The Care Quality Commission (CQC) has told Blackpool Teaching Hospitals NHS Foundation Trust that it must make urgent improvements to the maternity services at Blackpool Victoria Hospital.
CQC carried out an unannounced comprehensive inspection in June to ensure women and babies were receiving safe care and treatment, after receiving concerns about how the service was managing with low staffing.
The maternity services were previously rated good overall and in all five key areas. Following this inspection, the service has declined to requires improvement overall as well as for being effective, responsive to people’s needs and well-led. Safe has dropped from good to inadequate and caring remains rated as good.
After this inspection CQC wrote to the trust describing the serious concerns found and requested an action plan explaining how the trust were going to improve maternity services. This has been submitted and we will monitor the trust’s progress through ongoing engagement and future inspection activity.
Ann Ford, CQC, director of CQC's North Network, said:
“We inspected the maternity services at Blackpool Victoria Hospital as we had concerns about the quality of services being provided. We weren’t assured that women and babies were receiving safe care and treatment.
“During our Inspection we found that leaders weren’t always visible and approachable for patients and staff. There was also a clear disconnect between the senior leaders and staff on the wards which was having an impact on people’s care.
“It was concerning that there wasn’t always enough midwifery staff to care for women and keep them safe. This was a significant risk to women receiving timely and appropriate care and treatment, exposing them to the risk of harm. We found that some women were waiting for prolonged periods of for induction of labour. There was no discussion as to how to reduce the potential risks associated with delayed inductions or how the service was risk assessing women and their babies while they were waiting.
“Records weren’t clear, up-to-date or easily available to all staff providing care. We also found there weren’t good processes ensuring staff had access to in date and safely checked equipment, or to safely store medicines which could expose women and babies to the risk of harm.
“However, staff were working hard and treated women with compassion and kindness. They took account of their individual needs and provided them with emotional support when they needed it. Women gave positive feedback about the service.
“Following our inspection, we immediately informed the trust leadership team of our findings. The trust has submitted an action plan and told us they will be taking action to make urgent improvements including enhancing the maternity workforce and updating the induction of labour policy to include managing delays in the induction process.
“We will monitor the trust closely to ensure that significant and immediate changes are made to keep women and babies safe, and we will expect to see sustainable improvements the next time we inspect.”
Inspectors rated the service requires improvement for the following reasons:
- Staff did not always provide effective care and treatment. Managers monitored the effectiveness of the service but did not always make sure staff were competent
- Staff did not adequately support women to breastfeed
- The service did not always have the facilities to respect women's privacy and dignity
- Staff did not always help women understand their conditions or take account of their individual needs. People could not always access the service when they needed it and did have to wait too long for treatment
- Leaders had the systems for effective governance processes but not all risks were reported
- There were insufficient processes in place to assess the risk of and prevent and control the spread of infections
- The service did not always manage safety incidents well and lessons learned were not always shared.
However:
- Staff understood how to protect women from abuse
- The service had enough medical staff to provide care and treatment
- When things went wrong, staff apologised and gave patients honest information and suitable support
- Staff gave women enough to eat and drink and gave them pain relief when they needed it
- Staff worked well together for the benefit of women, advised them on how to lead healthier lives and key services were available seven days a week
- The service planned care to meet the needs of local people and made it easy for people to give feedback
- Midwifery staff supported women to make decisions about their care and had access to relevant information
- Staff were focused on the needs of patients receiving care. All staff were committed to continually learning and improving services
We found the following outstanding practice:
- The deputy head of midwifery and maternity matron hold hour-long Facebook Live events where women and their families can ask questions and any worries can be addressed. This was implemented during COVID-19 when face-to-face appointments were limited.