New Royal Liverpool University

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

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

People are always treated with kindness, empathy and compassion. They understand that they matter and that their experience of how they are treated and supported matters. Their privacy and dignity is respected. Every effort is made to take their wishes into account and respect their choices, to achieve the best possible outcomes for them. This includes supporting people to live as independently as possible.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Peoples experience

Patients considered their care to be good, brilliant or exceptional. One patient responded that they had received ‘The best care I could ever hope for in this hospital’, another responded that it was a ‘Fantastic hospital, staff are brilliant, not met one unpleasant person’.

Patients commented that they felt listened to, staff were kind and thoughtful and talked to them. One patient commented that ‘The staff can't do enough for me. This is a great hospital’. Another commented that ‘I was on the corridor for half an hour, they kept me informed, gave me water and soup and kept checking up on me. I was okay’.

The division provided us with information from family and friends test (FFT) conducted in August 2023 which highlighted inpatient ward satisfaction consistently was greater than 90%. The trust overall scored 10th out of 120 acute trusts for overall patient experience, and 21st out of all 131 trusts including specialist trusts.

LUHFT was highlighted by CQC’s national patient survey, as one of the 8 most improved trusts for overall patient experience. LUHFT was found to be significantly higher than the 2022 results for overall experience, cleanliness of rooms and privacy when being treated or examined.

Feedback from staff and leaders

Staff demonstrated a good knowledge of patient care pathways including dementia and SWAN. One member of staff told us about the memory making they completed with a family and a patient who was end of life (EOL) and how it made a difference to the patient and the family.

Another member of staff told us of examples where they had sought approval from managers to allow EOL patients pets to visit because of the comfort they found in them. They told us the manager was open to such ideas as normal practice.

Staff understood and respected the personal, cultural, social and religious needs of patients and applied this in relation to care needs. Staff gave a positive example of an EOL patient of Muslim faith who died over a bank holiday weekend. Despite there being a doctors’ strike the staff were able to access a consultant OOH to verify and sign the death certificate. They contacted an Imam to support the family and enable them to receive their relative’s body to adhere to religious beliefs and practices. A ward manager gave examples of providing compassionate care when caring for patients with different religions. They also arranged for them to bring animals onto the ward and have had miniature pigs, cats and had a budgie. They also used Rosie the trust service dog as part of wellbeing initiatives.

Another member of staff told us how they accessed a Jehovah's Witness Champion to support giving compassionate EOL care to a patient of that faith who declined a blood transfusion. The advice available supported staff to discuss alternatives knowledgably and sensitively.

Observation

Overall, we observed staff to be attentive, kind and compassionate in their care. For example, we saw staff working with patients in the activity area undertaking crafting activity and board games. We observed staff providing one to one observation who were responsive and quick to help their patients and support their needs. We observed a member of staff engaging with a patient by gently spinning them in their wheelchair and ‘dancing’ with them.

Call buzzers were answered very quickly across all wards. Staff observed it was noticeable how quickly they were answered on many wards. We did observe some patients waiting on a trolley for a bed on some wards. They were provided with a privacy screen and a bell and told us the staff were responsive to their needs and checked in on them regularly.

All patients were cared for in private individual rooms and we saw staff maintained patients’ dignity and privacy whilst assisting with personal care needs. We saw and heard about numerous examples of care where staff had ‘gone the extra mile’. Staff were highly motivated, passionate and inspired to offer the best possible care, that was kind, considerate and promoted people’s dignity.

Peoples experience

Patients told us they felt listened to and supported. They spoke highly of their care with one patient telling us they were asked about their food preferences and staff brought them what they liked. Another patient told us the staff are very familiar with and aimed to respect wishes and preferences. Patients waiting for a bed on wards received up to date and clear information and reported the communication to be "great".

Feedback from staff and leaders

Staff were knowledgeable about how they would adapt care and treatment to ensure patients' personal, cultural, social and religious needs were taken into account. They spoke about examples of care given to end-of-life patients and families to offer dignity and compassion. They told us how they used memory boxes to create lasting memories for family members.

Staff described how they used templates to record patient's individual preferences including milk and sugar preferences for hot drinks.

Senior leaders told us patient experience has been central to the Fundamentals of Care programme, with bespoke patient experience surveys, development of patient stories and patient focus groups to drive improvements in projects for pain management, pressure sores and management of falls amongst other information. Staff provided compassionate care accommodating religious beliefs and requirements.

Observation

We observed consistent practice of staff giving individualised care based both on risk assessment and patient preference.

We observed a strong ethos of compassion on all wards with all staff working towards common goals. The willingness to provide personalised choice was evident and SWANS was embedded in all wards. People's individual needs and preferences were understood, and these were reflected in their care, treatment, and support.

Information was readily available to support staff, patients and family on noticeboards throughout wards, particularly in relation to dementia care and end-of-life care.

Staff told us they used interpreters where necessary to make sure information was conveyed correctly and patients could make informed choices. Information leaflets were available in a variety of languages.

Staff members used varied means of communication including a simple white board for patients struggling to communicate verbally.

Sensory aids were available on the wards, which included communication cards and sign language BSL words, to communicate with people with additional needs.

Processes

Processes were in place to access the trust chaplains to provide spiritual care out of hours. Interpreters were accessed via telephone and in person where necessary. The Compassionate Companion Programme was offered to all staff to enhance communication with patients.

