Southend University Hospital

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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 people were always treated with kindness, empathy and compassion. We checked that people’s privacy and dignity was respected, and that they understood that they and their experience of how they were treated and supported, mattered. We also looked for evidence that every effort was made to take people’s wishes into account and respect their choices, to achieve the best possible outcomes for them. This was our first assessment we rated this key question Good.

This meant young people and their families were well-supported, cared for or treated with dignity and respect. They were able to tell us they were treated with kindness and compassion. Staff demonstrated they treated young people as individuals and supported their preferences. Staff responded to young people in a timely way.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We scored the service as 3. The evidence showed a good standard. The staff always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

Young people and their families told us staff were kind, warm and friendly and showed compassion during care delivery. Family’s comments included that staff were “amazing” and “...they not only look after your child they look after the parents too”. During our assessment staff were observed to be kind and friendly with children, young people and their families. We also saw respectful and professional conversations between nursing and medical staff.

Staff told us they did their best to provide the high standard of care. However, they often left shifts feeling frustrated at not being able to give children and families the time and attention they needed due to the ongoing demand on the service. Play teams within paediatric departments underpinned children and young people general wellbeing and support whilst using the service. They offered support for both planned and emergency attendances making sure parents and carers were also supported.

The service did carry out the national friends and family test survey and results were published quarterly. The Friends and Family Test (FFT) is an important feedback tool that supports the fundamental principle that people who use NHS services should have the opportunity to provide feedback on their experience. Recent results showed 85.7% of 3602 family’s surveyed had a positive experience of children and young people services within the trust. Some families commented that “staff on Neptune ward were fantastic” and “staff were exceptional they were very attentive and very caring”

We scored the service as 3. 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 culture, unique backgrounds and protected characteristics.

Young people and their families told us staff treated them as individuals and nurses would take time to sit and play with their children.

However, some staff told us at times of increased workloads would impact on the time they were able to spend with children and young people. During our assessment we saw staff did support children’s individuals physical and emotional needs. Staff told us the use of hospital passports and reasonable adjustment cards made it easier to deliver tailored individualised care. Families told us they could request adjustments such as distraction aids, moving and handling equipment and communication support. All this could be arranged in advance of their outpatient appointments which had positively impacted on care experiences.

There were resources and information available for families throughout the paediatric departments, with diversity and inclusion, as a key focus. Displays explored health conditions, neurodiversity, mental health and wellbeing. They had 2 staff champions for people with a learning disability and autistic people on the ward that were available to staff and families.

We scored the service as 3. 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.

Parents and families told us they were able to express opinions about their child’s or baby’s care. Their options were discussed and medical staff explained risks and benefits of treatment to enable families to make an informed decision.

The service did use a hospital passport document to enable parents and families to inform staff of their child’s choices such as food requirements, personal preferences for activities and forms of communication. Staff, parents and families told us this resource was helpful when planning care.

However, the trust did not have effective guidance for staff on how to support and promote children and young people’s independence and choice whilst they were in hospital, for example Gillick competency. Gillick competency is applied where a child under 16 can consent to their own treatment. We reviewed the consent policy which did not outline how staff would follow Gillick competency or access advocacy services. Although requested, there was limited evidence to demonstrate how the service monitored care in relation to child and young people’s independence, choice and control.

We scored the service as 3. 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.

Families on the inpatient ward and the paediatric assessment unit said staff were prompt at responding to call bells, however at times of high demand, they may have to wait a short time to be assisted. They told us staff were attentive to both parent’s and children’s needs. On assessment we saw staff acted quicky after their child had fainted and supported the family as well as providing clinical care to their child.

During our assessment we saw staff were doing their best to respond to children and young people’s needs throughout departments. However, staff told us they would often have no breaks and would stay late when the service was busy. Leaders were aware of the demands on the service. They were monitoring the responsiveness of teams and ward leaders were prioritising children’s safety.

We scored the service as 2. The evidence showed some shortfalls. The service did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

Some staff told us there had been a recent improvement in culture. Staff moral had improved as a direct consequence of this. However, at times they told us bad behaviours were not always challenged and addressed by senior leaders, and more work was needed trust wide to support a substantive cultural shift in paediatrics.

Staff told us there were effective processes after incidents, and there would be “hot debriefs” as a multidisciplinary team. Staff reported good informal peer support between colleagues and were comfortable approaching senior leaders if they were struggling. However, some staff told us there was limited opportunities for career development and training was at a minimum due to financial restraints on the service.

Senior trust leaders acknowledged staff would often not get breaks, but this was monitored daily by rota coordinators. They told us there was no short-term plan to address this, but financial support was needed to increase recruitment. Leaders acknowledged staff morale was low and nursing sickness rates were 6.63% sitting above the trust target of 4%. Leaders told us staff’s wellbeing and enablement was identified as a priority, but this was not reflected by staff’s experience or senior leadership actions.

We requested evidence on how the service supported staff’s wellbeing an enablement. Information reviewed showed there was a Professional Nurse Advocates on each neonatal unit in the trust. The service had in house occupational health teams and had collaborated with local stakeholders to provide staff with a 24-hour wellbeing support phone line. Previously there had been a permanent Well-being hub for staff, however this provision had been downsized. It did not have a permanent location and was now staffed with volunteers. Staff had limited knowledge of all services available to them and improved communication on well-being provisions was needed.