Spire Little Aston 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

There was an exceptional, visible and values‑driven culture of person‑centred and non‑discriminatory care.

Staff cared for patients and each other in a way that exceeded expectations and fully respected their privacy and dignity. Staff demonstrated genuine empathy for the patients cared for.

People who used services, their families, carers and advocates were true, empowered partners in their care. Their expertise lived experience and preferences meaningfully shaped assessment, planning, treatment and review.

Feedback from people who used the service, their families, carers and stakeholders was consistently strongly positive, reflecting the exceptional respect, compassion and dignity with which staff treat people.

The service was exceptional at helping patients to understand their rights and express their views so that staff and managers at all levels understand their views, preferences, wishes and choices.

The embedded culture of kindness and respect extended to colleagues as they were treated in the same manner.

At our last assessment we rated this key question good. At this assessment the rating has improved to outstanding.

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 was exceptional at treating patient with kindness, empathy and compassion and in how they respected patient’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

Patients received care and support that was exceptionally compassionate and kind and took account of their needs. Patients we spoke to said they or their loved one were treated with kindness, compassion and dignity in their day-today care and support. People told us:” All the staff have been wonderful”, “I couldn’t fault them” and “they can't do enough for you they have all been so kind.” One person said a member of staff had not been as caring as others; we shared this during our inspection with the Hospital Director.

Patients were given the “Bedroom standard feedback” this enabled immediate feedback to address any issues around the patient's experience. Staff were discreet and responsive when caring for patients. Staff took the time to understand the needs of the patients and interact with patients and those close to them in a respectful and considerate way.

Patients were kept informed in a sensitive and timely manner, including updates on test results, transfer to theatre, time expected for return to the ward and changes to their treatment plan. When patients were discharged, they were supported to understand their ongoing treatment, including when to seek further help. This supported safe and informed decision-making.

We saw a ward hostess ask if a patient wanted them to bring them another hot drink the patients initially said no. The hostess then came back to them and said, “I'll get you another hot drink and bowl of soup” and the patient agreed.

Leaders promoted and supported staff to ensure patient dignity and privacy were central to the care they provided. At every opportunity, curtains were drawn, and blinds were closed on bedroom doors by staff when they provided care. We saw signs on bedroom doors saying patients did not wish to be disturbed as they were resting. Patients told us staff closed blinds to give them privacy when they were distressed.

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 in the anaesthetic room responded to patient’s anxieties about their operation and took steps to reduce the stress within the environment. 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 supported to be dressed or always covered.

Patients felt staff knew and understood them, including their preferences and wishes. Information about patient’s wishes were recorded.

Patients said staff responded to their needs quickly and efficiently, especially if they were in pain, discomfort, or distress.

Patients were assured information about them was treated confidentially and they knew staff respected their privacy. Staff followed policy to keep patient care and treatment confidential. The service had an information governance policy, and staff were compliant with it. Conversations between staff and patients were kept private and sensitive information was never shared in the presence of those not authorised to hear it.

All staff we spoke with or had contact with treated our inspection staff with kindness. The days of the inspection were extremely hot, staff ensured we had sufficient fluids, were well hydrated and looked after. On each day of our inspection, we found staff were welcoming and helpful. Several staff commented the difference working at Spire Little Aston was staff smiled and acknowledging other staff and visitor’s which was normal practice for everyone.

Recent patient satisfaction surveys demonstrated positive experiences of care. Of those surveyed, 96.4% said they were given sufficient privacy when discussing their condition or treatment, and 94.3% reported they were treated with dignity and respect.

The evidence showed an exceptional standard. The service treated people as individuals 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.

People’s individual needs and preferences were at the heart of the service, which delivered a fully tailored, holistic care experience. Patients care and treatment was individualised to meet their needs. Care and treatment was planned with the patients and they were aware of their care, treatment and hospital stay. Staff recognised and respected the totality of patient’s needs. They always took patient’s personal, cultural, social, and religious needs into account, and find innovative ways to meet them.

There was a proactive approach to understanding the needs and preferences of different groups of people and to deliver care in a way that met these needs, which was accessible and promoted equality. This included patients with protected equality characteristics, people and patients who had complex needs.

Staff understood and respected the personal, cultural, social, and religious needs of patients and how they may relate to care needs. For example, we saw a prayer box was available which contained items such as a prayer mat, candles, a prayer book and a cross and a sign to put on the door as rooms were interchangeable. A dedicated room would be identified every day to allow privacy. Staff told us they had recently had a patient with dementia they had given the patient the double room so their wife could stay overnight with them and reduce their anxiety.

