Quality Care Commission welcomes improvements at Northwick Park maternity services - rating improved from 'Inadequate' to 'Requires Improvement'

 From the Quality Care Commission

In October, CQC carried out an unannounced comprehensive inspection of the maternity department at Northwick Park Hospital, run by London North West University Healthcare NHS Trust*. This was to follow up on concerns identified during a previous inspection in April, when CQC told the trust to take urgent action to keep mothers and babies safe.

Following the October inspection, the overall rating for maternity services improved from inadequate to requires improvement. Safe, responsive and well-led remain as requires improvement. Caring remains good, and effective moved up from requires improvement to good.

Nicola Wise, CQC’s head of hospital inspection, said:

“I am pleased to say we saw a number of improvements in the maternity department at Northwick Park Hospital during our recent inspection.

“After our previous inspection, we were concerned there was a blame culture within the service which stopped incidents being escalated and improvements being made. This had improved, and staff are encouraged to give feedback and report incidents which are now being reviewed and learning shared, with improvements being tracked. We found a zero-tolerance policy regarding bullying and inappropriate behaviour, which was an improvement from our last inspection.

“Women using the service told us staff treated them with kindness. One person who had recently given birth, said that staff had gone above and beyond to provide safe care and treatment. They also respected people’s personal, cultural, social and religious needs. One woman who wore a hijab said that staff had respected them and their privacy regarding this.

“Following this inspection, we pointed out areas where further improvements need to be made. However, the interim leadership team is aware of the issues, and is committed to making the required improvements. Staff told us that senior managers were much more visible, and they were impressed by the change in approach from the leadership team, saying there was no longer a feeling of ‘them and us’. It is clear that leaders need time to fully embed the improvements in the maternity service and make permanent appointments to the team.

“We will continue to monitor the service to check that improvements are made and fully embedded, however, we recognise that all hospitals and healthcare professionals are under extreme pressure at the current time, and they need to be given the space to focus on delivering safe care to patients and supporting staff through this difficult period.”

Inspectors found the following during this inspection:

• The service did not always have enough midwifery staff with the right qualifications, skills, training and experience to keep women safe from avoidable harm and to provide the right care and treatment. Waiting times were longer for women across maternity services when staffing levels were low, though staff were encouraged to report delays as incidents. The birth centre was closed due to staff shortages. Staff shortages also impacted on home visits and clinics provided by community midwives
• Compliance with mandatory staff training was 84%, which did not quite meet the trust’s target of 85%, although it was an improvement
• The service had one never event in September. Never events are serious, largely preventable patient safety incidents. A swab was left inside a patient when they were being induced, even though two members of staff had signed a document showing that the correct number of swabs had been counted following the procedure. Learning from this event was shared across the trust
• The department’s policy was to admit women on their third call in 24 hours to explore any concerns. However, there was no system of recording the time at which women with concerns had previously called
• Some equipment on the resuscitation trolleys was out-of-date and cold cots** in the bereavement suite had been out of operation for two months, as the cooling system had failed, even though this had been reported to the trust
• Inspectors found an open trolley on the delivery suite which contained two drugs vials, presenting a risk that unauthorised people could have access to the vials
• One-to-one antenatal appointments with community midwives were not always being recorded. Inspectors also saw loose paperwork relating to patient assessments which could become detached from women’s notes so information could be misplaced
• Women who were attending the service to have their pregnancy terminated often had to wait for 45 minutes for their appointment in the same waiting room as women attending antenatal and postnatal clinics, which could be distressing for them
• Antenatal classes had been reduced as a result of the logistics of providing classes during the COVID-19 pandemic and staff availability, which meant women did not have access to information that could help them improve their health and wellbeing during pregnancy. Online classes had been planned, but these had not been implemented.

