The Care Quality Commission (CQC) has told South Tees Hospitals NHS Foundation Trust to make improvements in maternity services, following inspections carried out in August.
The services at The James Cook University Hospital and Friarage Hospital were inspected as part of CQC’s national maternity services inspection programme. This will 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.
This is the first time maternity services at both hospitals have been rated as a standalone core service. Previously, maternity and gynaecology services were inspected and rated together.
Following this inspection, maternity services at The James Cook University Hospital have been rated as requires improvement overall, and for being safe and well-led.
Maternity services at the Friarage Hospital were rated requires improvement overall and for being well-led. It was rated good for being safe.
Both hospitals and the trust remain rated as good overall.
Carolyn Jenkinson, CQC's deputy director of secondary and specialist care, said:
“When we visited maternity services at South Tees Hospitals NHS Foundation Trust, we found leaders were generally visible and approachable for staff, as well as women, people using the service and their babies. However they didn’t always understand and manage the priorities both maternity services faced in a timely way.
“At the Friarage Hospital, the maternity unit was sometimes closed for births as staff were required to work at The James Cook University Hospital instead, due to low staffing levels. This made it difficult for people to plan a birth there.
“We found areas of concern at The James Cook University Hospital. For example, there was no birthing pool on the delivery suite or on the midwifery led unit. Staff used a standard bath instead of a birthing pool, which was unsafe and was putting people at risk due to the design of the room and the bath. Once this was highlighted to the trust, they stopped immediately.
“Leaders were also highly responsive and engaging in relation to other concerns we raised with them during the inspection and acted promptly to improve the standard of care they were providing.
“We will continue to monitor both services, so the trust can build on where it’s providing good care and make improvements where they’re needed.”
Inspectors found at the Friarage Hospital:
- The service did not always have enough midwifery staff, or they were frequently redeployed to The James Cook University Hospital
- Leaders did not operate effective governance systems. They did not consistently monitor the effectiveness of the service and did not always manage risk well.
However:
- Staff understood how to protect woman and people using the service from abuse, and managed safety well
- Staff assessed risks to woman and people using the service, acted on them and kept good care records.
Inspectors found at The James Cook University Hospital:
- The service did not always have enough staff and staffing levels did not always match planned numbers, which could put safety of women, people using the service and their babies at risk
- There were various aspects of the environment that were not fit for purpose. This had implications for safety, efficiency, privacy and dignity.
- Staff assessed risks to people but did not always act on them to remove or minimise risks.
However:
- The service generally managed infection risks well
- The service engaged with people and the community to plan and manage services
- Managers generally made sure staff were competent, and staff were focused on the needs of people receiving care.