Window to the Womb in Liverpool is owned by 1st Glimpse Ltd, and operates under a franchise agreement with Window to the Womb (Franchise) Ltd. The service provides diagnostic pregnancy ultrasound services to self-funding women across Merseyside and Cheshire.

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

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.

The main service provided by this clinic was diagnostic imaging.

Services we rate

We have not previously rated this service. We rated it as Good overall.

We found the following areas of good practice:

• The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care. Managers appraised staff’s work performance annually and checked to make sure staff had the right qualifications and professional registration for their roles.

• Staff assessed risks to women, they kept clear records and asked for support when necessary. Staff kept records of women’s appointments, referrals to NHS services and completed scan consent documents.

• The service provided care based on national guidance. The service checked to make sure staff followed guidance through local audits, annual clinical audits and peer review.

• The service controlled infection risk well. The clinic had suitable premises and equipment which met the needs of people who accessed the service. This included people who accompanied women and children.

• The service made innovative use of technology to provide women with ways to access the service and their scan images. They had developed a mobile phone application which enabled women to document and share weekly images of their pregnancy ‘bump’. They used social media to provide instant information on frequently raised questions and concerns.

• Window to the Womb had clear governance arrangements that were appropriate to the size and scope of the service. Senior managers from the franchisor actively engaged with managers of 1st Glimpse Ltd and clinic staff. All managers promoted a positive culture that supported and valued staff.

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

• Managers could not assure themselves that all staff would identify and respond appropriately to the needs of vulnerable women attending for multiple scans.

• The service did not have access to translation services for staff to use with women who did not speak English during scan appointments.

Following this inspection, we told the provider that it should make some improvements, even though a regulation had not been breached, to help the service improve.

Ellen Armistead

Deputy Chief Inspector of Hospitals (North)