The Care Quality Commission (CQC) regraded services at Worthing Hospital, run by University Hospitals Sussex NHS Foundation Trust, from requires improvement to good, following an inspection in February last year.
The CQC said the inspection was carried out in response to ongoing concerns about the service and to follow up on improvements the CQC told the trust to make at previous inspections.
Inspectors found that there had been improvements since the previous visits; however, some breaches of regulations were identified relating to safe care and treatment and the effectiveness of departmental management, which they said has negatively impacted on other key question ratings.
Following this latest inspection, the CQC has upgraded how well-led the service is from requires improvement to good. Safe is re-rated as requires improvement. Caring is re-rated as good. Responsive and effective were not rated at the previous inspection and are rated as good.
The overall rating for Worthing Hospital remains rated as requires improvement.
The Sussex service is also part of the national Amos review which is reviewing maternity care at a number of trusts with a view to making recommendations as to how services can be strengthened across the country.
Inspectors said concerns included the failure of leaders to ensure staff had access to up-to-date guidance, allowing many policies to remain “significantly overdue” for review, including the labour induction policy. As a result, staff may have delivered care using outdated processes or procedures.
They said the department failed to identify and mitigate ligature risks in some areas, leaving people at risk of self-harm or suicide without adequate protection.
And they found the department did not routinely carry out or embed audits and had no audit schedule in place. For example, leaders did not audit sepsis cases, meaning they lacked data on case numbers and actions taken. There were also major concerns that the hospital only has one dedicated obstetric theatre for planned and emergency caesarean sections.
The trust said these areas are in the process of being addressed.
More positively, inspectors said the service ensured there were enough experienced staff to deliver safe care and recently introduced maternity nurses, easing pressure caused by midwifery vacancies.
The praised staff for using daily huddles and structured handovers to maintain continuity of care and sharing information across teams, so people only needed to tell their story once.
They said staff actively supported women to improve their overall health, displaying posters to encourage smokers to switch to vaping and running wellbeing clinics that offered healthy eating advice.
They also found that the service provided a dedicated bereavement suite where women and families could spend time with their baby after a death, including access to specialist equipment such as cold cots that allowed families to stay with their baby for several days.
Staff had developed thoughtful initiatives like ‘hope boxes’ for women who would be legally separated from their babies after birth. These contained items from the baby and mother.
Amanda Williams, CQC deputy director of hospitals, secondary and specialist care in Sussex, said: ”When we inspected Worthing Hospital’s maternity services, we saw staff working hard to support women throughout their pregnancy journey. The service offered specialist midwives for mental health, bereavement and safeguarding, and provided 24/7 access to emergency mental health support.
“Leaders have worked to create a more positive culture where staff feel confident to speak up and share ideas. The trust appointed an independent freedom to speak up guardian, and staff told us they now feel safe raising concerns with managers. This open approach helped the service learn and improve continuously, making care more effective and responsive.
“The service worked closely with the local Maternity and Neonatal Voices Partnership to make sure women’s voices shaped how care was delivered. Women told us they felt involved in decisions about their care and didn’t feel anxious about raising concerns. Feedback surveys consistently showed above 90 per cent positive feedback.
“However, we found some areas where improvements are still needed, including more work required to improve policies and the trust’s audit programme. There was also only one dedicated obstetric theatre for planned and emergency caesarean sections where national guidance requires two. This meant if two women needed an emergency caesarean at the same time, one of them would have to be transferred elsewhere and their emergency treatment could be delayed.
“We have asked the trust for an action plan to address some of the concerns we found during our inspection and we’ll continue to monitor the service to ensure ongoing improvements continue and women are safe while this happens.”
Dr Tim Taylor, chief of service for the women and children’s division at the trust, said: “We welcome the CQC’s recognition of the improvements made to maternity services at Worthing Hospital. We know we have made great strides to improve maternity services in recent years, but it is really encouraging to have that improvement recognised by the CQC as well.
“Our teams work extremely hard to give people safe, compassionate care – I hope that they welcome this new rating as a recognition of the huge amount of the commitment and compassion they offer every day. And I hope that local families feel encouraged that the service they rely on is working to such a high level.
“We never lose sight of the utter devastation that families face if a baby is lost and so the work to improve is never over – we must keep trying to be better.
“We are committed to building on the progress made at Worthing, and to listening to families, including through our work with the Sussex National Maternity Voices Partnership. We need to ensure future improvements are shaped around the needs of the people who use our services.”
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