The Care Quality Commission (CQC) inspected maternity services at Basildon University Hospital, run by Mid and South Essex NHS Foundation Trust, on 18 September 2020.
The unannounced, focused inspection was carried out to follow up on a warning notice that was issued to the department in June 2020.
During the latest inspection, CQC found several concerns which led to inspectors issuing an urgent notice of decision, under Section 31 of the Health and Social Care Act 2008. This notice placed conditions on the trust’s registration to enable the improvement of safety within the maternity service.
Several serious concerns were identified, including; the service did not always have enough staff to keep women safe and staff did not identify and escalate safety concerns appropriately. Multidisciplinary team working continued to be dysfunctional which had impacted on further safety incidents. There was poor structure to the safety handover on the delivery suite and confusion to what constituted a safety huddle.
The longstanding poor staff culture had created an ineffective team where doctors, midwives and other healthcare professionals did not support each other to provide good care.
Additionally, leaders did not have the skills and abilities to effectively lead the service. Some staff did not feel able to approach colleagues which did not benefit the care of women and babies.
Following this inspection, maternity services at Basildon University Hospital remain Inadequate overall. The service is rated Inadequate for being safe, effective and well-led.
CQC’s Chief Inspector of Hospitals, Professor Ted Baker, said:
“On our return to Basildon University Hospital’s maternity service, we were disappointed to see some longstanding concerns around staff culture and poor behaviours were still impacting on women’s care.
“Doctors, midwives and other healthcare professionals did not always work well together, and the absence of an open culture meant that staff did not always feel able to raise issues or report incidents so that learning could be effectively shared to help embed improvements.
“All staff we met during our inspection were welcoming, friendly and helpful. However, it was evident that many were concerned about the safety issues within their department.
“Inspectors received an action plan on steps to improve staff culture from the trust’s leadership after the June inspection. These improvements were still in their infancy, however, and had not yet been embedded on our latest visit.
“Following the inspection, we placed conditions on the trust’s registration to ensure mothers and babies have access to safe, effective and personalised care.
“In addition to this enforcement action, our inspection team escalated their ongoing concerns to NHS England and NHS Improvement and a risk summit was held to discuss a way forward to ensure sustained improvements are made.
“The leadership team is clear about the steps they need to take, and we will continue to monitor progress closely and will inspect again to check the necessary improvements have been made.”
The full report will be published on CQC’s website at the following link: www.cqc.org.uk/location/RAJ12
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