Cleveland Clinic London 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

People were treated with kindness and compassion. Staff protected their privacy and dignity. They treated them as individuals and supported their preferences. People had choice in their care and were encouraged to maintain relationships with family and friends. Staff responded to people in a timely way. The service supported staff wellbeing.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Throughout our onsite assessment we observed patients being treated with kindness and compassion. Staff were respectful to patients and each other. Porters transferred patients in a caring way engaging with the patients and other staff. Staff we spoke with told us the culture of the organisation was kind and caring.

We saw staff talking to patients about their treatments and asking for permission before any procedure was carried out, making sure they were comfortable throughout. We saw staff respond to patients’ discomfort and distress. One patient we spoke with told us their caregiver always maintained their privacy ensuring the door was closed and blinds were drawn, and staff were always helpful. The staff were always quick to respond to the call bell ensuring the patient was well cared for. Before the procedure was carried out the team waited for a family member to arrive, so they were included and kept up to date.

Staff understood each patient had individual needs and ensured these were met. One patient we spoke with told us their individual religious needs were met, and their family circumstances were taken into consideration when family were visiting.

Patients had a choice of several menus with varying dietary needs. The dietitians worked closely with the catering staff to ensure the meals could meet the needs of the patient.

Staff understood that patients in critical care weren’t always able to communicate in the way they were normally did or needed additional support. Staff could use different tools to assess pain. Staff used the critical care observation tool for intubated or sedated patients. This tool included looking at facial expressions and body movements to assess their pain and to take appropriate action.

The provider had undertaken the patient led assessment for the care environment audit (PLACE). This annual assessment looked at non-clinical aspects of the patient environment. Critical Care scored well in most categories however, the environment was 50% compliant as a dementia friendly space. Scoping dementia friendly facilities was outlined in the safety and quality improvement plan to enhance the service. Patients were invited to give feedback as part of the PLACE audit. Feedback on the multi-faith room highlighted there were not designated areas for men and women to sit separately, which is part of different faiths. Patients were pleased that the audit was being undertaken as it showed that the provider genuinely cared about individual needs.

People were supported to maintain relationships and networks that were important to them. People had access to their friends and family while they were in the critical care unit. Visiting hours were set from 8am to 8pm but individual circumstances were reviewed to accommodate visiting outside of these hours

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The provider had relationships with local hotels or used vacant rooms on closed wards when available for relatives who wanted to stay in the hospital near their relative whilst they were a patient on the critical care unit.

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During the multi-disciplinary team (MDT) meeting we attended, the team discussed long term patients on the unit and how to support their ongoing needs. One patient had been allowed to have their pet visit to aid with their recovery and wellbeing.

People were supported to have a choice and control over their own care and to make decisions about their care, treatment and wellbeing. One patient told us that procedures were explained to them, and their permission sought. Their preferences were asked for and felt well informed to be able to say yes or no to a procedure. Doctors ensured chaperones were present during intimate examinations providing a safeguard and protection for both patient and doctor.

The critical care unit had a dedicated pain nurse to support the patient and staff in meeting the patient’s needs. They used several tools, depending on the individual’s communication ability, to help patients express their level of pain. Advance nurse practitioners worked with the team and were able to prescribe medications for patients to have their needs met immediately.

The consultants had an office within the unit and there was always a consultant available. Ward staff from across the hospital could access the critical care outreach team easily via online consultation form which sent alerts to the team and facilitated timely responses to deteriorating patients who were on the wards or other departments.

As many patients on the critical care unit were bed bound, it was important for staff to check and document any break down of the skin. Staff told us there was a skin integrity ward round at which their findings were discussed. Staff educators regularly attended the unit to provide advice and training on caring for patients who were bed bound and how to manage any skin concerns.

All rooms had ceiling hoists meaning patients could be moved easily and equipment did not have to be shared, assisting with providing care being delivered in a timely manner.

Staff told us they felt supported, and their wellbeing was important to senior leaders. They felt there was a culture of inclusivity, listening and open conversations creating a positive environment to work in. Several staff members told us they were happy working in the unit and were proud of the team they worked in.

Staff reported being valued by their leaders and colleagues and their ability to contribute to decision making. There were opportunities for staff to speak up in meetings and during senior staff rounds where they could have open conversations with leaders.

Staff had access to a caregiver lounge which created a comfortable area for staff to relax. The provider had introduced wellbeing applications for staff to access online for example, an employee assistance programme that included financial services and a counselling service. Staff could access 15 trained mental health first aiders who they could contact if they required and support their wellbeing.

Staff could join a range of staff networks which had representation from a cross section of staff at all levels. Information on staff networks was easily accessible on the provider’s intranet.