CQC publishes report on maternity services at Mersey and West Lancashire Teaching Hospitals NHS Trust

The Care Quality Commission (CQC) has published a report following an inspection of the maternity services at Whiston Hospital and Ormskirk District General Hospital run by Mersey and West Lancashire Teaching Hospitals NHS Trust in December.

The inspection 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.

Following the inspection, the maternity services have been rated as follows:

• Whiston Hospital - good overall and for being safe and well-led
• Ormskirk District General Hospital - good overall and for being well-led. It has been rated requires improvement for being safe.

This was a focused inspection, so CQC didn't rate how effective, caring and responsive the services were.

The trust rating has not changed following the inspection and remains rated as outstanding overall.

Carolyn Jenkinson, CQC's deputy director of secondary and specialist healthcare, said:

"When we visited the maternity services at Whiston Hospital and Ormskirk District General Hospital, it was encouraging to see leaders had the skills and abilities to run the services However, at Ormskirk District General Hospital, they didn't always use those skills to understand or manage the priorities and issues they faced, and we found a differing level of leadership at both hospitals as a result.

"At Ormskirk District General Hospital, leaders needed to do more to improve safety. The waiting and triage areas are not set up in a way that enables staff to prioritise people with urgent needs. The space was easily filled by people with less urgent issues, and staff didn't have a line of sight into all areas. This placed people at risk of staff not noticing if someone's condition was deteriorating while they were waiting.

"People's experiences at Ormskirk District General Hospital were generally good, and it was great to see leaders listening to and acting on feedback. For example, people staying on the maternity ward at the hospital had told the trust it could be too loud, so they installed. a device to measure sound levels. They also encouraged people to keep noise at an appropriate level for the benefit of parents and their newborn babies.

"However, we found managers investigated incidents thoroughly and shared learning with their staff to try and stop them from happening again. We found staff had also involved women, people using the service and their families in the investigations and even shared draft reports with the families for comment.

"It is clear that staff and leaders are compassionate and working hard however, we've told the trust where we expect to see improvements, especially in safety. We will continue to monitor both services going forward, while those improvements are happening to ensure women and people using the service receive the safe care they have a right to expect."

At Whiston Hospital inspectors found:

• Staff had training in key skills and worked well together for the benefit of women and people using the service
• Staff understood how to protect people from abuse, and managed safety well
• The service controlled infection risk well. The environment was suitable, and the service had enough equipment to keep people safe
• The service had enough midwifery and medical staff
• Leaders ran services well using reliable information systems and supported staff to develop their skills
• Staff felt respected, supported, and valued
• The service staff engaged well with people using the service and the community to plan and manage services
• People could access the service when they needed it and did not have to wait too long for treatment
• All staff were committed to improving services continually.

However:

• Staff did not always complete baby observations
• Not all epidural medicines were recorded in line with trust guidance.

At Ormskirk District General Hospital inspectors found:

• The service controlled infection risk well
• The service had enough emergency equipment to keep people safe
• Staff were committed to improving services continually
• Staff felt respected, supported, and valued. They were focused on the needs of people receiving care
• The service engaged well with people using the service and the community to plan and manage services
• The service managed safety incidents and learned lessons from them.

However:

• The service did not always deploy staff effectively to meet the needs of the service
• Staff did not always document and use risk assessment tools effectively. There was a risk that staff would not recognise signs of deterioration
• Some equipment and facilities such as delivery beds and bathrooms had become old and were not fit for purpose
• Leaders did not always operate effective systems. They did not consistently monitor the effectiveness of the service.

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