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We are carrying out a review of quality at Leighton Hospital. We will publish a report when our review is complete. Find out more about our inspection reports.
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Inspection report

Date of Inspection: 4 May 2011
Date of Publication: 4 July 2011
Dignity and Nutrition Report published 4 July 2011 PDF | 80.02 KB

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

We reviewed all the information we hold about this provider, carried out a visit on 04/05/2011, checked the provider's records, observed how people were being cared for, looked at records of people who use services, talked to staff and talked to people who use services. We were supported on this review by an expert-by-experience who has personal experience of using or caring for someone who uses this type of care service.

Our judgement

The provider is meeting this essential standard by having processes in place to help ensure people who live there are involved in their care and their views are respected.

User experience

All patients told us they were happy with the way staff treated them and that they were treated with respect and dignity. Most patients understood why they were on the ward although some seemed unaware and relied on their relatives to explain to them. Almost all patients had been asked how they liked to be addressed and this name was used. Most patients understood how to raise concerns although a few seemed unaware, despite having been given information packs that explained this.

A few patients said staff did not respond quickly enough although most found the response to be fine and some commented that they realised staff needed to prioritise between patients. Most patients said they had been consulted about the planning of their care although some said they had left it to their relatives. A few patients expressed anxiety about what would happen when they went home.

Other evidence

The Trust has a Privacy and Dignity Matron who takes the lead in a variety of initiatives associated with the privacy and dignity agenda. When we spoke to ward staff they were very much aware of this person's role and referred to the support that was available to them from both the initiatives and the individual.

Privacy and dignity issues are given a high profile by The Trust and they are covered in the mandatory and induction training programs. Senior staff told us of a ward managers' development program which encourages the dissemination and adoption of good practice across the hospital. We were sent a good deal of supporting documentation which we used to corroborate our observations of care and our conversations with staff and patients.

The Patient Environment Action Team scores for 2009 were similar to or much better than expected for most data items and do not give cause for concern.

The Trust has a Delivering Same Sex Accommodation (DSSA) policy and an action plan to achieve the outcomes associated with this initiative. The DSSA policy is comprehensive and addresses transgender issues, accommodation in critical or specialist care areas and the approach to clinically justified breaches.

When we visited the wards we found that although the wards were mixed the same sex accommodation requirements were entirely met. We saw that The Trust had effective systems for managing same sex accommodation on mixed wards and that these worked well.

When we visited the wards we saw that at all times patients were treated with respect and we noted many instances of compassion and sympathy. When we spoke to staff they expressed the importance of this aspect of nursing to them and they seemed to set high expectations of themselves and their colleagues. We noted that The Trust had effective training and audit systems in place to ensure standards were maintained.

When we spoke to patients everyone said that they had been treated with the respect due to them. Almost all patients had been asked their preferred form of address and told us that it was used.

We saw that patients were afforded privacy through the use of curtains and we saw that these were used at all times. Staff told us that it was sometimes difficult to use the older curtains and we were told that on one ward we visited these were being replaced as a result of staff feedback. We saw a confused patient who threw his covers off and we noted that a member of staff quickly came and covered him up. One patient gave us an example of a staff member protecting their dignity by leaving them to adjust their dress alone. All the patients we spoke to told us they had not suffered embarrassment during their stay due to this kind of issue.

We did note examples of doctors talking quietly about patients in front of them and this was particularly so during a teaching ward round. When examinations or discussions took place we observed that staff moderated their voices to reduce other patients overhearing their conversations. We also saw that specific steps were taken during shift handover to ensure that the team could discuss patients without their details being overheard by other patients. However on one occasion we heard a patient who had been admitted overnight being asked by a doctor a number of questions about their lifestyle which were of a personal and potentially embarrassing nature. Given the patient was up, about and dressed, these might have better been discussed in a more private setting.

All our observations and conversations with patients demonstrated that staff explained procedures to patients and asked permission before they carried them out. Staff told us of the techniques they used to obtain non verbal consent with patients who were confused and we saw staff putting this into practice.

We saw staff taking time with patients, being supportive and friendly. Staff smiled, made eye contact and were sensitive to individual needs. It was noted by a member of the inspection