HELLO BABY

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• 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 inspected but not rated. At this assessment the rating has changed to good.

Scans were delivered in line with pause and check BMUS guidelines. Consent processes were followed and appropriate for adult women. The service had referral pathways in place to support concerns identified in scans.

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.

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 using a set of pre‑booking questions available on the service website, online and telephone bookings undertaken by staff. Staff completed a risk assessment for each woman on arrival at the clinic to confirm there were no changes to their health, including allergies. The ultrasound technician told us that consent were sought again prior to the scan. Staff had demonstrated an understanding of and responded promptly to any immediate risks to women’s health. The service had informed women via its website that if they were experiencing bleeding, they should not attend a souvenir scan and had advised women to contact their local NHS maternity unit. Women were informed and understood when and how they would receive their scan images and results prior to and during their appointment. During scans, the ultrasound technician asked women if they were comfortable or experiencing any pain and explained they could stop the scan at any time if the woman wished.

The service had access to interpreting services and women were asked to notify the service in advance of any requirements for communication support or translation services.

Staff made sure women and their families understood their care and treatment. The service’s website provided clear information about scanning options available and the appropriate time in a pregnancy for these to take place. The service provided information on their website to support pregnant women during and after their pregnancy.

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.

Regular team meetings took place and meeting minutes were recorded by the registered manager.

All policies were found to be up-to-date and related specifically to the service and reviewed by the registered manager. Staff were aware of how to access policies, which were in paper format. Policies and protocols were in line with current legislation and national evidence-based guidance from professional organisations, such as BMUS.

The service followed the ALARA principle. This was in line with national guidance written by The College of Radiographers (CoR) and BMUS (who produce Guidelines for Professional Ultrasound Practice). Where possible, we observed the ultrasound technician completed an ultrasound scan appointment within 15 minutes to help reduce ultrasound doses.

The registered manager ensured that they received the necessary specialist training for their role. We saw evidence of their training records.

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.

The service maintained a positive working relationship with local NHS maternity services, referring women when concerns were identified or abnormalities detected during ultrasound scans.

The Ultrasound technician used referral pathways to ensure women received timely on-going care. The ultrasound technician clearly explained any concerns identified from the scan and referred women to the appropriate early pregnancy unit. The registered manager confirmed that they had established contact with key staff from these organisations, fostering effective collaboration.

We scored the service as 3. 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.

Women were informed that scans provided by the service should not replace any routine NHS antenatal scans.

The service provided information leaflets and links to support organisations for women to manage their health and wellbeing. We saw health promotion leaflets available and accessible in the reception area of the premises.

Posters on domestic violence were displayed in the toilet. A range of leaflets were readily available, offering guidance on mental health, anxiety, pregnancy, childbirth and breastfeeding.

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 from people to improve service provision and quality. The service encouraged women to provide feedback through online and social media reviews. The service routinely monitored women's experiences to continuously improve. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Regular clinical, environmental and compliance audits such as incidents, inaccuracies and complaints were completed by the registered manager to monitor the service's performance and to identify any areas where improvements were required. Regular team meetings included discussion of audit results for staff learning and feedback.

The ultrasound technician had annual peer reviews with an external sonographer to the service to assess competence and standards.

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.

The service made it clear on their website and consent form that women should attend all NHS scan appointments and advised that scans completed at the service were not a replacement for NHS scans.

When women arrived for an appointment, we observed staff clearly explaining the consent process and allowing women time alone to consider and sign the consent form. Staff checked women’s preferences regarding how they wished to receive information about the baby’s gender, including whether this should be shared immediately or provided to take away. Consent was sought and confirmed at appropriate stages throughout the scanning process.

The registered manager told us that the service offered translation of consent forms and pre-booking questions in multiples languages to ensure understanding. Staff had completed mandatory training on the Mental Capacity Act (MCA) and learning disability awareness to support women and their families.