You are here

Royal Surrey County Hospital Good

All reports

Inspection report

Date of Inspection: 16 August 2012
Date of Publication: 4 September 2012
Inspection Report published 4 September 2012 PDF

People should be treated with respect, involved in discussions about their care and treatment and able to influence how the service is run (outcome 1)

Meeting this standard

We checked that people who use this service

  • Understand the care, treatment and support choices available to them.
  • Can express their views, so far as they are able to do so, and are involved in making decisions about their care, treatment and support.
  • Have their privacy, dignity and independence respected.
  • Have their views and experiences taken into account in the way the service is provided and delivered.

How this check was done

Our judgement

The provider had arrangements in place to ensure that people’s privacy, dignity and independence were respected.

The provider was meeting this standard.

User experience

When we spoke with in-patients and their relatives, people told us that, in the main, staff treated people with dignity and respect. Patients gave examples of this, which included being addressed by their preferred names, and ensuring personal care needs were dealt with in private. Patients commented positively on both the ward staff and the A&E staff, one summing this up by saying that the “Staff looked after me with kindness and respect.”

The majority of people we spoke to told us that they had been involved in discussions about their care, and their wishes had been taken into account. One person told us about their individual situation and said “I am conscious of their honesty in the way that they have informed me of my diagnosis.” It was said that the staff had fully involved this patient in frank and open discussion, which had enabled planning for the future and “Reduced the level of worry.”

The relatives we spoke to had a number of positive comments to make about the care including “The care is brilliant” and there is “Total respect from what we have seen.” The care in A&E was said to be “Second to none,” with “Absolute respect for dignity.”

Some patients gave us information that we passed on to the management of the hospital for their attention, for example a hearing impaired relative felt a member of staff had not tried to communicate properly with them, and another staff member had been disrespectful whilst speaking with a patient. Whilst CQC do not investigate individual complaints, we passed on any information where the hospital needed to do more work to improve the patient experience.

On the Outpatients’ self completion questionnaires people were asked if they, and other patients, were treated with dignity and respect. A total of 77 out of the 79 respondents agreed that they were; two people left this question blank. Many had added comments to this answer such as ‘Yes, everyone is kind and helpful’ and ‘Staff are very polite’.

We also asked Outpatients if they had been involved in discussions about their treatment and care. The majority felt that they had been involved, though some noted they were in the early stages of their treatments and had added ‘Not yet’. Only four out of the 77 patients who answered this question said ‘No’, they had not been involved in discussions about their treatment. The majority of people who answered the question about whether their wishes and preferences had been taken into account answered ‘Yes’ and added comments such as ‘They have always listened to me’ and ‘At all times.’

Other evidence

During our two day visit to the hospital we made observations on the wards, spoke with staff at ward and management level, and looked at a number of records and documents.

Observations on the wards showed that in the main, people were addressed in a respectful way, and offered privacy in relation to their personal care needs. We saw that staff used curtains and privacy notices, and closed doors when patients used toilet and bathing facilities. We saw that staff protected the privacy of patients by ensuring they were properly covered as they walked about in the wards, for example where gowns did not fasten properly. We noted on the elderly care wards that staff had regard for the privacy of patients who were unable to maintain this for themselves.

Interviews with members of staff confirmed that they had received training in promoting dignity and respect, and protecting people’s human rights. They were able to give examples of how they ensured patients were treated respectfully and given choices, including choice about whether they preferred a male or female to attend to their personal care, and choices relating to dressing, hair care and toiletries.

We were told people were addressed according to their preference, and that this would be recorded on the staff handover sheet (which each member of staff was given at the start of each shift) or by their bed. Health care assistants and those involved in giving personal care emphasised how people were encouraged to maintain their independence, for example checking what people were able to do for themselves, with either the patient or with their relatives.

During one discussion with a trainee doctor we were told that choices and preferences related to the patient’s care and treatment tended to be part of the discussion in ward rounds, and examples of this were given. We were told by the doctor that training was provided to them to assist them in communicating to patients in a way that enabled them to understand information about their treatment and care.

We looked at some written records on the wards to check whether these promoted dignity and respect for patients. We found examples such as the patient’s preferred form of address being recorded. However, this was not done consistently as sometimes this was recorded on the nursing records in the office, and in other instances this was only on the handover sheet, or only in the care folder by the patient’s bed; we could not see a preferred form of address for some patients at all, though staff we spoke with said if it was not recorded, then they just asked patients when they first met them.

The handover sheet was a useful tool carried by each member of staff on the ward giving them instant access to important information about each patient. This included how to assist each patient to mobilise, what support was needed with meals, and a brief background for each person, such as why they had been admitted, and who normally looked after/lived with them. For those patients who had special needs, this was also recorded, for example on one ward there was a learning disabled patient, and several people with dementia and this was clearly recorded. This overview supported staff to treat people respectfully, as it enabled them to have up to date knowledge on important needs and to take these into account when dealing with patients.