A HEALTH watchdog has highlighted its key reasons for rating a maternity unit 'inadequate' twice in one year.

Basildon Hospital's maternity unit has faced criticisms from the CQC and told to make improvements.

Here are some of the key reasons why they have reached the verdict.

Mothers not always shown compassion

Maternity staff did not always treat women with compassion and kindness.

But inspectors found staff did respected their privacy and dignity, and took account of their individual needs.

Inspectors observed two uncaring face to face interactions with women and their partners and one telephone interaction between a member of staff and a woman.

In these incidents, inspectors said that staff did not interact with women who used the service and those close to them in a respectful and considerate way.

There were curtains in the rooms and ward areas and staff knocked before entering to ensure privacy for expecting mums.

Infection risks present

The unit did not always control infection risk well, the care quality commission said.

Staff did not always use equipment and control measures to protect women, themselves and others from infection.

This included three members of midwifery staff seen not wearing face masks properly, and immediate action was taken. The equipment and the premises were kept visibly clean.

Not enough staff with necessary qualifications

There was not always enough maternity staff with the right skills to keep women safe.

This meant that women were at risk of avoidable harm, but the watchdog stated to mitigate the risks, managers would regularly review and adjust staff levels and skill mix, with agency staffing given full inductions.

As of August, the trust reported an overall vacancy of 29.59 whole term equivalent, equating to 14.6 per cent of qualified midwifery staff in maternity.

Vacancy rate has continued to increase despite the trust recruiting 20 whole term equivalent midwives since June. From June to August, 16,013 hours were covered by bank midwives and 2,990 hours were covered by agency midwives.

No 'open culture' for staff

The maternity unit did not have an open culture where staff could raise concerns without fear, the watchdog said.

The report said: “It was evident that staff remained concerned about safety within the service.

“All staff we spoke with were very aware of the longstanding poor culture and safety concerns. Staff told us that some of the consultants and longer serving midwives poor behaviours continued.

“Staff told us some colleagues were not welcoming of new staff, judgemental and demeaning in front of women which was demoralising.”

Staff told the inspectors they could raise concerns with the senior leadership team, but that they did not see improvements.

Hospitals' trust response

The trust for the maternity unit has put in a host of measures have been put in place to improve - including better places for staff to rest and boosted numbers.

Ahead of Basildon Hospital’s urgent November 9 deadline to make changes, a duty manager for midwifery was put in place seven days a week, while a “freedom to speak up” guardian has been put in place for staff to raise concerns.

The urgent deadline was given before September’s inspection, which was published yesterday, with concerns raised about the spread of infection, staffing levels, and mothers not always been treated with compassion.

The trust say the staffing levels have improved and that regular announced and unannounced visits are made to get assurances and feedback to the changes.

The trust has also installed a new improvement director, and a director of midwifery, with extended on-site consultant cover and increased cover at night.

Thurrock Gazette:

Clare Panniker

Clare Panniker, chief executive for the trust, said: “We acknowledge and accept the care quality commission’s findings and have taken immediate action to make our services better for women and their families, which we are determined to continue.

“Our robust improvement plan includes introducing extra consultant cover, putting additional leadership in place to support staff, improving staffing levels and working more closely with expectant and new mums so we can deliver a service that meets their needs.”

A “civility saves lives” campaign has been set up to improve the multi-disciplinary team behaviours and working practices, previously described as “dysfunctional” by the watchdog.

The “Freedom to Speak Up” guardian is a direct result of some staff stating they felt could not raise issues without fear of reprisal.

There are more wellbeing spaces for staff to take breaks, and the governance systems have been overhauled and the maternity governance team has been strengthened.

The trust has also ensured the serious incidents management and related action plans are up to date and SI action plans by the end of September.