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New Forest Birth Centre Good

Inspection Summary


Overall summary & rating

Good

Updated 17 April 2019

• The hospital always had enough staff with the right qualifications, skills, experience and training to keep women safe from avoidable harm and abuse, and to provide them with the care and treatment they needed.

• Staff had clear understanding about their safeguarding responsibilities and were confident about actions they would take if they had any concern about a woman’s well-being. Staff followed internal procedures for safeguarding women and children.

• Women had access to maternity services when they needed it, with access to telephone guidance twenty- four hours a day and prompt responses. The trust provided maternity services seven days a week.

• The service provided care and treatment that was based on national guidance and monitored its application in practice.

• Actions were taken to improve service provision in response to feedback, incidents investigations and complaints received.

• Staff told us there was good working relationship with Princess Anne Hospital and they felt well supported in delivering care to women and babies.

• The trust vision and strategy was understood by staff and staff said they were supported by their managers.

However:

• There was only one midwife on site and staff relied on support from the main hospital which may impact on care of women.

• The service treated concerns and complaints seriously, investigated them, learned lessons from the results and shared with staff. These were not completed in a timely way; detailed responses had resulted in delays for the complainants which the trust was working to improve.

• Not all staff had received annual appraisals to provide support and monitor their practice. This was below the compliance rate set by the trust.

• All staff had not completed additional training for management of women in the birthing pool.

Inspection areas

Safe

Good

Updated 17 April 2019

Effective

Good

Updated 17 April 2019

Caring

Good

Updated 17 April 2019

Responsive

Good

Updated 17 April 2019

Well-led

Good

Updated 17 April 2019

Checks on specific services

Maternity

Good

Updated 17 April 2019

We rated it as good because:

This was the first inspection of the core service of maternity at the New Forest Birthing Centre as a separate service. Therefore, we cannot compare our new ratings directly with previous maternity and gynaecology ratings.

We rated this service as good because:

  • Midwives and obstetric staff had completed additional training for the management of emergency including the Practical Obstetric Multi Professional Training (PROMPT) for obstetric emergencies such as shoulder dystocia, ante-partum and post-partum haemorrhage and maternal sepsis.
  • Staff had clear understanding about their safeguarding responsibilities and were confident about actions they would take if they had any concern about a woman’s well-being. Staff followed their internal procedures for safeguarding women and children.
  • Staff carried out detailed assessments of women including the most vulnerable groups and ensured that safeguards were in place.
  • Actions were taken to improve service provision in response to feedback, incidents investigations and complaints received.
  • Ante-natal risk assessments and screening for safeguarding and mental health were recorded and actions instigated as needed.
  • Women had access to maternity services when they needed it, with access to telephone guidance 24- four hours a day and prompt responses. The Trust provided maternity services seven days a week.
  • The service had developed a needing extra support team who managed the care of women with complex needs and providing continuity in their care.
  • The service provided care and treatment that was based on national guidance and monitored its application in practice.
  • Incidents were managed well and staff were supported to report incidents. Learning from incidents were shared regularly with staff group which encouraged openness.
  • Services were planned and delivered to meet the needs of the local population and reflected some aspects of the National Maternity Review.
  • Staff told us there was a good working relationship with Princess Anne Hospital and they felt well supported in delivering care to women and babies.
  • There were effective multi- agency working to meet the needs of women and children.
  • Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
  • Managers at local levels in the Trust had the skills to manage the service providing quality and sustainable care.
  • The Trust vision and strategy was understood by staff and staff said they were supported by their managers.

However:

  • There was only one midwife allocated per shift and staff relied on support from the main hospital or staff in the community which may impact on care of women and babies.
  • The service treated concerns and complaints seriously, investigated them, learned lessons from the results and shared with staff. These were not completed in a timely way; detailed responses had resulted in delays for the complainants which the Trust was working to improve.
  • Not all staff had received annual appraisals to provide support and monitor their practice. This was below the compliance rate set by the Trust. The trust told us they had taken steps following the inspection to improve appraisal rates, such as allocating protected times on the duty roster for appraisals.
  • All staff had not completed additional training for management of women in the birthing pool.