Hey Baby 4D - The Revive Healthy Living Centre

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 safety was a priority for everyone, and leaders embedded a culture of openness and collaboration. Staff recognised clinical concerns and referred patients to appropriate services when needed. There were safety processes arranged before procedures started. Staff worked together to ensure the right patient had the correct imaging. Patients were safe from neglect, abuse, and discrimination. 

At our last assessment we rated this key question good. At this assessment, the rating has remained good.

This meant the service always worked with patients and healthcare partners to establish and maintain safe systems of care. They make sure there was always continuity of care. The service always worked with patients to fully understand and manage risks by thinking holistically. The service had a proactive and positive culture of safety, based on openness and honesty. The service worked with patients to understand what being safe meant to them. The service made sure equipment, facilities and technology supported the delivery of safe care. The service made sure there were enough qualified, skilled and experienced staff. However, the service did not always assessed and managed the risk of infection.

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.

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. 

The service had a current incident reporting policy in place. There had not been any reportable incidents in the previous 12 months. There had not been any repeated themes or trends in the year prior to our assessment as there had been no reportable clinical incidents. The service had an accident book for when people injured themselves. 

Staff told us they were able to identify and report risks. They were confident concerns would be acted on.  Staff felt confident to act when immediate risks were identified. We observed and staff were able to give examples of how they had handled such situations, for example, if an anomaly was found during a scan. 

Leaders told us they share feedback from investigation of incidents in team meetings if there had been any, we saw that accidents were discussed. Staff knew about any actions and learning. 

Some understood the concept of duty of candour. However, they had not had to use it as there had been no incidents. There was a duty of candour policy. 

We scored the service as 4. The evidence showed an exceptional standard. The service always worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was always well managed. They made sure there was always continuity of care, including when people moved between different services.

Safety and continuity of care was a priority throughout people’s care pathway. Patients were asked to fill in a pre-scan questionnaire prior to booking. The questionnaire included various relevant questions. This included cycle length, any previous scans, as well as other medical history, specifically in relation to pregnancy. Patients would not be scanned prior to this. They also included option to discuss mental health and anxiety, so staff were aware prior to the scan.

Qualified and skilled staff accompanied patients in and undertook the required diagnostic procedure. Patient records were electronic and were kept securely. Staff completed first aid training and had access to a first aid kit if required.

When overall responsibility for the care and treatment of a patient moved to a different service provider, such as transfer to the NHS, there was effective communication. This allowed for seamless transfer. Staff told us they had good working relationships and communication with the local maternity unit at the NHS trust. Staff provided as much information as possible to the other provider. Staff would contact the NHS provider on the patients behalf and made referrals to other services as required. Staff also supported women to attend onward appointments, including arranging transport if required.

Staff completed an informed refusal form when patients declined referrals to organisations from the service.

We scored the service as 3. The evidence showed a good standard. The service worked with patients and healthcare partners to understand what being safe meant to them and the best way to achieve that. The service shared concerns quickly and appropriately and kept people safe from the risk of harm.

Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff received adult and children's safeguarding training appropriate for the role they provided, with all staff completing level 3 safeguarding training for adults and children. There were current safeguarding policies, which reflected the national guidance for adults and children.

Staff knew how to make a safeguarding referral and who to inform if they had concerns. Staff had the local contacts for safeguarding written down. Staff would also be able to find the contact details of local authorities outside of their region if needed. The registered manager had oversight of safeguarding within the service. We observed the registered manager make a safeguarding referral to the local authority to protect an adult and a child during the inspection.

The service did not perform scans on anyone under 18; staff would ask for identification if they suspected the person was under 18.

The service had an up-to-date chaperone policy, which all patients were informed of when they attended the service. We observed that chaperones were available for every scan that took place. We saw posters in the patient toilet displaying information on domestic violence.

We scored the service as 4. The evidence showed an exceptional standard. The service always worked well with patients to fully understand and manage risks by thinking holistically. They provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them. 

The service worked with patients to understand and manage risks. The treatment and care met patients’ needs in a way which was safe and supportive. Staff explained the importance of also attending routine NHS pregnancy scans and appointments and explained the risks if the patients chose not to. The information pack provided to women also contained useful contacts for women during their pregnancies, including pregnancy and gynaecology services.

Staff provided patients with information about the risk of having scans including if a fetal anomaly was found during the scan. We also saw an information leaflet available on various conditions. Information was available on the Hey Baby website and also in a pack that was provided to patients when they attended the clinic, if they wanted to take it. Staff had processes for referrals to other organisations if something of concerns was discovered during the scan.

