Spire Portsmouth 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

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

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 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.

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 maintained patient privacy and confidentiality by avoiding private conversations around patients.

Patients consistently told us they were treated with kindness, compassion and empathy throughout their care. Patient feedback demonstrated staff took time to support them emotionally, particularly when they felt anxious or vulnerable. Patients described staff as caring, friendly, professional and attentive to their individual needs. A patient told us, ‘Staff are supportive, kind and efficient’.

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, who were between 16 and 18, 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. Throughout our assessment we saw how staff supported patients with compassion. Patients appeared comfortable and were engaged in conversations because there were sufficient staff. Patients told us, ‘Staff are always polite and helpful’ and ‘Everyone here is genuinely warm personable and caring’.

Staff followed policy to keep patient care and treatment confidential. Difficult conversations took place in a private setting and voices were kept as low as possible when talking about personal information in a communal area. There were no reported patient confidentiality breaches in surgery in the last 12 months.

Patients spoken with felt their needs were met in a timely way and we observed staff responded quickly to call bells. We saw patients were attended to in a kind and supportive way. Patients praised the staff with comments such as ‘‘Staff were attentive and caring and always treated me with dignity and respect.’

We also reviewed patient feedback provided by the service. Overall, this showed that patients were treated with kindness, empathy and compassion. Patients consistently reported feeling cared for, respected and reassured, and described interactions with staff that promoted their dignity and wellbeing throughout their care journey.

The service had a Dignity Champion who was part of a national network led by the National Dignity Council. Their role was to promote compassionate care, challenge poor practice and act as a positive role model for staff. A Dignity Champion is an individual who believes that being treated with dignity and respect is a basic human right rather than an optional extra.

Leaders told us that their goal was to achieve 99% or over positive feedback every month. The service responded to any neutral or negative feedback immediately to ensure improvement was made.

The evidence showed a good standard. The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’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. We reviewed 10 care plans and saw these were tailored to individual needs and circumstances.

We spoke to patients who confirmed they were treated in a way that considered their needs and preferences. One patient told us, ‘Throughout I have been treated as an individual and all my needs have been responded to without most care.’ ‘The communication to patients and between stuff flows professionally and seamlessly. My care felt bespoke’.

Feedback was gathered through patient surveys and concerns were responded to. We reviewed feedback which showed patients felt valued as individuals and staff treated them with dignity and respect. Patients frequently described staff taking time to listen, answer questions and provide personalised support. Survey results supported this, with 95% of inpatient respondents and 97% of day-case respondents agreeing or strongly agreeing they felt really cared for and looked after. In addition, 90% of both inpatient and day-case respondents agreed or strongly agreed they felt truly valued as an individual.

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

Patients understood their care and treatment plans and felt informed and involved in decisions about their care. One patient told us, ‘My plan for care was explained carefully and questions answered fully.’ Another patient told us ‘Nurses here are very attentive, keeping me informed at all times.

Patients consistently described a positive experience from admission through to discharge. The Friends and Family Test results were positive, with 97% of inpatient respondents and 99% of day-case respondents stating they would recommend the service. Overall, experience ratings were very high, with 88% of inpatient respondents and 90% of day-case respondents rating their experience at the highest level.

We saw patients were encouraged to be as independent as soon as they were able following surgery. Patients were well cared for, clean and with the items they needed such as glasses or walking aids close by. 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.

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 the 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.

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. This was also confirmed in patient feedback. Patients told us staff listened to and responded to their concerns. For example, one patient said, ‘Any concerns I had about my treatment were listened to and responded to with care and understanding’ and ‘Staff took time to explain things concisely.’

Patients used a call bell to alert staff to their needs. People who used mobility aids, such as walking frames or crutches, had access to them when needed and were supported by staff to use them safely until they regained their usual level of mobility. Staff observed patients and intervened where they saw people were uncomfortable, uncovered or distressed. We saw that staff frequently went to their rooms to assess patients. Staff encouraged people, where able, to eat and drink sufficiently to maintain health.

Information was tailored to individual need. Patient identifiable information was protected. We observed that white boards in areas accessible to all did not contain identifiable information. All patients had their own rooms which meant discussions about their care were kept private. Although rooms displayed the name of the patient, this was kept to minimal detail.

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.

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

Staff had access to personalised support that recognised and responded to the diverse needs of the workforce. They had access to resources and facilities for safe working. The service had 6 mental health first aiders from different specialities, 2 of which also served as wellbeing champions. Staff could contact them for emotional or mental health support. There were support networks, advice and resources sent by weekly wellbeing emails. This included mental health awareness for men and women and physical health events at a local gym.

There were celebration events for staff such as International Nurses Day, Operating Department Practitioner Day, and a Spring party for all staff. There were also notice boards throughout the service where staff could praise each other for care and kindness.

Staff had access to indoor and outdoor facilities to ensure they had an area for rest breaks. There was a restaurant that offered freshly cooked meals at affordable prices. The resident medical officer had access to private sleeping, changing, showering and toilet facilities.

We spoke with staff on wards, who told us there was a positive and supportive culture within the service. Staff said they felt respected and valued. Staff in theatres also told us they felt there were positive attitudes in the working environment and were supported by their colleagues. Throughout our inspection, staff told us they enjoyed their job and the majority of staff we spoke with had worked for the service for a considerable amount of time.

Staff felt able to provide feedback, raise concerns and suggest ways to improve the service and staff experience. Systems ensured their views were acknowledged and responded to. We reviewed staff feedback, which identified areas for improvement, particularly within the preoperative team. There had been operational changes with preoperative assessment which had resulted in some staffing reductions. We spoke with staff who felt these had impacted directly on staff wellbeing and concerns in work process. Staff in this area spoke to us and praised their manager for their kindness and support. This aligned with the staff survey which showed preoperative staff were overwhelmingly positive about local leadership and team culture, with concerns appearing more related to workload, staffing pressures and operational processes.

Staff survey results suggested generally positive perceptions of immediate managers, with high scores relating to trust, empowerment, respect and safety across the surgical workforce. Strategic Alignment scores were low in every department, ranging from 16.67% to 50%. Strategic alignment is a measure of whether staff understand, support, and feel connected to the organisation's overall goals, priorities and direction. A poor Strategic Alignment score indicates that effort and resources may not be focused on the organisation's key priorities, increasing the risk that objectives are not achieved and reducing overall organisational effectiveness.

The service responded positively to staff survey feedback by implementing improvement plans. This included relocating the Pre-Operative Assessment team to larger accommodation and improving communication and working practices.