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Early Days Baby Scan Ltd Good

Inspection Summary


Overall summary & rating

Good

Updated 15 March 2019

Early Days Baby Scan Ltd is an independent medical provider offering antenatal ultrasound imaging and diagnostic services to self-funding or private patients.

Early Days Baby Scan Ltd is located in Wakefield town centre, and is served by good public transport links. The location benefits from on-street public parking, and private car parks are available close by. The service is located on the ground floor of a business property. The reception and waiting area has sufficient seating, and leads on to a bathroom. Refreshments and entertainment (radio and magazines) are available whilst waiting. Ultrasound scanning takes place in an adjacent private room with ample space and seating.

The service offers early pregnancy reassurance (from six to 15 weeks pregnancy), sexing/gender (from 15 weeks pregnancy), 3D and 4D (from 24 to 32 weeks pregnancy), reassurance (from 15 weeks pregnancy), and presentation (from 35 weeks pregnancy) ultrasound scans. Depending on the type of scan performed, these might involve checking the location of the pregnancy, dating of the pregnancy, audio fetal heartbeat check, determination of sex, and fetal presentation at the time of appointment. All ultrasound scans are performed transabdominally. Patients are provided with ultrasound video or scan images, and an accompanying verbal explanation or written report.

We inspected the service using our comprehensive inspection methodology. We carried out a short-announced inspection on 18 January 2019. We had to conduct a short-announced inspection because the service was only open if patient demand required it.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with fundamental standards.

Services we rate

We had not previously inspected this service. We rated it as Good overall.

We found the following areas of good practice:

  • There were procedures in place for referral to other agencies; such as NHS antenatal healthcare providers, and local authority safeguarding teams. Staff understood how to protect patients from abuse.

  • Staff understood how to keep people safe from avoidable harm and to provide the right care and treatment. The service had systems in place to manage patient safety incidents well.

  • The service treated concerns and complaints seriously, and had systems in place to investigate them and learn lessons from the results.

  • The service had suitable premises and equipment and looked after them well. The service controlled infection risk and staff kept equipment and the premises clean.

  • Staff completed and updated risk assessments and care records for each patient. The service had policies and procedures in place to promote the confidential and secure processing of information held about patients.

  • We saw extensive evidence of positive feedback from women who had used the service; including from women who had received challenging news, and those who had previously experienced pregnancy loss.

  • We saw the service had voluntarily refunded deposits for women who had cancelled appointments due to pregnancy loss; and had provided complementary repeat sexing/gender scans if the baby’s sex could not be determined at the time of appointment.

  • Staff understood the importance of obtaining informed consent, and involved patients and those close to them in decisions about their care and treatment.

  • The service planned and provided services in a way that met the needs of local people and took account of patients’ individual needs.

  • Managers in the service and had the right skills and abilities to run a service providing high-quality sustainable care and promoted a positive culture.

  • The service was committed to improving services, had a vision for what it wanted to achieve, and engaged well with patients to plan and manage appropriate services.

However, we found the following issues that the service provider needed to improve. These findings were fed back at the time of inspection:

  • We observed that consent forms at the service didn’t clearly follow Public Health England (PHE) guidance.

  • The service did not have a specific consent form for patients under 16 years of age which evidenced use of the Gillick competence test.

Following our inspection, we told the provider that it should make some improvements, even though a regulation had not been breached, to help the service improve.  Details are at the end of the report.

Ellen Armistead

Deputy Chief Inspector of Hospitals (Hospitals)

Inspection areas

Safe

Good

Updated 15 March 2019

We had not previously inspected this service. We rated safe as Good because:

  • The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment. The service had systems in place to manage patient safety incidents well.

  • Staff understood how to protect patients from abuse and the service had systems in place to do so.

  • The service had suitable premises and equipment and looked after them well. The service controlled infection risk and staff kept equipment and the premises clean.

  • Staff completed and updated risk assessments for each patient. Staff kept detailed records of patients’ care and treatment. Records were clear, up-to-date and easily available to all staff providing care.

    However:

  • Consent forms were not in line with Public Health England (PHE) guidance.

Effective

Insufficient evidence to rate

Updated 15 March 2019

We do not currently rate the effective domain for diagnostic imaging services, however, we found:

  • The service provided care and treatment based on national guidance and evidence of its effectiveness.

  • The service made sure staff were competent for their roles.

  • There were referral pathways to other agencies in place for staff to follow to benefit patients.

  • Staff understood the importance of obtaining informed consent.

    However:

  • The service did not have a consent and mental capacity act policy for staff to follow. However, we saw evidence that the sonographer had been trained to assess mental capacity.

  • The service did not have a specific consent form for patients under 16 years of age which evidenced use of the Gillick competence test.

Caring

Good

Updated 15 March 2019

We had not previously inspected this service. We rated caring as Good because:

  • Staff cared for patients with compassion. The service evidenced extensive positive feedback from patients, which confirmed that staff treated them well and with kindness.

  • The scan practitioner had counselling and bereavement qualifications, and provided emotional support to patients to minimise their distress. We saw positive feedback about the “incredible” service from women who had received challenging news, and who had experienced pregnancy loss.

  • We saw the service had voluntarily refunded deposits for women who had cancelled appointments due to pregnancy loss; and had provided complementary repeat sexing/gender scans if the baby’s sex could not be determined at the time of appointment.

  • The service positively encouraged participation, and staff closely involved patients and those close to them in decisions about their care and treatment. Staff communicated clearly, demonstrated patience, allowed good time for questions, and appropriately answered these.

Responsive

Good

Updated 15 March 2019

We had not previously inspected this service. We rated responsive as Good because:

  • The service planned and provided services in a way that met the needs of local people.

  • The service took account of patients’ individual needs.

  • People could access the service when they needed it. The service opened according to patient demand, and offered a number of appointment booking methods.

  • The service treated concerns and complaints seriously, and had systems in place to investigate them and learn lessons from the results, and share these with all staff.

    However:

  • Staff told us that there was no provision of information in any language other than English.

Well-led

Good

Updated 15 March 2019

We had not previously inspected this service. We rated well-led as Good because:

  • Managers in the service had the right skills and abilities to run a service providing high-quality sustainable care, and promoted a positive culture.

  • The service had good systems to identify risks, plan to eliminate or reduce them, and cope with both the expected and unexpected.

  • The service had policies and procedures in place to promote the confidential and secure processing of information held about patients.

  • The service was committed to improving services, had a vision for what it wanted to achieve, and engaged well with patients to plan and manage appropriate services.
Checks on specific services

Diagnostic imaging

Good

Updated 15 March 2019

Early Days Baby Scan Ltd is an independent medical provider offering antenatal ultrasound imaging and diagnostic services to self-funding or private patients. The service offers early pregnancy reassurance (from six to 15 weeks pregnancy), sexing/gender (from 15 weeks pregnancy), 3D and 4D (from 24 to 32 weeks pregnancy), reassurance (from 15 weeks pregnancy), and presentation (from 35 weeks pregnancy) scans. Depending on the type of scan performed, these might involve checking the location of the pregnancy, dating of the pregnancy, audio fetal heartbeat check, determination of sex, and fetal presentation at the time of appointment. All ultrasound scans are performed transabdominally. Patients are provided with ultrasound video or scan images, and an accompanying verbal explanation or written report.