Updated
1 March 2024
Pages 1 to 3 of this report relate to the hospital and the ratings of that location, from page 4 the ratings and information relate to maternity services based at Royal Berkshire Hospital.
We inspected the maternity service at Royal Berkshire Hospital as part of our national maternity inspection programme. The programme aims to give an up-to-date view of hospital maternity care across the country and help us understand what is working well to support learning and improvement at a local and national level.
The Royal Berkshire Hospital provides maternity services to the population of Reading and West Berkshire.
Maternity services include a fetal medicine unit, outpatient department, maternity assessment unit, Marsh antenatal ward, central delivery suite, Rushey midwifery led birth centre, 2 maternity theatres, Iffley postnatal ward and an ultrasound department. Between April 2023 and October 2023 2,721 babies were born at Royal Berkshire Hospital.
We will publish a report of our overall findings when we have completed the national inspection programme.
We carried out a short notice announced focused inspection of the maternity service, looking only at the safe and well-led key questions.
Our rating of this hospital stayed the same. We rated it as Good because:
- Our rating of Good for maternity services did not change ratings for the hospital overall. We rated safe and well-led as Good.
How we carried out the inspection
We provided the service with 2 working days’ notice of our inspection.
We visited the maternity assessment unit, central delivery suite, maternity theatres, midwifery led unit and antenatal and postnatal wards.
We spoke with 3 doctors, 14 midwives and managers, 3 support workers, and 2 women and birthing people. We received 16 responses to our give feedback on care posters which were in place during the inspection.
We reviewed 5 patient care records, 4 observation and escalation charts and 6 medicines records.
Following our onsite inspection, we spoke with senior leaders within the service; we also looked at a wide range of documents including standard operating procedures, guidelines, meeting minutes, risk assessments, recent reported incidents as well as audits and action plans. We then used this information to form our judgements.
You can find further information about how we carry out our inspections on our website: https://www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection.
Medical care (including older people’s care)
Updated
7 January 2020
Our rating of this service dropped one rating. We rated it as good because:
- Patients were protected by a strong comprehensive safety system and there was a focus on openness, transparency and learning when things went wrong.
- Staffing levels and skill mix were planned, implemented and reviewed to keep patients safe at all times. Any staff shortages were responded to.
- Outcomes for patients who used the service were mostly better than expected when compared with other services.
- Staff’s skills, competence and knowledge were continuing being developed as integral to ensure high-quality care.
- Staff were proactively supported and encouraged to acquire new skills, use transferable skills and share best practice. Volunteers were proactively recruited, trained and supported in their roles.
- There was excellent, effective multidisciplinary working within the medical care services.
- Feedback from people who used the service, friends and family was consistently positive about the way staff treated people and provided care. Staff were highly motivated in delivering patient-centred care in a respectful and dignified way.
- Patients told us they felt involved in decisions about their or their loved ones care and treatment.
- Clear governance structures were in place and we saw effective management of risks. Senior managers were visible and highly regarded.
- Staff were proud of the organisation as a place to work and spoke highly of the culture.
However:
- Not all staff were up-to-date with their mandatory and safeguarding training.
- There were lapses in infection and prevention control practices.
- Storage of equipment did not always follow best practice or was kept in inappropriate areas of the wards.
Services for children & young people
Updated
24 June 2014
Babies, children and young people were cared for in wards and departments that were clean. Infection control practices were adhered to. There were sufficient nursing and medical staff across all areas. Staff used recognised early warning systems for both neonates and paediatric patients. Staff reported incidents, and learning was shared across the area to prevent the likelihood of a reoccurrence. Security for patients and staff in the neonatal and paediatric areas was good. Access to mandatory and additional training was available to staff, to allow them to develop additional skills.
Care and treatment was delivered in line with national guidelines. Outcomes were reviewed, and there was active participation in research and audit. Care plans and pathways were in use. Multidisciplinary team working was good in all areas.
Staff provided care in a kind and compassionate manner. Parents were involved in both decision-making and the delivery of care and were given appropriate emotional support. There was a highly visible leadership team and an open and supportive culture.
