The Care Quality Commission (CQC) has dropped The Hillingdon Hospital’s maternity services rating from good to requires improvement, following an inspection in August.
This inspection was carried out as part of CQC’s national maternity services inspection programme. The programme aims to 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 locally and nationally.
As well as dropping in rating overall, the service’s rating for safe has also dropped from good to requires improvement. The service’s rating for well-led has dropped from outstanding to requires improvement. This inspection didn’t look at how effective, caring, or responsive the service was, so all of these retain their previous rating of good.
This inspection does not change the overall rating of the hospital as a whole, which remains rated inadequate. This inspection does not change the overall rating of The Hillingdon Hospitals NHS Foundation Trust, which remains requires improvement.
Carolyn Jenkinson, CQC’s deputy director of secondary and specialist healthcare, said:
“When we inspected maternity services at The Hillingdon Hospital we found most staff doing their best to provide women and people using the service with safe, compassionate care. However, they were under a lot of pressure due to staffing issues, and leaders didn’t always respond quickly to concerns. This put people’s safety at risk.
“For example, we saw staff didn’t always fully complete risk assessments for people when they arrived. This meant people at the highest risk weren’t always seen quickly enough.
“When things went wrong, the service raised and investigated this well. However, leaders didn’t always make sure learning was fully implemented to protect people in future.
“We saw the trust was doing their best to respond to staffing pressures, which are a problem across the NHS. Recruitment was ongoing and leaders had organised a wellbeing programme for staff stressed by high workloads. However, staff gave us mixed views on how effective this was.
“We’ve shared our findings with the trust, who have begun addressing our concerns. We’ll continue to monitor the service closely, including through further inspections, to make sure these improvements are carried out promptly. We won’t hesitate to act further if we find people are not receiving safe care.”
Inspectors also found:
- Not all staff had training in areas needed to keep people safe, including safeguarding and adult basic life support
- Staff didn’t always recognise people’s health deteriorating, meaning this wasn’t always acted on quickly
- Staff told inspectors that some births took place before reaching the labour ward, because beds weren’t available soon enough
- The service didn’t always store medicines correctly
- The trust commissioned an independent review of their staff culture in early 2023 in response to concerns raised about an unfair working culture for staff from ethnic minorities or with care responsibilities outside work, as well as a lack of diversity in management positions. The review made recommendations for improvements and senior leaders said they were acting on these, but not all staff or leaders were clear on the outcomes of this.
However:
- Staff knew how to protect people from abuse and worked well with other organisations to do so
- Staff kept detailed care records to make sure people’s needs were met
- Leaders supported a culture in which women, people using the service, and their families felt safe to raise concerns
- The service actively engaged with local people and organisations to plan services.