However:

• New interim leaders had the skills and abilities to run the service. The new managers understood and managed the priorities and issues the service faced. However, the trust needed time to embed this improved leadership and also to forge a period of stability by making permanent appointments to the leadership team
• In response to external reviews of the service, managers had produced a maternity improvement plan, which was reviewed and updated weekly
• There had been improvement in doctors, nurses and other healthcare professionals working together as a team to benefit women
• Staff recognised and reported incidents and near misses. Managers investigated incidents and shared lessons learned with the whole team and the wider service. It was easy for people to give feedback and raise concerns about the care they received. The service treated concerns and complaints seriously, investigated them and shared lessons learned with all staff
• Work was in progress to ensure staff completed and updated risk assessments for each woman and took action to remove or minimise risks
• The service had recently employed an audit midwife and a risk midwife to ensure monitoring of patient outcomes and benchmarking of service
• Work was in progress to monitor domestic abuse being assessed at all antenatal appointments
• The service had information boards which carried updates for staff on the maternity risk register. Policies and clinical guidelines were up to date and had dates for review
• The service made sure staff were competent for their roles. Managers appraised staffs’ work performance and held supervision meetings with them to provide support and development
• Staff understood and respected the personal, cultural, social and religious needs of women and how they may relate to care needs. 
  

On Twitter Cllr Ketan Sheth, chair of Scrutiny where he has done much to hold local NHS services to account, said: 

 Pleased to see the Care Quality Commission have upgraded London NW University Healthcare NHS Trust's Northwick Park maternity service to Requires Improvement and rated the service as Good for caring & effective. This is welcome progress for our local maternity service.

The full report is available HERE

 

100 Ace Cafe bikers deliver Christmas presents for Sufra foodbank clients. You can help Sufra too.

 

There was some speculation on social media from people who witnessed 100 bikers dressed as Santa and other Christmas characters speeding in convoy across the borough.

 

All was revealed in the Sufra Foodbank's latest Newsletter:

 This is what Christmas at Sufra NW London  is all about: a community of concerned, compassionate people from all backgrounds, faiths and cultures, coming together to give hope and joy (as well as lots of food and professional support) to people in crisis. It’s inspirational to witness.

A huge thank you to everyone who has supported us so far – including 100 Santas from the Ace Café who delivered presents on their motorbikes at the weekend. What a sight!

As I write this, Fahim, Nina and Prince are rallying our amazing volunteers to start prepping 600 Christmas meals (with free-range chicken and all the trimmings), which will be delivered by another set of speedy volunteers to families in need on Christmas Day (yes, really!) along with Christmas presents for all the family. Many of these will go to isolated asylum seekers confined to tiny rooms in contingency hotels.

Meanwhile, YOU have all stepped up too: we’ve hit the halfway mark in our Winter Appeal, which will unlock the Lady Fatemeh Trust’s match funding. This is brilliant news for our guests – thank you for all your support, especially LFT!

Even more great news: The Beta Charitable Trust have generously agreed to match fund the next £15,000 you donate, which means THEY WILL DOUBLE EVERY PENNY YOU GIVE – so please keep giving so that we can help more people like Adam...

Adam’s Story of Hope

Adam (not his real name) found himself homeless and destitute after a series of unfortunate life events that were not his fault. When he arrived at Sufra – cold, hungry and devoid of hope – he was too embarrassed to ask for food or help. Oddly, he started to fix our broken toilet instead. Turns out he was once an excellent plumber.

We provided him with a regular supply of food and arranged emergency accommodation to get him off the streets and keep him warm and safe. Our Advice Team also applied for a grant to get him the tools he needed to start earning a living wage again. We even found him some paid work.

Adam still volunteers to fix all our dodgy plumbing, but he also has a well-paid job and has just signed a lease on a decent flat.

He called Fahim the other day and told him, “I’ll never forget what everyone at Sufra did for me. I had lost all hope and would have never rebuilt my life without you guys. God bless you all.”

The Tip of the Iceberg

We hear touching stories like this every week at Sufra. It’s what keeps us going.

But Adam is just one of the hundreds of people who will come to Sufra for emergency food and support this winter – and we can’t give them hope without your help. 

Please click here to donate to our Winter Appeal.

South Kilburn residents object to high rise redevelopment proposal on the Crone, Craik and Zangwill site

 

 

Block A maximum 10 storeys c65metres,  Block B maximum 16 storeys c86metres, Block C maximum 12storeys c72metres.

