Queen's Medical Centre

On this page

• 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

At our last inspection we rated this key question good. At this inspection the rating has remained the same. This meant people’s needs were met through good organisation and delivery. Patients, care givers and loved ones had good outcomes.

During our inspection we observed that people’s care, support and treatment reflected these needs and protected equality characteristics, ensuring people were at the centre of their care. As part of our inspection, we reviewed evidence that showed people were encouraged to live healthier lives. Leaders made sure that consent to care processes were undertaken appropriately. Staff worked to ensure that current outcomes and exploring best practice was part of their everyday work.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

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

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Staff ensured patients received effective care and treatment through assessment and regular review of their health, wellbeing, and communication needs.

We reviewed 19 electronic patient records. Care records and personalised treatment plans were clearly documented following admission and kept up to date to reflect identified needs.

Observations of multidisciplinary ward rounds showed staff reviewed results collaboratively and discussed treatment options before engaging with patients.

Staff used risk assessment tools effectively to assess and monitor patients’ needs and took prompt action to escalate concerns about deteriorating patients. Patient records showed early assessment of clinical risks. Daily nursing handovers included discussion of risk, and care plans were adjusted to reflect changing needs, with risk assessments and onward referrals completed where required.

Patient records showed that nutritional needs were accurately assessed and met, with food and fluid charts in place.

Staff  recorded the patients vital sign observations using the National Early Warning Score (NEWS) accurately, appropriately, and kept them up to date, supporting early recognition and escalation of patient deterioration.

Care records we reviewed were correctly scored and documented electronically.

Care records across medical wards showed that venous thromboembolism (VTE) risk assessments were consistently completed.

Patients we spoke with told us their care and treatment needs were met, and they spoke highly of the staff. They knew their care plans, saw appropriate medical teams daily and were involved in conversations about their care.

Staff knew and understood how to assess patients’ needs and used appropriate risk assessments to ensure safe care, including nutrition, hydration and falls risk assessments were regularly assessed in line with guidance. Staff were aware of how to monitor skin for pressure ulcers and use body maps when repositioning recording skin integrity. Staff told us they could access medical staff and that they participated in daily ward rounds, as well as morning handovers.

Staff had access to various tools and information to assess patients’ needs, these included current and past medical history, health, and communication booklets, and communication aids.

The service used an electronic patient records system which flagged patients with additional needs. This included patients with complex or communication needs. Staff routinely assessed patients’ psychological and social needs and reviewed this in preparation for discharge.

Specialist support from allied health professionals such as dieticians, occupational therapy and therapies were available for patients who needed it.

Staff adjusted patients’ meals to enable religious, cultural, and personal preferences. Staff on the wards made sure patients had enough to eat and drink, including those with specialist nutrition and hydration needs.

We saw that care episodes were documented and kept up to date. Records reflected individual care needs and end goals of care were documented highlighting progress towards discharge to an appropriate environment. We saw a good standard of multidisciplinary team (MDT) working which was also documented in patients’ records.

Patients had the equipment they needed to mobilise readily available and to hand.

The SDEC unit had their own pharmacists who were available during the services operating hours.

We reviewed 14 Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) forms and found that 2 were not completed correctly on the acute respiratory care unit and on the stroke unit. We escalated these to the nurse in charge, and when we reviewed them again, they had been completed appropriately.

Staff communicated with patients to ensure they understood their care and treatment, including adapting communication methods to meet the needs of patients with communication difficulties. Staff used a “This is me” booklet for patients who had additional care needs, for example patients, living with dementia which contained key information to help plan and deliver care.

We scored the service as 2. The evidence showed some shortfalls. The service did plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Staff had the right skills and knowledge to meet the needs of patients and their families and loved ones. However, training data we reviewed showed that mandatory training compliance across the service fell below the Trust's compliance target of 85% in most areas, for example, information governance, PREVENT radicalisation and Equality, Diversity and Human Rights.

Data was received from the service. However, a site-level breakdown was not available, and the data could only be provided at service level.

Staff had access to the full range of specialist staff required to meet the needs of patients. This included doctors and nurses, as well as occupational therapists, physiotherapists, speech and language therapists (SALT), dieticians and pharmacy staff. Additional support staff including housekeeping, portering and discharge teams, were also available to support care delivery.

Staff used a range of nationally recognised assessment and screening tools to support safe and effective clinical decision-making, including the National Early Warning Score (NEWS2) to identify and respond to patient deterioration, the Malnutrition Universal Screening Tool (MUST), venous thromboembolism (VTE) risk assessments, falls risk assessments, and recognised pain assessment tools.

There was a clear escalation policy in place for the management of deteriorating patients, with staff taking timely and appropriate action. Managers were able to deploy enhanced one to one staff to provide patients requiring enhanced levels of supervision to keep them safe. Staff upheld the rights of patients subject to the Mental Health Act 1983 and made appropriate referrals to the Mental Health Liaison Team when and if specialist input was required.

Managers provided staff with supervision meetings to discuss care management, to reflect on and learn from practice, and for personal support and professional development and appraisal of their work performance.

