East Lancashire Hospitals NHS 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 people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service treated patients with kindness, empathy and compassion and usually respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

Staff were usually discreet and responsive when caring for patients. Staff took time to interact with patients and those close to them in a respectful and considerate way. During all of our structured observations of care on the wards we observed warm and positive interactions between staff and patients. The patients we spoke with, and their family carers, usually said staff treated them well and with kindness. However, we did receive one concern about staff on the night shift on one ward not speaking kindly to a patient. During the bedside handover we observed on Hartley ward, staff were not always fully mindful of patients’ privacy and dignity, as personal care information was discussed at an audible volume in the presence of other patients on the shared bays.

Staff understood and respected the individual needs of each patient and showed understanding and a non-judgmental attitude when caring for or discussing patients. This included patients' personal, cultural, social and religious needs. The patients and relatives we spoke with told us that staff were aware of their needs and respectful of their dignity. Care records showed that each patient’s individual needs were identified in their care plans and individualised care was delivered to meet the identified needs.

The service treated patients as individuals and made sure patients' care, support and treatment met their needs and preferences. Staff took account of patients' strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service made adjustments for disabled patients – for example, by ensuring access to premises and by meeting patients’ specific communication needs. Managers and staff described how interpreters could be requested if needed to support people with their communication and written materials were available in a variety of accessible formats and other languages on request. All the wards were fully accessible to wheelchair users and other people with impaired mobility and the patients and relatives we spoke with told us that patients found the ward environments met their accessibility needs.

Staff did not consistently ensure that patients could obtain relevant information, such as information about their care and treatment, the facilities on the ward and how to complain about their care if needed. Some patients and relatives told us that they had not received some information which would have been helpful to them, for example about their medicines, the facilities available on the ward or the trust’s complaints process. However, each ward did have a patient information notice board which included a range of relevant information for patients and visitors. The patients and relatives we spoke with told us that staff were usually responsive to requests for information.

Patients had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerances. Patients' records showed that any particular dietary needs were identified on admission and menus included a range of options to meet differing dietary needs. Patients on all wards told us that they could choose their meals and they were able to access food which met their needs from the menu options available. However, some patients at Burnley General Teaching Hospital told us that the food could be cold at times and, at the Rakehead Rehabilitation Centre, that portion sizes could be too small.

Staff ensured that patients had access to appropriate spiritual support. The hospitals had on site chaplains which patients could access on request. None of the patients or relatives we spoke with raised concerns about not being able to access spiritual support. Information about hospital chaplaincy services was included in the information packs available for patients on their admission to hospital and on the trust’s website. There was a chapel and an Islamic prayer room on site at Burnley General Teaching Hospital.

Staff gave patients and those close to them help, emotional support and advice when they needed it. The patients and relatives we spoke with told us that they felt well supported by staff. The care records we reviewed showed that all patients were screened for symptoms of depression and anxiety as part of their admission assessments and care plans were put in place to support patients who needed psychological or emotional support. The admission information leaflets provided to patients and families included information on the support available for family carers.

Staff understood the emotional and social impact that a patient's care, treatment or condition had on their wellbeing and on those close to them. We observed staff caring for patients in a sensitive and compassionate way on all the wards we visited. Patients and relatives told us that they felt staff were very caring.

The service promoted patients' independence, so patients knew their rights and had choice and control over their own care, treatment and wellbeing.

Patients and family carers told us that staff supported them to be as independent as possible during their admission. We observed nursing, support and therapy staff all promoting patients' independence during the care we observed. Records showed that patients had rehabilitation care plans setting out how patients would be supported to increase their independence and so work towards discharge from the wards. Patients had access to the equipment they needed to support their independence, for example walking aids.

Patients had access to their friends and families during their admission. The patients and relatives we spoke with told us that visiting hours were flexible and enabled family visits to take place at convenient times. We observed family carers being able to visit their relatives on the wards at different times of day during our time on the wards.

The service did not always listen to and understand patients' needs, views and wishes. Staff did not always respond to patients' needs in the moment or act to minimise any discomfort, concern or distress.

The records we reviewed did not show how staff had taken the time to understand patients' views and wishes as part of the care assessment process, as the way patient consent to the care plan was documented was just a tick box. The patients and relatives we spoke with said they were not aware of the contents of patients’ care plans and most patients said they did not have copies of their care plans. Some patients told us that they had not been given as much information about their care as they would have liked.

Due to the staffing pressures on some of the wards we visited, staff were not always able to respond promptly to patients' immediate needs. For example, we observed buzzers sounding and staff not being able to respond to them in a timely manner due to being engaged in caring for other patients. We observed a patient struggling to remove their shoes while sat in a wheelchair, which posed a falls risk. The staff present on the bay did not offer support due to being engaged in a medicines round with other patients at the time. Some patients told us that staff were sometimes too busy to respond to their buzzer promptly, and some patients told us they were sometimes asked to wait when they needed support to use the toilet.

However, staff usually identified and responded to changing risks relating to patients' care. Patients' physical health was monitored by 12 hourly vital signs checks and National Early Warning Score (NEWS) 2 calculations and action was taken to respond to any concerns identified by these observations.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Staff usually felt respected, supported and valued. The staff at all levels who we spoke with told us that they felt valued and that their immediate managers were supportive. Rates of staff being injured in the course of their work were low (20 incidents across all 7 wards in the 6 months preceding our inspection).

The trust had systems in place to support staff in relation to their own physical and emotional health needs through an occupational health service and a range of staff wellbeing initiatives. A monthly staff wellbeing newsletter was produced to share information with staff about the wellbeing and occupational health support which was available to them. There was also a staff wellbeing directory which was updated every six months. Bitesize wellbeing sessions were available for staff on a range of topics, such as self-care, sleep and mental health. Staff could also take on the role of wellbeing and engagement champion to support colleagues and promote wellbeing. Staff appraisals included conversations about career development and how this could be supported, and the staff and managers we spoke with told us they felt well supported in relation to their career development within the trust. The trust publicly recognised staff success through employee of the month and staff awards schemes. However, staff were not offered regular opportunities for supervision, so structured opportunities for feedback and one to one conversation were limited.

However, staff survey data across a range of indicators was often slightly lower than the trust average for the topic in question. This data was gathered from a small pool of staff within the community inpatient service due to low rates of uptake of the survey (99 staff across 6 wards, as Albion Mill was not included in the survey). There was an action plan put in place in response to the 2024 NHS Staff Survey results and work to implement this was ongoing at the time we inspected. Rates of formal staff grievances were low with only 5 having been received across all 7 wards in the 12 months preceding our inspection.