Royal Derby Hospital

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We assessed 5 quality statements within responsive. Following this assessment safe is rated as good.

Staff provided person-centred care which considered the individual needs of the person. When it was recognised that a patient was suitable for discharge staff recognised the importance of timely discharge recognising the impact of a prolonged admission.

Processes were in place to ensure that all people were able to communicate with staff and the trust understood the importance of feedback to aid with service improvement.

Staff undertook difficult discussions with people to ensure that their wishes were considered in planning for future care.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

A multi-faith chaplaincy service who provided pastoral, spiritual and religious support to people. The service was available between 09:00 and 17:00 Monday to Friday with an on-call service available outside of these hours. There was also a multi faith centre in the trust which people could visit.

The trust had a spiritual healthcare policy in place which was available for staff to access. This policy included information on how to provide care in line with NHS Chaplaincy Guidelines 2015: Promoting Excellence in Pastoral, Spiritual & Religious Care and NICE Quality Standard [QS144] Care of adults in the last days of life. The policy also included information on different religions to allow staff to consider the religious needs of a patient when delivering care.

The patient records we reviewed showed daily documentation from nursing and medical staff about ward rounds, test results, patients’ progress and discussions with relatives. All records included details of treatment plans and daily consultant review.

Staff reported that there was no shower available for patients on the unit. They showed us the patient bathroom which was being used as a storeroom. They explained that this was due to the bathroom only containing a bath which patients were unable to safely use. This meant patients had to be washed at their bedside, they told us that they had escalated their concerns around this and had requested a wet room to allow patients to shower, when appropriate, and maintain their privacy and dignity.

Patients were admitted to the unit in a timely manner and appropriately discharged to either the step-down ward or appropriate medical ward with support from the critical care team.

The unit would follow the East Midlands Critical Care Network guidance if there was a need to transfer a patient to another critical care unit due to speciality need or bed availability.

Staff understood patients’ personal, cultural and religious needs and aimed to accommodate these during their admission.

All care was provided in line with national guidelines for the provision of intensive care services. Multidisciplinary teams workled together to ensure treatment was coordinated and joined up.

Staff aimed to transfer people out of the unit to a more suitable ward once it was clinically safe to do so as they recognised the impact of prolonged stays in a critical care setting on the patient. They told us that this could be a challenge due to bed flow throughout the trust and that not all wards were equipped to deal with the complex needs of the patients.

Translation services were available for people whose first language was not English. Staff knew how to access this service and told us that the service could be accessed by phone. The trust had a policy for interpretation and translation which was accessible to all staff. The trust discouraged staff from routinely using relatives as interpreters as it was recognised that the information provided may not be accurate.

There were information leaflets available for people to explain some of the treatment that patients may receive.

We observed relevant information being shared between staff during handovers.

Staff provided up to date information to people, where appropriate, during ward rounds and whilst delivering care.

Patient information, such as medical records, were stored in line with data protection and legislation requirements.

The trust understood the importance of the views of people. Staff feedback to aid service improvement was gathered through surveys and questionnaires.

There was a trust wide concerns and complaints policy in place. This policy was in line with NHS complaints standards and all other relevant legislation. Information on how to make a complaint and contact the Patient Advice and Liaison Service was readily available on the unit. Complaints were registered on the trusts incident reporting system and reviewed by leadership team.

The service had received no complaints in the month prior to our assessment.

We did not look at equity in access during this assessment. The score for this quality statement is based on the previous rating for responsive.

The critical care unit nursing team ran follow up clinics and all patients were offered a follow up appointment.

The service had processes and policies in place which ensured patients were treated in line with requirements under the NHS constitution and legal and human rights. Staff told us reasonable adjustments were made when required.

The processes in place ensured that patients were not discriminated against and ensured that care and treatment was equitable for all.

Patients who were approaching the end of life were identified and appropriate discussions with people took place to ensure that patients were able to have a comfortable and dignified death.

Staff documented discussions around cardiopulmonary resuscitation taking place in the patient records that we reviewed. This was record using a Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) form.

Patients’ who were discharged from the unit were offered an appointment in the follow up clinic to allow them to seek additional support in returning to their daily life following admission.