The Care Quality Commission (CQC) has upgraded the rating of maternity services at Salisbury District Hospital, from requires improvement to good, following an unannounced inspection in September.
Inspectors visited the maternity services, run by Salisbury NHS Foundation Trust, due to concerns CQC had received about culture, poor care, low staffing and poor performance. CQC found these concerns to be unsubstantiated.
As well as the overall maternity services rating improving from requires improvement to good, so has the safety rating. How well-led the service is, has improved from inadequate to good. Effective, responsive and caring remain rated as good.
The overall rating for Salisbury District Hospital and Salisbury NHS Foundation Trust both remain rated as good.
Neil Cox, CQC deputy director of operations in the south, said:
“During our inspection of maternity services at Salisbury District Hospital, we found significant improvements in how well-led the service was. Our experience tells us that when a service is well-led, they’re more likely to meet people’s needs in the other areas we inspect which is what we found here.
“Staff told us there had been a huge change of the culture in the department and leaders now embodied the culture and values of the organisation. This support from leaders to staff was having a positive impact on people’s care.
“The service now had a strong safety culture, which was actively promoted in the department. Staff were open and honest when things went wrong, and they investigated incidents and shared learning to avoid them from happening again. As a result, we saw much safer care for women and babies.
“People were seen and triaged quickly by well qualified staff, and were involved in making decisions about their own care. We saw this reflected in the positive feedback people gave about the service. Women told us they felt safe and could raise concerns if they had any without fear of it impacting their care.
“Leaders had also taken steps to improve the physical environment at the hospital, which was now well maintained and met people’s needs. Additionally, we saw a significant improvement in staff retention which was also having a positive impact on people’s care.
“Staff should be proud of the improvements they’ve made, and we’ll continue to monitor the service to make sure these are embedded.”
Inspectors found:
- Staff reported incidents promptly and received feedback from leaders which was also shared to others. This demonstrated a strong safety culture.
- Staff understood duty of candour and were open and honest when things went wrong or could be a risk.
- The team met regularly to discuss and learn from service performance. Leaders took direct action to address identified risks.
- The team collaborated closely with the mental health team to support women who had experienced birth trauma. They offered dedicated support through a birth reflections service.
- Leaders took proactive steps to address staff challenges. This included implementing a twilight midwife role to ensure there was consistent care from 4pm until midnight.
- People were supported to raise concerns without fear of being treated negatively if they did so.
However:
- The trust needs to make sure people’s privacy and confidentiality is maintained on the day assessment unit as conversations and telephone calls could be easily overheard at the midwife station.
- Some women fed back that they had experienced delays and long wait times when waiting for an obstetric review, medical consultation or scan result.