The Royal Orthopaedic 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.

Children and young people received care and support that was kind and compassionate. Staff treated children and young people as individuals and fully respected their privacy and dignity. Staff had a good understanding of monitoring and assessing children and young people’s individual needs, including communication and any reasonable adjustments they required. The service had a positive culture and staff morale had been positive. Managers promoted staff’s health and wellbeing.

At our last assessment we rated this key question as good. At this assessment, the rating has stayed as good. This meant people felt well-supported, cared for and or treated with 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 and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

We spoke with 5 children, young people and their families and observed 6 clinics where we were told staff were kind and compassionate. We also observed during the clinic’s doctors being very kind and respecting privacy and dignity.

When staff needed to take the height and weight measurements of the children and young people, they ensured this had been done in a separate room to ensure their dignity and privacy had been respected. One staff member told us “There are lots of children and young people who struggle with confidence in relation to their weight, and do not feel comfortable having this done in front of other people, and we want them to feel comfortable and reassured that we are here to support them”.

A chaperone was present for any physical examinations of children or young people which was usually a registered nurse and or a parent, the service consulted with the child initially to advise them of the options, and the child or young person decided who they felt most comfortable with to attend their appointment with them.

When observing clinics, we noted that staff greeted the children, young person, and their families, they took them into the clinic rooms and ensured doors were closed to maintain privacy and dignity, also to ensure conversations were not overheard.

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

Because the hospital did not provide acute services to patients, one parent told us they “had more time to spend getting to know my child and can better identify and respond to their needs.” This parent told us about how their child did not respond well to having a mask put on for anaesthesia, so staff worked with the child to build rapport, then hugging, then were able to put the mask on while hugging the child. The child had been successfully able to wear the mask for anaesthesia and had a successful surgery.

The named nurse for safeguarding told us about how the hospital culture recognised intersectionality, and how different aspects of patient’s lives, and their past experiences shaped them. This in turn impacted on how people experienced treatment at the hospital.

Another parent told us, “The staff here are lovely they recognise my child has significant needs and always give us a quiet space in which to wait.”

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

We observed consultants speaking with children, young people and their families about the care and treatment needed, they explained this in a way they were able to understand. Also, when decisions were being made about pre-surgery they gave the children, young people, and their families the information required to be able to make choices about their surgery, and what would be best for them.

Staff told us there had been times when they had provided age-appropriate information to young people, about sexual health, to enable the young person to make the correct choices.

The service offered the chance for children, young people, and their families to visit the service before their appointment or pre- and post-surgery, to help them understand what the service offered, what would happen, and to ensure they could take control of their stay in hospital.

The service offered the child and young person the opportunity to choose a distraction method in the clinic. The service had a variety of visual and tactile resources available, including fidget toys and bubble machines.

The service promoted gradual independence, an example of this was that the children, young people started with small tasks, like helping with a test, such as blood pressure recording, asking them which numbers appeared on the monitor, which medication they took, and to gradually increase their responsibilities and independence.

The service supported informed decision making by following the ‘three questions’ trust initiative. These were: ‘What are my options?’, ‘What are the benefits and risks to each of the options?’ and ‘How do I get support to help me make the decision that’s right for me?’. There were posters around the trust to support these and ensure people go the most out of their appointments.

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.

The service ensured that before a child or young person attended an appointment, they gained all the information needed to be able to deliver care and treatment, this included any reasonable adjustments, translation services, and the use of communications aid to meet the individual’s needs.

We observed medical and nursing staff working closely together to meet the children and young people’s needs and delivering a good level of care and treatment.

We observed care and treatment for children and young people living with a learning disability, the care was individual to each patient. Staff responded to their immediate needs and were patient focused.

The learning disabilities team provided support to the children and young people during clinic appointments, advocating for their needs and providing a care plan including hospital passports with reasonable adjustments following consultation with children, young people and their families or carers.

The service did not always act in line with recommendations made for improvements. For example, the learning disabilities action plan update in November 2024 identified the need for a line asking for patients to inform the hospital of reasonable adjustments needed. This had not been added to the appointment letter. These were noted as ‘not commenced’ as there were some conflicts about who would be responsible for recording and enacting the reasonable adjustments once the patient notified the hospital.

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

The service promoted free breakfasts at the café, if anyone had been struggling with the cost of living, to ensure people using the service could have a healthy breakfast.

The service completed a world mental health day, mental health, and wellbeing at work webinar, which encouraged staff to take time to look after their own mental health, what they could do and what support they could seek if needed.

There was an app “GetUBetter” for staff who experienced musculoskeletal pain. It offered a personalised programme and support to self-manage pain and recover.

The hospital achieved “thrive at work” foundation status for its commitment to staff wellbeing, structured initiatives and support for physical and mental health, financial wellbeing, and creating a positive, inclusive culture with strong management support and staff networks.

There was access to free sanitary products for staff who needed it to reduce period poverty.

The service provided various areas for staff to be able to take breaks these included seating areas inside and outside.

The service had several wellbeing champions who promoted, identified, and signposted their colleagues to national health and wellbeing support.

The service provided a wellbeing pack to staff, this included information where staff could gain support, included the intranet page, health and welling officer, mental health first aiders, freedom to speak up guardians, pastoral care, and counsellors who could be either internal or external support.

The service provided a resource library of support, guidance and signposting using the five ways to wellbeing, these were where staff could gain information for a number of services to help and support their wellbeing.

The service offered staff meals provided for colleagues who worked outside of core hours, and meals for £1; they also had a pantry where staff could access food items, toiletries, and sanitary products.

The trust had menopause champions who were there to support staff to offer any advice or support that staff needed.

There was coaching support for managers as a “Me as a Manager” programme. It was an internal managers development programme.