Three Shires 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

Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand care and treatment. They provided emotional support to patients and families and understood how to provide people with adapted care to meet individual needs. The service encouraged people to give feedback, which was persistently positive and achieved or exceeded the provider’s expected standards. Such standards were furthered by the team’s internal audit system and care ethos that focused on patient centred, compassionate care.

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

Staff worked in the provider’s ‘circle of compassion’, which embedded values such as dignity and kindness in all aspects of care. These were clearly present throughout the service and the culture promoted thoughtfulness from staff. Ward staff noticed when patients looked uncomfortable in bed and helped them to reposition without being asked for help. The hotel services team, responsible for housekeeping and catering, built a rapport with each patient, improving mood and wellbeing.

During all our observations, physiotherapists were reassuring with patients during post-operative sessions. They introduced themselves, explained their plan, and took time to answer questions. Recovery goals were realistic, and physiotherapists adopted an engaging manner with each patient, adapted to their goals and abilities. Where a patient was nervous about exercising, the physiotherapist persuaded them to “go for a little wander” as a successful technique to encourage movement. Where patients were low in mood or worried, physiotherapists adapted their approach and worked with the individual to provide additional support.

In all cases we saw staff treat people with dignity and respect. For example, physiotherapists checked patients had fresh towels to take a shower after their exercise session. Nurses were unwaveringly positive with patients after their surgery and built confidence through their approach.

The service used the NHS Friends and Family Test (FFT) to gather feedback. In the previous 12 months, over 99% of patients said they were treated with dignity and respect and felt they were given enough privacy. Recent patient comments included, “I was treated extremely well by all staff members, from the lovely morning receptionist to my dedicated nurse, the anaesthetist and my consultant – thank you all.”

All 13 patients we spoke with during our assessment were unwaveringly positive about their care and interactions with staff. None of the patients identified areas for improvement.

The ward team facilitated an active and friendly atmosphere, and staff encouraged patients to move around as safely as possible after their procedures to promote effective recovery. Patients gave consistently good feedback about this approach. A recent patient commented, “Excellent staff, made me feel very at ease as I was so nervous about my operation, they talked me through everything that was going to happen and explained in depth to put my mind at rest, thank you.” Another patient said, “From being admitted to discharge, I felt all staff, clinical, administrative, housekeeping and porters included treated me as an individual and with respect. Thank you.”

A dedicated booking team worked with pre-operative care nurses to complete screening and assess whether patients needed to be seen in person or if they could be assessed remotely. The team was always guided by clinical need and risk and met each patient’s preferences where possible.

Ward teams introduced bedside handovers between each patient’s named nurses as shifts changed. We observed this during our inspection and saw the process was interactive and individualised. Nurses discussed care with each patient, explained any updates, and discussed how they were feeling. Each nurse signed a statement of accountability to note they had reviewed the patient’s care and understood the next steps in the treatment plan. All patients were accommodated in single en-suite rooms, which ensured confidentiality.

Nurses carried out bedside handovers quietly and outside the patient’s bedroom in cases where they were asleep. The nurse taking over then reviewed the care plan with the patient when they woke up, demonstrating a good standard of individual care. The pharmacy team met with the patient to discuss medicines after discharge, which ensured they understood their prescription.

Patients said they felt confident in staff because they were open and honest. A patient said, “What they’ve said will happen – the nurses, the doctors – has happened. I’m very confident about the care here.”

Patients were supported to have choice and control over their own care and to make decisions about their care, treatment and wellbeing.

In the FFT, patients frequently commented on choice and involvement in decision-making as positive aspects of their experience. In the previous 12 months, over 99% of patients said they were involved in decisions about their care. In the same period 98% of patients said the pre-admission process helped them to be adequately informed and prepared for their procedure. Recent comments included, “I felt very confident about what was going to happen as everything was explained clearly”, and “At all stages through my treatment, from initial consultation to going home after surgery, I was given more than enough time and information about what I could expect and allowed to make informed decisions about my treatment.”

Staff worked with patients to develop treatment and recovery plans in line with their goals and desired outcomes. For example, physiotherapists established information about each person's work life, hobbies, and home activities to ensure recovery exercises would enable them to return to these as quickly as possible. We saw physiotherapists used positive reinforcement to encourage patients to challenge themselves and push their abilities within safe limits.

Patients we spoke with described comprehensive and easy-to-understand education and advice from staff. A patient told us, “The consultant came and sat with me and explained everything. They took their time, and I liked how they described things. The physio gave me brilliant advice and I feel confident this [my treatment] will all work out for me.”

Staff used various communication tools to ensure they promoted choice and control with each patient. For example, a nurse worked with a translator to ensure a patient who did not speak English could make their decisions known to the ward team. Physiotherapists used a visual communication board to support patients with verbal speech challenges. Such approaches ensured the service was inclusive and assured independence for each patient.

Staff involved patients at each stage of care. Consultants met with each patient after surgery to explain next steps. We observed consistently good listening skills from all staff, particularly when patients were nervous or anxious.

Physiotherapists made sure patients were comfortable during therapy and regularly checked how the person was feeling. They used gentle reassurance where patients found the first stages challenging. For example, during an observation a physiotherapist said to a patient, “It’s just about taking little bits at a time.” Such an approach helped the patient, who was notably more relaxed afterwards.

Staff used an intentional rounding system to continuously monitor patient need. Intentional rounding refers to a structured, nurse-led practice that monitors vital signs and other patient needs. This process resulted from a quality improvement project designed, piloted, and implemented by the ward manager.

Staff used a telephone language translation service to maintain communication at each step of treatment. We observed this process during our inspection. Nurses worked with the patient and the translator to ensure the pre-operative consent process was fully understood. They gave the patient time to ask questions about treatment, and nurses worked well with the translator to complete risk assessments. Staff maintained their caring and compassionate approach throughout translation and made sure the patient knew they were at the centre of care.

Staff demonstrated consistent pain management during each patient's care. They documented regular pain checks in records, and we observed physiotherapists discuss this with each patient during rehabilitation.

Patients spoke positively about the strategies staff used to promote good outcomes. For example, 1 patient said, “The food here is amazing. I took photos of it to send to my friends, it made me feel so much better after surgery.” Another patient said, “My pain has been managed really well. The nurse explained the medicine I’ll be taking home, and I’ve seen the physio twice already. Everything feels just right."

The hospital held Workplace Wellbeing Charter accreditation and was listed on the Wellbeing National Charter Register. This recognised the provider’s work to create an empowered, motivated workforce that had access to support and development. The provider acted on feedback from a culture audit carried out amongst staff and provided access to mental health and healthy living resources. Such work included every team and department in the hospital.

Staff spoke positively about the provider and working culture. A member of staff told us, “I’ve never worked in a team that’s so enthusiastic, it feels like we’re going to from strength to strength.”

The physiotherapy team completed a quality improvement project to review a reduction in morale and engagement. This resulted in the introduction of a new 1-to-1 supervision process and more opportunities for team communication and liaison. The project was an example of how staff effectively used support systems to review, reflect on, and improve working relationships and systems.

Leaders supported professional development and staff said they had the freedom and resources to plan their own career paths to contribute to the hospital’s impact and success. For example, a healthcare assistant had undertaken advanced training to establish a bladder scanning clinic as an end-to-end process for patients during pre-assessment.