During this inspection we inspected the inpatient maternity and midwifery services. We visited the in patient wards providing antenatal and postnatal care and the labour ward including induction and day unit. We spoke with three mothers and their partners about their experiences and care they had received. All were very positive and felt they had been consulted and involved in treatment decisions. They were happy with the care they had received and felt that staff had been available when they were required. Staff working on the wards and labour ward said they usually had enough time to meet people’s needs. Records of care provided on the postnatal ward and discussion with labour ward midwives and medical staff showed that people were receiving appropriate care.

The inspection lasted one day and one inspector was accompanied by a clinical advisor with specialist knowledge and experience in maternity services.

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.