The Care Quality Commission (CQC) has found improvements in the care being provided in maternity services run by County Durham and Darlington NHS Foundation Trust following an inspection in January. This latest inspection sees the overall rating for maternity services at two of its hospitals improve from inadequate to requires improvement.
An unannounced focused inspection was carried out at University Hospital of North Durham and Darlington Memorial Hospital. This was to follow up on the progress of improvements they were told to make in a warning notice CQC issued after their previous inspection in March last year. Following this latest inspection, CQC determined the trust had met the terms of the warning notice and it has therefore been removed.
As well as maternity services overall at University Hospital of North Durham and Darlington Memorial Hospital improving from inadequate to requires improvement, so has how safe and well-led the services are.
The overall rating for both hospitals has improved from requires improvement to good. The trust remains rated as good overall.
Linda Hirst, CQC deputy director of operations for the north, said:
“When we inspected maternity services at County Durham and Darlington NHS Foundation Trust, we were pleased to find the trust had made improvements since our inspection in March last year. Leaders were now more visible and approachable for staff, and a new director of midwifery had been appointed, therefore we expect to see further improvements next time we visit.
“We found improvements with the management of incidents. For example, we reviewed four serious incidents and found the service now implemented much better action plans in response to investigating findings. This ensured lessons were learnt and women, people using the service and their babies were receiving safer care as a result.
“There had also been some improvements around staffing and ongoing recruitment. However, both services didn’t always have enough senior, experienced midwives on labour wards which needs to be addressed as a priority.
“We did have some other areas of concern including timely inductions of labour to meet people’s needs, which weren’t always happening at either hospital. Although oversight of these delays had improved, new processes put in place to improve them weren’t fully embedded yet.
“Staff had clearly worked hard since our previous inspection to improve the quality of care they were delivering to people, and they know where further improvements are needed so people receive the high standard of care they deserve.
“We will continue to monitor the trust, including through future inspections, to ensure the trust builds on the improvements it has already made, and further changes are made and embedded.”
Inspectors found at both hospitals:
- Staff understood how to protect women and people using the service from abuse. Staff assessed risks to people, acted on them and kept good care records
- The service now had enough cardiotocograph equipment and staff were trained to use it
- There was improved incident reporting, timelier actions, and systems were now in place to improve shared learning with staff
- Leaders and staff had strengthened their engagement with people, staff, equality groups, and local organisations to plan and manage services.
However:
- Although there was now a process for documenting arrival times when women and people using the service attended triage, the new systems in place within the triage unit were not yet fully embedded
- Staff still did not always complete environmental and emergency equipment safety checks, in accordance with trust policy
- Staff did not ensure all medicines and sterile consumable items, were always stored, managed, and replaced timely, prior to expiry dates, in accordance with trust policy and best practice guidance.