Maternity unit improvements 'need to be embedded'

Improvements made at a hospital maternity unit need to be "embedded and sustained", inspectors have said.

The Care Quality Commission (CQC) said maternity services at the James Paget Hospital, in Gorleston, had progressed from "inadequate" to "requires improvement", but more needed to be done.

The findings of the September inspection mean the overall rating of the hospital, which provides maternity services to people in east Norfolk and north Suffolk, has risen from "requires improvement" to "good".

Jonathan Gardner, executive managing director, said he was pleased the "commitment to putting the needs of mothers, babies and families at the core of our maternity services have been recognised".

Inspectors found the service, since it was last inspected in 2023, had a fully established leadership team following a period of instability.

Staff told inspectors that senior leaders were "open to listening and making change" and were "a complete change to previous heads of midwifery".

But it added that some staff felt changes were made without assessing how it would impact wellbeing and workload.

Its safety rating was noted as "requires improvement" due to staff not managing patient paper records safely.

It said it found loose documents in two of 11 patient records that either lacked patient details or contained important safeguarding information on the reverse of a patient sticker for monitoring testing.

It did find that managers investigated incidents thoroughly and there was enough safe equipment.

The service was also rated as "required improvement" in the "well-led" category.

Inspectors found that "the culture within the service had improved" but a "small pocket of dissatisfaction" remained - although there were systems were in place for staff to raise concerns.

At the 2023 inspection it found there were not sufficient numbers of staff to "keep women and babies safe" but in September the number of staff matched the "planned numbers in all areas".

It did find there was only one midwife in triage which "potentially put women at risk of not being assessed quickly enough".

It also found there was no dedicated telephone triage midwife in place, meaning women seeking advice during busy periods could face delays in getting through.

Comments from patients said "they have done everything I need", "they have been great" - and described staff as "amazing" and "very helpful".

Gardner added that the hospital would focus on "additional actions" to continue to improve.

Prof Lesley Dwyer, chief executive of the Norfolk and Waveney University Hospitals Group, said: "While there is more to do, these improvements see the service on a solid improvement trajectory with the right leadership, skills and resources in place to be confident of delivering high quality care for the local community."

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