East Surrey 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 the service involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question as good. At this assessment the rating has remained good. This meant people were supported and treated with dignity and respect; and were 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 did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did not always treat colleagues from other organisations with kindness and respect.

Patients reported staff were not always respectful and responsive. There were mixed responses from people regarding staff attitudes and behaviours when interacting with patients. For example, a patient’s relative told us, “Some staff are wonderful, some are here to tick boxes.” One patient told us, “It’s not too bad, some treat me better than others. Some are a bit rough when they wash you. Some treat you like a human and some don’t.” 

However, one patient described how staff responded to episodes of incontinence with discretion and sensitivity, helping to preserve their privacy and dignity. Another patient told us, “Everyone is looking after me well, no complaints.” Other people reported staff were “doing the best they could” and “staff had been amazing but worked too hard and don’t have time to stop”. 

Across all wards we observed thank-you cards from patients and their relatives displayed, which reflected positive feedback about the care provided by staff. Comments included, “Thank you for all you did…you made his last moments special and we could not have gone through this without you”, and “We were so moved by the dignity and respect shown to our dad… he felt safe in your care… we are forever grateful for the wonderful nurses who were with him until the end.”

Staff on one ward shared a recent example which demonstrated the impact of the care they provided. They told us the previous day a patient visited the ward before being transferred to a hospice for palliative care. Staff said the patient wanted to see the team to express their appreciation for the care and support they had received when they had been treated on the ward two years earlier.

The service did not always support patient’s privacy and dignity due to capacity. Staff provided end of life care in bays, when side rooms were not available. Staff tried to maintain the person’s dignity as best as they could by closing the curtains around the bedspace. However, this would not be the preferred option. 

Some wards did not have designated private spaces available for staff to hold sensitive or difficult conversations with patients or relatives. Staff told us when they needed to communicate distressing or sensitive information to families, they used the ward manager’s office or the staff room. These environments were not designed for this purpose and did not always provide an appropriate or supportive setting for these types of discussions.

To support dignity for people being cared for in critical capacity escalation bed spaces, bedside cabinets and portable call bells were put in the spaces to create a more standard bed space. However, curtains were not available to all these bed spaces, with privacy screens required.

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.

Staff recognised patients’ individual needs and supported them. For example, housekeepers recognised patients and remembered their preferences. Drinks were given in appropriate containers, and biscuit packets were opened for people if required. On some wards, patients who preferred to sit out for meals were identified on lists displayed on bay doors. This helped ensure staff were aware of patient preferences and could support them accordingly.

Red trays were used to identify where assistance was required to support people with their meals. Dietary needs were respected with cultural food choices available, such as Halal meals. The trust respected and supported individuals' religious beliefs by providing a prayer room and access to multifaith chaplaincy services.

Communication tools such as translator services were available. Staff knew about these services and how to support people with their understanding of information. 

Where people had reduced mobility or dexterity and were unable to use a standard call bell effectively, an alternative larger call bell was provided to ensure they could gain assistance when required.

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

Staff supported patients’ choice and independence with mobility. We observed staff help a patient who needed to transfer to a trolley for discharge. Staff supported the patient’s decision to transfer independently instead of using a transfer aid. Staff drew the curtains, assisted the person into their own clothes and helped support the person’s choice to mobilise to the trolley safely. This promoted the person's independence and confidence, while supporting their right to make safe choices about their own care.

Staff understood how to support people's care and wellbeing through choice and control. Staff shared how they used people’s hospital passports for people with learning disabilities. The passports provided key information about a person's needs, preferences and care choices, helping staff to deliver appropriate care and treatment.

Patients were aware of capacity pressures and how it may affect their care. One patient told us they had no choice about being in a critical capacity bed. However, they recognised how busy the service was and reported they were just relieved to get a bed. 

Visitors were welcome to the hospital, with flexible visiting arrangements available, which supported patients’ wellbeing. 

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.

Staff identified and responded to people’s changing needs. Staff were aware of individual risks, including pressure ulcers and Malnutrition Universal Screen Tool (MUST) scores, and care was planned accordingly. Staff responded quickly to call bells, which ensured people received timely assistance. We also observed staff supporting a confused and agitated patient with kindness and compassion. Staff listened to the patient’s concerns and responded calmly to reduce distress.

One patient told us staff supported them to use their hearing aid and communicate effectively. Staff removed their own face masks, where appropriate, to support lip reading, reducing the risk of misunderstandings and demonstrating a holistic approach to care.

People told us they knew who they could raise concerns and complaints to, including speaking with clinical staff and the Patient Advice and Liaison Service (PALS).

The service did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

Staff did not always feel listened to or involved in improvements. We received mixed feedback from staff regarding work at the service. Many staff spoke positively about working within their local department and team and were proud to work in their roles. However, many staff reported it was challenging as they did not feel listened to by the service leaders, and that their feedback led to no actions or improvements. Many staff recognised the lack of privacy and space for patients but felt there was nothing they could do about it. Which had a negative impact on staff morale. Reduced staff engagement could also affect the quality and consistency of care delivered to people. 

Staff facilities did not always support the wellbeing of staff or the security of their belongings. Although the service provided lockers, staff told us they were too small to accommodate anything larger than a small handbag, meaning personal belongings were often left unsecured. The staffroom was small and located in the centre of the ward, with noise from the surrounding areas carrying into the space. Staff told us this environment was not relaxing and did not provide a suitable area to take a break away from the activity of the ward, which could impact staff wellbeing. 

However, multiple internationally recruited nurses informed us the trust had helped with their transition to the service, providing accommodation, training and support. The service shared how teams were recognised and positive feedback was shared with staff. For example, we received data showing quarterly ward specific feedback including quotes, such as “The girls on the ward looked after my mum so well and the nurses were amazing.” On Tilgate Ward there was an “Employee Star of the Month” voting box, with certificates of recent winners displayed behind it. 

Clinical senior leaders acknowledged their hard-working teams and recognised the emotional toll staff could face. Managers provided support and the ability for staff to reflect on their experiences. For example, a senior nurse spoke with their team when they experienced significant numbers of patient deaths to provide wellbeing support. The service offered staff support for their own physical and emotional health needs through the occupational health service.