Poole Hospital

On this page

• 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

We looked for evidence that people and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality characteristics.

At our last inspection we rated this key question as requires improvement. At this assessment the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

This service scored 71 (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 made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff gave examples of where they had tailored the service to meet the individual needs of patients. There were good examples of where the staff had updated the service to meet the needs of patients with a learning disability or living with dementia. Staff identified patients’ individual needs at the preadmission assessment process, with their needs communicated to the admitting ward/team so any reasonable adaptations could be put in place. Examples of reasonable adaptations that staff had put in place included, patients being put first on the operating list, side room provision to reduce the impact of over stimulation, 1 to 1 care/nursing, working collaboratively with patients’ carers, and enabling patients to bring in familiar objects for reassurance.

The service provided feedback from 2 families about the care and support they received from the Learning Disability service and the rest of the surgery teams to provide support and care to minimise distress for patients with learning disability and communication challenges. This included a run through of accessing the hospital by staff to identify the the least stimulating route for the patient to access the hospital and identifying a named member of staff who would be looking after the patient.

Staff received training to give them the skills to support people with a learning disability and autism. As part of staff mandatory training, they were required to complete training about learning disability and autism appropriate to their role. Data provided by the service showed this training had been provided to staff from September 2024. The service had made progress with staff completing this training. Data for December 2024 showed for the different staff groups (administration and clerical staff, medical staff, nursing, and health support workers) there was a range between 74% and 87% of staff who had completed the training.

Staff, patients, and carers could access interpreters or signers when needed.

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.

Processes were in place to support joined up care. Discharge planning processes supported continuity of care once the patient was discharged. Access to specialist teams such as the Learning Disability Team, the Psychiatric Liaison Team, and the Dementia team supported staff to ensure patients received continuity of care for their other conditions, rather than just a surgical concern they were admitted with.

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

The service provided a range of leaflets for patients that provided advice and guidance about preparing for their surgery, what to expect on their admission to hospital, and what to do to support their recovery from surgery at home. The information was specific to different types of surgery. The trust website also had a library of patient information leaflets specific to certain conditions and surgery. Leaflets were able to be translated into different languages.

The trust website had a tool that allowed all information on the website to be translated into different languages, with many of the languages able to be read aloud. There was also the ability to change the size and style, the font and change the colour of the background to support people who had trouble reading or recognising the written word.

Staff had access to interpreters. Staff had guidance in the Interpreting and Translation Service policy. Translation services were available for patients whose first or preferred language was not English or who had a hearing impairment that required the use of an interpreter or lip speaker. The trust Interpreting and Translation policy gave staff guidance about how to access a range of interpreting resources, including face to face interpreters, and video or telephone interpreters. Each ward area had access to interpreters with the use of a video interpreting facility on the ward based iPads. Staff confirmed they had access to interpreting facilities, and following best practice guidance would not use patient family members as interpreters.

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

Detail about how to give feedback about care and treatment was detailed on the trust website. This included compliments, concerns, and complaints feedback processes. The trust published a monthly summary of complaints and their response to them on their website. This gave themes from across the whole of the trust.

A trust wide complaints policy gave staff guidance about managing and responding to complaints. The most recent data provided by the service showed the Surgery Directorate across both Poole Hospital and Royal Bournemouth Hospital had the greatest number of complaints exceeding the trust 55 day response time. However, as details were not given in percentages, it could not be confirmed that the surgery directorate had the highest proportion of complaints not resolved in the set period.

Review of complaints and the services responses to patient complaints showed the service provided answers to questions, an explanation of actions they were taking to make improvements and gave an apology to the patient.

Wards had ‘you said, we did’ boards which detailed the action they had taken in response to patient comments. An example included actions taken to reduce noise on the ward at night to enable patients’ sleep.

Patient feedback forms were available on wards, and completed ones were displayed on ward notice boards.

The service also used the friends and family test to get feedback and support improvements to the service. An example included a number of friends and family feedback commenting on the quality of the food, including it being served too cool. The service acted to resolve this and said there had been no further concerns raised about the temperature of food. However, feedback we received from patients during the inspection suggested this issue was not fully resolved.

The service did not always make sure that people could access the care, support and treatment they needed when they needed it.

Staff said there were frequent cancellations of surgery due to lack of intensive care capacity and availability of ward beds. Data provided by the service showed that in November 2024, a total of 215 patients had surgery cancelled on the day of surgery. In December 2024, 255 patients had their surgery cancelled on the day of surgery and in January 2025, the figure was 234. Reasons for cancellation of surgery were availability of equipment, no ward or ITU bed, surgery postponed, list overran, or surgeons were unavailable or on leave. This data was for the surgical services across both Poole Hospital and the Royal Bournemouth Hospital, there was no specific data to Poole Hospital.