Managers ensured that staff had access to regular team meetings, staff confirmed this during the inspection. 

Staff told us they historically had regular appraisals; however, these had been paused over the winter period due to service being exceptionally busy due to patient numbers. 

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff worked well across teams and services to support patients and shared information effectively when patients moved between services.

We observed good communication and coordination between staff of all roles and grades. Patient information was shared promptly and effectively ensuring continuity of care.

Staff across the medical  wards spoke positively about the strong culture of teamwork and collaborative working at local level. Managers held regular multidisciplinary team meetings that promoted cohesive working, shared learning, and collaborative decision making. 

Handovers, nurse safety huddles and ward rounds varied across medical specialties to ensure the right staff were present for each area.

Multidisciplinary attendance included registered nurses, consultants, junior doctor’s physician associates, therapists, advanced clinical practitioners, students, pharmacists, and healthcare assistants.

We observed positive, open communication during daily board rounds, safety huddles, and handovers. This proactive approach supported timely escalation of issues, effective risk management, and smooth coordination of care.

Staff from the virtual ward and Same Day Emergency Care (SDEC) told us they assessed the patients’ needs at home and could contact social services and community services for ongoing support.

The discharge lounge accepted patients that had planned discharges from all wards. The electronic bed management system showed how many bed spaces and sit up chairs were available to allow staff to transfer patients waiting for discharges. The discharge lounge staff arranged medicines to take home, transport for patients and liaised with the families and discharge location regarding the time and date of the planned discharge.

We scored the service as 3. The evidence showed a good standard. 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.

Staff supported patients effectively to manage their health and wellbeing.

They promoted healthy lifestyles and provided practical advice and support to encourage recovery and independence. Specialist nurses visited wards regularly to offer expert guidance on specific conditions, for example dementia, continence care and tissue viability. This ensured patients received tailored and targeted support based on their specific needs. This included education on disease management, safe medication use, and lifestyle changes to promote long term wellbeing.

Physiotherapy staff focused on preventing deconditioning by promoting mobility, exercise and independence throughout patient hospital stays, supporting faster recovery and improved outcomes.

We observed a range of patient information materials supporting patient discharge. These resources promoted healthy living, discharge planning, and signposted patients to relevant local and national support services and charities.

The Trust had a ‘Mealtimes matter’ guideline, which aimed to ensure patients received essential nutrition they needed for their recovery.

A red tray and red jug system was in use for patients who needed them. The red tray and jug system is a visual tool used to identify patients at risk of malnutrition or dehydration, signalling staff to provide extra help with eating, drinking, and to monitor intake, or offer modified diets. 

We observed meals were served for some patients on a red tray, and sometimes red cups and jugs with red lids that were used for fluids, ensuring patients received necessary nutritional support. We saw staff supported patients to eat and drink.   

We scored the service as 3. The evidence showed a good standard. 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 risk assessments to identify the needs of patients in relation to risk of falls and their nutritional needs. They identified patients preferred options and these were recorded for all staff to access as required. Staff supported people to take part in activities to promote wellbeing and maintain independence, we saw this during our assessment in the activities room in the frailty unit. Processes ran smoothly on a day-to-day basis to ensure daily assessment of patients by doctors and multidisciplinary teams on ward rounds and in daily meetings.

Individual needs were considered when discharges were being planned, and patients were able to remain for rehabilitation in the frailty unit, even when medically fit for home, improving their overall standard of living. Physical therapy staff were accessible on the wards.

Patient outcomes were measured using standardised tools, enabling national benchmarking and ongoing monitoring to inform service improvement and enhance rehabilitation outcomes.

Individual needs were considered when discharges were being planned, and patients were able to remain for rehabilitation in the frailty unit, even when medically fit for home, improving their overall standard of living. Physical therapy staff were accessible on the wards.

Staff had access to and followed a wide range of policies and treatment guidelines which were stored electronically on the Trust's intranet. Policies and procedures were based on best practice from National Institute Clinical Excellence (NICE). Outcomes for patients were monitored and action plans developed to improve the services. 

For the period January to March, data showed a low percentage of readmissions following discharge, between January and March 2026 this was below 0.05% for each month.

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

Patients understood their rights around consent to the care and treatment they were offered. Patients told us staff explained care and treatment options and gained verbal consent for physical assessments.

All patients we spoke with told us they had the opportunity to talk to staff and ask questions about their care and treatment, and staff made sure they understood what was being said to them. They felt listened to by staff for example a patient told us staff always asked permission prior to starting any treatment.

Staff took time to build rapport with patients to help build patient confidence in their decision making. Patients we spoke with told us that they appreciated staff taking time to talk to them.

Staff told us consent was gained before any sharing of patient information, both internally and with other care services. 

Staff we spoke with understood the importance of consent when delivering care and treatment to patients. We observed staff seeking consent from patients prior to examination.

The Trust had up-to-date policies and procedures regarding consent and the Mental Capacity Act (2005). These included the mental capacity act documentation, deprivation of liberty procedure, consent procedure and lack of capacity procedure.