Chippenham Hospital

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence that the service met people’s needs.

This is the first assessment for this registered service. This key question has been rated good.

This meant people’s needs were met through good organisation and delivery.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with them, how to respond to any relevant changes in their needs.

The service ensured patients were at the centre of their care and treatment decisions, working in partnership with patients and their families to respond to changes in individual needs and preferences.

Staff understood what mattered to people and provided care that met physical, emotional, and social needs. We observed staff delivering person centred care and meeting fundamental care needs.

We observed a staff member had understood a patient living with Dementia needed time to process what they were being told, we saw the staff were patient and gentle to the person’s needs.

Staff provided examples of reasonable adjustments, including flexible visiting and access to meaningful activities.

Staff used a quality-of-life questionnaire to support patients in expressing how they felt and ensure care remained responsive to changes in wellbeing.

Specialist nursing teams, including a tissue viability nurse (TVN), visited patients on wards to provide tailored clinical advice.

Patient records were individualised and holistic, with recording of nutritional requirements on charts and bed boards. Menus met national dietary guidance and catered for medical, cultural and lifestyle needs, including diabetic diets. Food and fluid intake was accurately monitored, and patients gave positive feedback about food availability and staff support.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service understood the diverse health and care needs of people and their local communities. Care was joined-up, flexible and supported choice and continuity.

Staff worked with other partners to meet patients’ needs. The service had strong partnerships with the local acute hospitals. As an example of this staff from one of the local hospitals attended the service’s meetings. This was to ensure there was continuity of care between the acute hospital and the community health inpatient service with many patients being discharged from the hospital into the community. Staff spoke positively about the partnerships with the local hospitals.

Managers planned and organised services, so they met the changing needs of the local population. Managers recognised patients accessing the service had increasingly complex physical health needs. Staff reviewed patients at the morning handover meetings.

When a patient was discharged from the service staff referred them back to their own GP to ensure continuity of care. The service had systems to help care for patients in need of additional support or specialist intervention.

The service was inclusive and took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services. They coordinated care with other services and services.

Staff supported patients living with dementia and learning disabilities by using patient passports. A patient passport is a document designed to help doctors and nurses understand the specific needs, communication styles, and medical backgrounds of patients with learning disabilities or autism. Staff liaised with families and carers to help meet these needs.

Staff understood and applied the policy on meeting the information and communication needs of patients with a disability or sensory loss. Patient communication methods were discussed in the daily handover to ensure staff were aware of how to meet these needs when visiting a patient.

The service provided appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service ensured that patients and staff had access to clear, accurate and current information provided in formats that met individual needs

Staff made sure patients understood what had been discussed. They ensured patients could obtain information on treatments, local services, patients’ rights, how to complain and so on. One relative told us, “I go with [my relative] into the physiotherapy room and [staff] explain everything to [my relative] and me and what they are doing [treatment wise]. And we understand.”

Staff ensured carers and families were regularly updated about the patient’s progress.

Safety boards displayed key information, and posters provided access to condition‑specific, treatment and self‑care information. Leaflets supported health education, risk awareness such as falls prevention, and signposted local and national support services. These were accessible to non-English speakers and were in an easy-read format.

Specialist nurses supported patients and staff, with teams such as tissue viability producing targeted leaflets and posters to promote best practice. Staff had access to clinical guidance and standard operating procedures to support safe and consistent care delivery.

We observed dementia friendly information, including noticeboards displaying patient feedback and staff information.

The service complied with the Accessible Information Standard.

The service made it easy for people to share their feedback and ideas or raise complaints about their care, treatment and support. They involved them in decisions about their care and told them what’s changed as a result.

People could share feedback and ideas or raise complaints to the service about their care, treatment and support. Staff involved patients in decisions about their care and told them what’s changed as a result.

Staff protected patients who raised concerns or complaints from discrimination and harassment.

Managers had used learning from concerns and complaints to improve the service. For example, following a recent informal complaint from a family member, managers met with the family to further understand how staff should have handled a situation differently. Staff going forward were asked to ensure they always used clear terminology around care and treatment across the team and when speaking with patients and their carers.

Carers and patients told us they would know how to raise concerns if they felt the need to and information was provided in the service leaflet. When patients complained or raised concerns, they received feedback.

Staff received feedback of complaints and acted on the findings. Complaints were discussed in the monthly governance meeting and the monthly staff team meetings.

The service made sure that everyone could access the care, support and treatment they needed when they needed it.

The service made sure that everyone could access the care, support and treatment they needed when they needed it.

Staff ensured carers, families were regularly updated about the patient’s progress. Patients and carers told us they were called with updates of any test results and any appointments made for further investigations.

Managers monitored admissions and made sure patients could access services when needed and received treatment within agreed timeframes.

Managers and staff worked closely with other services to transfer patient care over to them once the patient had recovered appropriately.

Patients and carers told us they knew what to expect from staff on these community inpatient wards with regards to their rehabilitation.

Managers and staff worked to make sure patients did not stay longer than they needed to and staff started planning each patient’s discharge as carefully and early as possible.

The service monitored delayed discharges, and no incidents of this type were identified when we reviewed the data they provided us . The service ensured more time was provided to those with complex care needs when planning their discharge.

The service actively listened to information about people who were most likely to experience inequality in experience or outcomes. They tailored the care, support and treatment in response to this.

Staff and leaders actively listened to feedback and information from people at risk of inequality and tailored care and support accordingly.

The clinical strategy recognised a proportion of the local population lived in areas of deprivation, with poorer health outcomes and barriers to accessing care. These included rural geography, digital poverty and marginalised communities. Leaders demonstrated a clear understanding of how these factors contributed to health inequity. They had plans to address this via their neighbourhood teams.

The strategy set out a whole system, equity focussed approach, aligned with national policy, with a focus on early intervention, prevention, self-management and delivering more care closer to home to improve population health and reduce avoidable admissions.

Future plans focused on expanding community and home-based care, developing new models of delivery and supporting effective delivery of “Neighbourhood Health provisions.”

Compliance with equality, diversity, inclusion, and human rights training was evidenced. This demonstrated a strong organisational commitment to promoting inclusive and equitable care.

The service supported people to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The service supported patients to plan for important life changes, so they have time, information and support to make informed decisions, including at end of life. This was communicated in a sensitive and dignified way.

Staff recognised the importance of early discussions about care preferences, including at admission and ensured these were clearly recorded and shared so care was delivered in line with individual wishes, where appropriate to do so. Staff told us how they escalated a person’s end of life care needs and requested additional support for the team.

Staff enabled patients to make advanced decisions to refuse treatment. Staff ensured existing advanced decisions were followed for patients. Staff followed patient’s wishes where they had a do not attempt cardiopulmonary resuscitation order (DNACPR) in place. This meant if the patient’s heart or breathing stopped, resuscitation should not be attempted.

Relevant healthcare professionals and partner services were actively involved in care planning, particularly for patients with complex needs. Palliative care and discharge liaison teams supported personalised planning, and staff reported easy access to specialist support, including specialist palliative care teams.