Huddersfield Royal 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

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

We found that staff treated patients and each other with compassion, empathy, and kindness. Care was responsive to individual needs and respected patients’ choices.

However, the service did not always promote the wellbeing of staff, and support and enable them to always deliver person centred 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.

Staff treated patients and their relatives with kindness, empathy, and compassion, and showed mutual respect toward colleagues. Most patients were respected for their privacy and dignity.

Across all wards visited, staff interactions with patients and those close to them were discreet, respectful, and considerate.

Staff took time to explain what they were doing when providing care or treatment, ensuring patients felt informed, reassured, and involved in their care. Communication between staff during handovers was calm, professional, and respectful, reflecting good teamwork and a positive culture of mutual support.

Patients spoke positively about the care they received and comments included, “I felt safe and cared for,” and “Staff took time to explain my treatment plan”.

Staff consistently maintained patient’s privacy and dignity during care and treatment. Curtains were drawn around bed spaces during personal care, medical ward rounds, and care planning discussions. Most wards had a quiet, safe space where private conversations took place. Patients confirmed that staff maintained their privacy and dignity.

Staff understood the individual needs of patients, including their personal, cultural, social and religious needs.

During the inspection, we observed a small number of unattended and unlocked computers-on-wheels (COWs) and computer screens displaying patient information on medical wards. This was a potential risk and breach of General Data Protection Regulation (GDPR). Staff we spoke with were aware of the importance of data security.

Most staff demonstrated good practice in protecting patients’ confidential information. Overall compliance with data security training showed a compliance rate of 88%. However, compliance among medical staff was lower than other staff groups reflecting a compliance score of 74%.

Chaplaincy staff and facilities were available to support patients, carers, and staff in response to cultural, religious, or unexpected needs such as a death.

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 demonstrated a person-centred approach to care, taking time to understand what mattered most to each individual. Patients were encouraged to share personal information and likes and dislikes at point of admission. The information enabled staff to learn how patients preferred to be addressed, details about their family life, pets, treasured possessions, and religious or cultural beliefs. This information was actively used to tailor care and treatment plans to each patient’s unique needs and preferences.

Staff used the ‘Forget Me Not’ symbol on patient information boards at nurse stations to discreetly identify individuals living with dementia, memory problems, or complex communication needs. This served as a gentle visual cue to remind staff to offer additional reassurance, time, and support to these patients.

Patient care records demonstrated that care plans were individualised and person centred, reflecting each patient’s values, and preferred ways of receiving care.

Ward environments were personalised to reflect each speciality. Noticeboards were colourful, engaging, and provided information tailored to support patients, relatives, and staff. We observed posters reminding staff, and reassuring patients that “everyone should be seen and treated as an individual”.

The service had access to a matron lead for learning disabilities. The matron supports adults with learning disabilities in accessing hospital services and advocating their needs.

Staff communicated effectively with patients using clear and accessible language and provided examples of how they used communication aids to meet individual needs. They had access to a full range of interpretation services to support patients whose first language was not English or who used alternative communication methods.

Staff also provided positive examples of meeting patients’ dietary, nutritional, and cultural requirements, confirming that specific foods could be ordered to respect patient’s beliefs and or preferences.

Spiritual needs were met sensitively. The trust’s chaplain regularly visited wards, providing support to patients, relatives, and staff regardless of faith or background.

Staff supported patients to make informed decisions about their own care, treatment, and wellbeing.

Patients we spoke with confirmed they had agreed to and provided consent for their care and treatment. Staff explained care and treatment options in a way that helped patients understand and make informed choices. Most patients told us they felt comfortable asking questions about their treatment plan.

However, some patients said they were not kept up to date of planned discharge arrangements. This was evidenced by the ongoing delays in discharge processes, particularly for patients with complex needs. It was evident there were delays within the system regarding rehabilitation beds within the community.

Patients expressed satisfaction with the quality and choice of meals provided. They said staff respected their preferences and dietary needs, which contributed positively to their sense of choice and well-being.

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.

We observed a morning nursing handover where staff demonstrated a clear understanding of patient’s current needs and prioritised actions to ensure these were met without delay.

Patients who required urgent medical attention were prioritised appropriately during ward rounds. Patient care records confirmed that prompt reviews were undertaken by the medical team when required. We observed a multidisciplinary hand over on the acute floor (wards 8/9) where we saw examples of differing staff reviewing specific risks, plans of care and discussing potential discharge.

