Hull Royal Infirmary

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

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to Good. This meant people’s needs were met through good organisation and delivery.

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.

This service scored 65 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

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. The service was previously in breach of the legal regulation in relation to the privacy and dignity. Improvements were found at this assessment and the service was no longer in breach of this regulation.

Staff were discreet and responsive when caring for patients. Staff took time to interact with patients and those close to them in a respectful and considerate way. We observed kind, caring interactions between patients and staff. Staff explained to patients what they were doing when providing care and treatment. Patients said staff treated them well and with kindness.

A local survey completed by the trust asking patients if ‘they felt they were treated with privacy and dignity’ showed that in the last 12 months 95% of those responding said they were happy with the privacy and dignity afforded to them.

We did note the difficulties faced by staff caring for patients in temporary escalation spaces but all patients we spoke with felt that they were cared for with privacy and dignity.

Staff and leaders acknowledged the difficulties in ensuring that dignified care was always upheld for patients and acknowledged the time other patients waited for treatment. Staff gave examples of how they understood and respected the individual needs of each patient. Staff told us that working relationships within the emergency department were positive, particularly how personal, cultural, social, and religious needs of patients and how these may relate to care needs.

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.

We noted that staff could access interpretation services by telephone and could also access sign language interpreters. We saw that patient information leaflets were available in various formats and languages. We saw survey results reported that 83% of patients felt supported with communication needs, this was a 15% improvement from previous results.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on. We saw posters and leaflets available in all patient areas. Survey results showed that 98% of patients felt that they received enough help to understand their condition and treatment.

Patients had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerances. Staff were able to give examples of how differing needs were met.

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 saw evidence of patient satisfaction reported in local patient feedback.

The evidence showed an inconsistent standard. The service did not demonstrate that it consistently listened to and understood people’s needs, views and wishes. Staff inconsistently responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Staff were aware but did not consistently assess and dealt with any specific risk issues, such as falls or pressure ulcers. We observed staff assessing, completing and updating care records following ongoing assessment of patients within their care.

We saw that lack of pain relief was highlighted in audit results and patient feedback. We also noted that only 23% of nursing staff had completed training in pain assessment which meant we were not assured that all staff would be able to effectively assess pain. We saw that a specific action plan had been created to address this shortfall.

We noted the use of a nationally early warning system (NEWS) to recognise and escalate a deteriorating patient. We reviewed patient records and saw the accurate recognition and appropriate escalation without error or omission.

The evidence did not show a good standard. The service had failed to consistently demonstrate how they care about and promote the wellbeing of their staff.

Not all staff felt respected, supported and valued. Staff survey results showed consistently low scores in staff not feeling valued or supported. All staff survey responses declined compared to the previous year.

Staff appraisals covered career development and support. Only 31% of survey respondents found the process useful, this was above the trust average of 23%.

We did note that senior leaders had identified these issues and had created an action plan to monitor and drive improvement.

Staff had access to support for their own physical and emotional health needs through an occupational health service. We saw that a range of services were available that staff could self-refer and access.

The service’s nursing staff sickness was 4% which was better than the national average.