Sue Ryder - Wheatfields Hospice

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. Staff treated people 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. Managers did not support staff wellbeing.

We looked for evidence that people were always treated with kindness, empathy and compassion. We checked that people’s privacy and dignity was respected, that 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 people’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 good. At this assessment the rating has changed to requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

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 demonstrated kindness, empathy, and compassion. During the assessment, we observed that staff treated service users with respect and maintained their dignity. For instance, staff were seen knocking before entering rooms and using curtains during personal care to preserve privacy and dignity.

Interviews with service users revealed positive experiences of care. One patient described the environment as wonderful, and another told us that staff were proactive in ensuring their comfort for example checking in regularly and responding to call bells or advising when a short wait might be necessary.

In addition, a picture of a wheatsheaf was displayed in the inpatient unit. Staff explained that this image serves as a discreet signal to indicate that a service user has recently died. As a result, when staff come on duty, they are aware of the loss and can make sensitive enquiries prior to handover.

We reviewed the Experiences of Care survey. The results were recorded as 100% across key domains such as respect and dignity, patient involvement, support, confidence and trust, and overall care. However, data was recorded over only four months within a 12‐month period with just seven responses (2 in August 2024, 1 in October 2024, 1 in January 2025, and 3 in February 2025). Staff told us that since the reopening of the hospice they did not always have meaningful interactions with service users. Interactions which did take place, were mostly task orientated. Staff told us that this was due to low staffing numbers, and they were unable to spend as much time with service users and their families as they used to do.

We saw multiple thank you cards from families who had used the service.

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

Staff told us they considered individual needs when care planning, this included being aware of cultural backgrounds and protected characteristics. We saw an example of this during our assessment onsite where staff had to arrange an interpreter for a family whose first language was not English.

The service offered a "Living Well" programme delivered by a multidisciplinary team comprising physiotherapists, occupational therapists, and complementary therapists. The programme was provided at the day therapy unit through both face-to-face and virtual sessions. It was structured over four sessions across four weeks for service users.

The service offered complementary therapies to inpatients, this included reflexology and aromatherapy. These services were very well received by the patients that we spoke with.

Staff did not complete training on bereavement and loss or breaking bad news.

We did not look at Independence, choice and control during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Responding to people’s immediate needs during this assessment. The score for this quality statement is based on the previous rating for Caring.

The service did not care about or promote the wellbeing of their staff. They did not support or enable staff to deliver person-centred care.

Staff we spoke with were passionate about their work and were driven to provide the best possible specialist palliative care. However, most staff we spoke with shared that they struggled to have the time to provide the person-centred care that they would expect people to be able to deliver. Staff told us this was as a result of staffing numbers failing to meet the needs of service users.

Staff shared emotional accounts of difficult circumstances they had found themselves in, along with feelings of wanting to leave, including no longer wanting to work in palliative care. Most clinical and non-clinical staff felt supported by their immediate colleagues but felt there was no support from the senior leadership management. Additionally, staff told us that sickness levels were high and that the main reason for short term and long-term sickness was the daily stresses of the job due to staffing and lack of support. Information provided after our assessment showed that in March 2025, 10% of all sickness was recorded as stress- work related or anxiety- work related.

Staff told us they felt leadership was not present and therefore, did not see first-hand the challenges they faced on an almost daily basis. Staff also told us that they felt under-represented. This they stated also made them feel misunderstood, and unheard when they escalated concerns about safety and staffing.

Staff also described the behaviour of service leaders as unprofessional, which they felt had been left without challenge. This lack of address had resulted in staff experiencing stress and anxiety and although these concerns had been electronically reported on several occasions, no formal action had been taken by leaders.

Staff told us there were no clear structures to provide all staff with adequate and timely support following an incident. For example, there were no set structures in place for debriefing and staff felt they were left to manage their own emotional support.

Staff reported that because of constantly low staffing levels, patient numbers, and patient acuity, they were frequently unable to take their breaks. Staff explained that taking these breaks could compromise the already stretched staffing ratios and make their unit unsafe. When asked whether staff had escalated these concerns or logged them electronically, staff indicated that although systems exist for recording issues, these staffing challenges are historic and have become largely normalised within the service.

Staff reported that their appraisals were overdue. We requested the appraisal data for the service, and although the documentation was provided, we were unable to access it because it was password-protected which we did not receive. As a result, we could not verify the details of the appraisal process during our assessment.

The appraisal data submitted following our assessment included staff who were no longer employed by the service. We also found that 15 staff listed on the rotas were not included in the appraisal records provided.

This meant it was unclear how the provider assured itself that all staff had received appraisals in line with its own policy.

The provider’s audit data also identified that the appraisal process required improvement. Staff we spoke with confirmed that not all had received regular appraisals.