The health watchdog has found improvements in maternity services and urgent and emergency services at the University Hospitals of Morecambe Bay NHS Foundation Trust.
But the trust overall still requires improvement.
The Care Quality Commission carried out the unannounced inspections in July to assess the progress of improvements it told the trust were needed during previous visits.
Inspectors visited maternity services at Furness General Hospital in Barrow, Westmorland General Hospital in Kendal and the Royal Lancaster Infirmary as well as urgent and emergency services at Furness General Hospital and Lancaster Royal Infirmary.
The report at the Royal Lancaster Infirmary found that the service was still in breach of the legal regulation in relation to safe care and treatment and staffing.
The CQC found that the service did not always provide safe care and treatment as medicines were not always managed well and the paediatric department was not secure or staffed well.
The maternity unit at the infirmary was found to not always have enough suitable equipment to help staff safely care for women and their babies.
For example, during the inspection, a number of staff told the CQC that there was a shortage of digital tablets used for completing recording of observations onto the electronic records system.
The way medicines were dispensed was highlighted as an area of concern. An example was a change in the size of a vial of medication which remained at the same strength had not been communicated to all staff, leading to a potential risk to patient safety.
Elsewhere corridors, used as temporary escalation spaces for patients, were not always suitable due to the width of the corridor and promoting patient dignity in the emergency department, according to the CQC report.
A triage window where patients were asked questions about their conditions was next to a reception window meaning patients could be overheard when providing sensitive information.
A fire risk assessment, completed in December 2024, identified concern about electrical equipment blocking corridors as well as the means of escape being blocked with patients on trolleys.
Six months on, the CQC said action was yet to be taken and noted staff did not always feel they could speak up and that their voice would be heard by senior leaders.
At Furness General Hospital, the CQC reported that the service did not always provide safe care and treatment.
It added that the emergency department faced challenges in managing patient flow to the wider hospital. Inspectors wrote that as a result, some patients spent time in areas that were not clinically appropriate, adding that it was a breach of safe care and treatment.
Following the inspections, the CQC ratings were:
- Maternity at Furness General Hospital – the overall rating has gone up from requires improvement to good.
- Maternity at Westmorland General Hospital – the overall rating has gone up from inadequate to good.
- Maternity at Royal Lancaster Infirmary – the overall rating has gone up from requires improvement to good.
- Urgent and Emergency services at Furness General Hospital – the overall rating has gone up from requires improvement to good.
- Urgent and Emergency services at Royal Lancaster Infirmary – the overall rating is rated requires improvement again.
“At this inspection, we were encouraged to see widespread improvements across maternity care,” Chris Storton, CQC deputy director of operations in the North West, said.
“We saw staff providing exemplary care who went above and beyond to ensure women and their babies were well cared for.
“We were also pleased to see improvements in the quality of care being provided to people attending A&E services, although some improvements were still needed at Royal Lancaster Infirmary.
“It was great to see that maternity leaders had increased the number of midwives and specialists since we last inspected meaning women and their babies were receiving a better standard of care.”
Inspectors reported staff did not always manage medicines safely and there were understaffing issues in the paediatric part of A&E at Royal Lancaster Infirmary.
The CQC’s assessments show maternity services at all three hospitals have also been rated as good for the first time since 2017, reflecting sustained improvements and progress since previous inspections.
Inspectors highlighted:
- Women were given the opportunity to speak to staff at Royal Lancaster Infirmary about their birthing experience, especially if the experience was not what they had wanted or expected.
- Staff at Westmorland General Hospital ensured women only needed to tell their story once by sharing their assessment of needs if they moved between services.
- Maternity services worked with the local Maternity and Neonatal Voices Partnership (MNVP) to contribute to decisions about care and make improvements.
- Staff and leaders actively listened to information about women who are most likely to experience inequality in care outcomes and supported their treatment in response to this.
In urgent and emergency services:
- People attending A&E at Furness General Hospital gave mainly positive feedback and there were several thank you cards on display.
- Furness General Hospital scored above average in the national patient survey for how staff communicated with people and how they were treated with dignity and respect.
- Leaders had made improvements at Royal Lancaster Infirmary for people who’d had a stroke to ensure they got access to treatment quicker.
- Staff didn’t always manage medicines safely and there were understaffing issues in the paediatric part of A&E at Royal Lancaster Infirmary.
“Leaders and staff should feel proud of the changes they’ve made and the positive impact these changes have had on people using services,” Chris Storton said.
“We’ve shared our findings with leaders so they know where improvements are still needed and we’ll continue to monitor the trust to ensure these improvements are embedded and sustained.”
Furness General Hospital is rated as requires improvement overall after receiving good ratings for effectiveness, caring and leadership, and requires improvement for safety and responsiveness.
Overall, the Royal Lancaster Infirmary is now rated as good after receiving outstanding for caring, good for effectiveness, responsiveness and leadership but requires improvement for safety.
The Westmorland General in Kendal performed well overall according to the CQC which rated the hospital as good, with good ratings gained in all areas: caring, effectiveness, responsiveness, safety and leadership.
“Our teams have worked incredibly hard to significantly improve our services, and we are pleased this has been recognised by the CQC following their recent inspection,” Scott McLean, interim chief executive of the trust, said.
“What is especially important to acknowledge is that despite the intense and challenging pressures colleagues are working in – especially in our urgent and emergency care services – they continue to provide compassionate and respectful care.
“We see this each and every day, but I am pleased it is reflected in the inspection findings as our colleagues deserve to be recognised for their efforts.”
