Northampton General Hospital’s maternity services rated ‘requires improvement’ for second time in four years

Maternity services at Northampton General Hospital remain rated as ‘requires improvement’ following an inspection by the care watchdog.

The service was inspected on November 30, 2022 by the Care Quality Commission (CQC). In a report published today (Friday, February 24), the CQC confirmed the service remains at an overall rating of ‘requires improvement’. For the areas of ‘safe’ and ‘well-lead’ the service is rated ‘requires improvement’.

Inspectors raised issues with the cleanliness of equipment and certain areas, record keeping and staff training. The hospital, however, says since the inspection these areas have been worked on.

The service was last inspected in October 2019 when it was rated ‘requires improvement’. The latest inspection of maternity services does not affect the hospital’s overall CQC rating of ‘requires improvement’.

The report found the following issues:

-Staff did not consistently complete checks of specialist equipment and there were some out of date and missing items on emergency trolleys.

The report says: “These inconsistencies could have had an impact on women’s care as staff relied on the items within the trolleys in an emergency or daily use.”

-Not all midwives and medical staff had completed level 3 safeguarding training or training in infection prevention and control.

The report adds: “Staff understood how to protect women from abuse and the service worked well with other agencies to do so. Staff were offered training on how to recognise and report abuse and they knew how to apply it. However not all staff have completed it.”

-Staff did not always fully and accurately complete records in relation to antenatal appointment and birthing plans.

The report says: “We reviewed seven records across labour and post-natal. These records showed details which should have been completed during antenatal appointments were either missing or completed by the women. These included the birth plan of the midwife or consultant. Carbon testing was not completed consistently and some records in relation to fetal movements at 25 weeks had not been completed.”

-Infection, prevention and control was not always followed to reduce the risk of infections, from the environment and the use of PPE.

The report adds: “The service could not be assured staff cleaned equipment after contact with women. When women were discharged from Robert Watson ward there was no system to inform the cleaning staff the area required cleaning. On a busy ward this placed a risk of areas not being cleaned between women using the same space.”

The report did also find positives:

-The service managed safety incidents well and learned lessons from them.

-Staff had undertaken mandatory training in some key areas and skills.

-The service had enough medical staff to care for women and keep them safe.

Craig Howarth CQC deputy director of operations in the Midlands said: “When we inspected maternity services at Northampton General Hospital, we saw that staff were competent and treated patients with kindness, but several improvements were needed across the department.

“Staff didn’t always follow infection control measures to help prevent the spread of infection which is especially important in an environment with new-born babies.

“The service had been on a journey where it recognised action needed to be taken to address the culture within the unit. Staff said although there were more opportunities to speak up, they still felt their concerns hadn’t always been listened to or addressed.

“However, we also saw some positive areas of care. Staff worked well together for the benefit of women and understood how to protect people from abuse and keep them safe.

“They understood the service’s vision and values and there was a new leadership structure in place which leaders hoped would implement positive change.

“We will continue to monitor the trust, including through future inspections, to ensure the necessary improvements are made.”

What the hospital has said

In response to the CQC report, bosses at NGH say they took “immediate action” to clean the areas CQC raised concerns about and they have worked to emphasise the importance of PPE and are using audits.

Bosses also say they have implemented a new checklist to make sure equipment is now checked regularly, and are moving towards electronic record keeping to make it more “consistent”. They also say work is being done to provide staff with more access to training.

Hospital Chief Executive Heidi Smoult said: “We welcome today’s CQC report which recognises the progress we have made in improving our maternity services but also highlights there is more still to do.

“Over the past 18 months, a lot of work has been undertaken including strengthening the senior leadership team in the unit, and greater monitoring and proactive recruitment of maternity support workers, midwives, and international midwives.

“We have also developed, and are implementing, quality improvement plans, which address local and national maternity priorities.

“We are delighted that the CQC has recognised we have kind and competent staff, who work well together, and that our staff understand our vision and the importance of our improvement journey. For us a key part of that journey is working closely with women and their families to deliver the care they need.

“We are also developing improvement plans alongside our staff and listening to them is a key focus. We have made progress in this area and we are committed to continuing on that journey to deliver excellence in our maternity services.”

Director of Nursing, Midwifery, and Patient Services, Debra Shanahan, added: “The CQC found our staff were committed to continually learning and improving services and that our leaders had the skills and abilities to run the services.

“We have done a lot of work around engagement and ensuring staff have more opportunities to speak up. We aim to continue to build on this so that we can work together to address our key priorities and ensure we provide families with safe and appropriate care.”

The full report can be found on the CQC website.