The Care Quality Commission (CQC) has again rated maternity services at Stockport NHS Foundation Trust as requires improvement following an inspection in September.
The inspection was carried out as part of CQC’s national maternity 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 at a local and national level.
Inspectors looked at the areas of safe and well-led in the maternity services at Stepping Hill Hospital. Following the inspection, the overall rating for maternity at Stepping Hill Hospital, as well as the areas for safe and well-led, remain as requires improvement.
CQC didn’t look at how effective, caring, and responsive the service was at this inspection, therefore the ratings for effective and caring remain as good and responsive remain requires improvement.
The overall rating for the trust remains as requires improvement.
Carolyn Jenkinson, deputy director of secondary and specialist healthcare, said:
“When we inspected maternity services at Stockport NHS Foundation Trust, we saw efforts to improve were underway, but it was too early to see any real progress and more work was needed to ensure care was safe for people using the service and their babies.
“We were concerned that staff often felt care was unsafe due to understaffing. On the day of our inspection there should have been 37 midwives for the 24-hour period but there were only 27 meaning staff were working under pressure, and stretched thinly, which could place people at risk. A staff survey showed understaffing and excessive workload was also impacting on their ability to take breaks which needs to be addressed to ensure they don’t get burnout.
“We also found no designated midwife allocated to answering the triage telephone line. This is important to ensure any concerns that people using the service have, are dealt with appropriately and in line with national recommendations. The service recognised this was a need and recruitment for a telephone triage midwife had been arranged.
“However, it was positive that despite understaffing issues, staff described the department as positive and friendly with a good culture where managers and colleagues were kind, caring, and showed respect for individual differences.
“We will continue to monitor the trust, including through future inspections, to ensure further improvements are made so people can receive safe and appropriate care.”
Inspectors found the following during this inspection:
- There were delays in discharging people and their babies which sometimes led to self-discharge without assurance staff had completed all required assessments and reviews
- Not all staff had completed training in key skills
- Staff didn’t always risk assess woman and people in their care
- Though staff were committed to improving services, they didn’t always have the skills and resources to do so
- Medicines weren’t always managed well, and care records weren’t always completed
- Important equipment wasn’t always serviced and maintained in a timely manner.
However:
- Staff understood the service’s vision and values, and how to apply them in their work
- Leaders had developed and delivered a training programme to educate all staff on how to identify and reduce health inequalities
- During the inspection, people who attended triage were seen and reviewed in a timely manner.