Queen Alexandra Hospital

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. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

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.

We scored the service as 3. The evidence showed a good standard. The service always treated people with kindness, empathy and compassion and respected their privacy and dignity.

Throughout the inspection we observed staff of all roles and grades interacting with patients in a kind and supportive manner, treating them with dignity and respect.

On wards we observed all staff were very friendly and helpful. For example, they supported patients to mobilise in a gentle and reassuring manner. We observed staff reassuring patients who were distressed and agitated in a calmly and respectfully.

Patients we spoke with during the site visit said staff treated them well and with kindness. Comments from patients during the onsite inspection included, "they're so polite and caring, nothing is too much trouble," and "nursing staff are very compassionate."

Friends and Family Test feedback was generally positive, with 88% of patients detailing they had a good experience of care and treatment in the medical services at Queen Alexandra Hospital. Comments included, "all the staff were so kind and considerate", "at all times I felt that the staff, from catering to medical, had my wellbeing in mind", "there is a genuine feeling of empathy and care not just from individual members of staff but from the whole cardiology department", and "the treatment by nursing staff was kind, compassionate and in short, just wonderful."

Patients were mostly supported to maintain their privacy and dignity. Observation during the site visit showed patients were suitably covered, protecting their dignity. Staff made sure curtains were fully closed round patients when providing personal care.

However, some patients were accommodated in a Your Next Patient space, which increased the risk of privacy and dignity of patients not being protected. Your Next Patient spaces are where, due to challenges with patient flow, patients were allocated to a temporary non dedicated care space on wards, which could be a chair, trolley or bed in a ward corridor or an additional bed in a ward bay. Staff spoke about challenges with protecting the privacy and dignity of patients allocated to Your Next Spaces which included supporting patients with personal care and providing treatments, such as intravenous infusions.

Although most patients spoke positively about how staff protected their privacy and dignity while accommodated in a Your Next Patient Space, there were some comments in the Friends and Family Test results that showed not all patients felt their privacy and dignity was upheld when accommodated in a Your Next Patient Space. Comments included, when a patient arrived in the ward where they had been told they had a bed, they found it was "a chair in a corridor outside the wards where I was supposed to sit until my bed was available…The nebuliser I was on was on was pulled across a ward entrance and people were complaining that I was in the way and causing a hazard." A second patient commented they were "moved out of ward D1 at 10.40 at night to C5 and left in a corridor no privacy or dignity no sleep for 3 long days and nights." A third patient commented "I spent my few nights in hospital on the ward in a corridor space, this didn't feel like the best place to be staying whilst being sick but it was a bed so got to take the win." A fourth patient commented "After a few days I was moved to a made up bed space right in the doorway. It was so cramped doctor/nurses had to pull out table to get to me to take obs. I had to climb out the gap at the end of the bed to go to toilet. This really stressed me."

Staff worked to protect patient confidentiality. However, the practice of using Your Next Patient spaces presented challenges in protecting patient confidentiality. For example, there was potential for patients accommodated in corridors to overhear staff conversations about other patients care and treatment.

We scored the service as 3. The evidence showed a good standard. The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They mostly took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Managers and staff were aware of patients’ individual needs, and this was shown through their risk assessments and the pre-admission assessment process. Patients spoke positively about how staff supported them to meet their individual needs. This included meeting patients emotional and psychological needs.

Patients could access the chaplaincy service who could provide support for patients of all and of non-religious beliefs. Prayer spaces were available for patients of all religious beliefs, all of which had Muslim prayer mats and facilities for ritual ablutions.

Staff had access to translation services, including British sign language interpreters. With the support of the trust Admiral nurse the use of “This is me” booklets for people living with dementia was embedded into the service. Use of the “This is me booklet” gave staff the tools to respond to a person’s needs in a person-centred and timely way. However, we were told that at times staff had to be encouraged and reminded to complete the booklet with patients’ relatives if the patient did not have one. For patients with a learning disability, learning disability passports gave staff the tools to respond individual needs in a person-centred and timely way.

Staff made sure patients living with mental health conditions and dementia, received the necessary care to meet all their needs. Staff could access support and guidance from specialist nursing teams, such as the Admiral nurse employed by the trust and the mental health liaison team that was provided by another NHS trust.

However, the Friends and Family Test results indicated that some patients did not have a positive experience, and reasonable adjustments were not put in place. One patient commented they were, “unable to have my carer with me on C6 and CDU despite being disabled and needing support with recalling and retaining information due to a neurological condition.” A second patient commented, “being hard of hearing and frail I didn’t feel that I was tended to gently or appropriately and communications to me should’ve been also relayed to my next of kin more timely as I was unable to relay due to not understanding what was being said.”

Access to the learning disability liaison team was limited. The service was provided by another NHS trust but had only been contracted by Portsmouth Hospitals University NHS trust to provide a service of 2 nurses, 30 hours a week spread over 5 days. This increased the risk that due to lack of support, patients with a learning disability might not have their immediate needs met appropriately on initial admission to hospital.

We scored the service as 3. The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Patients were supported to have choice and control over their own care and make decisions about their treatment and wellbeing. They said they felt informed about their procedures and care, and staff supported them to make informed decisions about their care and treatment. Comments from patients included, “[staff] take time to explain everything to you”, “[I am] involved in decisions of care”, “doctors have been very good, I know what’s happening and why” and staff “explained all the treatment and care”.

Most patients expressed satisfaction with the provision of meals and drinks. Patients commented positively on the choice and quality of food.

We scored the service as 3. The evidence showed a good standard. The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Feedback from patients said they were listened to, spoken to in ways they could understand, with staff taking time to talk with them and address any needs promptly. Comments made by patients in the Friends and Family Test results indicated staff gave information and explanations to patients in a manner they could understand. Comments included, “they explained everything I had to do and everything we'd do in the long run. They did everything at my pace and reassured me when I wasn't overly confident at times”, “The doctors explained what they were doing and why. They also took time to answer all of my questions”, “Staff on D1, D3 and G5 were all exceptional in their care and their willingness to listen and work with me when drugs were reacting adversely.”

Patients commented their pain was well controlled, and staff provided pain relief when they needed it.

We observed during the site visit that patients had access to call bells to summon assistance and call bells were generally promptly answered. However, not all patients accommodated in Your Next Patient spaces were provided with bells to summon assistance from staff.

Staff observed patients and intervened where they saw patients were uncomfortable, uncovered or distressed. Patients appeared well cared for, clean and with the items they needed such as glasses or walking aids close by.

Staff made sure patients living with mental health conditions and dementia, received the necessary care to meet all their needs. Staff could access support and guidance from specialist nursing teams, such as the Admiral nurse employed by the trust and the mental health liaison team that was provided by another NHS trust. However, the Learning Disability Liaison Team had limited availability to provide guidance to staff about supporting patients with a learning disability.

We scored the service as 3. The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

The trust had several resources that medical services staff could access to support their wellbeing. This included access to musculoskeletal therapy service, access to psychological support and counselling and debt advice. Staff were informed of wellbeing resources through newsletters and there were dedicated health and wellbeing champions.

All staff we spoke with spoke positively about how their immediate leaders supported their wellbeing at work. Ward managers demonstrated in conversations a commitment to support and promote their staff’s wellbeing.