Royal Bolton Hospital maternity unit must improve, report says

Staff supported women to understand and make decisions about their care, inspectors said

The maternity unit at the Royal Bolton Hospital has been told to improve by inspectors following a "deterioration" in standards of care.

Issues around staffing meant the birthing centre was frequently closed, the Care Quality Commission (CQC) said.

However, it did find staff supported women, families and carers to understand and make decisions.

The unit has been downgraded from good to requires improvement overall following the inspection in November.

It has also dropped from good to requires improvement for being safe and well-led, but recent management changes "had started to make some improvements", the CQC said.

A Bolton NHS Foundation Trust spokesman said it was "already on an improvement journey to make sure we are providing the very best care to everyone".

'Workforce gaps'

The watchdog did not inspect how effective, caring and responsive the service was on this visit, so they all remain rated as good from the previous inspection.

Inspectors found:

• The unit provided mandatory training in key skills, however, did not always ensure everyone had completed it

• The service did not always manage safety incidents well as there was a backlog of incidents awaiting review

• Staff did not consistently complete checks of specialist equipment

However:

• Staff assessed risks to women and birthing people, acted on them and kept good care records

• Leaders and staff actively and openly engaged with women and birthing people, staff, equality groups, the public and local organisations to help plan and manage the services the trust were providing

Carolyn Jenkinson, deputy director of secondary and specialist healthcare, said: "We found a deterioration in the standard of care being provided across the areas we looked at."

She said "issues around staffing levels" led to "frequent closures of the birthing centre and midwifery-led hospital unit" which "reduced the birthing options available".

Ms Jenkinson added: "Additionally, during the inspection one of the postnatal wards was closed due to staffing issues, which caused delays transferring people from the labour ward.

"This situation was regularly assessed by leaders who moved staff around to ensure women and birthing people received appropriate care."

Tyrone Roberts, chief nursing officer at Bolton NHS Foundation Trust, said it had been a "difficult couple of years" and "like other NHS organisations, we are experiencing challenges when it comes to addressing workforce gaps in maternity services".

"The CQC highlights the areas we already knew needed improving and this will enable us to accelerate our plans.

"We have a new leadership team who all share the same exciting vision and commitment to make the changes needed to create an outstanding service," he added.

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