During this inspection we looked specifically at the maternity services provided at the hospital. The hospital has a midwifery led birth centre. The centre provides a number of labour rooms well equipped with birthing pools and birthing balls, for example.

We spoke with four patients who were receiving care, and ten staff members including midwives, health care assistants and managers.

Everyone we spoke with gave very positive feedback about the service and the way they had been cared for. Comments included;

‘’They have been absolutely fantastic. Everything has been just how we wanted it. My midwife was wonderful she even helped us mix aromatherapy oils. You get the feeling nothing is too much trouble.’’

‘’I was worried and they really listened to me and brought my antenatal appointment forward.’’

‘’When I had my baby, I felt so confident with them. I just felt like I could trust them straight away.’’

We looked at five areas during the inspection including the ways in which patients were enabled to make decisions about their care and the quality of care provided. Other areas included arrangements for the safeguarding of patients from abuse and staff training. We also looked at how the Trust monitored the safety and quality of the service.

We found positive evidence of compliance with all areas we inspected.

Throughout our visit we spoke with a number of patients and in some cases, their families. During these discussions we received extremely positive feedback from everyone we spoke with.

People spoke very highly of staff and expressed satisfaction with their (or their loved one’s) treatment and care. Comments included;

‘’We cannot fault any aspect of care. From arrival to date it has been exceptional.’’

‘’The staff here are brilliant – they are not just here to make up the numbers – they are all good caring people.’’

‘’They really care here. The Sister told me I can phone anytime if I have any concerns.’’

‘’Staff here seem to really know what they are doing and keep you in the picture.’’

‘’It is fantastic here – First class care!’’

‘’Staff are excellent, very friendly – very responsive.’’

‘’I am so glad she is here with these people. I think she has every chance of recovering well because of the way she is being looked after.’’

None of the people we spoke with had any concerns about the standard of care they were receiving and people told us that they would be comfortable in raising any concerns they may have in the future. One relative said ‘’I have no complaints whatsoever, but if I did I wouldn’t have any hesitation in speaking up. I think they (the staff) would want to know.’’

Prior to our visit we also spoke with a number of organisations including the Lancashire Link Local Involvement Network. Local involvement Networks are in place across the country and their role is to ensure people have a say about their experiences of services and how their health and social care services are planned.

No organisations we consulted had any concerns about Chorley and South Ribble Hospital.

Further comments made by people in relation to specific outcome areas are included throughout this report.

Our rating of services stayed the same. We rated it them as requires improvement because:

• The hospital had made improvements to compliance with mandatory training, life support training and safeguarding training in some areas but compliance in other areas such as urgent and emergency care was still not meeting the trust’s targets.
• The emergency department at the hospital did not have the appropriately trained staff to assess and treat children. The hospital did not have staff with the appropriate level of life support training working on every shift within the department.
• The access and flow of patients was an issue for the hospital which was demonstrated by the hospital not meeting national performance targets or performing worse than the England average. There were also a high number of bed moves at night.
• The hospital did not always have enough staffing in every area. While there had been improvements since the last inspection some areas such as some medical wards and maternity did not always have enough staff.
• The hospital was not always managing medicines well. There were different issues with medicines management in areas of the hospital such as patient group directions and controlled drugs.
• While the number of staff who had received an annual appraisal had improved since the last inspection, in areas it was not at the trust target.
• Staff lacked understanding and awareness of the Mental Capacity Act and the Deprivation of Liberty Safeguards in areas of the hospital.
• Patient records were not always completed in line with best practice and were not always kept securely.
• Some of the environment was cluttered and in disrepair and some items of equipment in the resuscitation trollies was past the manufacturer’s expiry date.
• Risks were not always recorded accurately, with timely action to mitigate risks. Some of the governance processes have recently been developed so were not yet embedded.

However:

• The hospital was managing safety incidents well. The environment and equipment were kept clean.
• Services were provided in line with national guidelines and best practice and services were participating and carrying out local audits to improve practice.
• Staff throughout the hospital were kind, compassion and caring to patients, their carers and family members. Patients were involved in decisions about their care and given emotional support.
• Services were planned to meet the needs of people using the hospital and services were in general responsive to the individual needs of patients. The hospital engaged well with patients and members of the local community.
• Staff were positive about their leaders across the hospital. There was a positive culture and staff were proud to work at the hospital.
• Staff were committed to making improvements, although some of these processes were yet to be embedded. Staff were positive about the focus on continuous improvement and initiatives such as the safety triangulation accreditation review process.