Chelsea and Westminster 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 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.

Staff treated patients with kindness and compassion and respected their privacy and dignity. They treated patients as individuals and their beliefs, culture and background were considered. The service promoted patients’ independence and enabled them to exercise choice and control over their care and treatment. Patients and their relatives were positive about their care and treatment. They felt supported in understanding their treatments, medications, and ongoing care plans.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

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 and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

We spoke to patients, and their carers or relatives and they informed us that they were treated with kindness and dignity by staff. They reported feeling well looked after and described staff interactions as respectful and warm. Staff were described as consistently courteous, respectful and professional in their interactions, contributing to a positive care experience.

Where possible people were cared for in side rooms which meant people could have their privacy and dignity protected. There were designated “butterfly rooms” to provide privacy, dignity and a calm environment for patients and their families during the last phase of life. During our assessment, all EOLC patients we observed were either in a designated butterfly room or a side room.

People felt that staff listened to them and communicated with them appropriately and in a way they could understand. During the assessment, we saw staff taking time to introduce themselves and their role to people and communicating with them in a respectful and considerate way.

We found there was a culture of kindness and respect between staff, people who used the service and their relatives. Staff treated patients with kindness and respect and were discreet when caring for patients. They treated colleagues from other organisations including community teams, cancer charities and volunteers with kindness and respect.

A team of butterfly volunteers offered compassionate companionship for end of life patients and provided a calm and caring presence. They sat with people, held their hands, listened to them and offered support to families at the most difficult time. They ensured that no one spent their final hours alone or in isolation.

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.

Patients we spoke with felt they were treated as individuals, and their beliefs and ethnicity were considered. A wide range of cultures and backgrounds were accommodated in the choice of food. For example, vegetarian and halal meals were available.

People who used the service had access to a broad, multidisciplinary network of support services, ensuring holistic care beyond clinical treatment, including emotional, psychological, spiritual and practical support. This included access to the chaplaincy service, the butterfly volunteer service, community palliative care teams and voluntary organisations.

The Trust provided access to a 24 hours a day, 7 days a week multi-faith chaplaincy service, ensuring that patients and families could access appropriate spiritual and religious support at any time. This ensured that people’s spiritual needs were met as they entered the final stages of their life.

The Butterfly Volunteer Service provided dedicated bedside companionship for patients in the last weeks, days or hours of life, offering emotional support such as listening, reading, and presence, alongside support for families and carers.

Voluntary organisations offered patients and their families emotional support including counselling and advice.

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

The service supported people to have choice and control over their care. We saw staff providing explanations to people and ensuring they had time to ask questions. People told us they felt able to express concerns and that staff respected their preferences, including when people requested further clarification or reassurance.

Information was provided in a way that enabled people to make informed choices. Staff also used interpreters and made adjustments to support people to communicate their needs effectively.

The results from the NACEL family bereavement survey (2025) showed that 89% of respondents indicated that patients were able to participate in decisions during their final days. The survey also reported that 87% of respondents reported timely communication at the time of death. Both these results were better than the national average.

Our review of care records showed staff documented discussions they had with patients and their relatives. Patients had an individualised care plan tailored to their needs. We saw evidence of advance care planning in place in line with best practice. Staff discussed with patients and documented their preferred place of death in the records reviewed.

The service was exceptional in how they 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.

We observed staff respond to patients’ needs. They took time to observe, communicate, and engage people in discussions regarding their immediate needs. Staff identified and responded to changing risks to patients. We observed staff escalate sudden deterioration in a patient and made them comfortable while alerting senior staff.

Patients felt supported in understanding their treatments, medications, and ongoing care plans. Patients informed us that staff took the time to explain medical decisions in a way they could understand.

Patients informed us their emotional and psychological needs were supported with a range of in-house activities dedicated to keep them engaged. A team of occupational therapists and physiotherapy staff helped patients to manage their functional and mobility needs. Where possible, therapy staff facilitated walks to the sky garden, an indoor botanical space which supported the cognitive function and wellbeing of patients.

We observed that staff were able to quickly recognise when people needed urgent help or support and used appropriate tools such as the National Early Warning Score (NEWS) to assist with this. Observations were regularly completed, and any concerns were escalated appropriately.

The trust offered open visiting periods for relatives of patients at the end of life. Patients and their families were also offered free parking, meals and refreshments. Recliner chairs were made available for visiting relatives staying overnight, ensuring the relatives were nearby and comfortable.

Patients had access to the multi-faith chaplaincy service. The service catered to people of different faiths and none. For example, the chaplaincy provided services tailored to those of the Christian, Muslim, Jewish, Hindu and Sikh faiths as well as humanists. Chaplains visited patients at their bedside and played a key role in supporting patients and families at the end of life. They provided religious rites and prayer, supported decision making at critical moments and delivered bereavement support.

Ron Johnson ward had a spacious conservatory with a glass ceiling where staff, patients and relatives could spend time together in a relaxed environment. Staff informed us they recently held a wedding at the conservatory to enable a patient to attend their daughter’s wedding.

Bereavement officers supported relatives and friends following a patient’s death by explaining legal processes and what to expect after someone died. They assisted relatives to register the death, arrange funerals and provided emotional support to families. They liaised with the chaplaincy team and mortuary to arrange viewings where required. They referred people to other community teams for bereavement support.

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

All the staff we spoke with were positive about the quality of care they provided to patients. They felt the trust supported and enabled them to deliver person-centred care for patients at the end of life. Staff were positive about the opportunities for training and personal development. They spoke well about the robust EOLC training provided by the SPCT.

Efforts were made to facilitate flexible working arrangements for staff. Where practicable, reasonable adjustments were implemented to support employees in fulfilling their roles effectively.

The trust had several initiatives to support staff wellbeing. Ward staff and members of the SPCT had access to counselling and debrief following patient deterioration or death.

The trust had an established approach to recognising staff contribution. These included awards recognising outstanding staff, teams, and long service among others.

The NHS staff survey results for 2025 showed the trust was above the national average for all areas for the people promise elements and themes including staff engagement, morale, flexible working, and teamwork among others.