The York 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

At our last assessment we rated this key question good. At this assessment the rating has remained good.

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

Patients told us that staff were caring, kind and respected their wishes. Patients received compassionate care and their privacy and dignity were mostly maintained.

However, there was limited interaction between patients and staff during our visit and patients were either in bed or sitting by their bed with no activity taking place or being facilitated, especially those who were elderly. We observed that call bells were not always responded to in a timely way.

Patients were not always supported by staff that felt valued by leaders or have the ability to contribute to decision making.

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 treated people with kindness, empathy and compassion.

Some staff felt they had sufficient time or space to spend with patients when they needed support, but other staff felt that time pressures and workloads meant that this did not always happen.

Medical services were delivered by caring and compassionate staff. We observed staff treating patients with dignity and respect especially when providing personal care. We observed patients receiving care in the corridor were treated with kindness, empathy and compassion and their privacy and dignity was respected.

As part of the continuous flow model patients were transferred to the discharge lounge as early as possible and we were told that if they required breakfast and drinks then this would be facilitated by the discharge team.

We observed staff supporting a family whose relative was end of life, by providing emotional support and information.

We spoke to several patients throughout our assessment. Most patients we spoke with were positive about their care and treatment. Comments included ‘staff have been friendly, caring and attentive’, ‘all the staff had been attentive, and they have listened when asking questions’, and ‘[couldn't] fault the staff, staff are brilliant’.

The friends and family test asks patients how likely they are to recommend a hospital after treatment. We reviewed the responses from a sample of medical wards and found that most patients would recommend medical services at the hospital. We saw that the response rates were low in some cases, however, we have been told that actions are in place to promote the friends and family test across the hospital.

Whilst the service did listen to and understand patients’ needs, views and wishes, staff did now always respond to patients’ needs in the moment or always act to minimise any discomfort or distress.

Staff we spoke with told us the service recognised that preventing patients' deconditioning while in hospital was everyone's responsibility. Staff told us across the service, including nurses, assistant workforce, and allied health teams, they made efforts to keep patients moving and encourage an appropriate level of exercise depending on patients' capabilities and their level of risk. However, during our time on the wards we observed there was limited interaction between the patients and staff and patients were either in bed or sitting by their bed with no activity taking place or being facilitated, especially those who were elderly.

We observed staff responding to patients who were distressed and in discomfort most times. People were being offered food and drinks by staff throughout the day. There was a choice of food and in most cases a choice of hot food as well as alternatives.

However, we saw a patient whose nightclothes were raised above their hips. They were exposed in a manner that did not maintain their dignity and they told us that they had soiled themselves. There were no staff in the bay area to attend to their needs. We raised this immediately with staff who came to see the patient. We also observed 3 patients partially dressed and exposed in one bay whose dignity was not being preserved. This bay was an open environment without a door.

Patient led assessments of the environment (PLACE) in 2024 showed for privacy the scores were between 59% and 90%.

Patients told us staff were responsive to call buttons. One patient told us staff on the ward said hello as they passed. Patients told us they "[couldn't] fault the staff, staff are brilliant" and another said "everything [had been] really good". However, we observed that 7 members of staff on ward 12 walked past a bay where a call bell was ringing. Staff responded once prompted by the assessment team.

We also observed that for one area of ward 12, the call bell could not easily be heard at the nursing station if the fire doors to that area were closed. Staff told us that staff from the neighbouring ward were frequently coming to alert them that a call bell was ringing as the main unit was on this neighbouring ward. We observed staff from another ward interrupting handover on ward 12 to inform the staff that a call bell had been ringing for a prolonged amount of time in that area. The call bell was not audible from where handover was taking place. Staff present did not immediately respond to this, they asked the staff member from another area to look for a healthcare assistant to respond. During our assessment this ward was open as a temporary ward to support capacity, however, senior leaders told us that the ward was decommissioned shortly after the assessment, but we consider this was not safe during our assessment.

There were processes in place to support staff wellbeing, but staff did not always feel supported to deliver person-centred care.

Staff took part in the annual staff survey. The results for 2024 had been shared with senior staff to prepare action plans and share with the rest of the staff. At the time of the assessment, we were unable to review these results as the trust told us these were embargoed until 13 March 2025. However, we did see evidence of actions taken from the 2023 staff survey.

Some of the staff we spoke with felt that there were times when they did not feel supported or valued to deliver good care. They felt the demands on the service affected their ability at times to provide person centred care and gave examples of this affecting time to enable patients to engage in activities and therapy to help them recover quickly.

Staff told us they were finding providing care in additional spaces emotionally difficult and were visibly upset when speaking to us. They did not feel they had the adequate resources to do this and maintain high levels of care and dignity.

Staff expressed concerns that the unsustainable pressure they were feeling would lead to further staff taking time off work due to work related stress.

Information provided by the trust showed that staff within the trust had experienced muscular skeletal problems in the last 12-months because of work; and have felt unwell in the last 12-months as a result of work-related stress.

Sickness absence for October 2024 within the trust was lower than their peer average and the national value across medical and dental, nursing and midwifery, and allied health professionals.

Senior leaders told us that there was a cultural objective with a focus on equality, diversity and fairness and recognised that there were areas, such as the workforce health and wellbeing improvement plan which were still not yet fully implemented as cultural change was required in this area.

The Staff Psychology Team offered 1-1 signposting sessions. These sessions were bookable 30-minute sessions which could take place either face-to-face across or remotely with a psychologist from the team. The aim of the sessions was to provide a confidential space for a staff member to briefly reflect on a work-related stress or difficulty which is impacting their psychological wellbeing. In addition to the signposting sessions, staff could access individual psychological therapy with a clinical psychologist. The staff psychology team also facilitated hot debrief following incidents.

The trust staff health and wellbeing team were providing focused support to specific areas. The staff psychology team were also running online skills-based workshops developed for trust staff in line with national research. There were four different sessions, and they were available to all staff, for example, learn the basic skills, anxiety and doing what matters.

Senior leaders told us that the chief nurse promoted the wellbeing of nursing staff, for example engagement with all senior nurses, holding regular question and answer sessions and utilising planned senior nurse back to floor sessions every Friday.

Compliments and positive feedback from patients and carers are shared with staff through several means including at board rounds, team meetings and also displayed on staff notice boards within the department or ward.