Mixed report as North Devon’s maternity services rated as ‘requires improvement’

The maternity unit at North Devon District Hospital remains with a rating of requires improvement following a snap inspection by health watchdogs.

Care Quality Commission (CQC) inspectors did praise some of the Barnstaple-based service, including short waiting times, supportive leadership and good engagement with women and the community.

But their short notice inspection in November did also find issues with staffing levels, which they said didn’t always match planned numbers and ‘put people at risk of harm’.

The inspection covered two categories: how well led the North Devon service is, reduced to ‘requires improvement’ from a rating of ‘good’ and how safe, which remains as requires improvement.

It is still rated as ‘good’ for caring, but ‘requires improvement’ for the effective and responsive categories, not covered during this inspection.

There was also concern leaders did not have good systems to manage issues and risks, plus medicines weren’t always stored or managed effectively.

The inspection found records were unclear if the service had been open and transparent with patients when things went wrong and the service also hadn’t carried out a recent drill exercise for baby abductions – required by national guidelines.

The CQC report published today (Friday, March 15) also revealed maternity services at the Royal Devon & Exeter Hospital, also run by Royal Devon University Healthcare NHS Foundation Trust, had been rated as ‘requires improvement’.

The inspection was part of the CQC’s national maternity inspection programme and reviewed two aspects of the service: safe and well led.

It did not cover the categories of how effective, caring and responsive the services were.

In the report, there are common themes of improvement required at both NDDH and RD&E. These include triage, training compliance, cleanliness, record-keeping, and management of risk and performance.

In North Devon, inspectors did praise several aspects, including that people were able to access the service when they needed to and didn’t have to wait too long.

They said infection risk was well managed, with a suitable environment and enough equipment to meet the needs of women, people using the service and their babies.

They also said it engaged well with women and the community, with outpatient hubs in different areas to support community needs.

Carolyn Jenkinson, CQC’s deputy director of secondary and specialist care said: ““We had a number of specific concerns with North Devon District Hospital, including around triage, incident reporting, and how leaders were auditing the service.

“Staff didn’t always risk assess people through telephone triage or on arrival using a standardised method. The service relied on individual clinical judgement to remove or minimise risks to people giving birth rather than supporting staff with good processes.”

But she added: “Maternity staff across the trust told us leaders were visible and approachable. They also encouraged feedback from women, people using the service and their families. Leaders should be proud of creating an open culture where people are able to raise concerns without fear and be listened to.”

Sam Higginson, Royal Devon trust chief executive, said they used all feedback as an opportunity to improve services.

He added: “We are of course disappointed with the outcome, however we feel the reports provide a constructive and comprehensive sense of the areas we must target for improvement to ensure we meet the needs of women and birthing people and their babies in North and East Devon.

““We are pleased that a number of strengths have shone through and we will build on these as we work together with our colleagues, patients and partners to improve our services.”

You can view the full reports for North Devon HERE and the RD&E HERE