Nuffield Health Hereford Hospital

On this page

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

The service worked with patients to understand and manage risks. Care met patients' needs in a way which was safe and supportive and enabled them to do the things that mattered to them.

When people communicated their needs, emotions or distress, staff could manage this in a positive way which protects their rights and dignity and maximised learning for the future about the causes of their distress.

We looked for evidence that patient were treated with kindness, empathy and compassion. We assessed the levels of patient’s privacy and dignity afforded to patients. We asked patients to tell us about their experiences, if they were respected, if they understood that they and their experience of how they were treated and supported mattered. We also looked for evidence that every effort was made to take patient’s wishes into account and respect their choices, to achieve the best possible outcomes for them.

At our last assessment we rated this key question outstanding. At this assessment the rating is good.

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.

The service always treated patient with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs. Staff introduced themselves to patients and said what their role was. Staff were discreet and responsive when caring for patients. They took their time to interact with patients and those close to them in a respectful and considerate way. Staff avoided holding private conversations over patients.

Staff in the anaesthetic room responded to patient’s anxieties about their operation and took steps to reduce the stress within the environment. For example, patients who were particularly anxious or who had cognitive impairment were able to have somebody familiar with them.

In theatres, patients were covered as far as possible and not unduly exposed. Staff were respectful to the anaesthetised patients. On wards and when moving around the hospital, patients were encouraged and supported to be dressed or always covered.

Patients said staff treated them well and with kindness.

Staff followed policy to keep patient care and treatment confidential. Bad news was broken in a private setting and voices were kept as low as possible when talking about personal information in a communal area.

The service treated patients as individuals and made sure patient’s care, support and treatment met patient’s needs and preferences. Staff took account of patient’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff understood and respected the personal, cultural, social, and religious needs of patients and how they may relate to care needs. For example, by ensuring people’s access to premises and by meeting patients’ specific communication needs. There was a designated bedroom on the ward for patients living with dementia or learning disabilities. The designated room had pictures and signs in large print to help patients find facilities including the toilet. The room had a clock with large numbers so patients could see the time. The toilet had a red toilet seat in-line with best practice guidelines. Staff used red crockery so patients could see their plate. This was also in-line with best practice guidelines.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights and how to complain.

The information provided was in a format accessible to the patient group. Staff used different techniques for ensuring that they could communicate with patients and making sure they were involved in their own care and treatment. For example, staff asked patients questions to clarify that they had understood what they had been told. They gave patients time for queries and used pictures or writing pads for patients who were hard of hearing.

Staff made information leaflets available in languages spoken by patients.

Managers ensured that staff and patients had easy access to interpreters and/or signers.

Patients had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerance's.

Staff ensured that patients had access to appropriate spiritual support, by providing a quiet, calm space, called the contemplation room and staff could assist with pastoral needs on request. There was a centre local to the hospital which was used by the local community for Friday prayers. This was based offsite close to the hospital, that was available if patients wished to attend.

Feedback was gathered through patient surveys and concerns were responded to. We saw evidence of this by the display of patient feedback cards on the ward and waiting areas. There were comments made in response to the feedback by the hospital.

The service promoted patient’s independence, so patient knew their rights and had choice and control over their own care, treatment and well being.

We saw patients were encouraged to be as independent as soon as they were able following surgery. This included becoming mobile and able to move around the ward area, toilets and bathroom. Physiotherapists provided exercise routines when needed and supported patients to learn new ways of moving, so they could be out of bed as soon as possible.

Consent processes involved explaining the risks as well as the benefits and options for their care. Lengths of stay were short unless complications occurred.

On discharge, patients were provided with verbal and written advice, including safety netting, in order to promote recovery at home. This would be done by a phone call to the patient 24 hours after discharge to see how they were doing.

Patients who attended a pre-assessment appointment were able to choose another preferred Nuffield location to facilitate travel. Patients had single rooms with ensuite facilities and families could visit them for longer hours during the day.

Patients were supported to have choice and control over their own care and make decisions about their treatment and well being. Each patient had their own room on the ward. There was a range of appropriate equipment, such as, crutches, walking frames, and specialist cooling equipment to reduce post operative swelling, to support and maximise people’s independence and outcomes from care and treatment. There were physiotherapists to support patients to maintain independence and mobility after surgery.

Patients who wanted to take control of their medicines were enabled to do so. We saw there was secure arrangements for them to access their own medicines by their bedside.

The staff listened to and understood patient’s needs, views and wishes. Staff responded to patient’s needs in the moment and acted to minimise any discomfort, concern or distress.

Patients could summon staff with a call bell and staff frequently went to their rooms to assess their needs.

Staff observed patients and intervened where they saw people were uncomfortable, uncovered or distressed. People appeared well cared for, clean and with the items they needed such as glasses or walking aids close by. Staff encouraged people, where able, to eat and drink sufficiently to maintain health.

The hospital had a trained psychologist, and patients could be referred when necessary. The hospital had a dementia and learning disability champions who would assist the staff with training needs and additional requirements.

There was a ward-based kitchen, and the service had hostesses who served food from the ward kitchen. Hostesses notified nursing staff if a patient had not eaten their served meal.

Staff gave patients and those close to them help, emotional support and advice when they needed it. They were empathetic and considerate of the stress of a theatre environment.

The service cared about and promoted the well being of their staff and supported and enabled staff to always deliver person-centred care.

Staff had access to resource and facilities for safe working. This included being able to take breaks, designated rest areas for duty doctors, drink and food out of hours and drinking water. The resident doctor had access to private sleeping, changing, showering and toilet facilities.

Staff were able to provide feedback, raise concerns and suggest ways to improve the service or staff experiences and could expect a response. Staff were able to provide examples of change, such as, enhanced recovery packages after surgery.

Teams worked and where relevant learnt together, staff felt respected, supported and valued. There was a culture of kindness and respect between the staff. Many staff told us the area they worked and the hospital itself was like a family. Staff felt supported by their colleagues as well as managers.

Staff felt positive and proud about working for the provider and their team.

Staff had access to support for their own physical and emotional health needs through Nuffield Health, with access to doctors, counselling, physiotherapists and gym access. Managers had team meetings to feedback to staff and to hear their suggestions for improvements. All managers sent the minutes to staff after each meeting, making sure everyone was informed and up to date. Feedback was also sent by email and an online closed communication application.

There were well being champions, and a ‘contemplation’ room. This room was quiet and decorated in a calm and welcoming manner. This was a private place staff could go to talk privately to the well being champions if needed, or just a space to take some time out. Patient’s relatives were also welcome to use this room if needed.

Staff appraisals included conversations about career development and how it could be supported. All staff in theatres and the ward had received an appraisal this year.

Staff felt valued by their leaders and their colleagues. Staff had opportunities to contribute to service development. We spoke to staff who told us, the provider and local leaders ensured that staff with protected characteristics felt included and respected within the service.