Northern Devon Healthcare NHS Trust has been told by health watchdogs it must make significant improvements in quality and safety. The trust has been rated as requires improvement by the Care Quality Commission (CQC) following an unannounced visit by inspectors in October. Following the inspection the CQC identified 21 areas where the trust needed to improve, including maternity, outpatients and urgent and emergency care. The report, published today (Tuesday) found staff at North Devon District Hospital (NDDH) were caring and ranked that category as good overall, but the safe, effective, responsive and well-led categories were all rated as requires improvement. Across the clinical categories, NDDH did score good in 25 areas, with one outstanding. Trust director of nursing Darryn Allcorn said the facts of the report were disappointing, but the trust had already taken quite considerable steps to deal with the areas identified. The last inspection in 2015 also left the trust with a requires improvement rating but this time around saw effectiveness and leadership downgraded from good. Inspectors raised concerns about maternity, where staff were not always following best practice, resulting in cases where a baby had come to harm. READ MORE: Northern Devon Healthcare Trust told it must keep improving They also criticised the cleanliness of majors in A and E and said the management of sepsis was poor, with antibiotics delivered to only 23 per cent of cases within an hour of diagnosis. In outpatients, people waiting for ophthalmology appointments were not always receiving the treatment they needed in time, with serious long term consequences for some of them. The Chief Inspector of Hospitals, Professor Ted Baker, said: It is disappointing to report that all four core services that we have inspected remain in need of improvement and in some cases we have found the same concerns that we had raised during our inspections in 2014 and 2015. **** Read the full report here **** Although the staff working at North Devon District Hospital are invariably caring and conscientious, I have serious concerns about the quality of some services. Mr Allcorn told the Gazette: What we can do is give assurance that we will be working with the teams exceptionally hard to ensure that we improve the areas the CQC has identified and can assure patients that the services we provide are safe. There are other areas in the report that have significantly improved, in our A and E department and within our end-of-life service. We are exceptionally proud of the staff in terms of their commitment and dedication and the fact that the report recognises that across all areas there are good ratings across the board including outstanding for medical care.