Updated
7 January 2020
This inspection was the first time the gynaecology service had been inspected as a stand-alone service. Previously it had been inspected alongside Maternity. We rated it it as good because:
The trust has 15 inpatient gynaecology beds located on Sonning Ward at Royal Berkshire Hospital. The ward admits both emergency and elective gynaecology patients, and also admits breast surgery and early pregnancy patients. The ward hosts a gynaecology day unit.
The trust has a range of outpatient gynaecology clinics including the colposcopy clinic, gynaecology emergency clinic, hysteroscopy clinic, minor operations and implants clinic, pelvic floor and urodynamics, and post-menopausal bleeding clinic. The trust also provides a fertility service.
(Source: Trust Provider Information Request – Acute sites)
The trust’s gynaecology service is part of their urgent care division.
The gynaecology services provided by the trust included 15 inpatient beds, clinics and theatres to support women’s health conditions. These included diagnostic and treatment services for a range of health concerns including; abnormal bleeding, cancer services, pelvic pain, hysteroscopy services, endometriosis, colposcopy and urogynaecology services.
Termination of pregnancy is not routinely carried out at the Royal Berkshire Hospital. The termination of pregnancy service is provided by an external provider. The Royal Berkshire Hospital only performs the procedure for women with very complex medical needs who are referred to them.
During the period 1 March 2018 to 28 February 2019 the service carried out two surgical abortions and no medical abortions
We visited the following areas:
- Early Pregnancy Unit (EPU). This is located in one room which has three curtained treatment areas.
- Sonning ward, which is a gynaecology ward for women receiving gynaecological procedures or treatment, including surgical management of miscarriage, and, rarely, termination of pregnancy. It has 15 beds in the form of two four-bed bays, one five-bed bay and two side rooms.
-
Outpatient’s department, which is where all gynaecology clinics including the post-menopause bleeding service, endometriosis service, oncology clinics and termination of pregnancy clinics are provided.
-
Gynaecology theatres, which are dedicated theatres for gynaecological surgeries. There are two dedicated theatres for the gynaecology service.
-
Hyperemesis day centre, which is located on the Day Assessment Unit. Staff treat women with rapid fluid and medication infusion through intravenous access on a day case basis. It has one room with two comfortable chairs for treating women.
- Hysteroscopy and colposcopy suite, which has one treatment room for hysteroscopy and minor ops, and one treatment room for colposcopy.
- Urogynaecology and urodynamics unit, which has two consultation and treatment rooms.
- Pre-assessment unit, which is where women go to be assessed one or more days before they are due for a surgical procedure. The clinic appointment is where nurses check if women have any medical problems that might need to be treated before their operation, or if they will need special care during or after the surgery.
- Our inspection was unannounced (staff did not know we were coming) to enable us to observe routine activity. We inspected all five key questions of the gynaecology service.
- Before the inspection visit, we reviewed information that we held about these services and information requested from the trust.
Updated
24 June 2014
The palliative care team was available seven days a week, with the hospice providing out-of-hours cover. Medicines were provided in line with guidelines for end of life care. DNACPR forms were not consistently completed in accordance with policy and there were no standardised processes for completing mental capacity assessments.
Training relating to end of life care was provided at induction and study days were arranged for palliative care link nurses from wards. Leadership of the palliative care team was good and quality and patient experience was seen as a priority.
All patients requiring end of life care could access the palliative care team. Viewing times in the mortuary were limited, which impacted on patients’ families being able to view their relative. There was a multidisciplinary team (MDT) approach to facilitate the rapid discharge of patients to their preferred place of care.
Relatives of patients receiving end of life care were provided with meal vouchers and free car parking. Patients were cared for with dignity and respect and received compassionate care. The ‘End of Life Care Plan’ was the pathway patients were placed on in the last few days of life.
Outpatients and diagnostic imaging
Updated
11 January 2018
A summary of this service appears in the Overall summary.
Urgent and emergency services
Updated
11 January 2018
A summary of this service appears in the Overall summary.