We observed a physiotherapy assessment review of a patient requiring rehabilitation. We witnessed a robust review of the patient’s medical history and reason for admission. Staff treated the patient as an individual and assessed their needs holistically. The patient was treated with kindness and compassion. We observed staff working closely with patients requiring assistance with mobility and equipment needs.

Staff told us they were responsive to changes in patient condition and immediate needs. Ward managers initiated one to one observation where necessary, staff were assigned to observe a bay of cohorted patients to maintain patient safety due to falls risks or confusion. Staff acknowledged this could be challenging at times due to staffing pressures and the high number of patients requiring enhanced observations.

We observed effective escalation and prompt clinical response. The clinical team could request assistance from security to support if they required assistance with restraint. We observed security staff attend the acute floor to assist with a patient requiring transfer for a diagnostic test. Security staff were trained in conflict resolution including safe restraint.

Appropriate referrals were made to specialist teams when required, including mental health, palliative care, dietetics, and occupational and physiotherapy services. We observed therapists reviewing patients, and staff confirmed that therapy teams attended daily to assess, support, and plan care for patients.

The Speech and Language Therapy (SaLT) team operated under a clear prioritisation framework.

Staff were able to refer patients for mental health assessments by the trust’s mental health liaison team, which was described as supportive.

Patients were able to access and use their call bells to alert staff when they required assistance. We observed staff responding to call bells in a timely manner.

Staff assessed and monitored patients regularly for pain and provided analgesia in a timely and appropriate way. Documentation confirmed that pain assessments were recorded accurately.

Most staff we spoke to reported feeling respected, supported, and appreciated by colleagues and matrons at ward level. They described a strong sense of teamwork, mutual support and collective pride in their work demonstrating a strong sense of belonging and shared purpose.

However, some staff felt unsupported by the senior team at executive level. They told us that staffing requests to fill rota gaps and 1:1 requests were not always secured. We observed staffing gaps on the acute floors on the days we inspected where bed capacity was full and the acuity of patients was high. We escalated this to senior leaders during inspection. We received assurance that the service complete twice daily staffing meetings at 10:30 and 3:00. Overnight clinical site matrons review staffing for the following morning in line with the business-as-usual arrangements.

The 2025 General Medical Council (GMC) survey had shown the trust to be in a poor position both regionally and nationally. There were many areas of concern across the medicine service. Interpretation of the survey results was difficult within this service, as there were several different training programs involved, spread across several differing specialty areas.

The areas identified reflected concerns surrounding local teaching, feedback, experience/satisfaction, induction and facilities available.

Staff told us meetings were ongoing with consultants and senior staff in each specialty, to analyse local and service survey results. Discussions focused on what could be done locally to improve ward-based and departmental teaching.

Engagement and listening events were held to develop understanding of the issues and inform priority actions. Events were extended to include key members of the multi- professional team such as ward managers.

The senior service team complete walk rounds of clinical areas to gain a better understanding of some of the issues particularly in relation to the environment.

The trust action plan was overseen by the deputy medical director with the service held to account for delivery of the action plan. There had been significant movement in many of the actions. This was confirmed by the triumvirate team for the service.

Ward managers and matrons were visible and approachable, contributing to a culture where everyone worked well together to achieve the best outcomes for patients.

Recognition and celebration of staff achievements were clearly embedded in the culture on the wards. Staff could be nominated for a “Star of the Month” and or recognised through “Greatix” which is the trust’s staff appreciation and recognition system. Ward managers also promoted positivity through “This Month We Are Proud Of” posters which celebrated teamwork, communication, and quality improvements.

Daily safety briefings included recognition of staff achievements and team successes, reinforcing morale and a shared commitment to delivering excellent care.

Managers provided clinical staff with regular clinical supervision sessions, which supported reflective practice, development and learning from practice. Managers had access to an online wellbeing toolkit to help support their teams effectively.

All staff received annual appraisals to review performance, identify development needs, and discuss career goals. Staff were offered opportunities for further learning and skills development; however, some healthcare support workers reported limited access to additional training beyond mandatory requirements.

The medical division promoted staff wellbeing through a comprehensive range of initiatives, including access to occupational health services, a 24-hour helpline, mental health first aiders, counselling and wellbeing workshops.

Spaces for quiet reflection and prayer, were available to support spiritual wellbeing.