St Mary's Hospital

Updated 14 December 2022

The Isle of Wight NHS Trust is an integrated trust that includes acute, ambulance, community and mental health services. Services are provided to a population of approximately 140,000 people living on the island. The population increases to over 230,000 during the summer holiday and festival seasons. St Mary’s Hospital in Newport is the trust’s main base for delivering acute services for the Island’s population. The maternity unit at the hospital comprises of a delivery suite, birthing pools, midwifery unit, a dedicated operating theatre, recovery area, antenatal and postnatal wards and a triage area. This is alongside the maternity clinics provided in an outpatients setting. From January to December 2021, there were 944 recorded births at the hospital.

We inspected the maternity service at St Mary’s Hospital, Isle of Wight NHS Trust as part of our national maternity inspection programme. The programme aims to give an up-to-date view of hospital maternity care across the country and help us understand what is working well to support learning and improvement at a local and national level.

During this inspection we spoke with 21 members of staff, both during the inspection and post-inspection. We spoke with the local Maternity Voice Partnership (MVP) lead, reviewed 7 maternity care records, spoke with and received feedback from 12 current and former women and partners and visited all areas of the maternity unit.

We will publish a report of our overall findings when we have completed the national inspection programme.

We carried out a short notice announced focused inspection of the maternity service, looking only at the safe and well-led key questions.

How we carried out the inspection

You can find further information about how we carry out our inspections on our website: https://www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection.

Updated 23 September 2021

Updated 23 September 2021

Updated 6 June 2018

Our rating of this service stayed the same. We rated it as good because:

• Staff understood how to protect patients from abuse and the service worked well with other agencies to do so.
• The service controlled infection risk well.
• Staff completed and updated risk assessments for each patient. They kept clear records and asked for support when necessary.
• The service had enough nursing and medical staff, with the right mix of qualification and skills, to keep patients safe and provide the right care and treatment.
• The service managed patient safety incidents well. Staff recognised incidents and reported them appropriately.
• The service followed best practice when prescribing, giving, recording and storing medicines. Patients received the right medication at the right dose at the right time.
• Staff gave patients enough food and drink to meet their needs and improve their health.
• Managers monitored the effectiveness of care and treatment and used findings to improve them. They compared local results with those of other services to learn from them.
• Staff of different kinds worked together as a team to benefit patients. Doctors, nurses and other healthcare professionals supported each other to provide good care.
• Staff understood how and when to assess whether a patient had the capacity to make decisions about their care. They followed the trust policy and procedures when a patient could not give consent.
• Staff cared for patients with compassion and provided emotional support to minimise their distress.
• The service took account of patients’ individual needs.
• People could access the service when they needed it.
• Service leaders had the right skills and abilities to run a service providing high-quality sustainable care.
• Managers across the trust promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.

However:

• Patients stayed longer on this critical care unit than was always necessary meaning mixed sex accommodation requirements were not always met.
• Seven day services were not fully established across all of the multi-disciplinary teams, although action had been taken which would develop the service to meet the seven day standard.
• Not all GPIC standards had been met in full however there were mitigations and plans in place to address the shortfall.

Updated 23 September 2021

Updated 23 September 2021

Updated 4 September 2019

Our rating of this service improved. We rated it as good because:

• There was strong, clear and visible clinical leadership that enabled the service to improve at pace. The end of life care and the specialist palliative care services were under one leadership of the integrated palliative and end of life care team. There was joined up working across the trust with a single point of referral and contact.
• Staff cared for patients with compassion and kindness and their dignity was respected and maintained. Staff were passionate about their vision and the improvements they wanted to make to benefit patients, their care and support.
• There were appropriate governance arrangements to monitor the service provision for all patients. There were action plans to address the shortfalls and monitoring systems to ensure continuous compliance to regulation.
• The trust assessed, monitored and improved the quality and safety of the services it provided. It undertook audits to assure staff consistently completed and reviewed evidence-based and end of life documentation. Data was collected from bereaved relatives and reported every six months and as a result, service improvements were identified.
• The trust had implemented safety systems. Staff completed and updated risk assessments for each patient. They kept clear records and escalated concerns when necessary.
• Staff were trained in safe administration of medicines via syringe drivers. There was now a structured training for their use and only staff who had completed their competencies could use the equipment.
• The lead clinician regularly checked and monitored that best practice was used to inform decisions about patient’s treatment and care. Wards were now monitored through unannounced inspection of their areas and were given feedback on their performance against the services strategy and vision.
• The trust planned and provided services in a way that met the needs of local people.
• Staff were aware of what constituted end of life incidents. The trust reported incidents relating to end of life care. There was a risk register to provide oversight of risks relating to end of life care that was monitored.

However:

• Key services were not available seven days a week.
• Staff did not always start patients who were known as end of life care onto the end of life care pathway, especially those in the last few days of their life, in a timely manner.
• There were delays in the transfer of deceased from wards to the mortuary.

Updated 14 December 2022

Updated 6 June 2018

We previously inspected outpatients jointly with diagnostic imaging so we cannot compare our new ratings directly with previous ratings.

On this inspection we rated the outpatients service as good because:

• People who used the outpatient services were kept safe from avoidable harm because there were suitable arrangements to enable staff to identify and respond to risks.
• There were sufficient numbers of staff, and they had been provided with safety training. Staff were further supported through service related policies and procedures in addition to evidence based professional guidance.
• Feedback from people using outpatient services, and those close to them, was continually positive about the way staff treated them.
• Services provided by the outpatient departments mostly reflected the needs of the local population.
• Most patients were able to access the service in a timely way, with many specialties in line with or close to the national averages in waiting times.

However:

• Outpatient services did not have clear, well-established and effective governance processes.
• Outpatient services did not have clear and effective systems for identifying risks, planning to eliminate or reduce them, and coping with both the expected and unexpected.

Updated 23 September 2021

Updated 8 April 2020

This rating is from the previous

comprehensive inspection. We did not

re-rate this service as part of this focused

inspection.

The staff had responded to issues raised in the warning notice served:

There was improvement in how staff assessed and responded to risk.

Some improvements with completion of records had been made, however there remained gaps in patient documentation.