The Countess of Chester 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 changed to requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The service was in breach of legal regulation in relation to how people were not always supported in a kind or dignified way.

Patients were not always treated with kindness, dignity, and respect. Staff interactions were often task-focused and lacked compassion, with privacy frequently compromised, especially for patients cared for in corridors. Independence and informed consent were not always promoted, leading to confusion and distress for patients. While some improvements were made, such as better access to fluids and support for staff wellbeing, the overall environment often failed to meet patients’ immediate emotional and physical needs.

This service scored 40 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity.

Staff did not always demonstrate a positive and professional culture within the department. We observed on one occasion staff speaking discourteously in front of patients and their loved ones. It was not clear whether the comments made by the staff member were in relation to patients or the inspection team, however, they were made with patients nearby. Due to the serious and inappropriate nature of what was said, this was escalated to the chief executive.

We heard from managers who told us addressing culture within the department was one of their top priorities.

Interactions seen during our observations were task orientated and lacked care or compassion, staff seemingly not having the time to care. Patients told us that staff were "great" but distracted as they were so busy.

We observed that people's privacy and dignity was not always maintained, with medical consultations taking place with partially drawn curtains and patients being transferred onto trolleys whose upper legs were showing, and staff not taking action to preserve their dignity.

Patients gave mixed feedback on how they felt their privacy and dignity had been respected and upheld, both in speaking with us and other agencies. There was a theme in the feedback relating to patients feeling their dignity had not been upheld when being cared for on the corridor. Patients commented on how the corridor was always busy with people walking past with 1 patient referring to the area as feeling as busy as a nearby motorway. Healthwatch feedback and complaints showed instances where patients had been toileted and washed on the corridor.

However, we did see examples of staff demonstrating kindness and compassion toward patients and explaining things in a way that they could understand their care and treatment.

The service did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences.

We saw staff carry out tasks and talk between themselves about patients without including the patient. Patients were routinely referred to as bed numbers rather than their names and we saw times that staff did not know which patient was where in the department and who the patient in front of them was.

We saw 1 occasion where a relative of a patient was shown into the relative’s room having been told her relative was in resuscitation, to then be taken through to resus to the wrong patient, when their relative was somewhere else in ED.

The service did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

We observed staff conducting checks and observations or moving patients without telling them or explaining what was happening. We observed 1 patient having their observations taken on the corridor looking confused and frightened at what was happening as they were having things done to them rather than it be explained and consent gained.

Feedback from patients collected by Healthwatch showed 1 patient told them that they had limited their hydration intake because they were worried that staff would not be available to take them to the toilet if they needed it.

Patients could have their loved ones with them in the department at any time.

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

Our SOFI observations showed that due to the pressures on the department, staff did not always respond to people’s distress. Staff conducted observations and moved patients without telling them what was happening which caused them to be distressed.

Feedback from people collected by the service and Healthwatch showed that patients felt their needs were not met quickly, including pain relief administration and personal care.

Following feedback from Healthwatch in December the trust had made improvements to availability of drinks and fluids in ED with stands throughout the department with drinks for patients and visitors.

Staff and leaders told us about the various ways staff were supported such as through an employee assistance programme and offering counselling.

The trust had a wellbeing practitioner that staff knew and told us was visible in the department to support them.

Medical staff had “anti-burnout shifts” once a month to spend time on learning and development in a specialty of their choosing.

The 2024 staff survey result for the category of “we are safe and healthy” scored on average 5.8 out of 10, which was slightly below the national benchmark average of 6.1 out of 10.