Calderdale Royal Hospital

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

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last inspection we rated this key question Good. At this inspection the rating has stayed the same.

This meant people felt well-supported, cared for and treated with dignity and respect.

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.

At our last inspection we rated this key question good. At this inspection the rating has stayed the same. This meant people felt well-supported, cared for and treated with dignity and respect.

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 scored the service as 3. The evidence showed how the dignity of people was supported. The service treated people in ways that respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

We observed staff treating patients with compassion and kindness in the various treatment areas. We observed interaction and saw staff working hard to maintain people’s dignity and make sure their privacy was respected including making sure people were covered with blankets when being moved through the department. We overheard kind and compassionate interactions between staff and patients. We saw no corridor care during our inspection, despite how busy the department was.

We also observed staff interacting with patients to help them understand their care and treatment. Staff found ways to communicate with all patients, including those with accessibility needs and included family and carers where this was agreed and appropriate to understand their health and care needs. Staff had access to interpreting services, including translation support. A mobile device could be taken to the patient to support communication. However, we observed family member were also used to pass information to and from patients, which is deemed as poor practice. And increased the risk of patients not fully ubnde3rstanding what they were consenting to.

Patients were moved to a cubicle for triage to support privacy during conversations. Staff were discreet when they spoke with patients. When patients were seen by doctors, this usually took place in a cubicle or treatment room. In open ward areas, such as resuscitation and majors, cubicles were separated by curtains, meaning conversations were not always private although staff did try to be discreet. This was consistent with the layout of an emergency department. Private rooms were available when sensitive or confidential conversations were needed. Staff preserved privacy and dignity in line with cultural and religious norms, and we observed examples of this.

Although privacy and dignity could be difficult to maintain in communal spaces the patients we spoke with did not raise concerns. They acknowledged the pressures the department was facing and told us that staff mostly listened and communicated with them in a way they understood. Patients described staff as kind and compassionate.

The department took part in the 2024 NHS Urgent and Emergency Care Survey and received 303 responses across the Trust. This is slightly worse than the national average but an improvement on the 2022 response rate. Results could not be split by site. One of the survey questions asked whether patients felt they were treated with privacy and dignity. The department scored 8.4 about the same as the national average of 8.3.

The department also carried out monthly Friends and Family Test (FFT) surveys supported with analysis of results by an outside organisation. The results showed staff were compassionate and caring, professional and worked well together as a team however there was no specific mention of privacy and dignity.

We reviewed the 2025 Patient Led Inspection of the Care Environment (PLACE) results. For the Privacy, Dignity and Wellbeing section, the department scored 94%, better than the national average of 88.22%.

Chaplaincy staff and facilities were available to support patients, families and staff with cultural, religious or unexpected needs, including following a death. A private room was also available for confidential conversations. This meant both staff and patients had access so support should they need it.

We scored the service as 3. The evidence showed a good standard of treating people as individuals. 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.

People could access food that met their cultural and religious customs, as well as any dietary or allergy needs. We observed patients being given drinks and light meals. Patients also had access to appropriate spiritual support. The service had a chaplaincy and spiritual care team that supported patients and relatives of all faiths and those without a religious affiliation. Patients and families could also access specific religious support if they wished, or simply someone to talk to.

Whenever possible, people living with dementia or people who were neurodivergent were offered quieter areas, including cubicles, if it was safe to do so. We reviewed the PLACE score for dementia for CRH. This was 88 out of a possible 100. There is no benchmark score at this time because full analysis had not yet been completed. We also reviewed the department for disability access and saw the department was designed to support people with physical disabilities such as wheelchair users and those who were visually or hearing impaired. The PLACE score for Disability was 87 out of a possible 100 with no benchmark score available.

The department had introduced care packs for people who may find waiting in a busy department overwhelming. These included ear defenders, books and crayons, tactile objects and easy read information about what might happen to then in the department. These were also available to children and young people.

Within the PED, There was no dedicated play specialists. Staff told us they could request support from the play specialist team on the children’s ward if required. National Play Well guidance states that therapeutic play should be a core part of children’s healthcare and that registered health play specialists should be integrated within multidisciplinary teams to support children during procedures and reduce distress. Therefore, the department was not following national recommendations.

The staff we spoke with demonstrated knowledge, skills and experience in supporting people with a wide range of needs, including cultural and religious needs, mental and physical health conditions, and language requirements. However, staff sometimes used relatives and friends to communicate with people whose first language was not English. This is not in line with best practice and raises a risk of poor or miscommunication.

