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Improvements have been made at a maternity unit that has previously faced criticism over staffing issues, although a report said "challenges remain".

Employees at the maternal unit at Singleton Hospital in Swansea had provided “kind and respectful” care to patients but "further improvements" were required to ensure “an acceptable standard of care”, Health Inspectorate Wales (HIW) said.

The unit was placed into enhanced monitoring by the Welsh government last year due to concerns raised by families.

Swansea Bay health board said it was fully committed to continuously improving maternity and neonatal services.

The unit at Singleton Hospital is one of the biggest in Wales with about 3,200 births each year.

A visit by HIW in April found staffing levels and leadership had improved since a previous inspection last September.

The inspectors observed staff providing "kind and respectful" care to patients and their families and, in general, arrangements were in place to provide patients with safe and effective care.

At the time of the inspection HIW found that staffing levels for midwifery and medical staff had been "appropriate".

However, they found some concerns had not been sufficiently addressed, including those that could be a risk to patient safety.

"During the inspection, staff shared their concerns for patient care due to the increased use of agency staff, and a lack of appropriate skill mix within the unit," the report said.

It added that "immediate assurance" was sought following concerns around the hospital's antenatal assessment unit due to low staffing levels.

Midwifery staff also told inspectors "they did not always have access to essential medical equipment to provide sufficient care to patients".

A staff survey also revealed that 32 of 62 members said they would be happy with the care provided if they were patients.

HIW said it has "continued to work closely with the health board since the inspection and has received a "comprehensive improvement plan".

Independent review

A separate independent review into Swansea Bay's maternity services, commissioned by the health board in December, is taking place after a number of concerns were raised by families.

The health board said "sustained scrutiny and comment" on the services in public had caused concern among the public and had affected staff morale.

The purpose of the review was to "help address these concerns and maintain confidence in the service, with good practice highlighted and any lessons to be learned clearly identified and actioned".

In June it was announced that the barrister leading the review - Margaret Bowron KC - was stepping down following calls from families for her to resign.

The health board then asked Dr Denise Chaffer, who was already a member of the review panel, to step into the role on an interim basis.

The health board said: "We are fully committed to continuously improving our maternity and neonatal services, and this latest HIW report recognises the significant improvements already made, particularly around staffing and service leadership.

"However, we acknowledge there is still more to be done and are taking firm action to complete all the outstanding recommendations."