The Care Quality Commission (CQC) has rated maternity services at three hospitals run by Royal United Hospitals Bath NHS Foundation Trust, and found one maintained its outstanding rating, following inspections in November.
Maternity services at Royal United Hospital Bath, Chippenham Birth Centre (Chippenham Community Hospital), and Frome Birth Centre (Frome Community Hospital), were inspected 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.
Following the inspection, maternity services at Royal United Hospital Bath maintained their outstanding rating overall. The rating for well-led remains rated as outstanding. It has been re-rated as good for being safe. This was a focused inspection looking at the areas of safe and well-led; from a previous inspection effective remains rated as good, caring and responsive remain rated as outstanding.
Chippenham Birth Centre (Chippenham Community Hospital) maternity services has been rated as good overall, and for being safe and well-led. This was the first time maternity services were inspected or rated at Chippenham Birth Centre.
Maternity services at Frome Birth Centre (Frome Community Hospital) has been rated as good overall, and for being safe and well-led. This was the first time maternity services were inspected or rated at Frome Birth Centre.
The maternity services ratings did not change the overall ratings for the hospitals or the trust. Royal United Hospital remains rated as requires improvement overall. Royal United Hospitals NHS Foundation Trust remains rated as good overall.
Carolyn Jenkinson, CQC’s deputy director of secondary and specialist care said:
“When we inspected maternity services run by Royal United Hospitals Bath NHS Foundation Trust we found good leadership and staff who were passionate about providing high quality care for women, people using the service, and their babies.
“We found leaders were running the services well across the three hospitals. They monitored the performance, identified risks and understood the issues the services were facing. Staff told us leaders were approachable and they felt respected, valued and supported to develop their skills.
“At Royal United Hospital Bath in particular, leaders should be incredibly proud to have developed a culture where staff can thrive and are empowered to provide the best possible care to women, people using the service and their babies. Its outstanding rating is a testament to the continued hard work and dedication of the entire team.
“We were also pleased to see the trust was committed to making improvements and had several improvement projects in place and made changes following feedback from staff and people using the service. For example, the trust had launched an infant feeding support project to identify areas of deprivation and provide extra support to those who needed it as well as a translation app, which had received positive feedback from users.
“The trust should look to learn how they can extend the excellent practice we found in maternity to their other services.”
At Royal United Hospitals Bath, inspectors found:
- Staff had training in key skills and were clear about their roles and accountabilities. They told inspectors they felt respected, valued, and supported by leaders
- Staff assessed risks to women and people using the service, acted on those risks, and kept good care records. They also knew how to identify and protect people from abuse
- Leaders effectively monitored how the service performed, knew the issues the service was facing and addressed risks when they needed to. The service learnt lessons and made improvements when things went wrong
- The service engaged well with the local community to make improvements. For example, they worked with the local maternity and neonatal voice partnership to improve communication with people from ethnic minority and LGBT+ communities
- Medicines were managed well. They were stored appropriately, checked regularly, and prescribed properly. Staff kept good records when people had been prescribed medicines
- People were able to access the services when they needed them and didn’t have to wait too long for treatment
- The service managed infection risk well, the environment was suitable and there was enough equipment to meet the needs of women, people using the service and their babies.
However:
- There wasn’t always enough medical and midwifery staff to cope with demand and staffing levels didn’t always match the planned numbers.
At Chippenham Birth Centre, inspectors found:
- Staff worked well together and were clear about their roles and accountabilities. They understood the service’s vision and values and knew how to apply them to everyday work
- Staff understood how to protect people from abuse, effectively assessed people’s risks and managed safety well
- Leaders effectively monitored how the service performed, knew the issues the service was facing and addressed risks when they needed to. The service learnt lessons and made improvements when things went wrong
- People were able to access the services when they needed them and didn’t have to wait too long for treatment
- The environment was suitable and there was enough equipment to meet the needs of women, people using the service and their babies.
However:
- Staffing levels didn’t always match the planned numbers to keep people safe, and some staff hadn’t completed the mandatory basic life support training they needed to.
At Frome Birth Centre, inspectors found:
- Staff understood how to protect people from abuse, effectively assessed people’s risks and managed safety well
- The service controlled infection risk well, the environment was suitable and there was enough equipment to meet the needs of women, people using the service and their babies
- The service had enough midwifery staff to keep people safe and people were able to access the services when they needed them and didn’t have to wait too long for treatment
- Staff were clear about their roles and accountabilities. They understood the service’s vision and values and knew how to apply them to everyday work
- Leaders effectively monitored how the service performed, knew the issues the service was facing and addressed risks when they needed to. The service learnt lessons and made improvements when things went wrong.
However:
- Some staff hadn’t completed the mandatory basic life support training they needed to, and some policies inspectors saw were out of date.