Derriford 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

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 remains the same as good. This meant people felt well-supported and cared for. However, staff did not always protect patients' privacy and dignity. In the orthopaedic theatres the service was in breach of the legal regulation relating to dignity and 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 always treated people with kindness, empathy and compassion. However, they did not always respect their privacy and dignity.

We observed people’s privacy and dignity was respected in the main theatres. However, in the 3 orthopaedic theatres we observed people’s privacy and dignity was not respected and the service failed to meet the Health Building Note (HBN) for Theatres 2.15 Protecting a Patient’s Privacy and Dignity best practice guidance. Three sets of doors from the corridor into the anaesthetics rooms, and from the anaesthetics rooms to the theatres had slow automated electronic opening and closing. This meant people could be seen by members of the public or staff walking along the corridor and between the anaesthetics’ rooms and theatres. During our visit we observed an incident when the doors between an anaesthetic room and a theatre were unintentionally activated (opened) by the sensors. The service failed to protect people’s privacy and dignity. This issue had been listed on the trust risk register and staff had met to review the doors. However, the trust had not addressed and resolved the situation until we identified it.

Following our visit, the trust addressed the operation of the doors by installing manual push buttons in the 3 anaesthetic rooms and 3 theatres. Staff had control to open and close the doors as required in addition to electronic activation.

Comments of appreciation from people included: “The staff were professional and kind. NHS at its best” and “[staff] provided expertise, kindness, compassion and unwavering dedication in my care which made a whole difference in my recovery.”

The staff we spoke with were caring and compassionate. Staff took time to interact with people in a respectful and considerate way. We observed staff speaking with people discreetly to maintain confidentiality. Privacy curtains helped protect people’s dignity.

People told us they were treated with kindness and compassion and highlighted how comfortable staff made them feel. Staff introduced themselves and checked what name patients liked to be called. They said staff were courteous and respectful.

The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. Staff took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

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

They were given the opportunity to discuss their individual health beliefs and preferences.

Staff could provide interpreter and sign language services for people when required.

There was a room designed for patients with learning disabilities and dementia with music, a fish tank, DVD and hearing loops. Sensory stimulation aids for people with dementia were provided.

The 23 hour recovery ward provided a dementia friendly room and another for people with anxiety. They were furnished and provided a relaxing environment.

The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

People were supported to have choice and control over their care and make decisions about their treatment and wellbeing. They said they felt informed, and staff supported them to make informed decisions about their care and treatment. They felt they had been involved in the decision making process and had all the information they needed.

We asked people about their wellbeing regarding food and drink. They said there was choice in food and drink to meet their dietary requirements. However, one person said they were not fond of the food. All reported they were routinely offered drinks by staff and we observed all people on the wards we visited had drinks in front of them.

People said discharge planning was discussed with them and most people knew when they could expect to be discharged and what needed to happen first.

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.

People said they were listened to, spoken to in ways they could understand, with staff taking time to talk and address any needs promptly. Most people commented their pain was well controlled, and staff provided pain relief when they needed it.

People had call bells in reach. Ward call bell audits showed monthly safety checks on emergency bells were carried out and any actions required were documented. Most people reported staff came quickly to call bells and checked on them regularly.

People told us staff were attentive and checked on their well-being and comfort regularly. Some people thought there were not enough staff but they were doing everything they could.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

The trust’s People Promise Exemplar programme supported the delivery of wellbeing initiatives to improve work-life balance, team development and leadership approaches to staff health. The trust also had a staff wellbeing team who signposted staff to resources and launched a Wellbeing Conversation template to support staff with setting goals and objectives.

There was a strong focus on workforce wellbeing including awaydays, social events across departments for team building. The Professional Nurse Advocate (PNA) programme supported staff wellbeing and professional development. Occupational Health, Staff Wellbeing and People Teams also supported staff.

Survey scores for opportunities for staff to show initiative in their role, make suggestions to improve the work of their team or department were worse than in 2023. However, staff told us they were well supported by colleagues and leaders supported their wellbeing. Main theatres had a board to post supportive comments and thanks of appreciation. Pastoral tutors were available for doctors. Educational coordinators were described as effective with a good range educational courses available.

Experience of physical violence at work increased from the 2023 survey results. Experiences of bullying and harassment from colleagues was significantly worse than average. However, we spoke to many staff who mostly said they had no experience of bullying or harassment. To prevent negative experiences between staff, the trust implemented modules including Respect and Civility, People Management and Compassionate Leadership.

Some staff and leaders told us they were very concerned how the forthcoming restructuring across the trust would affect staff wellbeing.