The proposal:

Phased redevelopment of the site comprising: Demolition of all existing buildings, structures and site clearance, construction of three buildings ranging from 6 to 16 storeys comprising 252 residential units (Use Class C3), and provision of 325 sqm of commercial, business and service floorspace (Use Class E). Hard and soft landscaping works, access and highway alterations, car and cycle parking provision, and associated ancillary works. | 1-75 Crone Court, 1-85 Craik Court and 1-10 Zangwill House, London, NW6 

 

A group of Craik Court residents have objected  to the above demolition and redevelopment on the South Kilburn Estate on the following grounds:

We object to this application because

 

1.   Residents were involved in the three consultations during the spring and summer of 2018. The plans in this application do not resemble what was proposed in the final consultation event in September 2018. In these consultations residents said strongly that they did not want buildings over 10 stories high.  We were given the impression in these meetings that what we were shown in September 2018 would resemble what was built. This is not the case.

 

2.   We do not want high rises in South Kilburn. The application says buildings up to 16 stories will be built. This goes against Brent's Local Plan for the area Craik (p.201) Crone p.202 only mentions up to 14 stories.  Why does this application add 2 extra stories? In the exhibition we were shown the buildings are 8 and 9 stories high. But in this application 16 stories are proposed.   In the Supplementary Planning Document (SPD) for South Kilburn on p48 it says  that the regeneration  plans " will not propose radical divergence from the mansion block typology" 16 Stories is a radical divergence from this . It has a knock-on effect of causing the area to be too densely populated and the loss of light to other blocks in the area.  

 

3.   Loss of parking. At the moment Craik has 22 parking spaces, Crone has 28 parking spaces . These spaces are very much in demand, There seems to be no new spaces in these plans but many more dwellings.  In fact there is a heavy loss of spaces. While we agree that with climate change we should discourage car use, many people living in the area need cars for work or because they are not able to get around without them. Where will they park?

 

The parking on the new plans is only on the road. These roads are now filled with the numbers of people living there. If these buildings are built there will be many more households needing  parking all looking on the same roads for very limited parking.

 

4.   Loss of light - The height and density of these blocks, if allowed  to go ahead, will cast shadows on the homes and open spaces behind them. This is unacceptable.

 

5.   Density -  if the number of new homes asked for in this application  is allowed it will put an enormous strain on the already strained infrastructure in the area.  Services such as doctors are over stretched.  There are no doctors at Kilburn Park Surgery and the other local surgery, Lonsdale Practice is full to the brim.

 

6.   Loss of green spaces. If this plan is accepted there will be a huge loss of green spaces. The area between the two new proposed sites, Canterbury Road, is dark and has 2 huge buildings looming over it in this proposal.

 

7.   Loss of play space.  The application has a huge loss of playspace which is not made up for with the new  park. The new park was built to replace other play spaces that have already been lost. There is a space in the middle of the building on Canterbury Road but that is only for residents of that block. It cannot make up for open accessible play spaces lost.

 

FULL DETAILS OF THE PROPOSAL HERE

80 year old twins show the way on protecting the local environment

 

Anne and Margie at work in Salmon Street

I came across Anne and Margie in Salmon Street, Kingsbury this morning and paused for a chat.

The 80 year old twins have formed the AM Litter Patrol to pick up litter  in the shrubby verges of Salmon Street and invite others to join them.

Their placard says, 'I'm only 80, you figure it out!' suggesting that if 80 year olds can do their bit for the environment then others can too.

The initiative emerged from the twins' concern about climate change and the impact it will make on the next generations:

We didn't realise at the time that we, unknowingly, were contribution to climate change along with the rest of our generation through rampant consumerism. We know now and want to play our part in preserving and improving the environment.

Like many others who take part in litter-picking they are stunned by the efforts people go to in order to avoid disposing of litter responsibly and amazed at the variety of objects that they pick up in the tangle of vegetation along Salmon Street.

Amidst the gloom of a grey winter's day and pandemic concerns it was a reat treat to meet Anne and Margie. Thank you.

