You are here

The Princess Royal Hospital Inadequate

All reports

Inspection report

Date of Inspection: 25 April 2013
Date of Publication: 18 June 2013
Inspection Report published 18 June 2013 PDF

People should be treated with respect, involved in discussions about their care and treatment and able to influence how the service is run (outcome 1)

Not met this standard

We checked that people who use this service

  • Understand the care, treatment and support choices available to them.
  • Can express their views, so far as they are able to do so, and are involved in making decisions about their care, treatment and support.
  • Have their privacy, dignity and independence respected.
  • Have their views and experiences taken into account in the way the service is provided and delivered.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 25 April 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members, talked with staff and reviewed information given to us by the provider. We reviewed information sent to us by other regulators or the Department of Health, reviewed information sent to us by other authorities, talked with other authorities and were accompanied by a specialist advisor.

We were supported on this inspection by an expert-by-experience. This is a person who has personal experience of using or caring for someone who uses this type of care service.

Our judgement

People’s privacy and dignity was not always respected. People’s views and experiences were not always taken into account in the way the service was provided and delivered in relation to their care and treatment.

Reasons for our judgement

We had received concerns about a lack of respect and dignity for patients and the lack of effective communication. We recently published a survey, which was completed by 516 people who were inpatients across the trust. They raised concerns that highlighted a lack of information about their treatment and condition, inappropriate arrangements for leaving hospital and patients’ overall negative views and experiences.

The inpatient wards we visited had been separated into male and female areas in order to comply with national requirements on single sex accommodation in hospitals. In the medical assessment unit (MAU) we saw a notice displayed advising patients that in order to provide patients with specialist clinical care they were not always able to offer same sex accommodation as providing the best possible treatment must take priority. However, same sex washing and toilet facilities were made available. At the time of our inspection patients were treated in the same sex bays. We saw there were limited facilities to examine patients in private in the assessment lounge. This meant that patients would not be able to have a conversation or have their observations carried out in private if the other areas were already being used. Staff told us that patients had commented that this area was not very private and had been concerned that they could be overheard.

We spent time observing care on the wards and departments we visited. We spoke with patients to obtain their views about how they were involved in their care and whether their privacy and dignity was respected. We saw that staff always used curtains around the bed when assisting with personal care. Although we saw patients' privacy and dignity was protected for the majority of the time, we saw this was compromised on three of the four wards we visited. We saw patients that were not covered properly, including one patient whose genital area was exposed. We observed several staff walk past this patient and not take any action. Another patient was in bed naked below the waist in full view of people passing. We saw a patient taken out on a trolley through a busy corridor with part of their body exposed with no consideration for the vulnerability of the patient in a public area.

Patients told us that staff usually responded promptly and in an attentive manner when they rang the call bells and we observed this during our visits to the inpatient wards. Patient’s preferred form of address was displayed above their beds and recorded in their records. We heard staff use patients’ preferred form of address. However, some staff addressed people frequently by using terms such as, “Darling” and “Sweetheart”...

On one ward we heard a member of staff ask if a patient wanted to open their bowels and later discussed their diagnosis with them and relatives in a loud voice. They made no attempt to lower their voice therefore everybody else on the bay overheard the conversation, including visitors. We also saw a patient being wheeled backwards in a wheelchair across the ward after being taken to the bathroom. This meant that staff were not respectful of patients’ feelings.

We observed a staff member taking blood samples from patients. Although they spoke to patients quietly and sensitively, they did not carry out the procedures in private. We also overheard staff asking another patient if they wanted the toilet as they accompanied them close to the busy nursing station. We did also observe some good practice to include a member of staff close the doors to a bay, the privacy screening and window blinds to protect a patient’s privacy and dignity when they fell in the middle of the bay.

On the same ward we saw a patient who was to be transferred to that ward left in their bed at the nurse’s station. There was very limited interaction with them despite numerous staff around the nursing station at the time. Eventually the patient was taken back out of th