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ScanLinc Early Pregnancy Service Good

Inspection Summary


Overall summary & rating

Good

Updated 9 April 2020

ScanLinc Early Pregnancy Service is an early pregnancy private ultrasound service providing care for the women and families of Lincolnshire and surrounding areas. The service has one location - Greetwell Place, which is a City Council owned managed workspace with car parking and reception staff and facilities.

The service provides an ultrasound scan service to pregnant women aged 18 and over for reassurance in early pregnancy, gender opinion and a 3/4D experience. The service also offers screening in the form of non-invasive pre-natal testing (NIPT).

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced inspection (staff did not know we were coming) on 14 February 2020 and carried out a further announced visit on 18 February 2020.

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 the Mental Capacity Act 2005.

Services we rate

We have not previously rated this service and cannot therefore compare ratings with the last inspection. We rated it as Good overall.

We found good practice in the ScanLinc service:

  • The premises and facilities of the service were appropriate, well maintained and visibly clean.
  • Infection prevention control guidance was consistently followed.
  • There was good partnership working and communication with other local healthcare providers to manage any unexpected or abnormal findings.
  • Women and staff reported that the service was very responsive, and we saw that women were able to be offered appointments quickly.
  • There was an overwhelming focus on delivering good quality patient care. Extended appointment slots meant that women received plenty of time. We observed that time was taken to provide information and advice and time was given for women to asks questions. The service demonstrated an extremely caring approach at all times which was commented on by nearly all women who provided feedback.
  • There was a very positive culture within the service with both staff demonstrating exceptional enthusiasm and passion in their work.

However, we also found areas of practice that required improvement in the ScanLinc service:

  • Complaints information in the form of leaflets or posters was not widely available meaning it may not be easy for women to know how to raise concerns or make a complaint.
  • Risk assessment templates lacked detail and risks were not rated or regularly reviewed.
  • There was no documented process for investigating incidents, identifying areas for learning and sharing this.
  • Not all women had the opportunity to provide feedback as comments cards were issued at random, and not routinely to all women.
  • There was no formal appraisal of the staff member working for the service, hence learning and development needs were not identified.
  • Staff had not completed any recent training in relation to the Mental Capacity Act in order to be able to assess women’s capacity to consent and make decisions about their care.

However, we found that the registered manager was very responsive to the concerns raised and took prompt action to put processes in place to address most of the concerns raised within two weeks of us completing the inspection. These actions are identified within the report.

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

Heidi Smoult

Deputy Chief Inspector of Hospitals (Midlands region)

Inspection areas

Safe

Good

Updated 9 April 2020

We have not previously rated this service and cannot therefore compare ratings with the last inspection. We rated it as Good because:

  • Staff understood how to protect women from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse, and they knew how to apply it.

  • The service controlled infection risk well. Staff used equipment and control measures to protect women, themselves and others from infection. They kept equipment and the premises visibly clean.

  • The design, maintenance and use of facilities, premises and equipment kept people safe. Staff were trained to use them. Staff managed clinical waste well.

  • Staff completed risk assessments for each woman and removed or minimised risks. Staff identified and quickly acted upon women in need of additional support.

  • The service had enough staff with the right qualifications, skills, training and experience to keep women safe from avoidable harm and to provide the right care and treatment.

  • Staff kept detailed records of women’s care and treatment. Records were clear, up-to-date, stored securely and easily available to all staff providing care.

  • The service managed safety incidents well. Staff recognised incidents and near misses and knew how to report them appropriately. When things went wrong, staff understood the need to apologise and give women honest information and suitable support.

However, we also found the following issues that the service provider needs to improve:

  • The manager did not have a process for investigating incidents and sharing lessons learned with staff.

  • The service did not ensure completion of mandatory training by all staff in all key skills.

Effective

Updated 9 April 2020

We have not previously rated this service and cannot therefore compare ratings with the last inspection. We rated it as Not rated because we do not currently rate effective for diagnostic imaging services. We found the following areas of good practice:

  • The service provided care and treatment based on national guidance and best practice. The manager checked to make sure staff followed guidance.

  • Staff assessed and monitored women regularly to see if they were comfortable.

  • The service made sure staff were competent for their roles. Peer supervision sessions were held between staff to provide support and development.

  • Sonographers and other healthcare professionals worked together as a team to benefit women. They supported each other to provide good care.

  • Services were available five days a week to support timely patient care.

  • Staff gave women practical support and advice to lead healthier lives.

