Horton General 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.

At the last assessment in 2024 we did not assess this key question.

At this assessment the key question has been rated as 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 treated people with kindness, empathy and compassion and respected their privacy and dignity.

Staff treated women and their families with kindness, compassion and respect. They consistently demonstrated caring, calm and professional behaviours when interacting with women, helping them feel safe, supported and listened to.

Staff welcomed women and their families in a warm and friendly way in the outpatient clinics and introduced themselves by name when meeting people for the first time. Interactions were respectful and unhurried, and staff took time to build positive relationships and trust.

We observed staff responding sensitively to women’s needs in a non-discriminatory way, including providing emotional reassurance and compassionate support when a woman felt unwell during a clinic.

Staff maintained women’s dignity. They knocked before entering rooms, ensured occupied signs were displayed and respected privacy during examinations and discussions. Women giving birth at the MLU were cared for in single-occupancy rooms during labour and the postnatal period, which ensured privacy and confidentiality and prevented conversations from being overheard.

Women and their families we spoke with in the outpatient clinics were positive about their experience and their interactions with the staff. Women used words such as kind, caring, supportive and safe when discussing the care they had received. Staff had communicated with women and their families in an empathetic and respectful way, particularly during sensitive discussions. We were told staff used gentle, reassuring language and took account of women’s feelings, ensuring they felt included, involved and respected in decisions about their care.

Although we did not speak directly to any women in labour or those who had recently given birth, we saw messages from new parents thanking staff for their help and support, and how amazing and professional the team had been. Another woman had said how they had felt safe and encouraged and would look back at the birth fondly.

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.

The midwife-led unit (MLU) provided care that was personalised and responsive to the individual needs, preferences and choices of women and their families. Staff treated women as individuals and supported them to remain central to decision-making throughout their care.

Women were supported to develop personalised care and birth plans that reflected their values, preferences and expectations for labour and birth. Staff used these plans in practice and reviewed them throughout pregnancy and labour to ensure care remained appropriate as women’s needs changed. Women were supported to make choices about their care, including their preferred birth environment, where clinically appropriate.

Staff told us they were mindful of women’s individual circumstances when providing care and treatment. This included recognising and responding to potential language barriers, family dynamics and cultural or religious sensitivities to ensure care was respectful, inclusive and person-centred.

Staff completed mandatory training in equality, diversity and human rights, which covered understanding and respecting different cultural, religious and social backgrounds, recognising and addressing unconscious bias, and promoting inclusive communication and behaviours. Staff completion rate was 95% which was higher than the trust target of 85%. Staff had access to specialist equality, diversity and inclusion midwives for advice and support when required.

The service had access to language translation services to support effective communication and help ensure women understood their care and treatment. The service had identified an increase in migrant women in the local area and recognised a growing need for Tetum interpreters.

We spoke with a woman attending an outpatient clinic who told us her cultural needs had been discussed with staff, including her preference for only female staff to be involved in her care. She told us staff listened to her wishes and that her onward care was being arranged with a female member of the medical team.

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

Women using the midwife-led unit were involved in planning and making decisions about their care. Staff gave clear and balanced information about care options, including benefits and risks, and checked women understood this information. Women were given time to make decisions and were not pressured.

Women told us they felt listened to, respected, and supported to make choices that were right for them. This helped them feel informed and in control of their care.

Women were supported to have a low-intervention birth. They were offered choices such as using birthing pools and birthing balls, and non-medical pain relief including breathing techniques, massage, and water immersion.

Midwives worked with women to develop personalised birth plans based on individual preferences. Continuity of care helped women build trusting relationships with their midwives, which increased confidence and feelings of control during birth.

Staff respected women’s right to make informed decisions, including when these decisions were outside local or national guidance. When women chose to birth outside of guidance, staff supported them through a clear decision-making process. Consultant midwives were involved when needed, and discussions about risks were explained and documented.

Women were supported to choose their place of birth, including choosing a midwifery-led unit (MLU) rather than a consultant-led unit. Clear information was provided about transferring to obstetric care if required. The MLU environment supported privacy, dignity, and a calm atmosphere.

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.

Women using the midwife-led unit received timely care that met their immediate physical and emotional needs during labour and birth. Staff were attentive and responded quickly to changes in women’s comfort and emotional wellbeing.

Midwives offered and supported a range of comfort measures, including access to birthing pools, massage, and birthing balls. Staff provided emotional support and reassurance throughout labour. Midwives remained present, offered encouragement, and responded early to signs of distress or anxiety. Women were kept informed about what was happening and were supported to make decisions in the moment.

Care was delivered in a calm, supportive environment that respected women’s dignity and choices. Staff listened to women and adapted care to meet individual needs.

Midwives were able to recognise when care needed to be escalated. Clear processes were in place to manage emergencies and arrange prompt transfer to obstetric services when required.

After birth, staff responded quickly to women’s postnatal needs. Women were supported with skin-to-skin contact, bonding, and early feeding, with staff available to provide ongoing support.

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

The trust had a guide to health and well-being which outlined the main forms of well-being support available to staff across the trust. This support was grouped into six key areas: emotional and psychological, physical, social, financial, occupational, and intellectual and environmental well-being.

Staff could access details of these services and initiatives via the staff support services intranet page. In addition, the maternity service had its own dedicated maternity staff support intranet page, which offered more tailored one-to-one support for staff. The service supported staff experiencing difficulties directly related to their work, such as stress, burnout, trauma, and anxiety. It also supported staff experiencing issues outside of work that had a direct impact on their ability to work, for example infertility.

The maternity staff support service worked closely with the professional midwifery advocates, who provided clinical debriefs and support for staff with personal and professional development, revalidation, and guidance during investigations or challenging clinical situations. Staff were able to self-refer to the maternity support programmes, or access support through referral by their line manager or occupational health.

The service used well-being champions and mental health first aiders, who were trained members of staff responsible for signposting and supporting colleagues to navigate the mental health and well-being support available across the trust.

The trust also offered spiritual support to staff, regardless of faith or denomination. A designated space was available at Horton General Hospital for prayer, reflection, and quiet contemplation.

The trust had several staff networks that provided safe spaces for staff with shared characteristics or interests to connect, share experiences, and offer mutual support.

The service used debriefs, which were structured conversations reviewing actions, decisions, and outcomes following patient care incidents. These sessions aimed to support staff well-being and improve future practice by providing a safe space for emotional processing and fostering resilience. Staff reported that they found debriefs particularly valuable following challenging or emotionally demanding situations.

Staff spoke positively about the well-being support available to them and gave examples of when they had accessed specific services. They also highlighted the importance of informal support from colleagues and managers within the maternity-led unit. Staff felt that this combination of informal peer support and formal well-being services contributed to good morale and a positive team atmosphere, which in turn enhanced the care they were able to provide to patients.