- NHS hospital
Horton General Hospital
Assessment report published 4 June 2026
Ratings - Maternity
Our view of the service
Date of Assessment: 07 - 08 October 2025
We carried out this assessment to assess if improvements had been made since the last inspection in October 2023 when the maternity service was rated as requires improvement. We assessed 32 quality statements across the safe, effective, caring, responsive and well-led key questions. We found the quality of care had improved. However, there were still areas where improvement was needed.
At the last assessment there were breaches of regulation relating to safe care and treatment and good governance.
At this assessment, improvements were found, and the service was no longer in breach of safe care and treatment or good governance.
At this assessment we found the service demonstrated a strong commitment to safety by working collaboratively with people and healthcare partners to understand what safety meant to them and how best to achieve it. They focused on improving people’s lives while protecting their rights to live free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. Concerns were shared promptly and appropriately. The service adopted a holistic approach to risk management, providing care that was safe, supportive and enabled people to do what mattered most to them. There were sufficient numbers of qualified, skilled and experienced staff who received appropriate support, supervision and development, and teams worked effectively together to meet individual needs. The service also assessed and managed infection risks effectively, taking action to prevent the spread of infection. Medicines and treatments were managed safely, with people supported to be involved in planning their care, including when changes occurred.
The service demonstrated a strong commitment to delivering effective care and treatment. People’s health, care, wellbeing and communication needs were assessed and regularly reviewed in partnership with them. Care and treatment were planned and delivered collaboratively, reflecting what was important to individuals and aligned with legislation, current evidence-based guidance and recognised standards. The service supported people to manage their health and wellbeing in ways that maximised independence, choice and control, including supporting women to live healthier lives and reduce future care needs where possible. Care and treatment were routinely monitored to drive continuous improvement and ensure outcomes were consistently positive, meeting both clinical standards and people’s expectations. The service also promoted and respected people’s rights around consent when delivering person-centred care and treatment.
The service demonstrated a strong commitment to person-centred care. People were informed about their rights regarding consent, and these rights were respected in the delivery of care and treatment. The service promoted independence, ensuring people understood their rights and had choice and control over their care, treatment and wellbeing. Staff listened to and understood people’s needs, views and wishes, responding promptly to minimise discomfort, concern or distress. The service also prioritised staff wellbeing, supporting and enabling them to consistently deliver person-centred care.
The service placed people at the centre of decisions about their care and treatment, working in partnership with them to respond to changes in their needs. Care was delivered in an integrated way across maternity healthcare and community services, with a clear focus on continuity. People were provided with appropriate, accurate and up-to-date information in formats tailored to their individual needs. The service made it easy for people to provide feedback, share ideas or raise complaints, and demonstrated that it acted on this information. The provider ensured timely access to care, support and treatment. Staff and leaders also listened to the experiences of people most likely to face inequality in outcomes and adapted care and support accordingly.
The service demonstrated a shared vision, strategy, and culture, grounded in transparency, equity, equality and human rights, diversity and inclusion, engagement, and an understanding of community needs and challenges. Leaders were inclusive and values-driven, they understood the context of care delivery and the context in which they delivered care, treatment and support. They embodied the organisation’s culture and workforce values. Leaders had the skills, knowledge, experience, and credibility to lead effectively, acting with integrity, openness, and honesty. The service promoted a positive speaking-up culture, where staff felt confident their voices would be heard. There was a clear commitment to valuing diversity and fostering an inclusive and fair workforce culture. Leaders identified actions aimed at improving equality and equity for staff. The maternity service had a governance framework in place.
However, we found that advice‑only calls to the 24‑hour telephone advice and screening service, which did not progress to labour assessment, lacked formal triage prioritisation and had limited audit oversight. This reduced assurance regarding consistency and governance. Handovers did not incorporate safety huddle methodology to systematically review patient safety incidents, current risks and shared learning. Documentation was not always completed to the expected standard reducing assurance that care decisions, risk assessments, and actions were clearly recorded and communicated. The service did not consistently detect and mitigate potential risks within the care environment, and aspects of the facilities did not always fully support the delivery of safe care. There were gaps in audit coverage and associated assurance processes. While actions to improve equality and equity were described, detailed local plans outlining how objectives would be delivered and monitored were not clearly articulated. Although a governance framework existed, it was unclear how local governance and risk management operated in practice. Furthermore, it was unclear what specific measures were being implemented at a local level to drive quality improvement and development within the service.
People's experience of this service
People who used the service told us they received care that was kind, compassionate, and respectful. Staff had demonstrated professionalism, maintained their dignity and privacy, and provided emotional and practical support tailored to their individual needs. Communication had been clear and accessible, ensuring they understood their care and could make informed decisions, with family involvement where appropriate. Care had been person-centred, culturally sensitive, and responsive. People had felt safe and been provided with high-quality treatment throughout their patient journey.
We refer to women throughout this report, but we acknowledge that some transgender men, non-binary people, and people with variations in sex characteristics (VSC), including those who are intersex, may also use maternity services and experience similar issues.