Window to the Womb is owned by Vision Beyond 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 living in Coventry and surrounding areas including Rugby, Leamington Spa and Stratford Upon Avon.

We inspected this service using our comprehensive inspection methodology. We carried out a short-notice announced inspection on 4 April 2019. We gave staff two working days’ notice that we were coming to inspect, to ensure the availability of the registered manager.

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. We rated it as Good overall.

We found areas of good practice:

• The service had a clear vision and strategy for what they wanted to achieve which staff understood and adhered to. Quality and sustainability were the top priorities and the service ethos was to provide the highest possible standards of service and care every time.

• 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 and treatment.

• Staff were caring, kind and engaged well with women and their families. Feedback was consistently positive about the kindness and care women received from staff.

• The service assessed and managed risks to women, their babies and families. There were clear processes to guide staff on what actions to take if any concerns were identified during the ultrasound scan.

• 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 national legislation that affected their practice.

• The service treated concerns and complaints seriously. The registered manager completed thorough investigations and measures were taken to resolve concerns and complaints raised. Learning from complaints was shared with all staff.

• The facilities and premises met the needs of women who used the service. The environment in which the scans were performed was spacious, homely and well arranged. Women were encouraged to make their scan experience a family occasion.

• Managers promoted a positive, open culture that supported and valued staff. Staff were proud to work at the clinic and committed to providing the best possible care and service for women and their families.

We found areas of outstanding practice:

• The service took a proactive approach to understand women’s individual needs and preferences. Care was delivered in a way that met those needs and 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, support and care.

• Window to the Womb had invested in technology and equipment which it used to enhance the delivery of effective care and treatment. The scanning room had three large wall-mounted screens which projected the scan images from the ultrasound machine. This enabled women and their families to view their baby scan more easily from wherever they were sitting. They had also developed a mobile phone application (‘app’). The app enabled women to document and share week-by-week images of their pregnancy bump with their family and friends and create a time-lapse video of their pregnancy journey. Any scan image taken during a Window to the Womb appointment was also saved on the app, which allowed women to have instant access to their scan images. Women could also book scan appointments through the app.

• Sonographers had timely access to remote advice and support from the franchisor’s clinical lead sonographer if they had any questions or concerns about scan findings. Window to the Womb had also developed a continued professional development platform which sonographers could access to enhance their knowledge and skills.

Nigel Acheson

Deputy Chief Inspector of Hospitals