Nuffield Health Bristol Hospital - The Chesterfield

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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

We looked for evidence that patients were treated with kindness, empathy and compassion. We assessed the levels of patient’s privacy and dignity afforded to patients. We asked patients to tell us about their experiences, if they were respected, and how they were treated. We also looked for evidence that every effort was made to take patient’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 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.

Patients told us staff were kind, encouraging, attentive and they felt safe. They said staff couldn’t do enough to support them. Patients told us everything was carefully explained and they understood what to expect. Patients said any anxieties were addressed through discussions with the surgeon, which helped to reassure them.

We observed staff supporting patients undertake their physiotherapy. Staff were kind and supportive, allowing them time to adjust following surgery.

Patients had private rooms. Staff ensured patients’ privacy and dignity was maintained by closing doors and knocking before entering rooms. There was a light system on patient rooms to indicate when personal care or sensitive discussions were taking place, helping to safeguard patient dignity at all times.

Patients wore theatre gowns and dressing gowns when being transported to theatres to protect their dignity.

During our theatre observations, we saw staff provide a patient with reassuring and compassionate support. Communication was clear, professional, and effective, helping to put the patient at ease prior to their procedure.

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.

The service made reasonable adjustments for patients to meet their needs and preferences. Staff told us they were provided with relevant information in pre-assessment to plan patients care in advance. For example, there was a dementia friendly room that could be arranged to meet patient preferences and support them during their stay. Patients could also request for a relative or friend to stay with them.

Most information leaflets were available in different formats, such as paper or digital to meet patient preferences. Staff were able to use a telephone interpretation service which could be arranged in advance. Staff told us this worked well. Staff told us they were able to make leaflets in large print if a patient requested this.

Staff understood and respected patients personal, cultural and religious needs and were able to adapt care for individual patient requirements.

Patients had a choice of food to meet their dietary requirements. Staff reported that a new food chart had been implemented to identify patients undergoing gastric band surgery. This ensured that patients who were unable to eat were not approached to make meal choices, reducing unnecessary stress and anxiety.

The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Patients were supported to maintain independence throughout their hospital stay, including after surgery. Staff supported patients to mobilise and ensured they were provided with the necessary equipment to aid them.

Patients were involved in their care planning and could request reasonable adjustments to be made.

Patients could request for a family member or friend to be with them during appointments and whilst on the ward. Patients could have visitors at any time on the ward.

The evidence showed a good standard. The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Patients had access to call bells to request support from staff if they needed anything. We observed staff responding promptly when a bell was activated. Patients told us staff supported them with personal care needs at any time.

Staff identified patient risks during pre-assessment and during observations on the ward. Patients at high risk of falls were cared for in rooms near the nurses’ station to enable closer monitoring and additional support.

Staff monitored patients’ pain and discomfort, providing adequate pain relief or escalating to the Resident Doctor for further clinical review.

The evidence showed a good standard. 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 onsite facilities to allow them to take breaks away from their role, access food and drink and were supported to do so by leaders.

During our assessment, we spoke to several staff who told us they felt valued and supported in their role. Staff said everyone worked well together and recent staff changes in theatres had improved the culture.

Staff said there were opportunities to progress and leaders supported this. Apprenticeships, leadership programmes, and continuing professional development (CPD) was available. Leaders told us they encouraged development and supported staff to attend training and conferences.

Staff had access to Mental Health Champions and counselling to support their mental health. They could also access Nuffield Health Gyms to support their physical health.

We observed daily huddles where staff were recognised and thanked for good work and achievements, helping to promote a positive culture and encourage continued good practice. The provider also recognised staff success with high 5 recognitions. This was a Nuffield wide recognition scheme where staff could be nominated for good work. Prizes such as vouchers or free meals in the staff canteen were available to win.

Staff were able to provide feedback anonymously with regular staff surveys and theatre staff surveys. Staff said leaders listened to their views and they received feedback from the surveys. Records showed, 82% of staff had participated in the most recent survey. The hospital had produced an engagement update outlining the actions it would take in response to the survey results, demonstrating that staff feedback was being reviewed and used to drive improvements.

Staff told us they were confident to approach leaders with concerns or improvement ideas and felt they would be listened to. They told us leaders had an open door policy and were always approachable.