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Inspection Summary


Overall summary & rating

Good

Updated 17 April 2019

We rated them as good because:

  • 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 24- 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.
  • The Trust vision and strategy was understood by staff and staff said they were supported by their managers.

However:

  • Emergency equipment was not managed safely, as all the necessary checks were not completed in line with the Trust policy and procedures.
  • There were weaknesses in the security of the service which may impact on women and babies.
  • The current arrangement for transfer of women was not effectively managed as the lift could not be overridden in an emergency in order to access the Labour Ward and the operating theatres.
  • Infection prevention processes and guidance were not always followed which posed risks of cross infection. We found some parts of the service did not meet the required standards for cleanliness particularly in the birthing room on the Labour Ward and the ante-natal and post-natal wards.
  • The medicines in the induction of Labour Ward was not stored in line with guidance and this may affect their efficacy.
  • 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 yearly 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.
Inspection areas

Safe

Requires improvement

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

  • 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 confident about actions they would take if they had any concern about a woman’s wellbeing. 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.
  • Antenatal 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 24/7 telephone guidance and prompt responses. The trust provided maternity services seven days a week.
  • The trust had developed a needing extra support team who managed the care of women with complex needs and providing continuity in their care.
  • The maternity was responsive to the needs of women and provided 24-hour care for women, seven days a week.
  • The service provided care and treatment that was based on national guidance and monitored its application in practice.
  • There were effective cross sector working with the New Forest Birthing Centre and staff said they were well supported when they needed additional help with staffing, and transfer of women and babies
  • 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 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:

  • Emergency equipment was not managed safely, as all the necessary checks were not completed in line with the trust policy and procedures.
  • There were weaknesses in the security of the service which may impact on women and babies.
  • The current arrangement for transfer of women was not effectively managed as the lift could not be overridden in an emergency in order to access the Labour ward and the operating theatres.
  • Infection prevention processes were poor and guidance were not followed which posed risks of cross infection. We found some parts of the service did not meet the required standards for cleanliness particularly in the birthing room on the Labour Ward and the antenatal and postnatal wards.
  • The medicines in the day unit was not stored in line with guidance and this may affect their efficacy.
  • 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 yearly appraisals to provide support and monitor their practice. This was below the compliance rate set by the trust.