Homerton cleans up maternity department following health watchdog inspection

Chief Nurse Sheila Adam says women are welcome to visit the unit

A rope in a birthing room “stained and encrusted with blood and other body fluids”, a “visibly dirty” floor and blood on a radiator in the triage room were all issues highlighted to staff at Homerton’s maternity department during a surprise visit last March by a health watchdog

Care Quality Commission inspectors said when they returned on a planned visit one week after their initial and unannounced visit, the issues had still not been addressed.

In its report in August, the CQC cited the fact that the maternity unit reported a high number of serious incidents including five maternal deaths 2013-15.

But, as Adam points out, NHS England’s clinical senate investigated four of the five deaths. On 26 March, just days after the CQC inspection, the board of directors reported that the Senate found no single factor appeared to link the deaths.

Now every effort is being made to reassure women that the department is safe and clean.

Chief Nurse Sheila Adam claims the department is now much improved but is still waiting for inspectors to check on progress, despite having invited them back twice.

“The areas the CQC have picked up have changed completely,” she said. “There were places that were not clean.

“We’d missed things and we took that on board immediately and started daily cleanliness checks.”

The report found that the department “required improvement” – triggering the “amber” warning in the CQC’s traffic light system.

Meanwhile outpatients, end of life care, services for children and young people, critical care, surgery, and older people’s care were all rated ‘good’. The urgent care unit was rated ‘outstanding’.

New recommendations

Chief Nurse Adam said that, after the inspection in March, the maternity department began to audit whether staff converted observations about obstetric patients into a ‘risk score’ – something that inspectors found was not consistently done in the department.

Inspectors also told the staff that incident investigations should be completed in a timely manner and the findings put into practice. The department has since appointed a divisional operational director to oversee this.

Edward Baker, the CQC’s deputy chief inspector of hospitals, said: “The Care Quality Commission conducted an unannounced inspection in response to a series of maternal deaths and a number of concerns raised from a variety of sources, including the local clinical commissioning group.

“Immediately after the unannounced inspection, the CQC raised its most serious concerns with the trust.

“Although the hospital said it had addressed the majority of issues, including cleanliness of the environment and patient safety, inspectors were not satisfied they had been resolved when they returned one week later to complete the inspection.”

“Since our most recent inspection, we have continued to work very closely with the Trust and local commissioners to ensure that the necessary changes and improvements are being made.”

When asked what she would say
to women who felt anxious about being patients at the maternity department, Chief Nurse Adam said: “Have a chat with your GP or your midwife and be very clear about what your
concerns are. We’d always want to be able to offer them advice or the chance to ask questions. So please contact us and we’ll respond.”

Tours of the department are available to expectant mothers so they can check cleanliness meets their own standards.

“We’ve worked so hard to make it a very safe and hopefully a very pleasant – as much as childbirth can be pleasant – as good an experience as it can be.”

On 28 September, representatives from the CQC attended a “risk summit” with NHS England representatives from Homerton Foundation Trust to discuss progress.

For now, the CQC will continue to monitor progress over the coming months and will be inspect the hospital again – although no date is set yet.