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This service was previously registered at a different address - see old profile

Inspection Summary


Overall summary & rating

Updated 5 July 2017

Head Office - Neighbourhood Midwives is operated by Neighbourhood Midwives Limited. The service has a registered postal office in North London, a base in Waltham Forest for its NHS work, and a base in South West London where meetings are held. Midwives and the central support team (CST) work remotely and are based at home.

The service provides community maternity and midwifery services, including self-pay private services and a commissioned NHS service. We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 11-13 April 2017.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Services we do not rate

We regulate this service but we do not currently have a legal duty to rate it. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary

We found the following areas of good practice:

  • We saw evidence that incident reporting, investigation and dissemination of learning were well embedded with incidents being seen as a tool for driving improvement.

  • The provider had a robust safer recruitment process in place to ensure that all safety checks were carried out before a member of staff commenced work.

  • Compliance with mandatory training was high and was monitored by the central support team.

  • Caseloads were capped at a level which ensured safe and consistent care for women

  • Care and treatment was provided in line with policies which reflected guidance from the National Institute of Health and Care Excellence (NICE) and Royal College of Midwives.

  • We saw that midwives had access to and used evidence-based guidelines to support the delivery of effective treatment and care.

  • There was evidence of multidisciplinary working.

  • Staff were competent in their roles and undertook appraisals and supervision.

  • Women had 24 hour access to their midwives throughout their pregnancy.

  • We observed that women were treated with kindness, dignity and respect by midwives.

  • Women told us they felt safe in the care of their midwife.

  • Feedback from mothers and those close to them was consistently positive.

  • Women told us they were partners in care with their midwives and they felt involved in decisions and well informed at all times.

  • Women’s’ individual needs and preferences were considered when planning and delivering services.

  • People for whom English was their second language were offered translation services.

  • Service provision was flexible and provided choice and continuity of care.

  • Complaints were managed and resolved in a timely manner.

  • There was strong leadership provided by the central support team.

  • There were risk management processes in place.

  • Communication amongst staff was good and was facilitated by frequent meetings and the use of information technology.

  • There was a high level of engagement with those who used the service.

  • All staff shared a vision of high quality care and service provision and demonstrated a high degree of loyalty to the service.

However, we also found the following issues that the service provider needs to improve:

  • Fridges did not maintain temperatures which were within the range at which drugs should be stored.

  • VTE scores were not consistently recorded.

  • There was inconsistent quality of record keeping.

  • The provider could not ensure that medicines were stored safely and the medicines management policy did not cover all aspects of medicines management for the service.

  • The service did not have a safeguarding lead with level 4 safeguarding children training. However, the provider confirmed that the safeguarding lead was working towards level 4.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with one requirement notice that affected maternity services. Details are at the end of the report.

Professor Edward Baker

Deputy Chief Inspector of Hospitals

Inspection areas

Safe

Updated 5 July 2017

We found the following areas of good practice:

  • We saw evidence that incident reporting, investigation and dissemination of learning were well embedded with incidents being seen as a tool for driving improvement.
  • The provider had a robust safer recruitment process in place to ensure that all safety checks were carried out before a member of staff commenced work.
  • Compliance with mandatory training was high and was monitored by the central support team.
  • Caseloads were capped at a level which ensured safe and consistent care for women.

However, we also found the following issues that the service provider needs to improve:

  • Fridges did not maintain temperatures which were within the range at which drugs should be stored.
  • VTE scores were not consistently recorded.
  • There was inconsistent quality of record keeping.
  • The service did not have a safeguarding lead with level 4 safeguarding children training. However, the provider confirmed that the safeguarding lead was working towards level 4.

Effective

Updated 5 July 2017

We found the following areas of good practice:

  • Care and treatment was provided in line with policies which reflected guidance from the National Institute of Health and Care Excellence (NICE) and Royal College of Midwives.
  • We saw that midwives had access to and used evidence-based guidelines to support the delivery of effective treatment and care.
  • There was evidence of multidisciplinary working.
  • Staff were competent in their roles and undertook appraisals and supervision.
  • Women had 24 hour access to their midwives throughout their pregnancy.

Caring

Updated 5 July 2017

We found the following areas of good practice:

  • We observed that women were treated with kindness, dignity and respect by midwives.
  • Women told us they felt safe in the care of their midwife.
  • Feedback from mothers and those close to them was consistently positive.
  • Women told us they were partners in care with their midwives and they felt involved in decisions and well informed at all times.

Responsive

Updated 5 July 2017

We found the following areas of good practice:

  • Women’s’ individual needs and preferences were considered when planning and delivering services.
  • People for whom English was their second language were offered translation services.
  • Service provision was flexible and provided choice and continuity of care.
  • Complaints were managed and resolved in a timely manner.

Well-led

Updated 5 July 2017

We found the following areas of good practice:

  • There was strong leadership provided by the central support team (CST).
  • There were risk management processes in place.
  • Communication amongst staff was good and was facilitated by frequent meetings and the use of information technology.
  • There was a high level of engagement with those who used the service.
  • All staff shared a vision of high quality care and service provision and demonstrated a high degree of loyalty to the service.

However, we also found the following issues that the service provider needs to improve:

  • The provider could not ensure that medicines were stored safely and the medicines management policy did not cover all aspects of medicines management for the service.
  • The provider did not have a policy statement for when midwives worked outside of NICE guidance.
Checks on specific services

Maternity

Updated 5 July 2017

The only service offered by Neighbourhood Midwives was maternity.

We regulate this service but we do not currently have a legal duty to rate it. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.