  • Staff supported women to make informed decisions about their care and treatment. They followed national guidance to gain women’s consent.

  • Staff always had access to up-to-date, accurate and comprehensive information on women’s care and treatment. All staff had access to an electronic records system that they could update.

However, we also found the following issues that the service provider needs to improve:

  • The manager did not have a documented appraisal process to monitor staff’s work performance.

  • There was no evidence that staff had completed Mental Capacity Act training, meaning they may not know how to support women who lacked capacity to make their own decisions. Nor had staff received training to recognise women who may be experiencing mental ill health.

Caring

Good

Updated 9 April 2020

We have not previously rated this service and cannot therefore compare ratings with the last inspection. We rated it as Good because:

  • Staff consistently treated women with compassion and kindness, respected their privacy and dignity, and took account of their individual needs. Feedback from families who had used the service was extremely positive and highlighted that staff took extra time to put families at ease.

  • Staff provided emotional support to women, families and carers to minimise their distress. They understood women’s anxiety, spent time offering reassurance and demonstrated empathy. If women had suffered a pregnancy loss, staff understood the impact of this and provided appropriate support both during and after appointments.

  • Staff supported and involved women, families and carers to understand their condition and make decisions about their care and treatment. Women and families were provided with appropriate information. Staff took additional time to explain scan findings and answer questions.

Responsive

Good

Updated 9 April 2020

We have not previously rated this service and cannot therefore compare ratings with the last inspection. We rated it as Good because:

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

  • The service was inclusive and took account of women’s individual needs and preferences. Staff made reasonable adjustments to help women access services. They coordinated care with other services and providers.

  • Feedback from women and staff identified that women were seen promptly and could access appointments easily and quickly.

  • The service had a complaints policy which demonstrated that it would treat any concerns and complaints seriously, however, no complaints had been received by the service.

However, we also found the following issues that the service provider needs to improve:

  • Waiting times for appointments were not routinely monitored. We were not therefore, able to judge if women could access the service when they needed it or if they received the right care promptly.

  • It was not always easy for women to give feedback and raise concerns about care received as there was no complaints information displayed by the service.

Well-led

Good

Updated 9 April 2020

We have not previously rated this service and cannot therefore compare ratings with the last inspection. We rated it as Good because:

  • Leaders had the integrity, skills and abilities to run the service. They understood and managed the priorities and issues the service faced. They were visible and approachable in the service for women and staff. They supported staff to develop their skills.

  • The service had an aim statement for what it wanted to achieve and objectives to turn it into action.

  • Staff felt respected, supported and valued. They were focused on the needs of women receiving care. The service had an open culture where women, their families and staff could raise concerns without fear.

  • Leaders operated effective governance processes, throughout the service. Staff were clear about their roles and accountabilities and had regular opportunities to meet. Team meetings were held and were used to discuss any issues of concern.

  • The registered manager identified relevant risks and issues and identified actions to reduce their impact.

  • The service collected reliable data and analysed it. Staff could find the data they needed, in easily accessible formats. The information systems used were secure.

  • Staff actively and openly engaged with women. They collaborated with partner organisations to deliver appropriate services for women.

  • Staff were committed to continually learning and improving services. They undertook professional development activities in order to remain up to date and improve their practice. The registered manager encouraged and supported the midwife sonographer in their continuing professional development.

However, we also found the following issues that the service provider needs to improve:

  • There were no systematic processes for monitoring service performance.

  • Risk assessment templates lacked detail and did not rate risks identified.

  • The service did not have plans to cope with unexpected events.

Checks on specific services

Diagnostic imaging

Good

Updated 9 April 2020

We rated it as good because:

  • The service had enough staff to provide the service and keep women safe. Staff had training in key skills, understood how to protect women from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to women, acted on them and kept good care records.
  • Staff provided good care and treatment. Managers made sure staff were competent. Staff worked well together for the benefit of women, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. The service was available five days a week.
  • Staff treated women with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to women, families and carers.
  • The service planned care to meet the needs of local people, took account of women’s individual needs. People could access the service when they needed it and did not have to wait too long for appointments.
  • Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of women receiving care. Staff were clear about their roles and accountabilities. All staff were committed to improving services continually.

However:

  • The service had a process to report safety incidents but did not have systems for investigating them and sharing the lessons learned.
  • There were not established systems for monitoring the effectiveness and responsiveness of the service.
  • The service did not routinely offer the opportunity for all women to provide feedback about their experience.
  • The service did not display information about how women could complain.