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

The service treated people as individuals and made sure their care, support and treatment met their needs and preferences. Staff considered people’s abilities, aspirations, culture, protected characteristics and unique backgrounds.

We observed staff interacting sensitively with patients and relatives who were anxious. They explained what they were going to do and what the patient journey involved. Staff spoke with patients in a way they could understand, used communication aids when needed and avoided jargon and abbreviations. Patients and families were given time to ask questions, and staff explained treatment options clearly.

In the paediatric emergency department, staff supported children, young people and their families and explained information in a child-friendly way. They allowed time for questions and reassured families by making sure they understood the next steps in the care and treatment journey.

The hospital scored about the same as other trusts in the 2024 Urgent and Emergency Care Survey for involving people in decisions about their care and for explaining why tests were needed. It also scored the same for listening to people and for giving clear explanations about their condition and treatment.

We scored the service as 3. The evidence demonstrated how staff worked to respond to people’s immediate needs. The service listened to and understood people’s needs, views and wishes. Staff respond to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Staff across all disciplines introduced themselves to patients and relatives and we saw them building professional and friendly relationships as a way of putting people at ease. We saw staff working hard under pressure to meet patients’ needs. They understood the importance of supporting people to minimise their distress and pain. Staff also gave emotional support to family members, providing professional and sensitive advice and reassurance at difficult times.

We observed times when staff could not always respond to people’s needs straight away such as for personal hygiene needs however, we also saw staff acting as quickly as they could and asking for help to reduce discomfort, concern or distress for patients. Call bells were answered quickly.

When we spoke with staff in the department they told us they understood how important it was to support both the patient and their loved ones and involve them appropriately in making decisions about care and treatment.

Patients underwent triage in a timely way within an average of under 20 minutes, however, they then experienced long waits to see a doctor or an advanced care practitioner (ACP) who decided what treatment they needed. We had a mixed response from patients about whether they were offered pain relief and how quickly this was given.

We spoke with ambulance crews. They told us the hospital had some delays but was one of the better emergency departments to hand over patients to. The department had a dedicated ambulance handover area staffed by nurses and HCSWs. Ambulance crews told us staff responded to patients’ needs in a timely way in this area.

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

We spoke with staff across the department from a range of roles and grades. Staff told us they were proud to work in the department and said colleagues worked well together to support patients and each other. The said managers and leaders within the department were approachable and listened to their concerns although some raised concerns about confidentiality which we raised with the management team. Staff also told us other support was also available; they could self refer to occupational health and there was an employee assistance programme which included benefits such as 7 day access to an online GP. Staff told us they felt respected by their colleagues, who recognised their individual skills and contributions

Staff told us there were ‘hot’ debriefs shortly after difficult or distressing incidents so they could discuss what happened, what went well, what could be improved and how the incident made them feel. These were viewed as positive. Staff also knew they could access mental health support services, speak with their line manager and access the psychology team. This included after violent incidents they had been exposed or subjected to. During our site visit a student was assaulted by a patient. They were supported by colleagues in the immediate aftermath and by more senior colleagues to make sure they were able to continue working that day. Security staff attended however there was no security dedicated to the department and therefore when there were violent incidents staff told us there were usually delays in security attending especially if they were elsewhere in the hospital.

Staff could also access the trust’s Freedom to Speak Up guardian if they did not feel able to raise concerns within their usual line management structure.

Staff had regular appraisals which included discussions about their wellbeing, concerns within the department and career development. Staff told us they were encouraged to progress and increase their skills and knowledge. HCSWs were encouraged to consider training to be nurses and others were encouraged to consider enhanced training such as to become advanced clinical practitioners.

Staff in the urgent and emergency care department scored the trust lower than the national

average on the NHS Staff Survey 2024 theme “We work flexibly”. This theme reflects how well staff felt they can achieve a good work–life balance and whether they are supported by the organisation to work flexibly. The results showed that staff in this trust felt less supported to balance their work and personal lives than staff nationally.

We reviewed the trust’s response to the survey, including the document “How do we improve our staff survey?”, and saw that the main action proposed in response to the lower flexible‑working score was to ensure annual leave is taken at regular intervals.

The UEC directorate carried out its own internal staff surveys alongside the national staff

survey. These local surveys were introduced after the Urgent Same Day Emergency Care

pathway was implemented, to understand how the changes were affecting staff experience.