- NHS hospital
City Hospital
Report from 21 November 2024 assessment
Ratings - Maternity
Our view of the service
Date of the on-site assessment was between 5 June to 28 June 2024. This assessment was in response to CQC receiving information of concern. Following the assessment, we issued the service with a Section 29A Warning Notice telling them they were required to make significant improvements regarding the quality to healthcare to ensure the trust took immediate action to keep women, birthing people and babies safe. Following the assessment the trust provided us with an action plan in relation to the concerns we raised. During our assessment we found opportunities for learning were not always recognised or embedded, staffing and skill mix was not in line with good practice and the service was an outlier for perinatal loss. Staff reported previous instances of bullying, and some found senior leaders were not visible or approachable. Additionally effective governance processes were not always in place. However, the service sought patient feedback and looked at ways they could use it to improve. Risk factors were recorded in patient records and the equality and diversity team had carried out a lot of work. The service ran specialist antenatal clinics based on maternal need, carried out improvement projects and benchmarked themselves against other hospitals. Many staff were complimentary about their immediate line managers and Freedom to Speak Up processes were in place. There was a midwife in place for equality, diversity and inclusion and another for risk and governance.
People's experience of this service
During our assessment we spoke to women, birthing people, and families throughout the maternity service. They reported some delays in care, people told us the areas were busy and staff were working hard to meet everyone’s needs but noticed that the wards were understaffed. Birthing people and their families had access to a communal kitchen area, showers, and bathrooms. Families reported the antenatal bay’s felt crowded, and noisy. People told us that they felt able to raise concerns to maternity staff and felt they were dealt with promptly. Most women and birthing people told us they felt informed about their care, included in decision making and provided appropriate maternity information; although one told us she was not aware of what procedure she had undergone as this had not been communicated. Some told us they felt their birth plan was not considered. At times interpreters were booked, language line was used but some were asked to bring a family member to translate. Some women and birthing people told us their induction of labour or artificial rupture of membranes management had been delayed due to lack of staff and beds on the unit. In triage we were told they had experienced delays waiting for doctors to review their care. We were unable to seek perspectives from families who were given bad news in triage. Friends and Family positive themes included staff attitude and implementation of care, negative themes included staff attitude, communication, environment and implementation of care.