There was a neurodiversity box that had headphones and fidget objects that staff could access.

Managers made sure staff, and patients, families and carers could get help from interpreters or signers when needed. There were hearing loops available in reception areas for patients if required. There was a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerances.

Patient satisfaction surveys showed that Spire Little Aston Hospital demonstrated high level of patient satisfaction with consultants, 96% of patients identified they would be extremely likely to recommend their consultant to friends and family if they needed similar care and treatment.

Feedback was gathered through patient surveys and concerns were responded to. We reviewed 11 care plans and saw these were tailored to individual needs and circumstances.

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

Patients told us they were fully informed of all the treatment options available to them, including the potential risk. They were aware of their condition, the surgery they required and plans in place for any ongoing treatment or follow up.

All patients we spoke with said they had sufficient information for what was happening before, during and post-surgery. They also knew who to contact if they needed anything. Two patients told us they had watched videos about their operation in “My Spire” which prepared them for how they may feel after their operation, pain relief and equipment which may be used.

We saw patients were encouraged to be as independent as soon as they were able following surgery (usually on the day of their 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 up out of bed as soon as possible. We saw several patients who had knee and hip replacement get out of bed with assistance on the day they had their surgery. Staff confirmed this promoted their recovery with most patients who had hip or knee replacements discharged home the day after their surgery mobile with walking aids such as sticks or a walking frame.

We saw the patients’ menu choices included hot and cold drinks and food, lighter meal options and specific dietary needs such as vegan, vegetarian, and gluten free. Snacks and sandwiches were available when requested as well as out of hours.

The friends and family test identified 87% of patients confirmed they were involved as much as they wanted to be in decisions about their care and treatment. The result suggested a high standard of care, strong communication, and a respectful environment, with opportunities to improve emotional support and medication-related information.

The staff were exceptional in how they 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.

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 and the impact of an operation. All staff we observed took time to explain procedures and the patients next steps and listen to patients or their loved one's anxieties We observed the porter talking patients to theatre providing reassurance and explaining their journey to theatre. We observed a pharmacist carefully explaining patients' medication and when it should be taken. Nurses explaining arrangements around patients discharge and follow up appointments and physiotherapists explaining patients exercises. All staff did this is a kind compassionate way reducing any anxiety they may have.

The Friends and Family Test feedback was consistently positive and demonstrated that patients felt informed and supported. Of those surveyed, 95.8% said staff had told them who to contact if they were worried about their condition. Most patients reported that consultants understood their needs (94%), explained information clearly (94%) and would provide appropriate care and treatment (96%). In addition, 84% felt they had sufficient time with their consultant, supporting informed decision-making and personalised care.

Staff responded promptly to people’s immediate needs by identifying and managing individual risks as part of delivering compassionate care. Staff demonstrated awareness of specific risk factors such as falls and pressure ulcers and ensured these were assessed on throughout the patient’s journey. We saw staff explaining the falls risk poster and explaining the needed to ring for assistance as they were assessed as “amber” risk of falls. Staff told us the availability of point of care blood testing provided timely results for patient management and was invaluable.

The night before our onsite assessment a patient had become unwell. The patient was seen by the resident doctor and their consultant. The consultant requested another speciality consultant to provide advice regarding the patient management. The consultant told us this was the benefit of working in at Little Aston Hospital where they could access other colleagues quickly as they worked closely. As a result, the patient was quickly stabilised.

Patients and their loved ones were given the both the hospital number and out of hours numbers should they have any concerns following discharge which they needed to discuss with staff. Staff would contact the resident doctor or patient’s consultant regarding actions they should take which may include returning for the hospital for further treatment.

Nursing staff told us about another patient who had become unwell and they had to arrange urgent transfer to another hospital. The staff member said a rapid review had been undertaken which demonstrated staff acted quickly and correctly to arrange the transfer. The staff member said the patient was now doing well.

We saw that special flat shoes were made available for patients if their usual footwear did not fit due to their bandages, so they were able to walk outside with outdoor shoes.

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.

We also saw when patients returned from theatres ward staff made them comfortable and ensured their call bell, mobile phone, glasses and asked if there was anything else they required and within their reach. Staff explained how much fluids they should have and when they may have something to eat. Patients appeared well cared for, clean and with the items they needed such as glasses close by. Staff encouraged people, where able, to eat and drink sufficient to maintain their health and wellbeing.

