4 & 5 April 2023
During a routine inspection
Furness General Hospital (FGH) is one of three hospital sites of University Hospitals of Morecambe Bay Foundation Trust’s and is one of the two main hospital sites. It serves the population of Furness and the surrounding areas in South Cumbria with consultant led maternity services.
At Furness General Hospital the maternity department consisted of one ward of 14 en-suite rooms where obstetricians and midwives provided antenatal, intrapartum, and postnatal care. Two maternity theatres adjoined this area and a specialist bereavement suite, a separate antenatal clinic and day assessment area. There was also a triage area on the birthing ward with trained rotational midwives providing cover.
Around 2,800 babies are delivered within Morecambe Bay Maternity services per year.
We carried out this unannounced comprehensive maternity inspection because at our last inspection we rated the service overall as inadequate. The trust was receiving mandated support as it was placed in SOF4 by NHSE. It was also in receipt of mandated maternity support.
Details of our last inspection on 20 April 2021 and the actions taken were published on 20 August 2021 and can be accessed on our website.
Our rating of this location improved. We rated it as requires improvement because:
- The service had enough staff to care for women and keep them safe. Most staff had training in key skills and understood how to protect women from abuse. Staff managed safety well. Staff assessed risks to women, acted on them and kept good care records. The service managed safety incidents well and learned lessons from them.
- Staff provided good care and treatment, gave women enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Key services were available seven days a week.
- Staff worked well together for the benefit of women, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
- Staff treated women with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to women, families and carers.
- The service planned care to meet the needs of local people, took account of women’s individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
- Leaders had improved information systems and supported staff to develop their skills. Staff were focused on the needs of women receiving care and were clear about their roles and accountabilities. The service was improving engagement with women and the community to plan and manage services. All staff were committed to improving it.
- Leaders had identified and acted on cultural issues where not all staff felt respected or valued.
- The service used systems and processes to administer and document medicines safely.
However:
- Women receiving maternity care, who were assessed as at risk of sepsis, did not always follow the required care and treatment pathway in line with national guidance and antimicrobial medicines were not always prescribed appropriately.
- The was no documented prioritisation of women requiring an induction of labour and there were delays in accessing fetal anomaly referrals. Staff did not always follow best practice guidance when monitoring the fetal heart rate and followed out of date emergency protocols.
- Medical staff mandatory training including safeguarding compliance had not improved since our last inspection and staff did not know or understood the service’s vision and values, or how to apply them in their work.
- The service did not always control environmental infection risk well or remove equipment when out of service. There was not always enough blood pressure monitoring equipment.