Watchdog considered closing East Kent maternity unit at centre of baby deaths scandal
The CQC considered shutting the maternity unit at a Kent hospital, run by an NHS trust at the centre of a baby deaths scandal.
ITV News understands the health watchdog considered shutting the unit at the William Harvey Hospital in Ashford following the damning inspection.
The East Kent Hospitals NHS Trust has had its maternity services downgraded to "inadequate" with the health watchdog saying the quality of care has got worse.
Inspectors found that vital resuscitation equipment wasn't always easily accessible, day care facilities were "poor" and "chaotic", while some fire exit doors weren’t working properly.
The Care Quality Commission report follows unannounced inspections in January of the William Harvey Hospital in Ashford and the Queen Elizabeth the Queen Mother (QEQM) Hospital in Margate.
East Kent Hospitals NHS Trust says that staff are "determined to improve services for patients" and that a number of changes have already been made.
The trust was the focus of an independent inquiry which concluded last year that at least 45 babies died needlessly because of substandard care.
The CQC imposed a raft of urgent conditions on the two maternity units earlier this year.
Helen Gittos, who lost her newborn daughter Harriet at the QEQM in 2014, described the findings as "thoroughly damning".
"They have had so long to fix this. Here we are now, all those years later, and with all the help that has gone into supporting this trust, things have got worse not better."
The CQC's director of operations, Deanna Westwood, said: "Over the last few years we have monitored the maternity services at East Kent Hospitals University NHS Foundation Trust closely, and where we have found action is needed this has been made clear so that the trust knows exactly where it must make improvements.
"Yet despite this we still found concerns and it is extremely disappointing that this latest inspection found a further decline in the quality of care people were receiving.
"That is why we have used our urgent enforcement powers to require immediate improvements.
"In particular we identified concerns around the use of resuscitation equipment at both hospitals we inspected.
"Babies needing emergency resuscitation were taken to a resuscitaire device – however in some cases these were outside the labour room and in the corridor.
"This could potentially result in delays in vital care and treatment for newborns, as well as separation from the mother and an increase in the potential for babies to be mis-identified."
Explaining why the services have been downgraded from "requires improvement" to "inadequate", the CQC reports highlight a long list of issues.
At the William Harvey Hospital maternity unit, CQC inspectors found that staff did not always ensure a second opinion was sought; discharge delays were not monitored; triage and day care facilities were poor; doors in the labour ward would not close automatically in the event of a fire; and the exit route through the labour ward was cluttered as a result of a lack of storage on the ward.
But inspectors did say the breastfeeding support team provided a good service. They also praised the hospital’s bereavement service.
At the QEQM Hospital, inspectors found there wasn’t a system for controlling who exited the maternity unit, posing a potential security risk. The CQC also criticised the fact that expressed milk was stored in unlocked fridges.
Inspectors did also find that people using the service were treated with compassion and kindness by staff at the QEQM.
In a statement, the Chief Executive of East Kent Hospitals, Tracey Fletcher, said: "I am sorry that despite the commitment and hard work of our staff, when they inspected in January, the CQC found that the Trust was not consistently providing the standards of maternity care women and families should expect.
"Our staff are determined to improve our services for patients. The CQC reports recognise the compassion and kindness they have shown to women and families and the outstanding practice of the service in proactively listening to and seeking feedback from every person who gives birth with us about what we can improve.
"We recognise that, despite the changes that have been made to the service so far, there is a lot more to do to ensure we are consistently providing high standards of care for every family, every time.
"We are continuing to work hard to improve the culture and multi-professional teamworking highlighted by Dr Bill Kirkup through the independent investigation into our maternity services, including implementing ‘civility saves lives’ staff training.
"I am grateful to the families who are helping us as we seek to make these improvements and to our staff, for their commitment."
In response to the findings, the trust said it made immediate changes to ensure better access to and regular checking of emergency equipment.
Among the other changes are electronic foetal monitoring alerts for staff, new dedicated foetal heart monitoring midwife, increased cleaning of the unit and the equipment.
It's understood that the trust’s maternity units are being closely monitored by the CQC and NHS England.
In January, the trust management warned that changing the culture of the organisation could take three years, but insisted important progress had already been made.
An internal report to the board in February set out a plan to fundamentally transform maternity services.