Conquest 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

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

We assessed all quality statements in this key question. 

At our last assessment, we rated this key question as good. At this assessment, the rating has changed to requires improvement.

The service did not consistently maintain patients' privacy and dignity. Departmental crowding resulted in the use of temporary escalation areas that were not designed for the delivery of patient care. As a result, staff could not always maintain patients' privacy, dignity, or confidentiality while providing care.

The service was in breach of the legal regulation relating to dignity and respect. The continued use of escalation areas compromised patients' experience and meant staff could not consistently deliver care in an environment that protected patients' privacy and dignity.

Workload pressures continued to negatively affect staff wellbeing, and staff worked in a highly pressured environment. Some staff told us they did not feel engaged in, or able to influence, operational decision-making.

Despite these concerns, we observed staff providing compassionate care to patients. Most patients we spoke with told us staff treated them with kindness and respect and that they felt reassured by the care they received.

Leaders recognised the impact of the working environment on staff wellbeing and told us they were developing initiatives to strengthen support for staff. They demonstrated awareness of workforce risks and the support staff required. Most staff told us they felt supported by their managers and colleagues and described a positive team culture within the department.

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 this service a 2. The evidence showed some shortfalls. The service did not always respect people’s privacy and dignity. However, staff treated people with kindness, empathy and compassion. Staff treated colleagues from other organisations with kindness and respect.

The service did not consistently maintain patients’ privacy and dignity. The department was crowded, and the service cared for patients in non-care spaces such as temporary escalation and super-surge areas. The open nature of these areas made it difficult to maintain privacy and dignity during conversations. The service provided portable screens, but gaps between panels meant patients could still be seen. This meant patients could be seen whilst having procedures undertaken. It also meant that patients with limited mobility could potentially be seen when toileting. We observed an example of this during the assessment. The service did not make sure patients in these areas had access to call bells. This meant that patients had to shout out for staff walking past to get their attention or when they needed help or support. 

The risk assessments for the escalation areas did not include documented exclusion criteria. Instead, they stated that decisions about which patients could be cared for in these areas were made by senior staff. We observed that the service mainly cared for patients with no significant mobility needs in escalation areas. However, we saw a patient with limited mobility being cared for in a super-surge area. This meant the patient had to rely on staff passing by to attract attention, which did not consistently support their dignity or provide timely reassurance. This patient did not have access to a call bell. 

Privacy and dignity were difficult to maintain in the temporary escalation areas. One patient described their experience of receiving care in a super surge area as "most undignified". Another patient told us they felt “very uncomfortable and without privacy” in this area. Many patients acknowledged the difficult circumstances staff were working in, even when they were unhappy with the environment. We saw staff make efforts to ensure that patients received compassionate and respectful support. 

The Urgent and emergency care survey 2024 showed the trust scored about the same (8.8 out of 10) to other trust for the question relating to being given enough privacy when being examined or treated. 

Staff were able to access interpretation services to communicate with patients whose first language was not English. Chaplaincy staff and facilities were available to support patients, carers, and staff in response to cultural, religious, or unexpected needs, including following a death. 

Leaders collected feedback through the NHS Friends and Family Test (FTT). In February 2026, 85.7% of patients rated their care as good or very good. This was consistent with feedback from patients and families during the assessment, with many people commenting on how hard staff were working. Results from the CQC Urgent and emergency care survey 2024 showed an overall experience score of 6.9 out of 10, which was similar to other trusts. 

One patient told us that the care they received had been “wonderful” and that the staff were “so lovely”. Another patient told us they “could not fault the care”. Patients we spoke to were mostly positive about the department and referenced how hard the staff worked. 

We observed a culture of mutual respect, with staff treating colleagues from other organisations with kindness and professionalism.

We scored the service as 2. The evidence showed some shortfalls. The service did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristic 

Staff did not always tailor care and communication to meet people's individual needs. Although the service had access to a range of support services and resources, staff did not consistently use them or demonstrate sufficient awareness of how to access them.

Despite having access to interpretation services, staff did not always use them when required. One relative told us their family member did not speak English and staff relied on them, rather than a professional interpreter, to translate information during interactions. This increased the risk that information was not communicated accurately or completely and may have affected the patient's understanding of their condition, treatment and care. It also reduced assurance that the patient could express their views independently, ask questions freely or provide fully informed consent.

Not all staff we spoke with knew how to access British Sign Language (BSL) interpreters when supporting patients with hearing impairments. This increased the risk that some patients may not have received information and support in a way that fully met their individual needs.

Processes for ensuring patients received hot meals were not consistently applied. Staff described different criteria for offering hot meals to patients. Some told us this depended on how long a patient had been in the department, while others said it was based on matron discretion or whether a patient was accommodated in a cubicle. Leaders told us all patients in cubicles should be offered a hot meal unless there was a clinical reason they could not eat. However, during the inspection, we observed hot meals were generally only offered to patients who had remained in the department for more than 12 hours. The lack of a consistent approach and oversight increased the risk that some patients, particularly those cared for in temporary escalation areas, may not have had their nutritional needs met.

Despite not observing them being used, the service had systems and resources in place to support individualised care. Staff could access interpreters for a range of languages by telephone and online, including access to BSL interpreters and face-to-face support where required. The service also provided information in accessible formats. Patients could access leaflets using QR codes, which enabled translation into different languages and easy-read versions.

The service had access to a learning disability liaison service, and staff could use tools such as a learning disability distress and discomfort assessment tool to support people with additional needs.

We observed staff, including security staff, responding to patients with mental health needs in a kind, compassionate and individualised way. Staff adapted their communication and interactions to meet people's needs and treated them with professionalism and respect.

