Castle Hill 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

At our last inspection we rated this key question as good and remained the same at this assessment. This meant people were supported and treated with respect and involved in their care.

We found that care was consistently kind, compassionate and person centred. Staff within medical care core service (the service) treated patients and their families with dignity and respect, communicated sensitively, and took time to understand what mattered to each individual. Interactions were warm, supportive, and reassuring, and patients spoke positively about the care they received. Teams demonstrated a clear culture of caring, with staff showing empathy for one another and collaborating closely to create a positive and supportive environment.

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.

Staff treated patients and their relatives with kindness, empathy, and compassion, and showed mutual respect toward colleagues.

The trust’s 2024 adult inpatient survey recorded high trust wide scores of 9.2/10 for respect and dignity and 9.1/10 for kindness and compassion.

Staff interactions with patients and those close to them were consistently warm, respectful, and considerate. We observed staff introducing themselves, which patients said they valued and explaining care and treatment, helping patients feel informed and involved told us they valued.

Communication between staff was calm, professional, and respectful, reflecting good teamwork and a positive culture of mutual support.

Patients spoke positively about their care describing staff as “fantastic,” “friendly,” “nice” and “kind and caring.” Staff ensured call bells were accessible, offered refreshments to relatives and wards displayed positive feedback from patients and relatives including positive feedback about the new Allam digestive centre.

We heard examples of compassionate care, including staff going over and above to support patients who did not have any relatives. The trust’s volunteer team made a positive contribution to the experience of patients, relatives and staff.

The trust wide patient survey scored 9.5/10 for privacy during examinations and treatment. We observed staff maintaining people’s privacy and dignity through appropriate use of curtains, covering and signage. Endoscopy staff accommodated religious needs, including allowing patients to wear shorts under gowns and providing female staff where requested. On the complex rehabilitation ward signs were used during assessments and therapy sessions to protect privacy.

Staff also shared positive practice examples including the use of a separate entrance for urgent endoscopy patients and oncology day‑unit patients waiting in a familiar environment rather than the emergency department.

Staff treated patients as individuals and ensured care, support and treatment reflected patient’s needs and preferences. Staff took account of patients’ strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff consistently demonstrated a person centred approach, taking time to understand what mattered most to individuals. One patient told us staff were “listening to me” which helped reduce anxiety.

We heard positive examples of personalised care. Cardiology staff supported patients living with dementia, tailoring interactions, taking time to talk about their lives and recognising those who attended regularly. On the infectious diseases ward, staff were able to meet cultural needs, including ordering halal injections.

On the frailty ward, activity staff supported patient engagement through structured daily activity programmes, including exercise and social activities such as games, bingo, arts and crafts, baking and cinema sessions.

Care records showed individualised, person centred care plans, including personalised nutrition and therapy plans. Ward round discussions demonstrated tailored discharge planning, with efforts made to plan discharges close to patients’ home areas.

Staff described involving families in care discussions and used the ‘Forget Me Not’ symbol to discreetly identify patients with dementia or complex communication needs, supporting appropriate reassurance and care.

Ward environments were personalised and supportive with care related information displayed.

Staff communicated effectively using clear language and communication aids, with access to interpretation services including British Sign Language, video translation and electronic devices. Face‑to‑face interpreters were arranged where needed.

Staff provided positive examples of meeting dietary and cultural needs, with individual menu boards displaying preferences, modified diets and feeding support requirements. Most patients gave positive feedback about food quality and choice and some told us they could request items not on the menu.

Oncology and frailty staff described using a therapy dog to support emotional wellbeing, and oncology patients had access to counselling services.

Visiting hours were extended in July 2025 by one hour (11am to 8pm), and care partners were able to access wards flexibly to support patients during times of need.

Staff supported patients to make informed decisions about their own care, treatment, and wellbeing. There was a clear emphasis on respecting individual preferences and involving patients in planning and reviewing their care.

Care and treatment options were clearly explained, and care records showed documented involvement of patients and families in care planning.

We observed ward rounds where patients were actively involved in discussions. Consultants explained prognosis and treatment options, and patients and relatives said they felt comfortable asking questions and involved in decisions. Some patients were less aware of their discharge plans, identifying an area for improvement.

The trust’s 2024 inpatient survey showed high trust wide scores for staff involving patients in conversations and decisions about their care. Scores were lower for discharge planning and family involvement, which the trust had recognised and was addressing.

Staff shared positive examples of promoting independence. Patients had protected mealtimes to support choice and routine. On the complex rehabilitation ward, patients had access to electronic devices to maintain contact with relatives. The oncology day unit reported that patients could self‑refer for advice and support, supporting choice and control.

Staff listened to and understood patients’ immediate needs and responded promptly to minimise discomfort or distress. Staff were vigilant to changes in patients’ conditions and escalated concerns appropriately.

Ward managers described initiating one‑to‑one observations or cohorting staff when required to maintain patient safety. Staff shared examples of effective escalation and timely clinical response, with appropriate referrals to specialist teams, including safeguarding and therapy services. Cardiology nursing staff reported prompt medical response when patients deteriorated.

We observed therapists reviewing patients, and staff confirmed therapy teams attended daily to assess, support and plan care. On the complex rehabilitation ward, therapy staff adapted schedules to meet patients’ needs, including supporting intensive interventions such as home assessments.

Patients used call bells to request assistance and reported timely staff responses. We observed call bells being answered promptly. On the frailty ward, patients said they rarely needed to use call bells as staff were consistently present.

Staff regularly assessed and monitored patients for pain and provided timely analgesia. Care records showed pain assessments were accurately recorded as part of NEWS monitoring. The trust’s 2024 inpatient survey scored 9.2/10 for staff doing everything they could to control pain.

The service generally promoted staff wellbeing and enabled staff to deliver person‑centred care.

Most staff across roles and services told us they felt respected, supported and valued, and were confident to ask for help.

Endoscopy staff described the move to a new building as challenging but successfully managed through strong teamwork, while cardiology staff reported a positive culture and high morale. However, staff on the frailty ward reported that uncertainty about the ward’s long‑term future had negatively affected morale and wellbeing. Staff described feeling resilient and continuing to prioritise patient care, although some said they did not feel consistently supported by leadership during this period of change. Care group leaders confirmed there were no plans to close the ward, although work was underway to reduce the number of ‘no criteria to reside’ (NCTR) wards.

Ward managers and matrons were visible and approachable, supporting teamwork and shared responsibility for patient outcomes. Resident doctors reported excellent access to senior clinical support, and weekly teaching sessions and training delivered by advanced clinical practitioners were well attended.

The infectious diseases ward received national recognition, including an NHS England “Shining Lights Award for Excellence”.

Managers provided regular clinical supervision, and most specialties met or exceeded the trust target for appraisal completion. Some medical specialties had lower appraisal rates, indicating areas for improvement.

The trust had trained 220 Professional Nurse Advocates, who provided staff with wellbeing support, including counselling referrals, occupational health access and support for newly qualified nurses. Staff also had access to a wide range of wellbeing initiatives, including occupational health, psychology and counselling services, and a wellbeing platform.

The trust’s ‘Putting People First’ programme, shaped by staff survey feedback, supported workforce wellbeing through improved communication, wellbeing support, and reward and recognition.

Additional Initiatives included engagement with the senior leaders, staff networks, wellbeing activities such as choir, gaming, sport and gardening groups, financial and emotional support resources, and schemes recognising staff contribution and development. Facilities to support wellbeing were available, including spaces for quiet reflection, prayer, and outdoor woodland walking paths.