Glenfield Hospital

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

Good: We looked for evidence that people and communities had the best possible outcomes because their needs were assessed. We checked that people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

At our last assessment we rated this key question as requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

Description: We maximise the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

We scored the service as 3. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing, and communication needs with them.

We looked at 15 individual care records. Staff completed a comprehensive needs and risk assessment of each patient in a timely manner at, or soon after, admission. The risk assessment informed the care and treatment plan for each patient.

People’s needs were assessed using a range of validated and standardised tools. Assessments considered the person’s health, care, wellbeing, and communication needs. This enabled patients to receive care or treatment which met their needs and had the best possible outcomes.

Patients told us they were involved in the assessment of their needs, and support was provided where needed to maximise their involvement. People’s communication needs were assessed and met to maximise the effectiveness of their care and treatment. Staff told us it was usual practice to use interpreters for people who did not have English as their first language or sometimes using hospital staff to help translate.

Patient risk assessments were completed and used to mitigate risks. Staff used these assessments to identify and address concerns, for example by providing pressure-relieving equipment to reduce the risk of pressure ulcers and walking aids for patients assessed as being at risk of falls. Most wards also monitored falls and pressure ulcers locally to track performance in real time and implement improvements where necessary.

Body maps were completed when patients first arrived on the wards, any pressure areas were recorded, treated and monitored.

The needs of carers of patients using services were assessed and met. The hospital supported their health and wellbeing in their carer roles and helped them to provide safe and effective care to the people they supported. On ward 20, staff told us they would allow carers to come into the ward and help care for patients where this was in the patients' best interest. This allowed carers to learn from hospital staff about how to treat and care for patients when they were discharged and patients were supported by staff they were familiar with.

Staff would use ‘about me passports’ which outlined additional needs so staff could learn more about the patient’s culture and preferences. These documents outlined patient’s personal, religious views, dietary requirements, communication and meal preferences. Therefore, the need for families to repeat their advocacy to their family members care and wellbeing was reduced.

Patients had access to specialist support when required. Staff described effective joint working between multidisciplinary teams, including timely referrals to specialist services to ensure patients' needs were appropriately assessed and managed. During the inspection, we saw evidence of collaborative working across professional groups and did not identify any concerns to suggest that patients were unable to access specialist advice or input when needed. This supported the delivery of coordinated care that was responsive to patients' individual needs.

Description: We plan and deliver people’s care and treatment with them, including what is important and matters to them and in line with legislation and current evidence-based good practice and standards.

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Patients received care, treatment and support that was evidence-based and in line with good practice standards. Staff followed up-to-date policies to plan and deliver high-quality care according to best practice and national guidance. Policies seen were reflective of national guidance. As per trust policy, each specialty had an annual audit programme to monitor the quality and outcome of care.

Staff protected the rights of patients subject to the Mental Health Act and followed the Code of Practice. At handover meetings we saw that staff referred to the psychological and emotional needs of patients, their relatives and carers when required. The provider’s systems ensured that staff were up to date with national legislation, evidence-based good practice and required standards. People were told about current good practice that was relevant to their care and were involved in how this was reflected in their care plan. People’s nutrition and hydration needs were met in line with current guidance. Staff and leaders were encouraged to learn about new and innovative approaches which evidenced improved outcome for patients. On our review of patient notes, we saw that appropriate assessments and treatment plans were in line with national standards. As part of our inspection, we reviewed a number of trust policies which were current, and reflective of national standards and guidance.

We reviewed documentation for patients at risk of pressure areas and saw appropriate care plans were in place and that advice from tissue viability nurses had been sought with reference to national standards.

Description: We work effectively across teams and services to support people, making sure they only need to tell their story once by sharing their assessment of needs when they move between different services.

We scored the service as 4. The service worked extremely well across teams and services to support people. They always made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

When patients received care from a range of different staff, teams and services, it was co-ordinated very effectively. All relevant staff, teams and services were involved in assessing, planning and delivering people's care and treatment and staff worked collaboratively to understand and meet people's needs. Nurses told us that consultants were very respectful and felt that they were able to provide opinions and professionally challenge clinical decisions where appropriate. This led to a more holistic and in-depth approach to patient care. Patients had enough to eat and drink, including those with specialist nutrition and hydration needs. Staff fully and accurately completed patients’ fluid and nutrition charts where needed. Staff used a nationally recognised screening tool to monitor patients at risk of malnutrition. Specialist support from dietitians and speech and language therapists was available for patients who needed it. We saw referrals were and carried out as appropriate in patients’ records.

We saw very effective multidisciplinary working across the service. Different professional groups attended ward handovers and MDT meetings to discuss patients' needs and support care planning, with the focus on each patient’s needs. Staff said they worked well with physiotherapists, occupational therapists, speech and language therapists, clinical nurse specialists and other specialist teams, and that specialist input was generally available when required. This supported coordinated decision-making and helped ensure patients received care that reflected their individual needs. There was a real understanding for effective MDT working across all the wards and clinical areas we visited, and all staff valued each other’s support. We saw an experienced local leadership team supporting all staff and patients inclusively, with some excellent multidisciplinary (MDT) working across specialties. We noted the excellent holistic and methodical handovers and board rounds, especially on Ward 27. We noted the excellent whole team approach on the Coronary Care Unit (CCU).

Description: We support people to manage their health and wellbeing so they can maximise their independence, choice and control, live healthier lives and where possible, reduce their future needs for care and support.

We scored the service as 3. The service supported people to manage their health and wellbeing to maximise their independence, choice, and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

The service had relevant information promoting healthy lifestyles and support on wards. A variety of information was available for patients and carers.

