Stroud Maternity Unit CQC Inspection Report Published

The CQC inspected the maternity service at Stroud as part of their national maternity inspection programme, which aims to give an up-to-date view of hospital maternity care across the country and help understand what is working well to support learning and improvement at a local and national level.

Stroud Maternity Unit (SMU) includes a birth centre, antenatal clinic, and conservatory area where additional support services are provided. The focused inspection of the maternity service examined only the safe and well-led domains within the regulator’s framework.

Stroud was previously inspected under the maternity and gynaecology framework in 2015, however, this was changed in 2018 and as a result, the historical rating and inspection are not comparable. This means that the resulting rating for Safe and Well-led from this inspection will be the first rating of maternity services for the location and does not affect the overall Trust level rating.

CQC rated Stroud Maternity Unit as requiring improvement, this is due to:

• Compliance for safeguarding training was low, staff did not always ensure equipment was safe and ready for use and medicine management was poor;
• Staff did not always complete risk assessments or follow policy to ensure women and birthing people were suitable for care and birth, and documentation was not contemporaneous;
• There was an ineffective governance process and oversight, and leaders did not always manage risk and manage safety incidents well;
• Leaders did not always use reliable information to evaluate and run the service;
• There was limited engagement with the team and community to review and develop the model of care and services provided.

However, the CQC noted that:

• Staff had training in key skills and controlled infection risk well;
• The team at Stroud Maternity Unit worked well together for the benefit of women and birthing people and were passionate about the philosophy of the unit.

Following the CQC inspection, the team have strengthened processes around medicines and the checking of equipment. They have also ensured that routine data collection is in place for the 36-week place of birth assessment, helping mums to be guided to the best place of care for them and their babies.

The team are grateful to the Stroud Hospitals League of Friends, for their support and work with staff, mums and families in co-designing additional services, including free singing and yoga for mothers and babies as well as groups to give practical and emotional support, as well as companionship to new mothers.

We are determined that this report will provide further momentum to address the issues identified and are working hard to engage and involve staff and local communities to improve our services.

The Trust expects the CQC to re-inspect the service soon and will be working with colleagues and partners to obtain an improved overall rating.

Read the report on the CQC website

Stroud postnatal beds

The six postnatal beds have been temporarily closed since September 2022 and midwifery staff have been centralised at the Gloucestershire Royal Hospital to ensure safety, and one-to-one care in labour and birth. Stroud Maternity Hospital remains open for labour and birth and the community midwifery service is unchanged.

The Trust welcomed the opportunity to meet with key partners in February 2024, to discuss the challenges facing maternity services. Although good progress has been made in terms of recruitment, there is still more to do to ensure safe staffing levels are achieved to enable the reopening of post-natal beds in Stroud. The Trust continues to work openly with partners and staff on long-term, sustainable solutions.

“The inspection highlighted a number of areas where we need to focus our work, and we have already taken steps to ensure better process are in place to address them. The CQC noted that safeguarding training compliance needed to improve, and the service is on track to achieve this by April 2024. This also forms part of our wider maternity service priorities.

The Trust appointed a consultant midwife last year, and she is working with the midwifery matrons and staff on a transformation programme across all three birth units in Gloucestershire. Risk assessments and medicine checks are included within that work.

Lisa Stephens, Director of Midwifery