Window To The Womb in Watford is owned by New Beginnings South 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 Hertfordshire, Bedfordshire, and Buckinghamshire.

We inspected this service using our comprehensive inspection methodology. We carried out a short-notice announced inspection on 8 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:

• The facilities and premises met the needs of the range of people who accessed the service. This included children who accompanied women to their scans. The service also recognised that women’s preferred method of communication had changed, and as a result, they had developed a range of innovative products to tailor their services and meet the needs of local people.

• The service took a proactive approach to understand women’s individual needs, and delivered care in a way that met these needs, which was accessible and promoted equality.

• Women could access services and appointments in a way and at a time that suited them. Technology was used innovatively to ensure women had timely access to treatment.

• The service treated concerns and complaints extremely seriously. The registered manager completed comprehensive investigations, which frequently involved input from other professionals, such as the lead sonographer. Lessons learned were shared with all staff.

• Staff were caring, kind and engaged well with women and their families.

• Managers 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.

• Window To The Womb 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. Managers also did not have full oversight of what training the sonographers had completed at their substantive employer. However, these concerns were addressed immediately after our inspection.

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)