The Princess Alexandra 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

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. We assessed 4 quality assessments.

Patients reported that staff were kind and provided good care, and during our observations we saw staff treat patients and relatives with dignity and respect. Although the 2024 NHS patient survey showed lower scores for dignity, respect and privacy than the national average, we observed staff preserving patients’ privacy and dignity in practice.

The service supported compassionate care through clear policies, mandatory training and equality and inclusion initiatives. Staff listened to patients, involved them in decisions and met religious, cultural and individual needs, including for patients with mental health needs, learning disabilities and dementia.

While staff remained committed to delivering good care, pressures such as staffing challenges and corridor care caused stress. Staff felt supported by leaders, wellbeing services and the Freedom to Speak Up Guardian, and overseas staff said they received appropriate guidance and support.

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 evidence showed some shortfalls. The service did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did not always treat colleagues from other organisations with kindness and respect.

The NHS patient survey for 2024 showed fewer patients said they were treated with dignity, respect and privacy than the national average. The service had guidance for staff when caring for patients using temporary escalation spaces. However, emotional and physical distress reported by patients and families due to prolonged waiting, lack of privacy or poor communication was one of the key themes from incident reporting about the use of these spaces. We saw that staff were kind and caring with patients during our observations as part of this inspection. They treated patients and relatives with respect. Patients said staff were kind and they were treated well. Comments included, “Not one fault here,” “Absolutely great care,” and “It’s clearly not just a pay check.”

The service had policies and guidance in place to support staff in providing care that protected patients’ rights to care and treatment in a supportive way. These policies also included staff codes of conduct for confidentiality and data protection.

Staff training for dignity, privacy and confidentiality, and equality, diversity and inclusion was included in core training that all staff were expected to complete. The overall compliance was just below the trust target of 90%, at 88%. We saw that staff preserved patients privacy and dignity when performing procedures, such as testing where clothes had to be moved. We saw that curtains were placed around patients and staff announced their presence before entering curtained off areas.

Equality, diversity and inclusion training also included values and behaviours and specific training for care of patients with a learning disability.

The evidence showed a good standard. 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.

Staff listened to patients’ preferences; we saw that staff asked questions when patients first arrived on wards and responses were recorded in patients care notes. Patients told us they were included in decisions about their care and kept up to date. However, one patient felt they were included too much in decisions about possible discharge dates, which then changed frequently.

The service had resources in place to meet patients religious and cultural needs. There was a full chaplaincy service with multi-faith representation, a multi-faith sanctuary and the ability to contact volunteers through different routes. The catering team were able to support cultural specific diets including Halal and kosher meals. The service had adapted hospital gowns to meet cultural needs and ensured gender-specific preferences were respected.

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.

The evidence showed a good standard. 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.

Staff made sure patients living with mental health problems, learning disabilities and dementia, received the necessary care to meet all their needs. Staff understood how to support patients with specific needs such as those with mental health difficulties and those living with dementia. Staff explained, when appropriate, necessary and with available space, the patient’s primary carer could stay with the patient.

Staff talked to patients in a way they could understand and made sure patients and those close to them understood their care and treatment. Staff listened to what patients were saying and clarified information when necessary. This ensured the appropriate level of support and resources were offered, while respecting patients’ wishes.

The evidence shows some shortfalls. Staff were committed to delivering good care, but gaps in processes and resources, such as staff deployment to other areas or corridor care, created stress and pressure.

Staff told us there were areas in which they did not always feel supported. They did not always receive additional staff to help care for patients that were placed in non-designated clinical areas to deliver care. Staff in one area told us they were often asked to send staff members to another area due to short staffing, which led them to also becoming short staffed. They felt that their staff were asked more often than staff in other areas and this created pressures for their area of work, without it being shared equally.

Staff from overseas told us the service had provided information and guidance for working in the UK, and they had received support to manage situations they may not have encountered previously. One staff member told us most qualified nursing staff were from overseas and there were occasionally communication issues. These were addressed in a sensitive way, as were the cultural differences in working environments.

The service had a Freedom to Speak Up Guardian service that staff could use if they were not able to speak to a senior staff member about concerns. Staff told us they were familiar with the service and there were staff at ward level they could speak with if needed.

Staff told us they were supported by senior ward staff, valued by most other staff members and service leaders, and they were happy to work for the service. One nurse told us site managers checked on them every 2 hours when they, as fairly junior staff, were in charge of wards. Staff were supported by professional nurse advocates and mental health first aiders, as well as an employee assistance programme and other wellbeing resources.