Your Baby Scan Crewe

We rated the service as inadequate because:

• We found that overall mandatory training compliance was low. It was not clear if the correct level of safeguarding training was provided to staff and staff did not always know how to recognise and report potential abuse. The service did not have effective control measures in place to protect women from infection and we found that the clinic was not always clean. We did not see evidence of equipment servicing, calibration and electrical safety checks. The service did not have policies for managing emergency situations and staff were not always aware of how they should respond if a woman became seriously unwell. The service did not have inclusion/exclusion criteria or a policy for rescan timeframes for staff to follow. Staff were not provided with incident reporting training and there was no policy for incident reporting.
• We found out of date guidance on the service intranet which could mean that staff were not practicing in accordance with the most up to date best practice guidance. Policies were created and reviewed without any clinical input. Outcomes and performance data were not monitored and shared with staff to measure performance and allow for improvement. The service had no induction policy and no process for checking that staff were competent in their roles. Staff did not receive training in consent or the Mental Capacity Act and there was no consent policy or audit of consent processes.
• Women were unable to speak to reception staff without being overheard by other women. Staff were provided with limited resources for signposting women who needed further care or support.
• The service did not always identify individual needs of women using the service and were not always able to support those women. They were not always able to meet the needs of people with hearing or sight problems and had no access to appropriate interpreters for those whose first language was not English. The service did not have a policy for meeting the needs of those with mental health problems or learning disabilities. The person responsible for managing and investigating complaints had not received specific training.
• It was not clear if leaders had the skills and abilities to run the service, and they were not always aware of challenges to the quality and sustainability of the service. Staff were not always aware of their responsibilities. The manager had no formal vision or strategy for the service. The manager did not have effective processes in place to ensure that staff were competent, skilled, experienced, held a current professional registration and had the right to work. Risk assessments were not fit for purpose and not all identified mitigating actions had been completed. The service did not always keep staff safe. It had no policies on lone working or on the management of aggressive service users. Staff had not been asked to complete individual COVID-19 risk assessments. The service did not have effective processes to monitor infection control or equipment safety. It had no policy for the storage of scans and records, and women were not informed of this in the service terms and conditions.
• Staff were not required to complete quality improvement training and were not provided with data to enable them to make changes or improvements to their practice.

However:

• The service had enough staff to care for women.
• Staff treated women with kindness and compassion.
• The service made it easy for women to give feedback.
• Staff felt respected, supported and valued.