Before the Stork

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’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question as not sufficient evidence to rate. At this assessment the rating has changed to good.

We found scans were delivered in line with pause and check British Medical Ultrasound Society (BMUS) guidelines. The service ensured women understood the terms and conditions of the scan and gave informed consent.

The service had referral pathways in place when concerns were identified.

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.

Description: We maximise the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

We scored the service as 3. 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.

Women were assessed via a telephone booking carried out by the registered manager. We observed women were signposted to NHS services when needed, due to the symptoms described instead of using the service. For example, if they were experiencing any bleeding or pain.

The sonographer carried out the scan and assessed if any referral was required from the findings. Transabdominal scans were carried out routinely. We were told a transvaginal scan would be offered for an early pregnancy scan if indicated. At the time of the assessment no transvaginal scans had being carried out for a number of years. If a scan picture was not successful, the woman was asked to go for a walk and rescan later. If needed, the scan would be rebooked for another day.

The service had access to interpreting services using the internet. Based on the demographic that used this service this had not been required at the time of the assessment.

Description: We plan and deliver people’s care and treatment with them, including what is important and matters to them and in line with legislation and current evidence-based good practice and standards.

We scored the service as 3. 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.

The service had policies in place to support the delivery of evidenced based ultrasound scans. Staff were aware of how to access the polices. Policies and procedures were in line with current legislation and national evidence-based guidance from the BMUS.

The service followed the ALARA principle. This was in line with BMUS.

The service carried out benchmarking and peer review with another provider annually to ensure standards were met.

Description: We work effectively across teams and services to support people, making sure they only need to tell their story once by sharing their assessment of needs when they move between different services.

We scored the service as 3. 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.

We saw the service referred women to local NHS maternity services during the booking assessment when needed.

The service had a policy in place for women when concerns or abnormalities were detected during the ultrasound scan.

Description: We support people to manage their health and wellbeing so they can maximise their independence, choice and control, live healthier lives and where possible, reduce their future needs for care and support.

We scored the service as 2. The evidence showed some shortfalls. The service did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control.

Women were informed the scans provided did not replace any routine NHS antenatal scans.

The service provided information about the scan packages available and what to expect on their website.

Description: We routinely monitor people’s care and treatment to continuously improve it and to ensure that outcomes are positive and consistent, and that they meet both clinical expectations and the expectations of people themselves.

We scored the service as 3. 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 actively sought feedback verbally following the scan appointment to ensure women were pleased with the images provided.

The service carried out an annual peer review with another provider to benchmark scanning systems and processes.

The sonographer worked for an NHS trust where competence and standards were assessed.

Description: We tell people about their rights around consent and respect these when we deliver person-centred care and treatment.

We scored the service as 3. 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.

We observed women arrive for their appointment and staff explain the consent process. Women were asked to read the terms and conditions for the scan and sign as part of the consent process.

Women aged 16 and 17 had to be accompanied by an adult who would sign the consent form.

Staff had completed training on the Mental Capacity Act and informed consent and expectations.

The sonographer checked verbally if the women consented to the scan and if they wanted to know the baby’s gender.