Basildon University Hospital

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Assessment findings:

We looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. We assessed three quality statements around kindness, compassion and dignity.

At our last inspection we rated this key question good. At this inspection the rating has remained good. People’s privacy and dignity were mostly respected, and they were mostly treated with kindness, empathy and compassion.

The service cared about and promoted the wellbeing of their staff, though further engagement with staff about daily pressures and ineffective processes would be welcomed

This service scored 65 (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 mostly treated people with kindness, empathy and compassion, and respected their privacy and dignity.

Assessment findings:

Patients mainly felt listened to and that their privacy and dignity were respected. They expressed lots of positive comments about staff treating them with kindness, empathy, and compassion. Those patients boarded under the full capacity protocol (FCP) told us staff did their best to maintain their privacy and dignity, used curtains, or took them to more appropriate areas to provide intimate or personal care.

A patient we spoke to was very positive about the food. They reported the food was "wonderful, lovely selection, lots of choice, it is appetising and can’t see how anyone could fault it".

Some patients and relatives said while staff communicated with them in a way they understood, they had concerns about untimely and conflicting communication regarding care, treatment, and discharge arrangements.

We carried out a group observation using the Short Observational Framework for Inspection (SOFI) method on 18 December 2024 on Florence Nightingale ward. The SOFI tool is used to review services for people who have conditions that mean they cannot reliably give their verbal opinions on the services they receive. We continually observed what happened to patients over a chosen observation period, making recordings at set intervals. In each time period we recorded the general mood of the service users, the type of activity or non-activity they were engaged with and the style and number of staff interactions with service users. In each time frame there may be more than one type of engagement and multiple interactions with staff. Interactions with staff are categorised as positive, neutral or poor.

During our SOFI observations, staff gained consent before providing personal care. Throughout the observation, we saw staff engage with patients in a warm friendly yet respectful way. Staff responded quickly to requests for help and encouraged patients to eat. As staff served drinks and meals, they acknowledged the patients and had a short chat with them. Staff pulled the curtain around one patient to deliver personal care.

Our other observations of patient care were mainly positive. However, we saw isolated incidents when patients’ dignity and privacy were not respected. For example, a staff member shouted a response to a patient’s request for intimate care across the ward, and another member of staff who was supporting a patient with cognitive impairment, did not manage the situation in an empathetic way and use appropriate de-escalation techniques.

The ward used a dandelion symbol to indicate where end of life care was being provided so staff and visitors were aware and could be more sensitive in these areas.

There was a culture of kindness and respect between colleagues. Staff collaborated with other experienced colleagues to provide support and treatment for patients.

Wards were visited by volunteers from the hospital chaplaincy. We observed a volunteer talking to patients and noted a positive interaction between them and the patient.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Independence, choice and control during this assessment. The score for this quality statement is based on the previous rating for Caring.

The service did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Assessment findings:

Mechanisms to respond to people’s immediate needs and avoid any preventable discomfort, concern, or distress were not always effective.

Patient views and experiences were mixed. Some patients told us, they only had to ask, and staff were attentive to their needs despite being very busy. Other patients told us they were not always communicated with and some of their diverse needs, such as dietary requirements were not met.

Our observations of staff practices were also mixed. Busy wards, nursing patients in corridors and supporting high amounts of patients with complex needs sometimes created challenges. Most staff recognised people’s immediate needs, though support to patients we observed was often reactive rather than thinking ahead to support health improvement and staying well.

During our SOFI observations staff mostly responded quickly to patients’ requests for help. There were only 2 occasions when staff were not able to respond quickly due to the busyness of the ward. However, there were times when we observed patients’ immediate needs not being met with patients waiting for call bells to be answered. For example, one patient’s call bell was continually ringing, and the patient did not receive support despite there being 3 staff members in the bay.

Staff were supported to respond quickly to people’s needs, minimise discomfort, distress, or concern by clear escalation procedures and processes. For example, NEWs scores enabled staff to quickly assess a patient’s medical condition and respond to any deterioration.

Staff had access to central monitoring systems which identified when patient observations were due. We saw inconsistencies and some delays in staff responses to these necessary interactions. We also found in AMU that patient’s monitors had been silenced with no staff assigned to review these patient’s observations. This meant at times there was insufficient oversight of a patient’s condition and a risk that staff would not notice or respond promptly to any deterioration.

Staff told us they sometimes found it challenging when managing escalating behaviours of patients with mental health needs. Lister Ward had 3 mental health patients, while 2 patients were supported by the required numbers of staff, the third was not, which was taking time away from other patients.

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.

Assessment findings:

Leaders and managers told us staff wellbeing was a priority. The organisation took part in an annual staff survey. The staff survey results of 2023 demonstrated that medical services were performing better regarding the People Promise. The highest scoring areas were ‘we are a team’, and we ‘work flexibly’. Leaders had recognised departments that were performing well, with processes to share learning implemented. When we requested the staff survey results for 2024, these were not available at the time of our inspection, though they had been made available to the service in March 2024. Leaders told us they were in the process of developing a ward manager study day and development programme to consider any learning or actions that were needed from these most recent results.

Leaders of different departments met each day for a ‘stepping up’ meeting, also described as a safety huddle. Leaders discussed that it was ‘wellbeing Wednesday’ and outlined what support there was for the staff team. Staff were encouraged to attend the wellbeing hub, reminded of the upcoming carol service and uptake figures of the flu and covid vaccination were shared.

The Equality, Diversity and Inclusion Strategy 2021-25 championed equality and diversity being applied in a consistently inclusive approach throughout the organisation. There were designated sponsors of protected characteristics and associated diversity networks.

However, mechanisms to maintain staff wellbeing, respond to their concerns, and support staff to provide safe and effective care to patients were sometimes ineffective.

Staff told us they felt supported by their ward managers. Some staff reported a disconnect with senior leaders and said their reports about daily pressures, ineffective processes, and the impact this had on staff wellbeing and morale had not resulted in any progress. Other staff told us they did not feel they had been fully consulted on changes that affected them and their patients.

While we saw comradery among staff, we also saw how ineffective processes impacted on staff’s ability to care for patients, take regular breaks and always maintain professionalism. Staff we spoke with expressed concerns which supported this observation.