Derriford 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

We looked for evidence people were always treated with kindness, empathy and compassion. We checked people’s privacy and dignity was respected, that they understood their experience of how they were treated and supported mattered. We also looked for evidence 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 staff were not always able protect patients’ privacy and dignity in crowded areas. However, people felt well-supported and cared for.

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 did not always respect people’s privacy and dignity. Staff faced difficulties due to crowding. However, staff treated people with kindness, empathy and compassion.

There was limited privacy and dignity in all areas of the department and especially for patients waiting on trolleys in corridors. However, the staff we spoke with were caring and compassionate. Staff took time to interact with people in a respectful and considerate way. Staff attitudes and behaviours when interacting with patients showed they were responsive, providing patients with help, emotional support and advice. Staff explained to patients what they were doing when providing care and treatment. Patients said staff treated them well and with kindness.

When ambulatory patients booked in at reception (located in the waiting room) there was no privacy and patient details could be overhead by patients sitting in the area.

The ambulatory treatment area was very cramped with mixed sex cubicles and some patients sleeping on recliner chairs. There was no privacy for distressed relatives.

We observed a lack of privacy and dignity for patients when care was provided in the ambulatory and majors treatment areas and in corridors. Sensitive conversations between patients and medical staff could be overheard by other patients. This meant staff were often unable to maintain confidentiality of information about patients.

There were good processes with senior doctors assessing patient risk and discussing treatment plans with nurses. Staff supported patients to understand and manage their care and treatment. Staff directed patients to other services when appropriate and, if required, supported them to access those services.

Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients without fear of consequences.

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

The service tailored communication to people’s needs. There was signage offering interpreter services. Staff used artificial intelligence telephones to interpret different languages. This meant people who did not speak English, with visual or hearing impairments were able to communicate with staff.

There were resources available to support people with learning disabilities and autism. Staff used visual aids and “getting to know you” booklets to communicate. Fidget toys and sensory items were also available. A patient with dementia told us staff had spoken slowly and repeated sentences so they could understand.

Patients had access to hot and cold food which met the dietary requirements of religious and ethnic groups and considered allergies (red wrist bands highlighted allergies). Patient service assistants (PSAs) provided food and drink and checked if patients had undergone a speech and language team (SALT) assessments (which might require specialist diets).

The service considered people’s backgrounds in providing targeted care. Security staff followed processes to provide individualised support to people. When the service requested support, the security team had a series of questions to understand the person’s background, such as whether the person was a victim of domestic abuse or had a fear of men. This allowed the security team to send the best gender of staff to assist.

The service met the requirements of the high volume of people who attended following drug overdoses, connecting patients to an addiction specialist and providing antidotes. Staff taught patients and family or friends who attended with them how to administer antidotes.

In the most recent fundamentals of care audit (October 2024 to October 2025) 90.36% of records audited stated patients were aware of their medical plans. However, some people told us they were not involved in decision-making in their care. This meant plans were not always tailored to individual needs.

We spoke with volunteers who said they enjoyed caring for people. However, one said they did not always feel respected by some staff. We observed volunteers escorting patients, providing water and waiting with patients.

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 understand their rights, care and treatment by using different ways to communicate. We saw examples of staff supporting patients to enable choice and participation in decision making regarding their care. One patient said information about their care and treatment was clearly explained but staff had not sought their input.

The trust was liaising with a system partner who worked together and collaboratively with primary care, the voluntary sector, communities, patients and carers to develop and improve services. This included helping people maintain independence for as long as possible both at home and in the community. By supporting preventative health, the partnership aimed to help reduce health inequalities and ensure equitable and fair access and outcomes.

The service listened to and understood people’s needs, views and wishes. Staff mostly responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Upon arrival, staff identified people’s needs and directed people to appropriate care pathways. Staff identified and responded to pressure ulcers and fall risks. Nursing staff were prompted on handheld devices every 2-4 hours to complete nursing assessments for patients. The fundamentals of care audit (October 2024 to October 2025) documented in 87.32% of records, that pressure ulcer risk assessments were completed. This meant staff monitored pressure ulcer risk adequately and worked to prevent pressure ulcers from developing.

Staff identified and appropriately monitored people at risk of falls. The fundamentals of care audit showed 100% of records checked had the falls risk assessment completed. Staff told us they worked to ensure the people at risk of falls in the majors treatment area were placed in appropriate bays or moved to the central temporary escalation space for monitoring. However, staff did not always consistently monitor all risks to people’s health, patient body maps were documented in only 67.36% of the records audited.

Staff worked together to address people’s changing needs. We observed an improvement since our last visit in the major treatment area when patients rang call bells and staff responded promptly.

Patients waiting on ambulances or trolleys were at higher risk of pressure sores developing. To mitigate against this, pressure mattresses continued to be available for patients and there were no reported incidents of patients acquiring pressure sores in the previous 3 months. Care had improved since our last visit as heel supports were also provided. However, supplies had declined and in response to our raising this, further heel supports were ordered.

The nurse in charge was responsible for overseeing patient deterioration which was monitored with escalation plans. For patients temporarily remaining on ambulances, crews escalated concerns to the hospital ambulance liaison officers (HALO) if there was evidence of changing patient risk.

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

Several staff told us they had worked at the trust for many years and described “a really great team”. Most said they were very happy and some said they “loved” the department and had spent the majority of their training and professional careers there. However, some staff said the pressure could be overwhelming and people attending the department could be disrespectful to staff.

The trust’s organisational structure review over the year had created uncertainty for staff. However, several staff members told us they felt supported by their line management during this period. Staff mostly described leaders as being very supportive and approachable. They said appraisals included career conversations and there were developmental opportunities. One said they had been provided with all the necessary training required, they enjoyed their job and felt part of the wider team.

There was a strong focus on workforce wellbeing including awaydays and social events across departments for team building. Staff organised events for colleagues to meet during and outside of work such as a “chip and chat” Friday, promoting inclusivity and respecting staff preferences of those who may not want to socialise in an environment which involves alcohol. Other activities included dog and family walks at weekends.

Security staff told us of regular incidents when they were required to restrain people and the number of patients presenting with mental health concerns had increased. They were supported by debriefs immediately following such incidents and offered talking therapy.

There had been a lot of work to improve staff’s working culture and recruitment. Most staff told us they enjoyed the working environment and felt their mental health was looked after. However, in the last 12 months we received direct feedback from some staff regarding concerns about the safe care and treatment of patients in the department and staff wellbeing.

The trust produced a leadership and manager’s passport to support learning and development based on feedback from staff. The toolkit set out required expectations and behaviours and outlined a consistent standard of leadership and management in line with trust values.