FoI request as Brent accounts for just under half of TOTAL London councils' spending on air travel

(SW  Londoner)

 Paul Lorber has made a Freedom of Information request to Brent Council in the wake of a report earlier this month in  the SW Londoner that Brent Council accounted for just under half of the total expenditure by all London Councils on air flights 2014-21

Lorber pointed out that Brent Council had declared a Climate Emergency and asked:

Can you please provide a justification for all this air travel and provide the date, the full cost, the purpose of the trip and the persons on the flight for each trip costing more than £100 over the period covered by the article attached.

https://www.swlondoner.co.uk/news/09122021-london-councils-land-bill-of-nearly-400000-for-air-travel-despite-climate-pledges/

 

 (SW Londoner)

At the time of the article's publication Cllr Krupa Sheth, Lead Member for Environment, told the SW Londoner:

Council officers do not fly anywhere on council business unless absolutely necessary. All of these flights are directly related to social workers working with vulnerable children. 

Family court orders may require social workers to assess a vulnerable child’s extended family in their home, which could be abroad, or accompany a child to be reunited with extended family members who live overseas, or visit a child in care a very considerable distance from Brent.

As a part of our strategy we are developing a plan to achieve net zero across our estate and operations by 2030 and we will consider this issue and the potential to offset any necessary flights as part of that review process.

Given that some other London boroughs have similar demographic profiles it is unclear why the Brent should be so much higher.

Independent London Flood Review announced into flooding events of July 2021

The London Flood Review has been set up to examine the flash flooding that affected many parts of the capital in July 2021.  The review seeks to better understand the extent and causes of these floods, to assess how the drainage systems performed, and to recommend how the increasing risks of future flooding events can be managed.

The review, which has been commissioned by Thames Water, will play an integral part in ensuring the company future proofs its infrastructure to protect its customers, their communities and the environment as such severe weather events look set to become the norm across the UK.

The review will also play an important role in improving collaborative working between all parties responsible for managing future flooding risks. As part of its focus, the review will provide insights on London’s wider drainage infrastructure and broader recommendations that could be adopted by all organisations with surface water management responsibilities.

 

INDEPENDENT REVIEW INTO THE FLOODING IN LONDON ON 12 & 25 JULY 2021

Terms of Reference

1. Why has Thames Water commissioned an independent review?
 

On 12 and 25 of July 2021, London experienced extreme rainfall events that led to extensive flooding, with more than a thousand homes and businesses flooded, and health, social and transport infrastructure also affected. Given the scale of the impact on its customers and local businesses, Thames Water has taken the unusual step of commissioning an independent review into the flooding as the organisation believes it is important to understand the root cause of the flooding, how its assets performed and to learn lessons so the company and other parties may better prepare for future risks, in an open and transparent way.

This review will also assist with Thames Water’s role (as a Risk Management Authority) in supporting Local Authorities in undertaking their flooding investigations as required by Section 19 of the Flood and Water Management Act (2010). Thames Water’s ambition is that the review should take no more than 6 months, with interim reports published as it progresses. This timeframe is planned so that the review concludes within a period where the findings are relevant to the key stakeholders and also are able to inform Thames Water’s draft PR24 business plan. As such, the review must balance the desire for comprehensive scope, level of detail and stakeholder engagement, with the need to complete within this timeframe.

This will mean that the review will primarily focus on the performance of Thames Water’s assets, within the context of other Risk Management Authorities’ assets, and be developed using existing Thames Water models.

A Brent Council spokesperson said: 

Brent Council welcomes the Independent Review into the flooding events of last summer that has been commissioned by Thames Water . We look forward to working with the review body to inform it's evidence base and to assist the review to meet its objectives.

2. What is the aim of the independent review?

The review has four core objectives. To:

1) Research, understand and report on the ‘what, when, why and how’ of the two July storms

 

Key to the investigation is capturing as accurately as possible what occurred, where and how customers were affected, i.e. the number and type of properties impacted, the type of flooding (internal/external, surface/sewer) they experienced etc. This needs to be undertaken in the context of understanding the storms that occurred i.e., characteristics of rainfall and also where it occurred because the impact will not be the same across the different affected areas. This will also identify whether there were other factors (such as high tide, time of day etc) that potentially contributed to the flooding and what impact
they might have had.

2) Examine the flooding mechanisms and to consider the performance of drainage systems against design standards.

 

This will determine how well Thames Water’s assets performed on 12 and 25 July in accordance with the duty set out in Section 94 of the Water Industry Act.