Staff knew how to signpost patients to relevant external services when required. Staff assessed each patient’s health when admitted and provided support for any individual needs to live a healthier lifestyle. For example, we saw information displayed across the trust promoting the trust’s smokefree environment and the trust had processes in place to identify patients who smoked. Patients would be offered support to manage their nicotine withdrawals on site, including nicotine replacement methods such as patches. Patients also had access to support from tobacco dependency advisors who could refer patients to community programmes once discharged. Posters and information provided by the trust to highlight the benefits of stopping smoking to encourage people to stop smoking.

People were involved in regularly reviewing their health and wellbeing needs where appropriate and necessary. People were encouraged and supported to make healthier choices to help promote and maintain their health and wellbeing in line with their current care and treatment plans.

Services focused on identifying risks to people’s health and wellbeing early and on how to support people to prevent deterioration, e.g. weight loss management, diabetes care, and medicines’ management. People were involved in regularly monitoring their health, including health assessments and checks where appropriate and necessary with health and care professionals.

Description: We routinely monitor people’s care and treatment to continuously improve it and to ensure that outcomes are positive and consistent, and that they meet both clinical expectations and the expectations of people themselves.

We scored the service as 3. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff used recognised tools to improve the detection and response to clinical deterioration in patients as a key element of patient safety and improving patient outcomes. For example, National Early Warning Score (NEWS2) and the Safer Care Nursing Tool (SCNT). NEWS is a clinical assessment system used by healthcare professionals to support the identification and response to patients at risk of clinical deterioration. We reviewed patient records and audit data and found these tools were being used appropriately to support the ongoing assessment and monitoring of patients. We found no concerns regarding the completion, escalation or documentation of observations and staff were able to describe how they responded when patients showed signs of deterioration.

The service participated in relevant national clinical audits that included outcome data relevant to medicine care such as the Review of Tuberculosis National Report: March 2025.

The service participated in the NHS England programme of Peer Review visits. The service also took part in Get It Right First Time reviews (GIRFT) such as the GIRFT Review of Tuberculosis National Report published in March 2025. GIRFT aims to reduce unwarranted variation to ensure best outcomes for patients and to maximise the use of existing resources and assets. We also saw a comprehensive set of clinical audits and improvement projects across the service, designed to improve patient outcomes, reduce health inequalities and improve productivity. The Nephrology wards submitted clinical information to the UK Kidney Association and the Midlands Kidney Network as per national requirements. Cardiology wards showed positive performance in the 2025 National Cardiac Audit Programme (NCAP) Annual Report. Outcomes were good and complication rates were low. A NIV cohort audit in 2023 showed much lower local mortality rates (7.1%) than the national average (24.5%).

Staff had access to the information they need to appropriately assess, plan and deliver people’s care, treatment and support. Staff were aware that policies could be found on the trust’s websites. We observed some information was displayed publicly such as Safer Care Nursing Tool (SCNT). This tool, developed by the NHS, supports chief nurses to determine optimal nurse staffing levels and deliver evidence-based workforce plans.

Staff undertook or participated in local clinical audits. The audits were sufficient to provide assurance and leaders acted on the results when needed. Management of risk, issues and performance were monitored within meetings, risk assessment and staffing data. Staff had access to the risk register at ward or Clinical Management Group (CMG) level. Staff at ward level could escalate concerns when required. Staff concerns matched those on the risk register especially around staffing for Tuberculosis (TB) patients.

Description: We tell people about their rights around consent and respect these when we deliver person-centred care and treatment.

We scored the service as 3. The service told people about their rights around consent and respected these when delivering person-centered care and treatment.

Staff understood how and when to assess whether a patient had the capacity to make decisions about their care. We saw that staff gained consent from patients for their care and treatment in line with legislation and guidance and appropriate to their grade and the local policy. When patients could not give consent, staff made decisions in their best interest, considering patients’ wishes, culture and traditions.

Staff made sure patients consented to treatment based on all the information available. For example, we observed staff asking patients before proceeding with cannulas, closing curtains or carrying out tests.

Staff recorded consent in the patients’ records. Staff understood the relevant consent and decision-making requirements of legislation and guidance, including the Mental Health Act 2025, Mental Capacity Act 2005 and the Children Acts 1989 and 2004 and they knew who to contact for advice.

Staff took all practical steps to enable patients to make their own decisions, and clearly explained the processes, side effects and care plans. Where patients could not speak English staff told us that interpreters were used. For patients that had hearing difficulties staff also told us they knew how to gain access for British Sign Language interpreters. For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately.

Where staff knew where and how to apply for Deprivation of Liberty Safeguards (DoLS) and record clearly in patient notes. When patients lacked capacity, staff were able to make decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history. Mental capacity assessments were always completed prior to a DoLS application, as the trust’s IT system was designed to stop an application being made without a capacity assessment.

We reviewed a sample of patient records and found Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions were recorded appropriately where required. Documentation we reviewed was completed and accessible within patient records, enabling staff to identify patients' resuscitation status. Where DNACPR decisions had been made, records demonstrated the rationale for the decision and evidence of review. Staff were aware of the process for completing and reviewing DNACPR documentation, and we did not identify any concerns regarding the recording or management of these decisions.

We also reviewed patient notes where a Deprivation of Liberty Safeguards (DoLS) authorisation was in place and found all documentation and care plans met national requirements.

Training compliance for Mental Capacity Act was 97% for nursing staff and 98% for additional clinical services.