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Chesterfield Royal Hospital Good

We are carrying out a review of quality at Chesterfield Royal 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: 5, 6 June 2013
Date of Publication: 23 July 2013
Inspection Report published 23 July 2013 PDF | 97.19 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)

Not met 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 looked at the personal care or treatment records of people who use the service, carried out a visit on 5 June 2013 and 6 June 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members, talked with staff and reviewed information given to us by the provider. We reviewed information sent to us by local groups of people in the community or voluntary sector and were accompanied by a specialist advisor.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We were supported on this inspection by an expert-by-experience. This is a person who has personal experience of using or caring for someone who uses this type of care service.

Our judgement

People using the service were involved in making decisions about their care and treatment and understood the choices available to them. People were encouraged to express their views views in relation to their care and treatment. However, their views and experiences were not always taken into account in the way the service was provided and delivered in relation to their care. People’s privacy, dignity and independence were not always respected

Reasons for our judgement

At our previous inspection in August 2012 we found that people’s privacy, dignity and independence were not always respected. We judged that this had a minor impact on people using the service and told the provider that action was needed. The provider told us in November 2012 about the action they had already taken and further action they planned to take to achieve compliance. The provider told us they would be compliant by the end of April 2013.

At this inspection we found many examples of staff treating people with consideration and respect. We saw staff mostly speaking courteously to people and providing sensitive assistance. Many of the people we spoke with told us they felt their privacy was respected and their dignity upheld. Most people said they had been asked for their preferred name and were addressed by this. We saw that toilets and washrooms were mostly clearly signed for male or female use. People were accommodated in single sex bays on the wards, or in single rooms. The exception to this was a designated ‘ambulatory’ bay on one ward which was mixed sex. People we spoke with in this bay told us they had no concerns about it being mixed sex. One person told us, “It’s not like I’m sat here in my night clothes or anything, plus I’m not going to be here long.”

People we spoke with said that they were supported to be as independent as possible. One person told us, “All of the staff are good at getting you to do things for yourself. The physios are great as well as the nurses. They make sure you’re doing as much as you can for yourself.” We saw that some people on one ward wore ordinary clothes during the day, rather than nightwear or hospital gowns. Staff told us this was to encourage rehabilitation and independence for people who were getting ready for discharge home.

However, we also found instances where people’s dignity, privacy and independence were not respected and promoted. We observed that staff sometimes discussed people within the hearing of other people using the service. On one ward we found there was a lack of suitable space if people required privacy for sensitive conversations with staff.

People we spoke with on two wards told us they had not been asked if they preferred male or female staff to assist with personal care. People were not aware that they had a choice. Two people, (both female), said they would prefer female care staff and wished they had been asked. One of these people said, “I think it’s because we’re an older generation. We get embarrassed with young men around when we’re getting dressed.” Staff we spoke with told us they did not routinely ask people about this preference. We saw the provider's policy 'Privacy and Dignity in Patient Care' which stated that staff should check that people had given their permission to be washed or examined by a person of the opposite sex, and should respect people's wishes where possible.

We saw a person on one ward was being assisted with a shower. The door to the shower room was open, compromising the person’s privacy and dignity. We observed two people wearing incontinence pads which were on view because the people had removed their bed covers. When we started to speak with these people, staff did come to cover them up.

We observed examples of inappropriate and insensitive communication between some staff and people on two of the wards. We saw that some people in the day room on one ward were embarrassed when a member of staff at a mealtime called out, “Who wants a pinny?” Another member of staff asked people individually if they would like an apron, which was a more dignified approach. We observed staff referring to people by the number of the bay and bed they occupied, rather than by their name.

People using the service were mostly involved in making decisions about their care and treatment. The people we spoke with were satisfied with how they were involved in planning their care and treatment. Most people we spoke with said they wanted