 

 The assessment should be of Thames Water’s drainage and sewerage assets in general in the affected boroughs, with a specific focus on recent flood alleviation schemes, including Maida Vale, Counters Creek and Westbourne Grove and their performance against their project objectives (this will include where Thames Water has installed FLIPs and other local flood risk management measures).

3) Consider how changes to existing and planned drainage system works, operations and/or policies might have alleviated the flooding and make London more resilient to future storms.  

 

Whilst the focus of the recommendations will be on the public sewerage system, these must be made within the context of the interaction between the Thames Water operated and maintained public sewerage system and third-party drainage and flood risk management systems. The review should highlight wider points on the future of the London’s sewerage and drainage system and identify key opportunities that should be considered in Thames Water’s DWMP and PR24 Business Plan, and other stakeholders’ plans and programmes.

4) Be as evidence based as possible.

Further lines of inquiry may be included as raised by the participants of the review, but as noted previously, these should not detract from the aim of achieving the core objectives within the stated timeframe.

3. How will the independent review be run and managed?

In order to be properly independent, the review cannot be led by Thames Water, but neither can it be entirely independent of Thames Water, as Thames Water is the major provider of information and resources for the review and will be a key recipient of its recommendations.

The structure of the Independent review is as follows:

1. An Independent Expert Group (‘IEG’) that will lead the review. The IEG’s role is to:
a. Agree the terms of reference and scope for the review, including the brief for thecontractors, in consultation with the Strategic Stakeholder Panel
b. Work with Thames Water to appoint the contractors to support the IEG
c. Work with the contractors to produce the interim and final reports in consultation with the Strategic Stakeholder Panel
d. Be responsible for the successful outcome of the review
e. Stand behind the findings of the review
f. Promote the review and the dissemination of its findings, including attending any potential scrutiny/inquiry meetings.

The IEG will consist of three experts with industry-leading knowledge and experience in sewerage and drainage modelling, legislation and regulation, and flood risk management. The experts will be appointed by and paid by Thames Water, but be otherwise independent.

A key early stage to the review will be an assessment by the IEG of available data/models in order to agree what gaps may exist and how best to resolve these gaps within the time available.

2. A Strategic Stakeholder Panel (‘SSP’) comprising representatives from the key strategic organisations in London with a responsibility for and interest in surface water and sewer flood risk management. The SSP will be consulted on the scope and objectives of the review, inputting into its course, receiving, and (where appropriate) endorsing, promoting, and
enacting its findings. The SSP will include senior representatives from:

a. Greater London Authority
b. Transport for London
c. London Councils

d. London Drainage Engineers’ Group
e. Environment Agency
f. Consumer Council for Water
g. Ofwat (as an observer)
h. Thames Regional Flood & Coastal Committee
i. Thames Water

The IEG will, as a minimum, meet with the SSP at each key stage (see ‘Key Deliverables’ below):
• Inception meeting to discuss and agree the Terms of Reference
• Meeting to review the work programme and agree data requirements from the SSP and other parties
• Review the findings of each stage of the review ahead of publication of the interim reports
• Review the findings of the final report and development of a non-technical summary

3. A contractor (Mott McDonalds) to provide the technical capability and resources to undertake the work detailed in a brief approved by the IEG. The contractors will be procured and funded by Thames Water, but report to and be managed by the IEG.

 

4. Key Deliverables

The following key deliverables are included to provided structure and clarity around what outputs are required. It is intended that each stage will build on the prior one:
• Stage 1: Full assessment of impact of the storms, detailing the nature of the storms that occurred and the impact (extent) of the flooding (who and what was flooded).
• Stage 2: Assessment of the flooding mechanisms and a technical view of where and how  flooding occurred.
Stages 1 and 2 together will form the ‘baseline statement’ for the review:
• Stage 3: Explanation of the performance of the sewerage system, including stating whether the sewerage system and key flood alleviation schemes performed to the intended levels of service.
• Stage 4: Lessons learnt - details of where improvements to the sewerage system and potentially third-party assets and policies may be appropriate. To be completed by end of April 2022.

A report will be published for each of the stages.