideration such as potential for higher complaints around Christmas time due to peoples raised expectations at that time of year.

Peer reviews of images were formally carried out annually by an external experienced sonographer. Peer support was available daily if required for second opinions and peer review.

Monthly record keeping audits took place. We saw a gradual increase in scores demonstrating improvement since the service opened in 2024 to the time of inspection.

The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff took all practical steps to enable patients to make their own decisions. The services website provided details on the nature of each scan and the timescale at which it was appropriate to book for each scan. There was a link on the website to follow for people whose first language was not English. This link allowed the same information to be read in different languages.

The website provided detail on the process for blood tests. Staff told us the laboratories used for blood testing would not process the request without completed consent forms.

Staff told us they offered consent forms in alternative languages.

Staff were able to describe the process for assessing capacity and explained they would not carry out a scan or take bloods if a person did not have capacity to consent although this situation had not arisen. There was a comprehensive Informed Consent and Mental Capacity Policy in place with clear processes outlined for staff to follow.