CQC tells Croydon University Hospital improvements are needed

26 April 2011

Croydon University Hospital not meeting six essential standards.

The Care Quality Commission has told the Croydon University Hospital that it must take action to address shortages of midwives in its maternity unit.

We carried out this review because concerns were identified in relation to:

• Respecting and involving people who use services.
• Care and welfare of people who use services.
• Safety and suitability of premises.
• Safety, availability and suitability of equipment.
• Staffing.
• Supporting workers.
• Assessing and monitoring the quality of service provision.

Croydon Health Service NHS Trust provides a range of health services to a population of around 360,000 centred on the London Borough of Croydon.

This review focused on the Maternity Unit at Croydon University Hospital, formerly known as Mayday University Hospital.

We reviewed all the information we hold about this provider, carried out a visit on 4 February 2011, observed how people were being cared for, talked to people who use services, talked to staff, and checked the provider’s records.

CQC found that the maternity unit at the hospital was not meeting six essential standards including:

• Care and welfare: While the majority of births at the maternity unit are safe, we were concerned at recent occurrences of maternal deaths and the trust’s ability to ensure optimum care when an emergency high risk situation occurs. We found evidence that the maternity unit may not always be able to provide 1:1 care on the labour ward, that the trust has not devised a process to ensure timely and effective provision of epidurals in all cases, and that an anaesthetist may not be available at all times. These scenarios are likely to impact on patient welfare and care.
• Safe and accessible surroundings: We were concerned about the lack of separate showers for women using the birthing pools and the lack of provision of beds in amenity rooms for partners.
• Safety and suitability of equipment: Equipment in the maternity unit was not always available when needed, especially during busy periods, and was not always repaired in a timely manner.
• Staffing: The trust was in the process of recruiting additional midwives at the time of our review; however, we were concerned that there were insufficient numbers of midwives giving direct clinical care to ensure people who use the services were safe and their health and welfare needs were met.
• Supporting staff: People who use the service may not receive treatment from competent staff as there is evidence that mandatory staff training was not up-to-date.
• Quality checking systems: The provider had implemented clinical governance and procedural changes following recent incidents and developed an action plan to improve the service. However we were concerned that the trust has not yet delivered effective learning from past incidents where there are high risk mothers or birth complications gained from effective root cause analysis, assimilation of learning from incidents and transmission of learning to all staff, including midwives, midwifery assistants, anaesthetists and consultants.

Colin Hough, Regional Director of CQC in London said, “The Maternity Unit at Croydon University Hospital is not meeting all of the essential standards people should be able to expect. We have told the trust where it needs to do more to comply.

“We will continue to monitor the trust’s progress, to make more unannounced visits if necessary, and to take any further action that we deem necessary to make sure the trust gets it right."

“We have asked the trust to reply within 28 days of receiving CQC’s report, setting out the action they will take to improve. We will follow up to make sure that the improvements have been made.”

Under the Health and Social Care Act 2008, the Care Quality Commission has a number of enforcement powers that enable it to act swiftly when services are failing people. These include issuing warning notices, restricting the services that a provider can offer or the way it is provided; or, in the most serious cases, suspending or cancelling a service. CQC can also issue financial penalty notices and cautions or prosecute the provider for failing to meet essential standards. 

Ends

For further information please contact the CQC press office on 0207 448 9239 or out of hours on 07917 232 143.

Notes to editors