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Maternity services rating drops from ‘good’ to ‘requires improvement’
02/09/2021
Visit was undertaken after concerns were raised
An unannounced inspection of maternity services at our local hospitals has seen the services rating drop from ‘good’ to ‘requires improvement’.
The Care Quality Commission (CQC) carried out the inspection of maternity services run by Oxford University Hospitals NHS Foundation Trust in May. The visit was undertaken after they received information of concern about the culture of the department, including claims of bullying, hierarchy and dysfunctional teams.
The inspection was carried out at the John Radcliffe Hospital in Oxford, the Cotswold Birth Centre in Chipping Norton and the Horton General Hospital Midwifery-led Unit.
The inspection looked at whether the service was safe, effective and well-led. Afterwards, the rating for maternity services went down from ‘good’ to ‘requires improvement’. The inspection did not change the overall rating for the hospital, which remains ‘requires improvement’.
The report said that women’s privacy and dignity was not always maintained. There was no signage to indicate when rooms were engaged.
On the Horton midwifery led unit staff did not use privacy curtains in the labour rooms.
The inspection also found that doors were opposite the birthing beds and women’s’ privacy and dignity could not always be maintained. A lack of en-suite facilities for labour rooms meant women had to walk down the corridor to access facilities.
Most staff said they were encouraged to be open and honest with people when things went wrong, but some staff reported that they were not always comfortable raising concerns without fear of what would happen if they did.
Although most staff felt they received support from their immediate manager, some said they felt that communication between senior management and staff was not always effective.
The inspectors also had concerns that staff did not always undertake all the necessary risk assessments for women in their care, particularly in relation to domestic violence, and they did not always manage medicines well.
The CQC report did highlight a number of positive areas and said staff provided good care and treatment and worked well together for the benefit of women. The service had enough staff to care for women and keep them safe. Staff had training in key skills and understood how to protect women from abuse.
Leaders ran services well using reliable information systems and supported staff to develop their skills. They were focused on the needs of women receiving care.
The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
Amanda Williams, CQC’s head of hospital inspection, said: “We found that most staff said that they were proud to work for the trust and that they felt respected and able to raise concerns without fear.
“Importantly, we found that there was an emphasis on learning and positive working relationships. Staff had regular multidisciplinary meetings to discuss the women and babies in their care. Rather than just focusing on those with poor outcomes, staff were encouraged to share learning from all cases. This meant that there was no ‘blame’ aspect involved in these meetings, which is very important in order to ensure that continual improvements are made.”
Ms Williams added: “Although most staff said they were encouraged to be open and honest with people when things went wrong, some staff reported that they were not always comfortable raising concerns without fear of what would happen if they did. Additionally, although most staff felt they received support from their immediate manager, some said they felt that communication between senior management and staff was not always effective.
“We also had concerns that staff did not always undertake all the necessary risk assessments for women, particularly in relation to the risk of domestic violence.
“We have told the trust that they need to address our concerns, and we will continue to monitor the service to ensure that improvements are made.”
Dr Bruno Holthof, Chief Executive Officer of Oxford University Hospitals, said: “On behalf of the Trust Board, I would like to thank all staff working in our maternity services for their positive approach to the CQC inspection in May and for everything that they do every day to look after the women and babies in their care.
“I am delighted that the CQC inspectors have publicly recognised in the report published today that our maternity staff provide good care and treatment and work well together for the benefit of women in their care, and also identified a number of other positive areas.
“However, it is important to acknowledge that the CQC inspectors also found significant areas for improvement and raised concerns which have resulted in the rating for our maternity services going down from ‘Good’ to ‘Requires improvement’.
“The Trust Board is working with the senior management team in our maternity services to develop a comprehensive action plan to address these areas for improvement and concerns. Completion of the action plan will be monitored through the Trust’s governance processes and completion dates for key actions will be agreed.”
Published: by Banbury FM Newsteam