The Care Quality Commission (CQC) has published a report on maternity services at Harrogate District Hospital, following an inspection in November.
The inspection at the hospital, which is run by Harrogate and District NHS Foundation Trust, was carried out as part of CQC’s national maternity services inspection programme. This will provide an up-to-date view of the quality of hospital maternity care across the country, and a better understanding of what is working well to support learning and improvement.
- During the inspection, they spoke with 20 staff members, and 9 patients. They reviewed 26 patient records and medicines charts and 10 policies.
- They ran a poster campaign during our inspection to encourage pregnant women and mothers who had used the service to give us feedback regarding care.
- Received 19 feedback forms from women, which were analysed to identify themes and trends
This is the first time maternity services at Harrogate District Hospital have been rated as a standalone core service. Previously, maternity and gynaecology services were inspected and rated together.
Following this inspection, the overall rating for maternity services has been rated as requires improvement. It has also been rated as requires improvement for being safe. Well-led has been rated as good. Effective, caring and responsive were not looked at during this inspection therefore remain unrated.
The overall rating for Harrogate District Hospital remains rated as good.
Sarah Dronsfield, CQC deputy director of operations in the north, said:
When we visited maternity services at Harrogate District Hospital, we found staff were focused on the needs of those receiving care, and people could access the service when they needed it, but several improvements were needed across the department.
On ward areas, inspectors found staff completed and updated risk assessments for women and birthing people and took action to remove or minimise risks. However, there was no clear system in place to identify or prioritise risks to people in the maternity assessment area which could have resulted in them coming to harm. However, following the inspection an action plan has been developed by the trust to show what improvements they plan to make.
Although staff understood how to protect women and birthing people from abuse, they didn’t always have training on how to recognise and report abuse which could put people at risk of harm and must be addressed.
The trust leadership team know where improvements are needed and we will continue to monitor the service, including through future inspections, to ensure women and birthing people are receiving the high standard of care they deserve.
Inspectors found the following:
- Compliance with appropriate safeguarding, life support training and medicines management did not meet targets, however there was a plan in place to improve this. Regular checks on life saving equipment were not always completed.
- Medical staffing numbers were not always sufficient, however there were mitigating actions in place.
- Information systems were not always appropriate for the service, however, there was a plan in place to improve this.
- Governance processes were not always robust and there was limited embedded audit in the service.
- Staff assessed risks to women and birthing people in most areas, acted on them and kept good care records.
- Managers monitored the effectiveness of the service and made sure staff were competent for their role.
- The service engaged well with women and birthing people and the community to plan and manage services.
Jonathan Coulter, Chief Executive at HDFT said:
With such positive findings in the CQC report it is difficult to understand the resultant rating change and we do not feel it is a fair reflection of the maternity service we provide. The report describes a maternity unit which is fully staffed, with a positive culture, with staff that are competent, listen to women and are always seeking to improve. We are proud of our team for the dedication, professionalism and caring attitude that they show each day whilst supporting those in our care. We are disappointed the rating applied to the service overall and for the safe domain does not appear to reflect the findings in the report.
Whatever the rating in this report, our response will be to focus on learning and improvement, as it is for any external or internal service review. As part of this focus on continually improving our services, we prioritise listening and learning to ensure we can provide the high quality care that our patients deserve. Listening to people who use our maternity services is so important, as we completely understand that peoples’ experience can differ. This is why, in addition to our own improvement work, we work in partnership with our Maternity Voices Partnership who provide another valuable way for us to hear the needs of those using our services.
Jen Baldry, Independent Maternity Voices Partnership (MVP) Chair, said:
We have a passionate and active group of people who work together to create Harrogate Maternity Voices Partnership. We recognise that the MVP is an essential tool for ensuring the maternity services provide the care that service users require by listening to women, birthing people and their families. We receive a lot of positive feedback from our community who praise the care they have had in the maternity department. We will continue to work collaboratively with the Trust to drive continuous improvement. We will take the feedback from the CQC report to help shape the work we do going forward.
Emma Nunez, Director of Nursing, Midwifery, and AHPs at HDFT said:
We recognise that families may have concerns when they see the rating from the CQC. We would ask anyone who has questions following the publication of the report to contact us, so that we can discuss any concerns and provide reassurance and information to them of the quality of care provided within the unit.
We would also of course welcome the CQC back into the unit at any time, so that they can see the level of service that we provide here in Harrogate.