Women and babies are still being put at risk at a scandal-hit hospital, the care watchdog has said as it raises fresh concerns.
Nottingham University Hospitals trust is failing to make improvements despite facing a major review into poor maternity care, the Care Quality Commission has warned.
“It’s disappointing that despite several inspections where CQC has told the trust areas they must improve to keep mums and babies safe, serious problems remain,” it said in a report.
The findings come as the trust is facing a new review chaired by Shrewsbury maternity inquiry lead by Donna Ockenden.
The scandal was exposed when an investigation by The Independent and Channel 4 News uncovered dozens of babies who had died or been brain damaged following poor care.
An initial NHS review was launched in July 2021 and almost 600 families have come forward to date. However, Ms Ockenden will now restart the process afresh.
The CQC report said inspectors found staff were not monitoring women to check if they had deteriorated during labour.
It also said the trust did not have enough nursing or midwifery staff to keep women and babies safe and not all staff had the right skills.
“Staff told us there were some staff members who did not complete the observations due to ‘not being their role’,” the report said.
Inspectors also raised concern over more than 400 safety incidents which had yet to be investigated by the trust and said they could not be assued staff reported all incidents and “near misses”.
According to the findings women who need induction were not always admitted when they needed to be due to “backlogs” in induction of labour.
The CQC has given the trust an “inadequate” rating again for maternity due to the findings, and taken out urgent “enforcement action” due to the concerns over staff observations.
Fiona Allinson, CQC’s director of operations, Midlands network said: “One of our biggest concerns was that staff weren’t always carrying out observations on women to check that their condition hadn’t deteriorated. Midwives weren’t always clear who could perform observations, some staff didn’t carry them out as they said it wasn’t their role, and overdue observations went unrecognised. This gave us serious concerns about their ability to recognise and respond to women who were deteriorating, so we have taken enforcement action against the trust to focus them on rapid improvement in this area.”
The CQC wrote to the trust following an inspection in March highlighting concerns, which also included failure to triage women within 15 minutes.
Addressing the staffing shortages across the services the CQC said: “The service still did not have enough nursing and midwifery staff to keep women and babies safe. During the inspection in October 2020, we placed conditions on the trust’s registration to ensure they actively assessed, reviewed and appropriately escalated any staffing concerns. During this inspection, we still found concerns with staffing.”
However, improvements were noted including improvements in culture and staff feeling supported.
The appointment of the new director of midwifery had been a significant factor in this. Where staff had disengaged with the development of the service, they had started to become re-engaged and believed in the vision and direction which the service was heading, the report said.
“Staff generally felt confident to make complaints or raise concerns if they witnessed cultural concerns,” the report said.
Nottingham University Hospitals NHS Trust was approached for comment.
