Preview Baby Limited is operated by Preview Baby Limited. The service provides diagnostic pregnancy and fertility ultrasound services, and obstetric screening services to self-funding women across Hertfordshire and its surrounding areas.

We inspected this service using our comprehensive inspection methodology. We carried out a short-notice announced inspection on 29 January 2019. We gave staff two working days’ notice that we were coming to inspect to ensure the availability of the registered manager and clinics.

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 inspected this service. At this inspection, we rated the service as good overall.

We found areas of good practice:

• Staff understood how to protect people from abuse, and the service worked well with other agencies to do so.

• The service had appropriate arrangements in place to assess and manage risks to women, their babies, and families.

• Women were supported to make informed decisions about their care. Staff understood how and when to assess whether a woman had the capacity to make decisions about their chosen care. Staff were aware of the importance for gaining consent from women before conducting any ultrasound scan or screening service.

• The service had effective arrangements in place for identifying and recording risks. The risks and their mitigating actions were discussed with the wider team.

• Staff were caring, kind and engaged well with women and their families. The directors promoted a positive culture that supported and valued staff. Staff confirmed they felt respected and valued.

• The service used current evidence-based guidance and good practice standards to inform the delivery of care and treatment. Staff demonstrated a good understanding of the national legislation that affected their practice.

• Preview Baby Limited had a clear vision and strategy for what they wanted to achieve, with quality and sustainability as the top priorities.

However, we found the following areas of practice that the service needed to improve:

• While most of the governance arrangements were clear and appropriate to the size of the service, there were not effective recruitment processes in place to assess sonographer competence and suitability for their role. However, this was addressed immediately after our inspection, and the directors reviewed and updated their current recruitment requirements.

• Peer review audits were not completed in line with national guidance. However, following our inspection, a rolling audit programme was introduced.

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

Amanda Stanford

Deputy Chief Inspector of Hospitals (Central)