Bed capacity on wards meant that some patients remained in recovery longer than they needed to, some waited up to four hours for a ward bed. Although there were no overnight stays in recovery, some patients were transferred to wards late at night.

Patients experienced delays in admission to wards from the emergency department. Data provided by the trust showed patients frequently spent more than 4 hours in the emergency department after the decision to admit to a ward.

The service was working to reduce the number of patients waiting for treatment. Data provided by the service which related to surgical services at both Poole Hospital and The Royal Bournemouth Hospital, showed that at the time of the inspection there were no patients waiting over 65 weeks to be seen and treated. This was an improvement form 206 patients waiting over 65 weeks in July 2024. At the time of the inspection there were 1295 patients waiting over 52 weeks to be seen and treatment, this was an improvement from 1444 patients waiting over 52 weeks in July 2024. For patients waiting to be seen and treated around 57% of them waited over 18 weeks. This was a constant figure for the period July 2024 to January 2025. The NHS constitution dictates that a patient has a right to begin their treatment for routine conditions following a referral into a consultant-led service, within a maximum waiting time of 18 weeks to treatment. Patient waiting times for planned surgery are monitored and reviewed at governance meetings. However, there was no evidence the service carried out harm reviews to identify and act on harm patients were exposed to because of delayed surgery.

However, there were improvements in the access to surgery for patients with a fractured neck of femur, with more patients receiving their surgery for fractured neck of femur in a timely manner.

The time to theatre for day trauma cases had improved with the introduction of a hand hub service 2 days a week where patients could have hand surgery under a local anaesthetic.

The environment on wards supported people with dementia to have equal access to facilities. Toilet and shower rooms had dementia friendly labelling. Door frames and toilet seats were of a contrasting colour to the walls and floors to make them clearly visible for both patients with dementia and for patients who were visually impaired.

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Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

There were processes in place to support staff to deliver care and treatment that did not put patients with protected characteristics at disadvantage. Staff said measures were in place to support patients with mental health conditions, this included support from the psychiatric liaison team provided by a mental health trust. There was guidance for the use of rapid tranquilisation and restraint, to ensure staff understood the legal framework for the use of them. Trust policy was that only security staff and police who had completed required training could carry out physical restraint. Nursing staff had no training about restraint, but did receive training in conflict management. A patient with a complex mental health condition described how staff on the ward had gone above and beyond to support them through a difficult diagnosis and were supporting them to have a successful discharge so they could live independently.

The service gave examples of how they had put in place tailored plans to support patients with a learning disability access the service and receive their care and treatment. An example included a patient with a severe learning disability who attended the hospital for dental treatment under a general anaesthetic. Staff tailored their treatment to meet their individual and specific needs. This included giving the patient photos of the staff that would be looking after them so they could recognise the staff, ensuring their favourite drinks and objects were available. Trimming hair and nails and checking ears for ear wax which normally caused the patient distress were carried out while they were anaesthetised.

For patients living with dementia, the service used the nationally recognised “This is me” document. The ‘This is me' helps health and social care professionals better understand who the person really is, which can help them deliver care that is tailored to the person's needs. It can therefore help to reduce distress for people with dementia and their carers. It can also help to overcome problems with communication and prevent more serious conditions such as malnutrition and dehydration.

The trust participated in a national study, the National Confidential Enquiry into Patient Outcome and Death (NCEPOD), focusing specifically on the care of acutely unwell patients with learning disabilities. This participation demonstrated a pro-active approach to understanding and addressing the unique needs and potential vulnerabilities of this patient group, aiming to ensure they receive equitable access to high-quality and appropriate care during emergency admissions.

However, the service had not carried out any reviews to identify whether patients with protected characteristics received their surgery and treatment in a timely and equitable manner as compared to patients without protected characteristics. They had planned to take part in a national study into acute illness in people with a learning disability which would evaluate the quality of care provided to patients with a learning disability who are admitted to hospital when acutely unwell.

People were supported 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 followed the Dorset wide Do Not Attempt Cardiopulmonary Resuscitation policy which was developed in collaboration with the trust and their health care partners in the Dorset area. Planning ahead for end of life which included patients’ preferences for place of care in last days or weeks of life and patients’ priorities at the end of life were completed on the trust electronic patient record system predominately by the palliative care team. Anticipatory care forms were completed by clinicians on the trust electronic patient records system.