The Care Quality Commission (CQC) has told Walsall Healthcare NHS Trust that it must make improvements to its maternity service at Manor Hospital.
An unannounced, focused inspection of the hospital was carried out in July in response to concerns around safety and governance. Inspectors looked at how well-led, safe and effective the service was.
As a result of the inspection, the overall rating of the maternity service at Manor Hospital remains as requires improvement. The service ratings for safe and well-led remain as requires improvement and the rating of effective went down from good to requires improvement.
Fiona Allinson, CQC’s deputy chief inspector of hospitals, said:
“When inspectors visited the maternity service at Walsall Healthcare NHS Trust, it was clear that staff supported one another to deliver patient focused care, but it was also evident that understaffing was causing a deterioration in the quality of that care.
“Some staff and midwives were visibly upset and frustrated when talking about their experiences, with each area we visited identifying low staffing as the main risk. The number of vacancies had been exacerbated by staff having to self-isolate due to COVID-19.
“Managers did not always accurately calculate and ensure there were sufficient numbers and grades of midwives, nursing assistants and care support workers needed for each shift in accordance with national guidance.
“This meant specialist midwives were often moved from their roles to cover vacant shifts elsewhere which left gaps in specialist services. We saw two incidents where infant feeding midwives were unable to provide support to mothers and babies as they were working elsewhere.
“Inspectors reported their findings to the trust leadership and will continue to monitor the service to ensure the necessary improvements are made.”
Service leads were knowledgeable of the risks, performance and development needs of the service and there was a cohesive plan to address concerns. However, some were not aware of the strength of feeling from staff, with some reporting their leaders were unsupportive, overly-critical and unapproachable.
Some midwives reported that concerns were not always escalated due to ineffective relationships with leaders. Others reported that no support was offered when they raised concerns.
Following the inspection, the trust must ensure the following improvements are made:
- There must be adequate numbers of staff to meet the demands of the service
- All risk assessments and women records must be completed accurately and reflect risks based on full assessments
- All medicines must be stored safely and securely
- Staff must maintain effective infection control and prevention practices
- Governance arrangements must be robust to ensure risks and poor performance are identified and any risks are mitigated.
Full details of the inspection are given in the report published on our website.
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