St Peter's 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

We assessed a limited number of quality statements from this key questions and found areas of good practice and concern. The scores have been combined with scores based on the key question ratings from the last inspection. Though the assessment of these quality statements indicated some areas of concern, our overall rating remains good. Prior to the assessment, we had received information of concern related to care delivery in the medical wards. Emerging themes included poor patient experience associated with low staffing and inadequate communication with patients and relatives. Some complaints cited poor attitudes among hospital staff and managers. Our findings during the on-site assessment did not support these claims. We interviewed 21 staff and 6 relatives from a sample of 5 wards and the discharge unit, who were overwhelmingly positive about their experiences. Patients we interviewed had been in the hospital for periods ranging from new admissions to 3 weeks stay. Patients and relatives said they had been treated respectfully by staff and felt their privacy and confidentially had been preserved. They told us that staff were caring and compassionate.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Our rating for this key question remains good. We spoke with 6 relatives from a sample of 5 wards and the discharge unit, all of whom were overwhelmingly positive about their experiences. Patients had been in the hospital for periods ranging from newly admitted to over 3 weeks

Patients and relatives said they had been treated respectfully by staff and felt their privacy and confidentially had been preserved. They told us staff were caring and compassionate.

Patients were treated with kindness, compassion and dignity. Patients and their relatives we spoke with were overwhelmingly positive about the care and support they received: One person told us, “The staff are all very good here: really quiet and calm.”

Staff obtained consent prior to procedures and ensured patient dignity was preserved. We observed occasions where staff were effectively communicating with relatives and patients about their care, including one example where staff were explaining how to manage their own medicines prior to their departure from the discharge unit .

We saw examples of excellent practice in the way the trust provided for the emotional wellbeing of patients, such as the 'healing arts' programme and space given over to market stalls and charity sales in the main concourse.

People told us about how staff helped meet their personal, cultural, social and religious needs. We visited the multifaith centre and saw leaflets on display describing how people could access a variety of religious services and resources along with other posters and publicity material on display throughout the hospital. This indicated that staff actively supported diversity and patient choice.

We observed occasions where staff were effectively communicating with relatives and patients about treatment plans. We saw patients were provided with information about their medicines as they were given them during ward rounds. People were supported to self-administer their medicines. Records were kept on the electronic prescribing system by staff to indicate if a medicine was self-administered.

People received safe, effective and person-centred care within the medical service. The trust recognised and met the wellbeing needs of staff. These included the necessary resource and facilities for safe working, such as regular breaks and rest areas.

Staff were given opportunities to provide feedback, raise concerns and suggest ways to improve the service. Senior nursing leaders provided a timely and considered response, however staffing constraints sometimes delayed actions being taken.

Staff and relatives spoke about a range of health promotion and advice posters and leaflets on display in ward corridors and other public areas, including signposting to local resources and support groups.

People’s independence was promoted and care planning took into account individual needs and choices when delivering care. Staff effectively communicated with relatives and patients about treatment options and were signposted to local resources and support groups.

Patients and their relatives felt staff responded well to their immediate needs.

We spoke with a variety of clinical and support staff from the 6 wards or units we visited. Responses we received about the patient experience were mixed. Some staff expressed anxiety and concern that patient care was not always a top priority.

We heard several staff say that patients “did not always get good care.” We were told that “Critical things like observations get done,” but medicine rounds were interrupted and insufficient staff at mealtimes meant those needing assistance to eat had food had their meals delayed . Other staff explained that feeding “could be rushed due to time pressure.”

Some staff became tearful when talking about the impact of poor staffing on patient care. Examples given included choosing the least time-consuming care such as a strip wash instead of a shower; leaving patients to lay in bed instead of assisting them to sit up in the chair and not applying creams to patient’s to dry skin. Nurses stated that medicine rounds were “constantly interrupted” for toileting or addressing the risk of falls.

We observed staff responding quickly to people using their call bell or make verbal requests for help. We saw that people had access to a call bell where appropriate and these were positioned within reach. Staff seemed to understand people when they were asking for help, including those that had difficulty communicating due to their illness or condition.

Senior managers recognised the wellbeing needs of staff, but these were not always met.

Although staff were given opportunities to provide feedback, raise concerns and suggest ways to improve the service, some staff expressed a loss of confidence in their leadership and said they were unable to raise concerns.