Leeds General Infirmary

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

Caring – this means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. At this inspection we rated caring as requires improvement. This meant babies and families were not always supported and treated with dignity and respect; or involved as partners in their care.

This service scored 60 (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 as individuals or make sure people’s care, support and treatment met people’s needs and preferences. Staff did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

We reviewed friends and family feedback and saw that families felt they had been treated with kindness, compassion and dignity throughout their involvement. People we spoke to during inspection told us that they had been listened to, and staff had communicated in a way that they could understand. We heard that staff on the transitional care unit had been able to respond to needs efficiently and took the time to understand individual's personal preferences.

We saw that a monthly compassion audit was carried out for the neonatal unit and transitional care unit. This comprised of five questions including pain control, infant feeding choices, hygiene support, environmental suitability, worries and fears and timeliness of help when needed. Over a five month period reviewed all areas scored 100%. However, it was not clear from the questions reported on how parents were supported to answer the questions on behalf of their babies, for example, ‘have staff done everything they can to control your pain?’ This audit did not appear to be specifically adapted to the needs of babies and parents on the neonatal unit rather than a generic trust wide audit.

Staff did not always take everybody's needs into account, for example, we saw individual care being given to neonates without privacy from curtains being pulled around. This meant that there was limited privacy at cot spaces where care was given and visitors to other cot spaces were not protected from observing care provision that could impact on their own wellbeing. We reviewed the most recent parent and staff feedback survey that identified space could be made more private and there was limited space for visitors around the cot area due to necessary equipment.

There was a designated space for private consultations. Staff told us the quiet room would be used, and in some cases, the bereavement room could be used.

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.

Families and staff told us that individual needs were taken into account when care planning. This included being aware of cultural backgrounds and protected characteristics.

Staff had access to an interpreting tool which was available in many differing languages. Staff could also access face to face interpreters if and when required.

Since the staff demographics such as cultural backgrounds and languages used were somewhat similar to the local communities, staff were able to communicate with families in their own language and in consideration of cultural needs. A family had reported this had been particularly supportive during a very difficult time when their baby was admitted.

There were educational materials, posters and QR codes available to meet a range of individual and family support.

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.

There was a family integrated care team dedicated to supporting families accessing the neonatal service. This team worked across St James Hospital and Leeds General Infirmary site. This team told us about a clear vision aimed at ‘supporting families to become partners in care and not just visitors to the service’. The team offered educational sessions for families to learn about areas of interest to them. We saw a weekly timetable of educational sessions that parents and carers could sign up to.

We spoke to allied health professionals (AHP’s) who aspired to support babies and families to have independence, choice and control over their treatment. Family integrated care and AHP staff recognised a short fall in staffing of AHP’s and therefore an impact on ability to provide consistent daily support for babies and families. The shortfall also meant there was limited MDT support and sharing of good practice to consistently ensure that families and babies had support to build independence with a range of choices available to them.

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. Access cards were provided for families following families’ requests to access the unit in a timely way, but the system was not safely managed.

We did not see effective systems and processes in place to consistently support babies’ voices being heard in a timely way. There were no clear plans identified for emotional support.

There was limited breast pump availability for parents and staff did not always have the training on use of breast pumps to support mothers. The parent and staff feedback survey identified that there could be a delay of up to 24 hours before mothers received support with expressing breast milk. Some mothers and staff felt that this was too long to wait. The trust provided a list of breast pumps available for loan in the community. These were provided free of charge for mothers living in the local areas but other people from the wider region had to pay a fee for the loan.

Access to the unit was via a buzzer entry to the ward. During inspection we did not encounter lengthy waits to access the unit following pressing the buzzer and staff would check who was there before releasing the electronic door lock from the ward clerk’s desk. We saw from family feedback that lengthy waits had been experienced by families and had caused additional stress and worry when families were anxious to get in to see their babies. Following this feedback the unit had organised a system implemented in April 2024 where some families received swipe card access following risk assessments that lessened this anxiety provoking time. However, although there was a formal process in place, we found the system was not safely administered or secure.

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

Staff sickness rates were just above 9% for the six months prior to inspection. The rates had fallen slightly from the previous six months. The leadership team recognised the pressures and emotional demands of working within the neonatal environment. We saw that the staff survey results for wellbeing had been used to further develop appropriate support options for staff. For example, informal safe space sessions had been created which allowed staff to connect with others and easily access other support services within the organisation such as chaplaincy services.

There was an established psychological support service for staff with dedicated psychology time. There was a clear understanding around the kind of support that might be required by neonatal staff in supporting their wellbeing at work. Staff supported each other during difficult situations and by holding hot and cold debriefs to ensure the whole team had an opportunity to discuss any concerns as quickly as possible following incidents and giving or receiving bad news.

There were processes in place to ensure support for staff was available from the beginning of their journey within the service. For example, a preceptor and buddy system.