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Inspection Summary


Overall summary & rating

Good

Updated 27 March 2014

St Mary’s Birth Centre is part of the University Hospitals of Leicester NHS Trust, a teaching trust that was formed in April 2000 through the merger of Glenfield Hospital with Leicester General Hospital and Leicester Royal Infirmary. The trust provides care to the people of Leicester, Leicestershire and Rutland as well as the surrounding counties.

St Mary’s Birth Centre, is a midwife-led unit based at St Mary’s Hospital in Melton Mowbray providing care for pregnant women and their families before, during and after birth. The centre risk-assesses women to ensure that its services meet their inclusion criteria. Home births are attended by the community midwifery teams. Community midwives also support the birth centre staff during busy times, particularly during the night.

We found that the service was safe, effective and caring while being responsive to the needs of its local population. In general, the midwives felt supported and involved in the management of the department. National guidance was taken in to account when designing policies and procedures that govern treatment, and all midwives knew about these policies and procedures.

The building is old and requires some maintenance in order for the environment to be easily cleaned. However, in general the service was clean. Women reported a good experience of using the service and felt involved in their care.

There are sufficient midwives to provide the service and a number of specialist midwives to support women in the community with specific issues. The location has low rates of infection and mortality as it does not undertake high-risk procedures. Staff were able to personalise the service to meet the needs of the women at the centre of their care.

Inspection areas

Safe

Good

Updated 27 March 2014

We saw a robust governance framework which positively encouraged staff to report incidents. Information on how to make a complaint was visible to the people using the service. There was also an extensive audit programme.

The building is old and requires maintenance to ensure effective infection prevention and control practices can be completed. However, we noted that the environment was clean.

Effective

Good

Updated 27 March 2014

The trust was able to demonstrate to us that policies, protocols and guidance were based on nationally recognised guidelines and standards. We saw the trust had a specialist midwife with responsibility to ensure all clinical effectiveness was embedded in practice and all policy and standards were evidence and research based. The trust had robust systems in place for the ratification of new policies and guidance.

Women were cared for by suitable, qualified and competent staff. We saw evidence that staff were able to access a variety of mandatory training and there were opportunities for further development.

Caring

Good

Updated 27 March 2014

We saw that women and their families were very much involved in their care. We saw an extensive 36-week antenatal risk assessment carried out jointly to confirm suitability for midwife-led care. We saw evidence that the risks and benefits were discussed with women and they signed a record to say all issues had been discussed with them.

Responsive

Good

Updated 27 March 2014

The staff we spoke with had a good understanding of the population who used the service and were all able to explain with confidence the requirements of the people who were inpatients.

The provider had an extensive team of specialist midwives, who supported care for the more vulnerable people within the community. We saw specialists for bereavement, safeguarding and female genital mutilation (female circumcision).

The provider had a robust complaints process. We saw evidence of shared learning across midwifery services.

Well-led

Good

Updated 27 March 2014

The midwives had access and were well supported by senior managers at the trust’s main location. Supervisors of midwives were available for support and were on call throughout the day and night. The ratio of supervisors to midwives was one to 20, higher than the recommended national standard of one to 15. None of the staff we spoke with expressed any concerns with access to a supervisor of midwives.

Training was available and utilised by midwives at this unit.

Checks on specific services

Maternity and gynaecology

Good

Updated 27 March 2014

Services for women in maternity were generally safe for women who had low-risk deliveries. Transfer arrangements were in place for those who were identified as requiring other services.

There was an effective mechanism to record incidents, near misses and never events (mistakes that are so serious they should never happen). Staff told us they knew how to report these electronically and in person to their manager. We saw a robust governance framework that positively encouraged staff to report incidents. Information on how to make a complaint was visible to the people using the service.

The building is old and shabby and does not create a pleasant environment for the provision of services nor for effective infection control practices. However, the trust is aware of this and is taking some action to address this issue.

The wards/departments were generally well-led.