Scarborough 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 requires improvement. This meant people’s needs were not consistently met through good organisation and delivery.

We looked for evidence that people were always treated with kindness, empathy and compassion. We checked that people’s privacy and dignity was respected, that they understood that they and their experience of how they were treated and supported mattered. We saw that pressures within the department affected patient experience.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

The evidence showed an inconsistent standard. The service always treated people with kindness, empathy and compassion but were challenged in respecting their privacy and dignity due to pressures on the department. Staff treated colleagues from other organisations with kindness and respect. The service was previously in breach of the legal regulation in relation to the privacy and dignity. Improvements were not found at this assessment, and the service remained in breach of this regulation.

We noted difficulties faced by staff when caring for patients in temporary escalation spaces. At times of high pressure there were limited options for patients to receive privacy and dignity, we noted that medical assessments had been undertaken in public areas where privacy and dignity could not be maintained.

Staff and leaders acknowledged the difficulties in ensuring that dignified care was always upheld for patients and acknowledged the time other patients waited for treatment. Staff gave examples of how they understood and respected the individual needs of each patient.

Staff reported positive working relationships in the emergency department, particularly in recognising and supporting patients’ personal, cultural, social, and religious needs and how these relate to their care.

We observed kind, caring interactions between patients and staff. Staff explained to patients what they were doing when providing care and treatment. Patients said staff treated them well and with kindness.

The evidence failed to show a good standard. The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences but could not provide assurance that patients with additional communication needs were met.

Staff were unable to describe how they could access interpretation services by telephone and access sign language interpreters. We saw that patient information leaflets were not available in various formats and languages.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights and how to complain but we did not see nor were we told about any information in languages other than English nor in different formats. Information provided following inspection showed that alternate formats were available at request, but staff we spoke with could not describe how this would be accessed.

We noted that the hearing loop system in reception and the waiting room was not working.

Patients had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerances. Staff were able to give examples of how differing needs were met.

The evidence failed to show a consistent standard. The service did not consistently promote people’s independence, so there was limited support to ensure people knew their rights and had choice and control over their own care, treatment and wellbeing.

Not all people were supported to understand their rights, care and treatment as there were limited resources available to staff to communicate with patients with additional needs.

We did see examples of staff supporting patients to enable choice and participation in decision making regarding their care. We saw evidence of patient satisfaction reported in local patient feedback.

The evidence showed an inconsistent standard. The service did not demonstrate that it consistently listened to and understood people’s needs, views and wishes. Staff inconsistently responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Staff were aware but did not consistently assess and dealt with any specific risk issues, such as falls or pressure ulcers. We observed staff assessing, completing and updating care records following ongoing assessment of patients within their care but when reviewing medical notes we saw omissions in risk assessments.

We requested completed audits and were provided with audits for the 3 months preceding inspection. We saw low levels of compliance across all three months.

We saw that lack of pain relief was highlighted in patient feedback. We also noted delays in the assessment of pain and the subsequent prescribing and administering of pain relief.

We noted the use of the National Early Warning Score (NEWS2) to recognise and escalate a deteriorating patient. We reviewed patient records and saw an inconsistent approach to the accurate recognition and appropriate escalation. We requested any audits regarding NEWS2, but none were provided.

The evidence did not show a good standard. The service had failed to consistently demonstrate how they care about and promote the wellbeing of their staff.

Not all staff felt respected, supported and valued. The NHS 2024 Staff Survey results showed that 49% of staff felt that their work was recognised and only 37% of staff felt that their work was valued. Both figures were a worsening response from the previous year. Survey results for 2025 were not yet available for review. All staff survey responses declined compared to the previous year and when benchmarked were lower with comparable trusts in the region.

We did note that senior leaders had identified these issues and had created an action plan to monitor and drive improvement.

Staff had access to support for their own physical and emotional health needs through an occupational health service. We saw that a range of services were available that staff could self-refer and access.

The service’s nursing staff sickness was 4% which was better than the national average.