Hospital did not have enough midwives to keep women and babies safe – msnNOW

Peter Byrne/PA Inspectors found 21 incidents affecting 13 patients during their visit to the Countess of Chester Hospital maternity unit - Peter Byrne/PA

An NHS hospital did not consistently have enough midwives to keep women and babies safe, a watchdog has found.

An unannounced inspection was carried out of the Countess of Chester Hospital in February and March by the Care Quality Commission (CQC), Englands regulator of health and social care.

In its report on Wednesday, it found the NHS trust requires improvement and served the trust with two warning notices requiring it to make urgent improvements.

The inspection looked at medical care, surgery, maternity, urgent and emergency services and how well-led the trust was, in response to concerns about the quality of care in certain areas.

It also found the effectiveness of the trusts leadership and the safety of its maternity service had worsened, with the maternity wing dropping from good to requires improvement since the last inspection in 2016.

In midwifery, the CQCs report found the service did not have enough maternity staff with the right qualifications, skills, training and experience to keep women safe from avoidable harm and to provide the right care and treatment.

Lack of staff was identified as the most reported incident in the maternity department last year, meaning the service did not consistently have enough midwifery staff to keep women and babies safe, inspectors found.

The report identified that women did not receive 1:1 care when in established labour and the antenatal and postnatal ward [Cestrian ward] did not have a ward manager at the time of our inspection.

During inspection we noted only one midwife on the ward on three separate occasions, the report added.

Maternity services should have the capacity to provide women in established labour with supportive one-to-one care, according to guidance from NICE, the National Institute for Health and Care Excellence.

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Inspectors also found 21 incidents affecting 13 patients during their visit to the Countess of Chester Hospital maternity unit.

The CQC report said: Five of the patients required an unplanned hysterectomy with an unplanned return to theatre. One of these was classified as severe harm, two classified as moderate harm and two classified as no harm in relation to an unplanned hysterectomy.

This meant that the trust could not be assured that it recognised and addressed incidents that were significant.

The service had not consistently reported incidents to external stakeholders. The Care Quality Commission were only made aware when a whistleblower contacted us.

Karen Knapton, CQCs head of hospital inspection, said: While we found kind and caring interactions from staff to patients across the services we inspected, the trust has work to do to ensure people consistently receive the safe and effective care they have a right to expect.

This was particularly evident in its maternity service, which we rated inadequate due to issues including a lack of staff and suitable equipment to keep women and babies safe.

The trust didnt learn from safety incidents to avoid them happening again and while some reviews were taking place, they werent effective in ensuring safe care and treatment in this service.

Medical care, surgery and urgent and emergency care had enough staff, but some lacked the training for their roles, and poor management of patient records increased the risk of people coming to harm.

She added: Since the inspection, the trust has started to address the issues we raised. Its also receiving additional support from NHS England and NHS Improvement to make improvements. We will continue to monitor the trust closely and will inspect it again.

Dr Susan Gilby, chief executive at the trust said: The CQCs report identifies a number of key areas for further improvement and development that are required at the trust, as well as recognising the work which has taken place to embed a culture of compassionate care and treatment across the trusts services.

The report illustrates where more progress must still be made to ensure the trust can provide the highest quality of treatment to the local community, which we are committed to delivering.

In our maternity department, we have implemented and are continuing to develop measures to ensure we can consistently provide patients with the safe and effective care they have a right to expect.

Despite unprecedented pressure, the trusts urgent and emergency services were able to maintain a good performance in terms of its provision of effective and caring treatment, which is a testament to the professionalism and commitment of our staff.

We are now working hard across the trust to implement the CQCs recommendations, so we can continue to make improvements and deliver increasingly high-quality care to our communities in the future.

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Hospital did not have enough midwives to keep women and babies safe - msnNOW

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