Staff were aware of the protocols of what to do in an emergency, such as if an ectopic pregnancy was found. Staff followed national guidance when assessing levels of risk where sonographers suspected an ectopic pregnancy. They asked people to disclose information such as history of pelvic inflammatory disease, abdominal surgery, smoking status, and whether they were sexually active. Sonographers used this information to assess risk more accurately and we saw detailed risk assessments completed appropriately.

The service had changed how they worked to allow more time to assess mental health concerns and needs. Staff discussed person expectations and reasons for scans in advance with each person. Sonographers used a mental health pre-assessment to ensure the person had the capacity to consent and understand potential outcomes. Staff ensured people understood this was a keep sake service and did not replace NHS clinical care. Staff made it clear to people that blood tests were processed by an external company that was responsible for any diagnosis and follow-up advice, guidance, or treatment.

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 design, maintenance and use of facilities, premises and equipment kept patients safe. Staff were trained to use equipment. There were safety measures for staff to contact the emergency services directly if a situation arose around security. 

Staff had access to suitable equipment provided and used it correctly. All equipment we inspected was serviced and fit for use. The ultrasound machine had annual inspections, and the service had an agreement in place for this and any repairs. Staff carried out daily safety checks of specialist equipment.

All portable electronic appliances had been tested for safety and were done annually.

Staff disposed of clinical waste safely. The clinical waste bin outside was locked behind a gate. The service had a contact in place for clinical waste to be collected on a regular basis.  

Staff stored hazardous substances safely in a locked cabinet. There was a control of substances hazardous to health file with information on storage, appropriate use and disposal of the hazardous substances.

All fire extinguisher appliances inspected were serviced within an appropriate timescale. Fire exits and corridors were clear of obstructions. The service had a fire evacuation plan in place.

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.

The service had enough staff, including a full time sonographer, with the right qualifications, skills, training, and experience to keep patients safe from avoidable harm and to provide the right care and treatment. 

Staff included a nominated individual, registered manager, sonographers, and reception staff. The service did not have any vacancies. 

New staff had a full induction tailored to their role before they started work. We saw induction checklists on staff files which included appropriate recruitment and skill checks. New starters would also have a scan audit and shadowing opportunities.

The service provided mandatory training in key skills to all staff, and all staff had completed it. New staff completed mandatory training prior to working for the service. Managers monitored mandatory training and alerted staff when they needed to complete updates. There was a current mandatory training policy. Staff told us they had time to complete mandatory training. Staff had access to additional training if it was required.

Leaders supported staff to develop through appraisals and supervision of their work. The registered manager signed off any new sonographers before they could scan alone, and scans were regularly audited. 

The sonographer demonstrated competency to safely scan and interpret images. The service supported the learning and development needs of staff and made sure staff received any specialist training for their role. Managers identified any training needs their staff had and gave them the time and opportunity to develop their skills and knowledge.

Patients felt their needs were met in a timely way and we observed staff attended to patients in a kind and supportive way. Patients were comfortable and had conversations because there were sufficient staff throughout the service, as staff were present in both areas.

Managers made sure staff attended team meetings or had access to the information shared when they could not attend as the meetings were minuted. 

We scored the service as 2. The evidence showed a good standard. The service did not always assessed and managed the risk of infection.

The service did not always manage infection risks well. Whilst most staff followed infection control principles including handwashing and the use of personal protective equipment (PPE); we observed 2 occasions whereby a staff member having direct clinical contact did not wash their hands between patients. The infection prevention and control policy for the service stated that staff needed to use antibacterial gel in between patients, except for specific circumstances where handwashing would be more appropriate. However, the policy also stated that staff should wash hands in front of the patient at the start and end of each procedure as best practice. There were handwashing facilities available for staff but the sink was located in a different room. We raised the lack of handwashing whilst we were on site and leaders immediately addressed this. Leaders completed regular audits which showed staff were compliant with hand hygiene and cleanliness requirements. Following the inspection, a sink has been plumbed into the main room to ensure that policy is followed.

Staff in clinical areas were bare below their elbows to allow for full hand decontamination. Hand gel was readily available in the waiting area and scanning room. 

The department was visibly clean, free from clutter and had suitable furnishings which were clean and well-maintained. Staff kept equipment and the premises visibly clean. Staff cleaned equipment after patient contact. We did not see the transvaginal (TV) probe used but the service had processes and procedures in place around use and cleaning. Cleaning log checklists were completed by staff for equipment and the environment.

Staff had access to a provider infection and prevention and control policy and an infectious diseases policy which provided guidance. 

There were clinical waste bins available, and waste was disposed of appropriately. Sharps bins were available to staff.

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