St George's Hospital (Tooting)

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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

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 also looked for evidence that every effort was made to take people’s wishes into account and respect their choices, to achieve the best possible outcomes for them.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people did not always feel well-supported, cared for and treated with respect.

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 service treated people with kindness, empathy and compassion. However, privacy and dignity were not always maintained for patients being cared for in corridors. We did not see the use of privacy screens whilst medical examinations were being undertaken.

The area where the streaming nurse sat and took information from patients was in an open area of the department which meant information relayed to them by a patient could be overheard by those waiting to be seen in the queue and further compromised a patient's privacy.

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In the paediatric ED on the day of the assessment, there were two mental health patients in cubicles next to each other separated by a curtain, one accompanied by police and one by a parent. This meant conversations could be overheard and it was difficult to maintain the dignity and privacy of the patient.

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Patients reported prolonged waiting times up to 55 in the ED this including patient who were on end of life care.

However, staff expressed a commitment to maintaining professionalism and a caring attitude, even during busy periods to ensure patients felt supported despite raising concerns regarding patient safety in corridors. People we spoke with described staff as friendly, approachable, and compassionate.

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Staff were compassionate and understanding towards people attending the ED with regards to their mental health. Staff expressed a strong commitment to helping patients recover. We observed staff interacting with patients in a kind and respectful manner, taking the time to explain procedures and answer questions clearly.

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The service treated people as individuals and took account of people's strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. Children in the ED had access to some sensory equipment and a play specialist.

Staff demonstrated an understanding of diverse patient needs and made effective use of face to face or telephone interpretation services. This benefitted individuals whose first language was not English or those requiring British Sign Language.

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The service has a chaplaincy and spiritual care team that provides support to patients and relatives, including on-call cover and regular visits. The team supports people of all faiths and those without a religious affiliation, speaking 27 languages and offering religious, emotional and spiritual care tailored to individual needs. The service employed the Butterfly Scheme to enhance care for patients with dementia, flagging patients on the electronic record system to identify these patients, prompting staff to provide individualised support.

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The service did not always listen to and understood people’s needs, views and wishes. Staff did not always respond to people’s needs and did not always act to minimise any discomfort, concern or distress.

Patients requiring immediate interventions, such as pain relief, did not always receive timely assistance from streaming nurses at triage. Staff were able to provide analgesics while patients awaited further assessment, however, this was impacted due to long waits.

We observed staff addressing physical and emotional needs of people even in challenging circumstances. However, some patients explained how staff did not respond as quickly, attributing this to long waiting times and overcrowding. We observed staff supporting relatives of patients who were emotionally distressed.

People’s hydration needs were met in line with current guidance. Water dispensers were available in the waiting areas, and staff actively offered water to patients, particularly those experiencing extended waits.