Warwick Hospital

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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

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

We looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

We rated caring as good. We assessed three quality statements around kindness, compassion and dignity. People were treated with kindness, empathy and compassion. Their privacy and dignity were respected. People were able to make their own decisions and be understood. Their information was kept confidential. Young people were able to make their own decisions when this met evidence-based practice. Staff felt supported however, they were at risk of burnout.

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.

People had generally positive experiences in the department and almost all patients reported they were treated with kindness, compassion and dignity. Arrangements were in place for patients at the end of their life and their families.

All staff we observed treated patients with kindness, compassion and dignity. A patient we spoke with in resus explained that they had been offered food and drink, toilet facilities and explanations of what was going on. Patients said they were generally very happy with their care.

Patient’s dignity and privacy was always upheld. Whilst the fit-to-sit area was more open, there were dividing curtains available should they be required. Patients were taken into a separate room for procedures.

There was a separate room available or patients at end of life, with an adjacent private room for relatives where bad news could be broken.

In resus, there was a folder of forms and checklists detailing how to manage the sudden unexpected death of a child.

Therapy animals were noted in the department.

Patient experience was inconsistent, with some patients reporting positive experiences, but a number of areas reported the department could work on to improve.

The Friends and Family Test (FFT) responses for the last 12 months showed improvement, and the most recent results in February 2025 showed 92% positive scores. There were plans to continue to improve the response rate.

The service collated themes from the FFT into themes. There were 4 key positive themes: caring and professional staff, efficient and thorough service, clear communication and clean and organised environment. Negative themes were across 5 areas: long waiting times, rude or unhelpful staff, facilities and comfort and inconsistent care. Staff were consistently praised for their kindness, professionalism, and empathy and they appreciated being treated with dignity and respect and commended for explaining procedures, keeping people informed and providing reassurance through stressful situations. The CQC Urgent and Emergency Care Survey were better or much better than expected all the questions in the sections on interactions with doctors and nurses, care and treatment and communication about tests.

Thew trust scored well in the CQC Urgent and Emergency Care Survey for the question on patients feeling that they were treated with respect and dignity, and overall experience whilst in AE were both better than expected.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Independence, choice and control during this assessment. The score for this quality statement is based on the previous rating for Caring.

There were systems for responding to people's individual needs, however they were not always effective. There were mechanisms to listen to feedback to improve services for patients to meet their needs, however they were not always effective. Volunteers supported with nutrition and hydration in the waiting room.

There were processes to understand people’s care needs, including streaming and triage. However, not all patients needs were responded to in a timely way. We observed a patient attend the department in obvious pain and distress who was not escalated, and staff gave examples where children who had experienced significant injuries were not escalated.

Patients told us they had been regularly offered drinks and food at mealtimes. We observed patients in the waiting room being offered drinks and some receiving treatment in the waiting room being checked on by nursing staff and volunteers. However, we also saw patients waiting for hours and assessments to understand their needs were not always completed in line with trust policy.

The hospital employed a specialist nurse for children with autism, learning disabilities, ADHD and mental health illnesses. Staff in the paediatric ED knew how to contact the specialist nurse and told us they would frequently come down to give advice and support for patients.

There was responsive and person-centred care for those with a learning disability. Adjustments and resources were available for patients in ED with additional and sensory needs, including weighted blankets, ear defenders and sensory toys. Staff told us there were planned fundraising activities to raise money for environmental improvements and adaptations in the paediatric area of ED, including adaptive lighting and cubicles.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff. Staff felt supported by leaders and wellbeing was a priority. There were services available to support staff including clinical psychologists who went to the department weekly. However, staff survey results showed staff were at risk of burnout.

The trust had a free and confidential staff support service comprised of a small team of clinical psychologists and psychological practitioners who offered a wide range of therapeutic approaches. Resources were available to support staff, around various topics.

There was a weekly clinical psychologist provision in the ED focusing on supporting staff mental health and wellbeing at work through individual and group discussions, teaching or training, brief consultation or supervision and support after difficult or distressing incidents. It was unclear if the provision was time-limited .

All staff described the working environment as supportive and open and felt that they could raise issues with their managers and consultants.

Resident doctors described a 4 monthly meeting for staff to feedback how the department runs and could be better for patients, as well as their own training. However, they could not recall any specific examples.

Staff wellbeing was sometimes compromised. We looked at the most recent staff survey results for the ED, and the overall themes for the division and the trust. Staff were more likely to report feeling burnout, emotionally and physically exhausted, worn out at the end of a shift, and experienced violence and aggression from members of the public. However, they were more likely to report that their employer had made reasonable adjustments, and they were less likely to say they were looking to find another hob.

We asked the trust to provide evidence of trauma risk management (TRiM) provision and training, which is a proactive approach to preventing and managing the impact of trauma on staff well-being and resilience. We saw there were resources available to the team, but did not see evidence of how these approaches were embedded in the department, or if staff had received specific TRiM training.