The Care Quality Commission (CQC) has rated maternity services at Torbay Hospital, Devon, as requires improvement following an inspection in November.
Maternity services at Torbay Hospital, run by Torbay and South Devon NHS Foundation Trust, 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.
The overall rating for maternity services at Torbay Hospital remains requires improvement. They have been re-rated as requires improvement for both how safe and well-led they are. This inspection didn’t rate how effective, caring, and responsive the service was, which remain rated as good.
The overall rating for the hospital remains requires improvement and the overall rating for the trust remains requires improvement.
Carolyn Jenkinson, CQC’s deputy director of secondary and specialist care said:
“When we inspected maternity services at Torbay Hospital, we found staff who were highly skilled and were focused on the needs of women, people using the service and their babies. However, executive leaders lacked urgency to support the service to address issues when they were found, and this was putting people at risk of harm.
“The trust board weren’t always taking enough action to address or manage risks when they were identified. Although leaders acted quickly to address risks we highlighted at the inspection, action could have been taken sooner as they were already aware of them. This included concerns regarding the need for a second theatre to carry out emergency surgery and staffing levels.
“We also found poor systems and processes for assessing women and people using the service who needed medical attention, including no dedicated triage phone line. People could call a general phone number if they had any health concerns, but it could have been answered by staff without the right training to assess their needs. Staff also weren’t using a standard method to assess and prioritise people based on clinical need. However, leaders made improvements to this following our feedback.
“There wasn’t always enough equipment to support the number of women, people and babies using the service. This included machines that can help babies in emergencies and with resuscitation, and equipment which monitors babies’ heart rates. Staff shouldn’t have had to share important equipment around, and we were pleased the trust planned to address this.
“Despite these concerns, we found staff and leaders were committed to improving the service. They engaged with the local community and sought feedback by hosting group sessions, baby cafés, and visiting children’s centres. They had several ongoing improvement projects including work to reduce smoking in pregnancy. They were also working to reduce health inequalities for people using the service who experienced social deprivation, which included a free phone line giving advice to people experiencing financial difficulties.
“We will continue to monitor the trust, including through future inspections, to check on the progress of the improvements we’ve told them to make, to ensure people and their babies receive a good standard of care.”
Inspectors found:
- Staff weren’t always following the trust’s policies to ensure a second person was checking unborn babies’ heart rates. They also didn’t always complete records that helped to identify when people giving birth were at risk of deteriorating and show when issues had been escalated
- Medical staff levels weren’t always safe and the trust acknowledged there was a need to increase consultant numbers. Consultants didn’t always have time for training, rest breaks following on call shifts, or to support junior doctors
- The service needed a second emergency theatre and a team in place to support this. Until this is set up, there could be delays with treating women and people who needed emergency surgery.
However:
- Staff were well-trained and understood their roles and accountabilities. They treated women and people using the service with dignity and respect, and understood the service’s vision
- Complaints were investigated and managed well. Staff were able to give examples of how they used women and people using the service’s feedback to make improvements.