County Durham and Darlington NHS Foundation Trust

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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

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

This service scored 80 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We observed staff speaking kindly and respectfully to patients while carrying out their treatment. Staff had a holistic view of their patients, not confined to their current clinical treatment. They knew their patients well and could describe their needs and preferences. They engaged with patients around their wider health and social needs, listening and encouraging people to tell their life stories and share personal histories. Staff were committed to helping patients recover or manage long term conditions.

Patients told us that the district nursing and specialist teams were appreciated. Patients and their families told us staff treated them with kindness, dignity, and respect. One patient told us, “They are all very nice and I’m grateful for their help. They are good nurses, good to me and they cheer me up, they are good people.” Another family member told us, “They were always very respectful and polite and explained what they were doing. Dad has vascular dementia now and they are always patient with him, tell him what’s happening, explain everything.”

Staff were passionate about delivering high quality care to patients. Staff were discreet and responsive when caring for patients, respecting their privacy and dignity. Most staff took time to interact with patients and those close to them in a respectful and considerate way.

Staff understood and respected the personal, cultural, social and religious needs of patients, how they may relate to care needs and took action to support these needs at all times. For example, cultural needs were taken into account by the bladder and bowel team when intimate examinations were required.

The service made adjustments for disabled patients. Environments were suitable for people with access needs. The provider ensured that staff had access to interpreters where they were required. Staff were able to give us examples of times where they had used interpreters and had a good understanding of the process for requesting support.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights and how to complain. The information provided was in a form accessible to the particular patient group. Staff made information leaflets available in languages spoken by patients.

Staff understood the emotional and social impact that a person’s care, treatment or condition had on their wellbeing and on those close to them. We observed staff supporting people who were distressed following diagnosis and providing appropriate levels of emotional support.

Patients and their families told us they were well-informed about their care. They told us there were satisfied with the level information they were given about their treatment, progress and prognosis.

We saw evidence of care and treatment being adapted to suit people’s needs, highlighting a collaborative, personalised approach to care.

Care plans reflected patient’s personal, cultural, social and religious needs.

During home visits and specialist clinic appointments, we observed staff treating patients and their families with compassion, respect and kindness.

Staff demonstrated a clear and detailed understanding of the individual needs and listened to patients’ views and wishes. Staff were aware of and dealt with any specific risk issues including risk of falls or pressure ulcers, and care planned for these accordingly. We observed staff taking time to minimise patients’ discomfort, concern and distress.

Staff were aware of potential risks and how these should be managed or mitigated. Staff identified and responded to changing risks to, or posed by, patients.

Specialist teams and services worked well with district nurses to provide holistic care and made appropriate referrals where required.

Staff acknowledged that at times the work they undertook was difficult, and busy, particularly during winter and said this sometimes impacted on morale. However, they told us that managers were quick to recognise this and took action in response. Staff told us they felt respected and supported by managers and gave us examples of times where senior managers had been available to support with their work.

Staff told us they felt proud of their work and the care they provided. Staff told us that they received feedback about areas of positive practice and these were shared amongst the staff team via various meetings. The trust had a ‘Supporting Our People Handbook’ which outlined a number of supports available to staff including an Employee Assistance Programme and Trauma Risk Management (TRiM) to support people who have experienced a traumatic incident at work.

A recent survey of wellbeing was undertaken by an external company on behalf of the trust. Staff were asked to rate their wellbeing in relation to work on a scale of 1 – 10, with 1 being most negative and 10 being most positive. Of the 495 respondents, 78.9% scored their wellbeing as a 7 or above.

Protocols were in place for community staff on visits. Staff carried mobile phones which had tracking enabled to show their location and they could utilise an emergency button to press if needed, which sends an alert to their manager. The trust covers a large geographical area with some very rural areas.

Staff told us they were supported to go out with accompanying staff where risks were identified. At the time of our assessment, the area was subjected to snow and we observed an increase in staffing to ensure the safety and wellbeing of staff.

Staff told us they received appraisals once a year in line with policy and regular supervision. Return to work interviews were conducted following periods of sickness and stress risk assessments completed where necessary. Staff also told us they could access additional support if required. For example, a counselling service was available to staff.