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Yeovil District Hospital

Provider Somerset NHS Foundation Trust Type NHS Healthcare Organisation Region South West

Overall rating: Not Yet Rated  View full CQC report

Domain ratings

Five CQC key questions
Safe
Not Yet Rated
Effective
Not Yet Rated
Caring
Not Yet Rated
Responsive
Not Yet Rated
Well-led
Not Yet Rated

Current CQC assessment

Single Assessment Framework

From 2024 CQC rates services through ongoing assessments rather than comprehensive inspections.

Not Yet Rated Assessed 27 June 2025
Date of assessment: 13 January to 11 February 2025. Yeovil District Hospital provides a range of NHS hospital services. Services at Yeovil District Hospital were not previously inspected under Somerset NHS Foundation Trust. Therefore, the rating from the Children and Young People Service has not been combined with ratings of the other services from the previous inspections. See our previous reports to get a full picture of all other services at Yeovil District Hospital. The overall rating of Yeovil District Hospital is insufficient evidence to rate. This assessment looked at the …

Ratings by service

Services for children & young people
Inadequate
Oct 2024

Regulatory breaches & enforcement

Current-framework "must do" equivalent

Breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, stated verbatim in the CQC assessment.

Warning notice Overall
We issued a Section 29A Warning Notice under the Health and Social Care Act 2008.
· 27 Jun 2025 · CQC source

Breaches identified (4)

Breach Overall
Improvements were not found at this assessment, and the service remained in breach of these regulations.
· 27 Jun 2025
Breach Caring
The service was also in breach of the legal regulations in relation to, staffing, need for consent, premises and equipment and good governance. > In instances where CQC has decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/or appeals have been included.
Regulation: Regulation 11 (Need for consent) · 27 Jun 2025
Breach Well-led
The service remained in breach of previous legal regulations concerning mandatory training and safeguarding, as well as new breaches related to staffing, consent, premises and good governance.
Regulation: Regulation 17 (Good governance) · 27 Jun 2025
Breach Safe
The service was previously in breach of the legal regulations in relation to mandatory training and safeguarding service users from abuse and improper treatment.
Regulation: Regulation 13 (Safeguarding service users from abuse and improper treatment) · 27 Jun 2025

Earlier inspection findings

pre-2024 framework · 6 must-do 3 should-do

Must-do actions (6)

Legal requirements based on regulation breaches identified during inspection.

Must-do action 1 of 6
Must do
Safe
The service must ensure staff are up to date with maternity mandatory training modules, including adult and children’s safeguarding training at level 3.
Regulation: Regulation 12 (1)(2)(c)
⚠ Not all staff had sufficient training to recognise and understand how to protect women and birthing people from abuse and manage safety well. Staff had not received training at a level appropriate to their roles on how to recognise and report abuse.
Must-do action 2 of 6
Must do
Safe
The service must ensure staff accurately complete, and document modified early obstetric warning scores and newborn assessment observation and early warning score forms in order to identify and escalate women and birthing people and babies at risk of deterioration.
Regulation: Regulation 12 (2)(a)(b)
⚠ Staff did not always utilise tools to identify if women and birthing people were at risk of deterioration. Staff had only fully completed 2 out of 6 MEOWS records reviewed, and a retrospective audit showed 49.6% compliance rate of NEWS forms.
Must-do action 3 of 6
Must do
Well-led
The service must ensure effective risk and governance systems are implemented which supports safety and quality care.
Regulation: Regulation 17 (1)(2)
⚠ Leaders did not operate effective governance processes throughout the service and did not have clear oversight. There was no effective program of regular local audit to ensure safety and quality.
Must-do action 4 of 6
Must do
Well-led
The service must ensure that policies are up to date and reviewed in accordance with the review date.
Regulation: Regulation 17 (1)(2)
⚠ The newborn security guidelines policy was overdue for review, and there was no effective process for reviewing and updating policies and guidelines.
Must-do action 5 of 6
Must do
Well-led
The service should ensure all staff must receive annual appraisals.
Regulation: Regulation 18 (2)(a)
⚠ Not all staff had received an appraisal of their performance or support with their development; only 50.5% of midwives had received an annual appraisal within the last 12 months.
Must-do action 6 of 6
Must do
Safe
The service must ensure electrical equipment is properly maintained.
Regulation: Regulation 15 (1)(e)
⚠ Medical equipment was not always serviced when it should have been, with compliance for equipment testing at 85.8%, posing a risk that equipment in use was not safe or effective.

Should-do actions (3)

Recommended improvements to enhance service quality.

Should-do action 1 of 3
Should do
Safe
The service should ensure that all staff adhere to the uniform policy to maintain effective infection prevention control.
Should-do action 2 of 3
Should do
Safe
The service should consider a review of arrangements for twice daily consultant led ward round to comply with national guidance.
Should-do action 3 of 3
Should do
Caring
The service should consider monitoring incidents by ethnicity to evaluate incidents and clinical outcomes to ensure equality in maternity care.

Location details

CQC ID: RH5O4
Local authority: Somerset
Region: South West

Inspection report

Type: Location
Date: 10 May 2024
Rating: Requires Improvement
Actions: 6 must-do 3 should-do
AI-extracted 3 Jun 2026

Related PFD reports

2022-0165 — Andrew Nixon ()
2025-0200 — Jacqueline Potter (Apr 2025)
2024-0349 — Michelle Moore (Jun 2024)
2018-0126 — Robin Richards (May 2018)