The trust had a multicultural team who helped inform staff of events of cultural significance such as Ramadan.

The trust devised the Liverpool Quality Assessment and Accreditation (LQA), and each clinical area was scored. The LQA framework was developed to take into consideration the CQC fundamental standards of care. It included the key clinical indicators that were designed to provide assurance of the quality of clinical care that was being delivered across the trust. It assisted clinical leaders to understand how they delivered care; identify what worked well and where further improvements were needed. Fortnightly training sessions were held to support staff with topic areas such as person-centred care and communication needs or patients.

The accreditation scheme focused on person-centred care, ensuring that privacy and dignity were maintained such as the appropriate use of curtains, screens, and appropriate clothing. It also aimed to ensure that patients were aware of the name of the nurse looking after them every shift, that call bell systems were within reach, that individual reasonable adjustments were recorded and shared at handover, that patients were called by their preferred name, and that overall patients and relatives had a positive experience receiving care and treatment.

The LQA was used to monitor end of life care and person-centred audits. Of the 17 medical wards none were graded as red (79% or below), 1 was graded as silver (80-90%) and 16 were graded as gold (90-100%).

Peoples experience

Patients we spoke with told us they were involved in their discharge plans and some described the different options that were available to them. Patients described a varied choice of foods available on menus, however some felt the diabetic option or gluten free was sometimes limited.

Feedback from staff and leaders

Staff described ‘This is me’ documentation was used for most patients including those living with dementia. If patients were undertaking activities, clinical observations such as blood pressure recordings could be carried out where the patient was, if they consented, allowing patients to remain together if they chose. Staff told us they encouraged patients to bring their chairs to the edge of their rooms so they could see and communicate with other patients and staff.

Observation

The wards had scheduled times in which friends and family could visit patients. These were clearly displayed on the ward. Activities coordinators were employed to promote wellbeing and independence such as playing music, facilitating board games like bingo, and art. These activity areas had been customised to look less clinical and more familiar.

Equipment was available and used to minimise risk based on personal risk assessments such as falls alarms and hoists.

Peoples experience

Most patients we spoke with on assessment commented they could access their call bell and use it to alert staff. Staff responded quickly when call bells were used and if there was a delay patients told us staff explained why. Patients told us they were offered regular pain relief if they were in pain.

Feedback from staff and leaders

Staff understood the importance of identifying needs, views and wishes and aimed to prioritise this. They told us they tried to ensure immediate needs were met but this was sometimes made difficult if a high number of patients requiring one to one care and they didn’t have dedicated staff available.

Staff told us the SWAN team, palliative care team and bereavement office were very responsive to patients and relative’s needs. For anything out of hours the duty manager had bereavement packs available. In addition, emergency death certificates could be provided for any patients with specific faith requirements.

Staff on a number of wards told us they had access to braille documents, hearing loops, BSL and language line and apps they could use for patients with sensory impairment.

Observations

We observed many good examples of staff being alert to patients’ needs and offering immediate intervention, support and help. We observed intentional rounding and staff supporting patients through mealtimes. Call buzzers were answered swiftly, and equipment was readily available for staff to use.

Volunteers were observed on some wards sitting chatting with patients for company.

Processes

Assessment tools were available to help staff identify patient need. A non-verbal pain tool was available, and staff described how they would use it. The Liverpool Quality Assessment (LQA) Pain management audits for 17 medical wards indicated; 1 was graded as red (79% or below), 5 were graded as silver (80-90%) and 11 were graded as gold (90-100%).

Feedback from staff and leaders

The majority of staff told us they had their breaks scheduled and did get to take them on time which we observed during our visit.

Leaders told us how they had actively listened to staff concerns and acted on feedback to improve the service. Particularly in relation to the move to the new hospital and ward environment; staffing levels were increased to accommodate cover for staff breaks and increase visibility in the zones.

Learning was made more accessible for staff by changing the presentation of learning aids which included the lilac backgrounds and using bullet points rather than high volumes of text.

Culture on the wards was reported positively with staff and ward managers giving positive examples such as displaying the graduation pictures of new staff, team building exercises such as guess the baby picture, and planned activities to celebrate events such as International Nurses day.

Direct recruitment processes were available to students who had placements on wards, and this was reported to improve morale and fast track recruitment processes.

Staff described the hospital as diverse both in its staff and patient demographic. They knew how to raise concerns if they needed to.

Senior managers reflected that since the move to the new building the way the staff worked as a multidisciplinary team had improved and resulted in better cohesive care offered to patients. Wellbeing initiatives were available to all staff members and staff feedback to leaders regularly took place.

Processes

Staff could nominate colleagues and teams for star of the month awards with the winners receiving trophies. Patients could also nominate staff.

The trust has a comprehensive holistic wellbeing offer that could support staff experiencing difficulties. This included the Life at LUHFT app (wellbeing Hub), Employee Hub Intranet, Line manager support, access to wellbeing champions, occupational health assessment and support.

Managers accessed training on managing and support for staff who were absent or struggling at work, focusing on reasonable adjustments. Policies to support staff included: wellbeing and sickness, stress risk assessment, financial wellbeing and access to Citizens advice. Food banks were accessible to staff and access to cognitive behaviour therapy and counselling was also available.