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)