Royal Lancaster Infirmary

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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

This means 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 requires improvement. At this assessment the rating has changed to good.

Good: This meant people were supported and treated with dignity and respect; and involved as partners in their care.

The service treated people with kindness, empathy and compassion and respected their privacy and dignity. The service treated people as individuals to promote independence by listening to and understanding people’s needs, The service cared about and promoted the wellbeing of their staff.

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.

We always treat people with kindness, empathy and compassion and we respect their privacy and dignity. We treat colleagues from other organisations with kindness and respect.

We scored the service as 3. The evidence showed a good standard. 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.

During the onsite inspection, we spoke with patients and those close to them and observed care and treatment.

Staff were observed to be discreet, respectful and responsive, providing patients with help, emotional support and advice at the time they needed it. Staff supported patients to understand and manage their care, treatment or condition. Patients said staff treated them well and behaved appropriately towards them.

Staff directed patients to other services when appropriate and, if required, supported them to access those services. Patients could be streamed to other, more appropriate areas for continued care such as the virtual frailty team.

The trust provided patient feedback from March 2025 to July 2025. Comments from patients and those close to them was positive about staff and the care they provided including ‘staff were nice’, ‘did a great job’, ‘were non-judgemental', ‘amazing’, ‘put at ease’, ‘very pleasant’, ‘great staff’, ‘lovely nurse’, ‘the best care’ and ‘wonderful’.

Patients also commented on the need to wait, due to capacity and how busy the department was, but with a recognition that staff were supporting them. Feedback from patients about the minor treatment unit (MTU) was positive and noted a quicker service.

There was a number of ‘thank you cards’ displayed in the staff room for staff to view with positive comments about care and treatment.

Following feedback received from patients and those close to them, the trust had made improvements. Vending machine provision and snack choices were improved and call bells were installed for patients being nursed on the corridor. However, the waiting room was still small and became overcrowded quickly.

The trust results of the urgent and emergency care (U&EC) survey published in August 2024 included a total of 914 eligible responses, which was a response rate of 33%. This was an increase from 26% for their previous survey and compared to a 30% average response rate for other similar organisations. The survey found that 92% of respondents reported that they were treated with dignity and respect. There were 93% of respondents who reported that they had confidence and trust in doctors and nurses.

For the trust’s Same Day Emergency Care (SDEC) survey, 2,177 patients who had attended SDEC between November 2024 and January 2025 were approached for feedback. There were 233 patients (10.70%) who responded. Of these 96.13% reported that they were given enough privacy when being treated or examined. There were 195 patients said they had received enough information about their condition or treatment given to them.

The CQC urgent and emergency care survey for the period of April 2024 and July 2024 showed that the trust scored about the same when compared to other trusts. They scored 9.5 /10 for being treated with dignity and respect.

We treat people as individuals and make sure their care, support and treatment meets their needs and preferences, taking account of their strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

We scored the service as 3. The evidence showed a good standard. 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 service made adjustments for patients. During the onsite inspection we observed examples of where patients and those close to them were treated as individuals. For example, those with a hospital passport could contact the department in advance to request access to a quieter waiting area. This was accommodated and they were seen promptly by staff in the service prior to referral to a specialty for on-going care and treatment.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on. There were posters in the waiting area that signposted patients to other services as well as how to feedback to the service.

Managers ensured that staff and patients had easy access to interpreters and/or signers. The trust’s “Interpretation Service & Document Translation Procedure” included details of how to contact the external telephone and video interpreter service for patients whose first language was not English as well as services for patients with a hearing impairment. There was also guidance on recording the patients preferred method of communication on the electronic patient record system. The video system was mobile meaning it could be transported to patient bedsides. However, there was no hearing loop in the department for people with a hearing impairment.

There were leaflets throughout the department, however theses were all written in English. Staff told us they could access other formats on an individual basis if needed.

Patients had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerances. The service employed housekeepers who were responsible for supplying both hot and cold food to patients in the department and liaised with nurses about who was able to eat and/or drink.

We promote people’s independence, so they know their rights and have choice and control over their own care, treatment. and wellbeing.

We scored the service as 3. The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

People were supported to understand their rights, care and treatment by using different ways to communicate.

We saw examples of staff supporting patients to enable choice and participation in decision making regarding their care.

We listen to and understand people’s needs, views and wishes. We respond to these in that moment and will act to minimise any discomfort, concern or distress.

We scored the service as 3. The evidence showed a good standard. 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 were aware of and dealt with any specific risk issues, such as falls or pressure ulcers and care planned for these accordingly. Staff were shared risks at handover and safety huddles and used the information during ‘seen and safe’ intentional rounding.

Staff identified and responded to changing risks to patients. We observed that patients were monitored, and treatment provided according to the presenting risk. We saw that patients were triaged and escalated according to their needs.

We care about and promote the wellbeing of our staff, and we support and enable them to always deliver person centred care.

We scored the service as 3. The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Staff felt respected, supported and valued. Staff we spoke with told us they felt supported by their colleagues and immediate line managers.

Staff felt positive and proud about working for the provider and their team. Staff we spoke with told us they worked well as a team of doctors, nurses and support staff.

Staff had access to support for their own physical and emotional health needs through an occupational health service. The trusts occupational health service were available to support staff to access services such as physiotherapy, psychological therapies such as person centred counselling, trauma response cognitive behavioural therapy (CBT) and hypnotherapy. The service offered individual, and team based support. Courses were also available virtually if preferred.

Hot de-brief sessions could be arranged for staff following any serious or traumatic events. Staff were invited to discuss and reflect on the situation and share their experiences. The sessions were held as quickly after the event as possible to enable all staff involved to attend. These sessions were consultant led, and a hot de-brief form could be used to record the discussion. Cold de-brief sessions could be held in the days or weeks following the hot debrief and were supported by the safeguarding Team.

The provider recognised staff success within the service including employee of the month awards.

Staff appraisals included conversations about career development and how it could be supported.