Patients we spoke with understood how to raise concerns or make a complaint. We observed staff responding attentively to patients throughout the inspection. One patient told us staff had gone "above and beyond" to support them in attending a chemotherapy appointment while they were receiving care in the department.

The service also provided food options to meet a range of dietary, religious, cultural and health needs, including vegetarian, soft food, puréed, gluten-free, dairy-free and high-energy diets. The CQC Urgent and Emergency Care Survey 2024 showed patients' experiences of accessing food and drink were similar to those reported by patients using other trusts. Volunteers and housekeeping staff regularly offered patients food and hot and cold drinks throughout the day.

We scored the service as 3. The evidence showed a good standard. 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 had access to appropriate equipment to support the care of patients attending the department. The service also had access to a hospital intervention team (HIT), which aimed to reduce unnecessary hospital admissions and improve patient independence and outcomes. This team included physiotherapists and occupational therapists.

The acute frailty team supported the care of patients living with frailty. The team developed frailty management plans that promoted independence, choice, and control. They also worked to reduce the length of stay for older people, with the aim of preventing deconditioning during hospital admission. Deconditioning means patients can lose strength and independence due to reduced activity during their hospital stay.

The trust worked collaboratively with community services to develop and improve service provision. This work focused on supporting people to maintain independence for as long as possible and, where appropriate, providing care within the community to avoid hospital admission. The service operated a virtual ward model, which enabled patients to receive additional community-based support and care within their own homes. 

We scored the service as 2. The evidence showed some shortfalls. The service did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

The service did not consistently meet people’s immediate needs. Patients experienced prolonged waits in the department and delays in receiving care, and washing facilities were not always sufficient. Documentation did not consistently demonstrate that all patient needs had been assessed and responded to appropriately.

A review of 23 patient care records found that, although staff generally completed relevant risk assessments, pressure ulcer risk assessments were not always undertaken. In addition, audit data from December 2025 to February 2026 showed poor compliance with completion of body maps and domestic abuse screening.

The service did not ensure all patients could summon assistance when needed. While staff responded promptly to call bells where these were available, patients cared for in some escalation areas did not have access to them. This posed a risk as patients could be unable to alert staff in an emergency or when they required support.

Patients in the waiting area did not consistently have their immediate needs met. Although a vending machine was available, its location meant it was not easily visible or accessible to all patients, and staff did not routinely undertake comfort rounds in waiting areas. This was reflected in the CQC Urgent and emergency care survey 2024, which found that the trust scored somewhat worse than expected compared with other trusts for patients receiving help from staff while waiting. Indicating that some patients did not feel adequately supported during their wait.

The service did not always ensure timely access to specialist support. Staff used a nationally recognised triage tool and understood referral processes for emergency support services, including psychiatric liaison teams. However, staff consistently reported delays in specialist teams attending following referral.

Staff did not consistently record patients’ allergies or current medications at triage, increasing the risk of medication errors and adverse drug reactions. The CQC Urgent and emergency care survey 2024 also found that the trust performed worse than expected in relation to pain management, indicating that some patients did not feel their pain was effectively controlled. The service did not monitor the timeliness of pain relief administration through routine audit. Leaders could not be assured that patients requiring pain relief received it promptly or identify opportunities to improve pain management. 

However, staff used effective processes and tools to assess patients on arrival. We observed triage staff carrying out assessments with kindness and compassion, asking patients about pain, and clearly documenting care plans and referrals. The service encouraged patients and families to provide feedback, and leaders displayed comments and actions taken in response to concerns, including environmental improvements such as the installation of air conditioning.

During the assessment, we observed staff and volunteers consistently offering refreshments, which was also reflected in patient feedback. Staff supported and involved patients, families and carers in decisions about care and treatment, communicated in ways patients could understand, and used communication aids where required. Across all staff groups, interactions with patients were caring, respectful and attentive. Patients told us staff introduced themselves, explained their roles and developed positive relationships that helped them feel informed and supported.

 We scored the service as 3. The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centered care.

Staff told us they were able to influence change and contribute to decision-making in the department. Staff we spoke with said they felt proud to work in the department, and teamwork was what they enjoyed most. 

All staff we spoke with told us they felt supported and valued by leaders within the department. Staff described regular support from a wellbeing team who attended the department and told us this was a usual occurrence. Staff said they would make an effort to see the team, particularly when the department was busy. 

Leaders told us there was a wellbeing champion for the emergency department.

The service had mechanisms in place to support staff following distressing or traumatic events, including access to two Trauma Risk Management (TRiM) practitioners and the chaplaincy team. A TRiM practitioner is a trained peer supporter who provides structured support and ongoing guidance to staff following such events.

The service offered a 6-monthly wellbeing program designed to support staffs mental, emotional and physical health. This included men’s health workshops, financial wellbeing support, menopause awareness sessions, access to Samaritans and stop-smoking clinics. Staff also had access to flexible working arrangements and an Employee Assist Programme, which provided wellbeing support as well as other employee benefits.

Leaders told us representatives from the emergency department contributed to trust-wide wellbeing meetings, attending to share best practice, highlight challenges and collaborate on strengthening staff support across the organisation. These meetings were also attended by the trust’s non-executive wellbeing guardians. 

Leaders demonstrated awareness of the pressures within the department and their impact on staff wellbeing. Most staff told us that, although they were very busy, they were able to take their breaks and had access to an appropriate and dedicated space to do so. 

The service had access to an internal occupational health service, which supported staff to be healthy at work. 

The service reported a sickness absence rate of 6.5% across all staff groups in the emergency department between December 2025 and February 2026. This was slightly higher than the trust’s average of 6.3%. 

Despite staff reporting that support mechanisms were in place, they consistently highlighted that the demands and pressures within the department were having a negative impact on their wellbeing. In addition, some staff felt insufficiently engaged by leaders and believed they had limited involvement in decision-making processes.