Before the Stork

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

We looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good.

Good: This meant people were safe and protected from avoidable harm.

We have not awarded this service a score for Safe.

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

Description: We have a proactive and positive culture of safety based on openness and honesty, in which concerns about safety are listened to, safety events are investigated and reported thoroughly, and lessons are learned to continually identify and embed good practices.

We scored the service as 3. The evidence showed a good standard. The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. We scored the service

A duty of candour policy was in place and staff had completed duty of candour training. Staff knew what incidents to report and how to report them. The service had no incidents reported in the last 12 months.

We were told women were triaged and signposted to NHS services for care and treatment when needed and this reduced the incident rate.

Description: We work with people and our partners to establish and maintain safe systems of care, in which safety is managed, monitored and assured. We ensure continuity of care, including when people move between different services.

We scored the service as 3. The evidence showed a good standard. The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Women completed a pre-scan questionnaire on arrival to the clinic, which included a signed declaration confirming where NHS care was given and consent to share medical information if required.

Women were advised to attend their routine NHS antenatal healthcare and baby scans.

There was a clear pathway for early pregnancy referrals to support if an anomaly was found during the scan. We were given examples where this happened. Information was shared with the NHS service and a scan appointment was made to attend for NHS care and treatment.

The service offered gender blood tests. The sample was taken by a trained phlebotomist and sent to a laboratory for testing. The laboratory used by the service was ISO 17025 accredited. Test results were emailed to the women.

Description: We work with people to understand what being safe means to them as well as with our partners on the best way to achieve this. We concentrate on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect, and we make sure we share concerns quickly and appropriately.

We scored the service as 3. The evidence showed a good standard. The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately.

The registered manager was the safeguarding lead for the service and had completed designated safeguarding lead training. Sonographer staff were trained in safeguarding level 3 for adults and children. Training included awareness of female genital mutilation (FGM) and identifying domestic abuse, trafficking, vulnerability or coercion during clinic visits. Staff knew how to make a safeguarding referral and how to contact the local authority if needed.

The service scanned women 16 years of age and over. Women who were 16-17 had to attend with a parent to sign the consent form.

Description: We work with people to understand and manage risks by thinking holistically so that care meets their needs in a way that is safe and supportive and enables them to do the things that matter to them.

We scored the service as 3. The evidence showed a good standard. The service worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Staff were aware of their responsibilities to advise women about the potential risks of ultrasound overexposure. Scanning time was limited and in line with the British Medical Ultrasound Society (BMUS) guidelines. The sonographer adhered to as low as reasonably achievable (ALARA) principle.

Women were advised about the importance of attending their NHS scans and appointments. The terms and conditions for the service explained this.

We observed telephone calls where women were signposted to their NHS service for care and treatment due to symptoms and concerns identified.

Description: We detect and control potential risks in the care environment and make sure that the equipment, facilities and technology support the delivery of safe care.

We scored the service as 3. The evidence showed a good standard. The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The service had appropriate premises and equipment that were clean, secure, properly used and maintained.

The scanning room had low lighting and a scanning couch. The scanning machine had appropriate checks and a service contract in place for maintenance as per manufacturers recommendations.

Waste was disposed of in line with national guidance and collected by a waste company under a service contract.

Description: We make sure there are enough qualified, skilled and experienced people, who receive effective support, supervision and development and work together effectively to provide safe care that meets people’s individual needs.

We scored the service as 3. The evidence showed a good standard. The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

We found staffing levels were appropriate for the service provided. There were no vacancies at the time of our assessment.

The registered manager monitored mandatory training compliance to ensure this was completed. Training included supporting people with learning disabilities and autism, unexpected findings and escalation referral, basic life support, information governance, chaperone protocol, fire safety, health and safety, manual handling, accident and incident policy and mental capacity act.

The sonographer worked for a local NHS trust where supervision and appraisal were carried out. Staff had protected time to complete training.

Description: We assess and manage the risk of infection, detect and control the risk of it spreading and share any concerns with appropriate agencies promptly.

We scored the service as 3. The evidence showed a good standard. The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff adhered to infection control principles, including handwashing. Women were asked to used hand sanitiser upon arrival.

We observed the sonographer carrying out transabdominal ultrasound scans, which were non-intimate examinations performed externally on intact skin.

Staff cleaned the equipment after patient contact as per manufacturer’s guidance. Transabdominal probes were cleaned with sanitising wipes after each scan.

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