Nuffield Health Cheltenham Hospital

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring Commentary (Key Question Summary)

At our last assessment we rated this key question Good. At this assessment the rating has remained Good.

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

We scored the service as 3. The evidence showed a good standard. The service always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

Patients told us that staff were kind, friendly, compassionate and they felt safe. They said staff consistently went above and beyond to support them and ensure their individual needs were met. Patients told us they were supported to understand their options, care plans and recovery.

Patients had private rooms. Theatre gowns and dressing gowns were worn to protect their dignity. Chaperones were available on request.

We observed staff responding to patient call bells promptly and respecting their privacy by closing doors so conversations were not overheard. Patients told us that when being transported to theatres, staff asked other people to leave the lift to maintain their dignity in a small space. Patient records were stored securely in locked cupboards.

All patients we spoke with said they were treated with kindness and compassion. One patient told us “staff are kind, friendly, open and professional”, and another said “Care is incredible here. I wanted a cup of tea 4:30am and it was no trouble. They go above and beyond.”

We scored the service as 4. The evidence showed an exceptional standard. The service treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The service took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff were supportive and understanding of people’s cultural and unique backgrounds and protected characteristics. The service was accessible for wheelchair users and patients whose mobility may be restricted. Lifts were available to all floors.

Staff told us they would make arrangements to meet patients’ needs based on the information provided by pre-assessment. Reasonable adjustments or preferences were planned in advance and care plans were written with patients to ensure their needs were met.

Staff told us they supported patients who, for example, had complex needs or were neurodiverse and anxious about coming in for surgery. They provided an example of a patient with autism whose anxiety about surgery was picked up in pre-assessment. The team arranged a tour of theatres and the ward, meeting staff and talking to the patient about what to expect. The patient was put first on the surgery list to reduce waiting time and anxiety. The outcome for the patient was, they recognised staff members when attending the hospital for their surgery which reduced their anxieties prior to going to the anesthetics room.

The provider had processes to provide accessible information to people including translation and interpretation services. However, not all staff were aware how to access leaflets in other languages.

We scored the service as 3. The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Patients were supported to maintain independence and exercise choice and control over their care. They told us they received sufficient information before surgery to make informed decisions. Staff worked with individuals and their families or carers to understand peoples individual preferences and made reasonable adjustments to meet these where possible.

We scored the service as 3. The evidence showed a good standard. The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Patients could call staff via a call bell at any time. We observed staff attending to patients promptly when a call bell was activated. Patients individual needs were discussed and written in their care plan. Staff told us they would put patients at risk of falls in rooms close to the nurses station and plan to have additional staff on duty.

Staff identified patient risks and responded appropriately. Staff responded promptly to an individual patient’s needs when post‑operative pain was not controlled, escalating concerns, adjusting pain relief, and arranging further medical review.

Patients told us their pain was well managed and there were “no delays or issues getting pain relief.”

We scored the service as 4. The evidence showed an exceptional standard.
The service always cared about and promoted the wellbeing of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care.

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During our assessment we spoke to numerous staff who shared they felt supported and happy in their role. Staff said recent changes in management had improved processes and communication and reduced stress. Staff working relationships improved, resulting in better overall care and productivity. One staff member told us “It’s an honour to work with the team. It’s a supportive unit.” Staff said they enjoyed working for the provider.

Staff said there were opportunities for career development and felt supported during training. There were examples of staff progressing within the organisation and undertaking additional qualifications to support their development. Some staff were successful at interview in progressing to a more senior role.

Provider support for staff included financial advice, counselling and mental health first aiders. Staff also had access to the hospital gym and the local Nuffield gym.

Daily huddles enabled department leads to recognise and acknowledge staff for achievements and good practice. The provider recognised staff success within the service. For example, there were head of department high 5 recognitions when staff could win £25 vouchers. There were also opportunities to win free meals in the staff canteen as recognition. There was a social committee which arranged summer fetes, Christmas parties and breakfast mornings.

The service gathered staff views with quarterly questionnaires, Peakon surveys, staff forums and leadership visibility. Peakon surveys are a tool used by organisations to gather anonymous feedback about the workplace experience. Staff said leaders listen to their views and improvements have been made. For example, benches were installed outside reception and flowers displayed in the main reception area.

The hospital had staff who were trained in mental health first aid to support both patients and staff.