The Care Quality Commission
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  • NHS hospital

The Ipswich Hospital

Overall: Requires improvement read more about inspection ratings

Heath Road, Ipswich, Suffolk, IP4 5PD (01473) 712233

Provided and run by:
East Suffolk and North Essex NHS Foundation Trust

Important: This service was previously managed by a different provider - see old profile

All Inspections

7th April 2021

During an inspection looking at part of the service

East Suffolk and North Essex NHS Foundation Trust (ESNEFT) provides both acute hospital and community health care and was formed on 1 July 2018 following the acquisition of The Ipswich Hospital NHS Trust by Colchester Hospital University NHS Foundation Trust. ESNEFT maternity consists of services at Ipswich, Colchester and Clacton.

At Ipswich Hospital, the delivery suite consists of six birthing rooms with three fully equipped obstetrics and gynaecology theatres, of which one is a dedicated emergency obstetric theatre to support consultant-led care and a three bedded midwifery-led birthing unit for women identified as low risk of complications. The triage area contains three beds, with two assessment rooms and a quiet room which can be used for bereaved families. The maternity ward has 23 beds and accommodates both antenatal and postnatal women. In addition, specialist midwives for cardiotocography, bereavement, clinical effectiveness, practice development, mental health, birth choices, safeguarding, smoking cessation, antenatal and new-born screening and infant feeding work within the multi-disciplinary teams. Ultrasound is provided at Ipswich and Colchester sites and includes fetal medicine specialist services.

From April 2020 to March 2021 there were 3137 deliveries at Ipswich Hospital.

We last inspected the maternity service at Ipswich Hospital between 11 June and 18 July 2019. The report was published on the 8 January 2020. The maternity service was rated good overall, with safe rated as requires improvement, effective, caring and well led rated as good and responsive rated as outstanding. The trust was issued with two requirement notices in relation to breaches in Regulation 12 of the Health and Social Care Act (RA) Regulations 2014 and was told to improve.

We carried out this unannounced, focused inspection of maternity services because of emerging concerns in relation to the safety and quality of the services.

Our inspection was unannounced (staff did not know we were coming) to enable us to observe routine activities. We carried out a focused safety inspection of maternity services related to the concerns raised, this does not include all our key lines of enquiry (KLOEs).

How we carried out the inspection

As part of this inspection we visited the following areas within the maternity services; maternity triage, the consultant-led delivery suite, ante-natal and post-natal ward and maternity theatre. We spoke with 26 members of staff; including service leads, matrons, midwives, doctors, maternity care assistants and administrative staff. We observed care, attended two handover meetings and ward rounds and reviewed 10 sets of maternity records. We reviewed two emergency trolleys and carried out medicine checks on two ward areas. We also looked at a wide range of documents including policies, standard operating procedures, meeting minutes, action plans, prescription charts, risk assessments and audit results. Before our inspection, we reviewed performance information about this service.

Focused inspections can result in an updated rating for any key questions that are inspected if we have identified a breach of regulation and issued a requirement notice. In these cases, the ratings will be limited to requires improvement. Because of this, there were changes to ratings for maternity services. Safe remained the same but well led went down giving an overall rating of requires improvement for maternity services at Ipswich Hospital.

Our rating of services went down. We rated them as requires improvement because:

  • Staff did not always feel respected, supported and valued by the leadership teams. Staff were not clear about their roles and responsibilities. Staff we spoke with told us morale was low and there was a disconnect between unit staff and the leadership team.
  • Leaders and teams did not always use systems to manage performance effectively. There was insufficient oversight and management of risks. The risk register was not up to date and leaders were unaware that mitigating actions were not being carried out. Some incidents were graded as no harm thereby potentially missing the opportunity to review the incidents in greater detail and improve practice.
  • The service did not have enough maternity staff with the right qualifications, skills, training and experience to keep women safe from avoidable harm and to provide the right care and treatment. The number of midwives and maternity care assistants on duty did not match the planned numbers.
  • Not all staff had completed mandatory training or specialist training in line with trust requirements. Compliance rates for medical staff were low. Managers could not be assured that medical staff were competent in key aspects of their role due to failure to complete this training.

See the Maternity section for what we found.

You can find further information about how we carry out our inspections on our website: https://www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection.

11 Jun to 18 Jul 2019

During a routine inspection

  • The service had enough staff to care for patients and keep them safe. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them.
  • Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
  • The service planned care to meet the needs of local people, took account of most patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
  • Leaders ran services well and supported staff to develop their skills. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services.

However:

  • Managers did not always make sure all staff completed required mandatory training. Not all staff had training on how to recognise and report abuse.
  • The ward environment in all three community hospitals did not support patients living with dementia and other complex needs