There were emergency call bells sited close to each bed and in recovery and theatre to ensure staff could call for additional and expert help could be summoned quickly.

People who used mobility aids such as walking frames or crutches had them close by and were assisted to use them until they regained their usual level of mobility. Patients were also provided with an additional pair of antiembolism stocking to take home so they had a pair to wash and a pair to wear. Staff were patient and carefully discussed dressings provided and whether they could have a bath or a shower.

Visiting hours for relatives were flexible, in some cases, family members could stay overnight, and the double bedroom would be used. Relatives were kept up to date of the patient's progress and timing for going to and returning from theatre.

The service cared about and promoted the wellbeing of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care.

The embedded culture of kindness and respect extended to colleagues. Patients received safe, effective, and person-centred care as Spire Little Aston recognised and met the wellbeing needs of staff. All staff we spoke to said they enjoyed working at Spire Little Aston and would recommend it as a place to work.

Patients benefited from staff who had regular opportunities to provide feedback, raise concerns, and suggest ways to improve the service or staff experiences. Leaders provided a timely and considered response. The service managers ensured staff were listened to.

There was a culture of kindness and respect between colleagues from other organisations. Patients were supported by staff who were valued by their leaders and their colleagues. They had a sense of belonging and the ability to contribute to decision making.

Staff had access to resources and facilities for safe working. This included being able to take breaks, designated rest areas for the duty doctor, and food and drink out of catering hours. The resident medical officer had access to private sleeping, changing, showering and toilet facilities. The morning staff huddle included a standard question if the resident doctor had had a disturbed night. The interim hospital director said if this was the case workload would be rearranged and if required another resident doctor would be brought in to cover the hospital. The interim hospital director philosophy was” if staff were tired there was an increased risk of mistakes and systems were in place to avoid this.”

The interim hospital director in response to current financial challenges experienced by some set up free soup and a roll for all staff. She said this ensured staff had hot food at least once a day when they were at work. The interim hospital director said its important staff can have something hot every day, we need to look after our staff so they can look after our patients well. All staff also had hot drinks and other snacks available to them.

The “Looking after you too” is a Little Aston initiative to promote staff wellbeing. All staff had a “Spire” water bottle provided to keep them well hydrated, Pilates sessions were held weekly and were available for all staff. Staff were entitled to a free comprehensive health check every 2 years.

Little Aston hospital had 3 mental health first aiders which included a nurse, medical secretary, and a manager. The mental health first aiders were a point of contact and reassurance for staff experiencing a mental health issue or emotional distress.

Leaders arranged special days such as nurses' day and tea and cakes with the senior leadership. Staff could drop in to enjoy tables with vintage tea plates, pots of tea, sandwiches, and cake. There was also an upcoming black-tie event to celebrate the anniversary of Little Aston for staff.

Staff could nominate other staff for an award, and they could receive a voucher. This was recognised during huddle meetings. Staff wellbeing was an agenda item in team meetings.

Staff felt valued by their leaders and their colleagues. Staff had opportunities to contribute to service development for example within a range of quality improvements plans such as improvements for waiting in the eye centre and improved outdoor seating for staff.

Staff were able to work agreed flexible hours to suit their personal life, caring responsibilities, or health requirements. For example, some staff preferred to work shorter shifts and not working a late shift then followed by an early shift.

Staff had access to personalised support which recognised the diversity of a workforce with proactive and reactive measures. There was a diversity champion who advocated for staff with protected characteristics. There were established staff network groups such as LGTQ+ (lesbian, gay, bisexual, transgender, and queer), Race Equality and mental health first aiders who provided a safe space for staff to connect, share experiences, and provide support and resources. There was a calender of events and initiatives that celebrated different cultures and traditions throughout the year. The events often included support materials and engagement from the catering team, opportunities for staff to learn from each other and to celebrate their diverse backgrounds and experiences. Examples of events included Race Equality week, International Women’s Day, Pride Month, South Asian Heritage Black History Month and Speak up month. There were LGBTQ+ educational events such as ‘lunch and learn’, speaker sessions and podcasts had recently been introduced to promote a more inclusive workplace culture.

There were 2 national programs for recognising staff who went above and beyond for their patients and celebrated staff for providing outstanding care. For registered nurses and associate nurses this was the Daisy award and for any other clinical staff Spire introduced the IRIS award. Little Aston Hospital had 3 staff who had won the award for the central region.