Macclesfield District General Hospital

Updated 30 January 2026

We assessed Macclesfield District General Hospital from 8 to 10 July 2025 and 8 September 2025.

Macclesfield District General Hospital was registered with CQC in April 2010 to deliver the regulated activities: Assessment or medical treatment for persons detained under the Mental Health Act 1983, Diagnostic and screening procedures, Family planning, Maternity and midwifery services, Nursing care, Personal care, Termination of pregnancies and Treatment of disease, disorder and injury.

The service had a controlled drugs accountable officer and a Nominated Individual.

At this assessment we assessed 3 assessment service groups: Urgent and Emergency Care, Medical Care (Including older people’s care), and Maternity. We assessed 33 quality statements for each of the 3 services.

We visited the following areas as part of the assessment:

Accident and emergency, same day emergency care, medical wards, maternity wards and the labour suite.

At this assessment we identified breaches of regulations: 9 Person-centred Care, 11 Need for consent, 12 Safe care and treatment, 16 Receiving and acting on complaints, 17 Good governance, 18 Staffing and 20 Duty of candour.

We rated the location as Requires Improvement.

Updated 29 April 2025

We carried out an unannounced onsite comprehensive assessment of the maternity services at Macclesfield District General Hospital on 8 to 10 July 2025. During the inspection we spoke with staff, leaders and people who used the service. We looked at care records, policies and procedures, complaints and incidents and we observed patient care.

We rated the service Good

We found midwifery and medical staffing levels were a challenge to support workload, complete training and provide learning opportunities within the service.

The service had made improvements since our last inspection to, processes, audit and equipment checks. The previous inspection in December 2024 was part of the CQC national maternity inspection programme, which looked at safe and well led questions.

We found multi-agency working with partners and stakeholders embedded in the patient pathway. Staff demonstrated kindness, compassion and patients felt respected and cared for. The service showed good practice in workforce well-being and freedom to speak up.

Updated 29 April 2025

Date of assessment 29 April to 10 September 2025. We conducted an on-site, comprehensive assessment visit of medical care (including elderly care) services on 8 to 10 July and 8 September 2025 in response to concerns around safe care and treatment.

We rated the service as Requires Improvement. We found breaches of 7 of the legal regulations in relation to person centred care, consent, safe care and treatment, complaints, governance, staffing and duty of candour.

Key issues included poor management of safety risks, poor compliance and understanding of the Mental Capacity Act, low training compliance, delays in discharge and access to care. Governance was notably weak, with poor documentation control, outdated and inconsistent policies and lack of oversight of risks in the service.

However, staff demonstrated kindness and compassion, patients felt respected and cared for, and there was a positive culture of learning from incidents. The service showed good practice in workforce wellbeing, diversity, and freedom to speak up, and had effective multi-disciplinary collaboration and community engagement.

We requested an action plan following publication of the final report.

Updated 29 April 2025

Date of assessment 29 April to 10 September 2025. We conducted an on-site, comprehensive assessment visit of urgent and emergency care services on 8 to 10 July and 8 September 2025 in response to concerns around safe care and treatment.

We rated the service as Requires Improvement. We found breaches of 5 of the legal regulations in relation to safe care and treatment, staffing, complaints, duty of candour and person-centred care.

Key issues included staffing in the paediatric emergency department, the management of mental health patients and completion of mental health risk assessments were not always robust, staff did not consistently follow best practices for infection prevention and control and complaint and duty of candour responses were not always timely.

The service fostered a positive learning culture with thorough investigations and shared improvements. Care was person-centred, with patients involved in decisions and information provided in accessible formats. Systems supported access to treatment, but high demand and limited bed capacity led to delays and overcrowding. Despite these challenges, the service maintained its commitment to partnership working and continuous improvement.

We requested an action plan following publication of the final report.

Updated 12 April 2018

Our rating of this service improved. We rated it as good because:

• Action had been taken and the service had improved since our previous inspection.
• The service provided mandatory training in key skills to staff. Mandatory training had been improved since the previous CQC inspection through the development of a paediatric essentials course.
• There were arrangements in place to help safeguard children and young people from abuse and neglect.
• The service controlled infection risks well and used control measures to prevent the spread of infection. Cleanliness, infection control and hygiene had improved since our previous inspection and effective systems and processes were now in place.
• The service had systems in place to assess and respond to risk. Children and young people were monitored for signs of deterioration using a paediatric early warning score system (PEWS). A sepsis tool was used to help staff escalate appropriately when signs of sepsis had been detected.
• The service had enough nursing and medical staff with the right qualifications, skills, training and experience, most of the time, to keep people safe from avoidable harm and to provide the right care and treatment.
• Record keeping had been identified as requiring improvement at the last inspection and the staff had been working to improve this. Staff now kept appropriate records of patients’ care and treatment.
• Medicines were managed and stored safely and securely.
• The service provided care and treatment based on national guidance and used the findings to improve them.

However:

• There was a shortage of band 6 nurses with APLS training on night shift. This was not compliant with national guidance.

Updated 4 October 2019

Our rating of this service stayed the same. We rated it it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

Updated 4 October 2019

Our rating of this service improved. We rated it it as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them.
• Staff provided good care and treatment, attended to nutrition and hydration needs appropriately, and gave them anticipatory pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, supported them to make decisions about their care, and had access to good information.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

• Compliance with mandatory training was low for the specialist palliative care team.
• Specialist end of life services were only available during weekdays in the hospital.
• There was no dedicated bereavement officer or office at the trust.
• The risk register did not record all identified risks for the service.

Updated 4 October 2019

We rated this service as good because:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients and acted on them. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service. However, staff did not always keep up to date records.
• Staff provided good care and treatment. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People requiring urgent care were seen promptly.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

• People requiring routine treatment could not always access the service when they needed it and there were long waits for some specialities.

Updated 12 April 2018

Our rating of this service improved. We rated it as good because:

• The service provided mandatory training in key skills to all staff.
• There were arrangements in place to help safeguard adults and children from abuse and neglect.
• The service controlled infection risks well and used control measures to prevent the spread of infection
• The service had suitable premises and equipment and staff looked after the majority of them well.
• Risks to people using services were assessed, monitored and managed on a day to day basis.
• The service had enough nursing and medical staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.
• Staff kept appropriate records of patients’ care and treatment. Records were clear, up to date and available.
• The service prescribed, gave, recorded and stored medicines well. Patients received the right medication at the right dose.
• The service managed patient safety issues well. Staff recognised incidents and reported them appropriately.
• The service provided care and treatment based on national guidance and evidence of its effectiveness.
• The service gave patients enough food and drink to meet their needs and improve their health.
• Staff assessed pain levels and provided pain relieving medicines when required.
• The service monitored the effectiveness of care and treatment and used the findings to improve them.
• Staff worked together as a team to benefit patients and supported each other to provide care.
• Patients were comprehensively assessed so that their clinical needs and general health status could be considered
• Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.

However:

• The risk of unauthorised access in theatre areas was not always managed effectively.
• The safe storage of medicines was not always consistent. For example the recording of maximum and minimum fridge temperatures was not always monitored in line with guidance.
• Risk assessments were completed when necessary but assessments did not include all of the potential risks. I
• Staff were competent in their role however the service did not always ensure that this was recorded and monitored using the trust individual staff self-assessment scoring system.
• Patients were not always able to access the service when they needed it. Waiting times for treatment and arrangements to admit, treat and discharge patients were not always in line with good practice.
• Information systems used to share information electronically with staff was not wholly effective. Staff struggled to locate information.