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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: 26, 27 November 2013
Date of Publication: 9 January 2014
Inspection Report published 09 January 2014 PDF | 89.32 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 26 November 2013 and 27 November 2013, observed how people were being cared for and talked with people who use the service. We talked with carers and / or family members, talked with staff, reviewed information given to us by the provider and reviewed information sent to us by local groups of people in the community or voluntary sector. We talked with other regulators or the Department of Health, were accompanied by a specialist advisor and used information from local Healthwatch to inform our inspection.

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

The privacy of people using the service was generally well respected. The dignity of some people was not always maintained. People were not always provided with appropriate information in relation to their care and treatment.

Reasons for our judgement

At our last inspection in June 2013 we found people using the service were not always treated with consideration and respect. We found that people were encouraged to express their views in relation to their care and treatment. However, we found that people’s views and experiences were not always taken into account in the way the service was provided and delivered in relation to their care. We told the provider that action was needed. The provider told us in July 2013 about the action already taken and the action planned to achieve compliance by the end of August 2013.

At this inspection we found that the provider had made improvements in relation to ensuring the privacy and dignity of people using the service. We spoke with four ward matrons who told us about their new role as privacy and dignity leads. They told us they reinforced good practice and challenged poor practice in relation to respecting people’s privacy and dignity. They said they felt that staff were generally getting better at promoting the privacy and dignity of people using the service. We found that each ward we visited had a suitable room for people to use when they required privacy for sensitive discussions with staff.

We found many examples of people using the service being treated with consideration and respect. One person on an inpatient ward said, “They’re golden, these nurses. They’ve got so much patience and they treat everyone here with the same respect, even when people can’t talk to them.” A visitor told us “They (the staff) have been very respectful to me as well as my partner and they’ve made sure I understand everything.” Another visitor said, “X (person using the service) is always clean and well dressed, which must be quite difficult to do because X has dementia and can get quite aggressive when people try and help.” We observed staff speaking courteously and respectfully to people and visitors. We saw staff using curtains to provide privacy during care or treatment.

However, some people we spoke with on one inpatient ward felt their dignity was not always maintained. We spoke with one person at 11am who appeared distressed and who told us they were still waiting for help to get dressed. Two other people in the same area told us they had waited a similarly long time for help to get dressed on the previous day. Four other people said that there were sometimes delays in answering call buzzers, especially during the night. One of these people told us they had waited a long time for help to use the commode during the night, “Bursting for a commode and had to wait ... only just made it I’d waited so long.” We observed on this ward that a person was assisted onto a toilet while the toilet door was still open. We saw that the provider's own assurance data and 'Friends and family' feedback corroborated our findings for this ward.

In the outpatients department most people told us that the nursing and care staff were always polite and respectful. One person said, “I think the staff here are very kind. They’ve got a lot of people to get through and they’re good with everyone.” We observed staff speaking courteously to people, directing people to the appropriate waiting area, and keeping people informed about long waiting times for some of the clinics.

However, four people we spoke with told us that some doctors in the outpatients department were not always so respectful. One person said that on a previous occasion they had been given bad news about their diagnosis in a very insensitive way by a doctor, causing distress to the person. We had also received similar information before our inspection from a person who had complained to the provider about the attitude of doctors in the outpatients department.

Most people we spoke with in the outpatients department said they thought their dignity was upheld and their diverse needs were taken into account. However, one wheelchair user and their relative told us they felt ‘in the way’ because there was n