CQC tells Royal Stoke University Hospital to make improvements in maternity services
The inspection was carried out as part of CQC’s national maternity services inspection programme. This will provide an up-to-date view of the quality of hospital maternity care across the country, and a better understanding of what is working well to support learning and improvement.
As well as maternity services at Royal Stoke University Hospital being rated requires improvement overall, how safe the service is, has dropped from requires improvement to inadequate. How well-led the service is has dropped from good to requires improvement. Effective, caring and responsive were not looked at during this inspection and remain rated as good.
Carolyn Jenkinson, CQC’s deputy director of secondary and specialist healthcare, said:
“When we inspected maternity services at Royal Stoke University Hospital, we found leaders had the necessary skills and abilities, however there are areas they need to improve to keep women and people using the service safe.
“We found they didn’t have effective oversight and there were potential risks they hadn’t addressed. There were discrepancies in incident reporting meaning that leaders couldn’t always identify risks and make improvements where needed.
“Inspectors found people were waiting too long to be seen and were asked to wait alone without the support of their loved ones. Also, staff weren’t triaging people effectively, and they couldn’t always physically see those waiting, meaning if people became unwell, staff weren’t aware which could put them at risk of further complications.
“Following the inspection, we raised our concerns with the leadership team and immediate action was taken. For example, improving their triaging process and changing the waiting area for people so staff can see them and provide the care they need in a timely way.
“We’ll continue to monitor the service closely, to check they’ve fixed the issues to ensure that women and people using the service receive the safe care they deserve.”
Inspectors found:
- People were not always able to access the service when they needed it without having to wait longer than the trust targets and as recommended in national guidance.
- There was a lack of embedded processes to triage and prioritise care and treatment for women and people using the service.
- Staff did not always have training in key skills, to ensure safe treatment for people.
- The design and equipment were not always suitable to meet the needs of people.
- Equipment was not always available for use leading to potential delays in treatment.
- Staffing levels did not always match the planned numbers putting people’s safety at risk.
- The service used systems to monitor performance and risks. However, staff did not always follow trust guidance to identify and escalate associated risks to people.
- Leaders did not have effective oversight and there was a risk necessary improvements were not always identified or made when needed. In addition, the service did not provide a local business continuity plan. CQC were unable to determine what the arrangements were should an unexpected major event occur.
- There were inconsistent incident reporting processes which reduced effective oversight and reduced the ability to identify themes and trends.
- Staff mandatory training did not meet trust targets, and staff did not always follow processes as outlined in guidance.
However:
- The service-controlled infection risk well and managed clinical waste well.
- Staff kept detailed care records and they managed medicines well.
- The leadership team were visible and approachable in the service for people and staff. Staff understood the service’s vision and values, and how to apply them in their work.
- Most staff felt respected, supported, and valued. They were focused on the needs of women and people using the service. Staff were clear about their roles and accountabilities.
- The service engaged well with people and the community to plan and manage services and all staff were committed to improving services.
- Staff took every opportunity to protect people from abuse.
