Maternity services rated 'good' despite safety concerns in north and west Cumbria
Maternity services in north and west Cumbria have been rated as "good" by inspectors, despite safety being rated as "requires improvement".
At the West Cumberland Hospital in Whitehaven, the Cumberland Infirmary in Carlisle and Penrith Community Hospital, the report said staffing levels put the "safety of women and birthing people and babies at risk".
Inspectors also said that staff at all three hospitals operated by North Cumbria Integrated Care NHS Foundation Trust (NCIC) "worked well together for the benefit of women and birthing people, understood how to protect women and birthing people from abuse, and managed safety well".
Following the inspection in April, the services were rated:
West Cumberland Hospital – the maternity rating for well-led is rated as good and safety is rated as requires improvement. The overall rating for maternity services at West Cumberland Hospital is good.
Cumberland Infirmary – the maternity rating for well-led is rated as good and safety is rated as requires improvement. The overall rating for maternity services at Cumberland Infirmary is good.
Penrith Community Hospital – the maternity rating for well-led is rated as good and safety is rated as requires improvement. The overall rating for maternity services at Penrith Community Hospital has been rated good.
Despite inspectors marking that maternity services were "good", the overall rating for the trust remains as requires improvement.
The inspection was carried out as part of Care Quality Commission’s national maternity inspection programme.
Inspectors found the following during this inspection:
At West Cumberland Hospital:
Leaders ran services well using reliable information systems and supported staff to develop their skills.
Systems and processes weren’t in place to monitor competency in the use of medicines.
Not all staff had training in key skills including life support and safeguarding training.
Staffing levels did not always match the planned numbers putting the safety of women and birthing people and babies at risk. The service had made improvements to recruitment and retention of staff.
Staff worked well together for the benefit of women and birthing people, understood how to protect women and birthing people from abuse, and managed safety well.
At Cumberland Infirmary:
Staff understood the service’s vision and values, and how to apply them in their work.
Staff worked well together for the benefit of women and birthing people, understood how to protect women and birthing people from abuse, and managed safety well.
All staff were committed to improving services continually.
Not all staff had training in key skills including life support and safeguarding training.
Staffing levels did not always match the planned numbers putting the safety of women and birthing people and babies at risk. The service had made improvements to recruitment and retention of staff.
At Penrith Community Hospital:
People could access the service when they needed it and did not have to wait too long for treatment.
Managers monitored the effectiveness of the service and made sure staff were competent.
Levels of appraisal completion wasn’t in line with trust targets.
Staffing levels did not always match the planned numbers, although this was managed well, and the safety of women and birthing people and babies was not at risk. The service had made improvements to recruitment and retention of staff.
Not all staff had training in key skills including life support and safeguarding training.
Staff worked well together for the benefit of women and birthing people, understood how to protect women and birthing people from abuse, and managed safety well.
Carolyn Jenkinson, deputy director of secondary and specialist healthcare, said: “When we inspected maternity services at North Cumbria Integrated Care NHS Foundation Trust, whilst we saw some good elements of effective leadership and teams working well together, there were some improvements needed to ensure safe care is being provided to women, people using the service and their babies.
“Staffing levels at each hospital didn’t always match the planned numbers needed to keep people and babies safe. Community midwives were sometimes moved to the main hospital sites to provide cover which meant there weren’t always enough staff at the birth centre or to assist with home births which could place people and their babies at risk.
“It was encouraging, however, that leaders had recruitment plans in place to fill any vacancies, including working with the local university which offered apprenticeships in midwifery, and recruiting internationally trained midwives who could bring a wealth of experience and knowledge.
“It was positive that leaders were visible and approachable across all three maternity sites. Staff told us how supportive their managers were, and it was good to hear that the executive team regularly visited wards and helped with any issues brought to their attention.
“Staff were focused on providing the best possible care and we saw several examples of caring and kind relationships between staff and people using the service. Staff from every role told us they felt valued and were treated as part of a greater team.
“We will continue to monitor the trust, including through future inspections, to ensure the necessary improvements are made so people and their babies can receive safe and appropriate care.”
Commenting on the report, Jill Foster, Chief Nurse at NCIC said: “Maternity services across the country are under intense scrutiny following recent tragic events. Maintaining a rating of ‘good’ is a great achievement by the team and I am very proud of them.
“The safety of women and birthing people and their children is of the highest importance to us all and we welcome the fact that the CQC has highlighted some areas where we can make further improvements to make sure we deliver safe high quality care every time.
“We are already acting on those recommendations because we want learn and continually improve our services for women and birthing people in north Cumbria.
“We know we have the strong leadership in place to make those improvements, with the CQC continuing to rate our Maternity teams as ‘good’ for ‘well-led’ in Carlisle and Whitehaven and upgrading the team at Penrith to ‘good’.
"It is great that our leadership team were recognised for their skills and abilities as well as their role in supporting staff to develop their careers.
“I was also pleased to note that staff feel respected, supported and valued which is so important in creating an open culture and delivering excellent care.
“The importance of listening to people who use our maternity services cannot be underestimated. We have a close working relationship with our local Maternity Voices Partnership who have had input into our strategy and vision.
“We are proud of our team for the dedication, professionalism and caring attitude that they show each day which was also reflected in the results of the CQC’s national maternity survey last year when NCIC scored higher than the national average when rated by women and birthing people”
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