Inspection finds maternity services at Cardiff's largest hospital needs further improvement

Inspectors completed the unannounced inspection of the hospital’s maternity services across three consecutive days in March 2024, reviewing various wards including the Delivery Suite, Birth Centre, maternity wards providing antenatal and postnatal care and the surgical theatres.

Overall, improvements had been made since our previous inspection in March 2023 to ensure the delivery of safe and effective care. Inspectors found staff morale had improved following an increase in resourcing, and when asked, patients told us they were happy with the level of care being provided. However, inspectors were not assured that the processes and systems in place were sufficient, and immediate assurances were sought in relation to infection prevention and control procedures, inconsistent medicines management documentation and insufficient ward security measures.

Staff were observed providing kind and respectful care and were working well as a team to provide women and birthing people with a positive experience that was individualised and focussed on their needs. When asked, women and birthing people mainly rated their experience positively as either ‘very good’ or ‘good’. Inspectors noted the unit had a wide range of good practice initiatives to support individualised patient needs, including specialist mental health support, diversity and inclusion awareness through various communication methods, and tailored bereavement care. It was positive to note that initiatives to improve the experience of Black, Asian and Minority Ethnic patients had been further embedded and developed.

Several non-compliance concerns regarding patient safety were identified during the inspection. Immediate assurances were sought surrounding the security measures in place to ensure that babies were kept safe and secure, inconsistent daily checks of the lifesaving equipment, the management of controlled drugs and the increased infection risks; including ensuring that birthing partners wore scrubs when attending theatre delivery.

We saw that some improvements in the Induction of Labour ward area had been implemented since our previous inspection in March 2023. There was a newly appointed Induction of Labour lead as well as a change in staffing levels to better support women through this area. The inspection team welcomed the addition of side rooms since last inspection which offered privacy to women and their birthing people. 

During the inspection we saw several safety concerns in relation to the physical environment of the unit. Staff advised us of ongoing issues relating to a leaking flat roof and multiple buckets of rainwater in corridors, including the theatre rooms. We reviewed some evidence that these ongoing issues had been escalated and risk assessed.

A relatively new management structure was in place, and managers appeared approachable and visible within the unit. Feedback from staff indicated that morale had increased, and communication had also improved. However, some staff told us they felt that challenges around staffing levels made it difficult for them to conduct their duties properly. 

 Alun Jones, Chief Executive of Healthcare Inspectorate Wales said:

It was positive to see improvement has been made since our previous inspection, with many instances of good practice. The highlighted issues of immediate concern must be addressed to ensure the quality of care provided to women and birthing people continues to improve. We will continue to engage with Cardiff and Vale University Health Board to ensure timely progress against our findings.

March 2024 - Hospital Inspection Report - Maternity Unit, University Hospital of Wales, Cardiff