We spent two days looking at records and speaking with patients, their relatives and staff about the care and treatment provided at these hospitals.

We visited the accident and emergency department, triage, assessment suite, and wards 30 and 31 at the Royal Victoria Infirmary – ward 30 is a short stay, acute medical ward for adults and ward 31 is a specialist ward for adults diagnosed with diabetes or endocrine related complications.

At the Freeman Road Hospital we inspected wards 14, 15, 16, 17, 19 and 29. Patients are referred to wards at the RVI and the Freeman Hospital from the Assessment Suite at the RVI. Wards 14 and 19 specialise in orthopaedic care and rehabilitation, ward 15 cares for acutely ill older patients and ward 29 cares for adult patients with respiratory conditions.

We saw that patients were assessed on arrival at the hospitals and on admission to the wards if they needed to be admitted to the hospitals for longer term care and treatment. Patients were placed on a care pathway appropriate to their identified needs. We saw that patients with dementia were kept safe because their risks were managed appropriately by committed and caring staff with good personal skills. Care was given in a responsive and unrushed manner.

We found the hospital had made a commitment to the Dementia Action Alliance’s ‘Right Care: creating dementia friendly hospitals’ initiative. However, this was being introduced and there is a considerable amount of work still to complete to fully embed the initiative in to hospital practice. We saw there was a clear action plan in place to ensure this happens effectively. We saw there were identified dementia champions on each ward visited.

We found the hospital worked closely with outside agencies to ensure patients received the support they needed when they were deemed medically fit and ready for discharge back into the community.

We spent time on three ward areas, two medical wards (one general and one for older people) and a surgical ward specialising in adult cardio thoracic surgery.

Overall we spoke with 22 patients and 15 staff of varying designations and we also observed care being delivered.

Patients told us they felt involved in their care and treatment and they felt respected by the staff. Their comments included, “The nurses and doctors always fully explain”; “Staff always ask and speak about what and why they are doing a procedure i.e. blood tests”; and, "My privacy is respected at all times".

Patients were complimentary about the care and treatment they received. Their comments included, "I get excellent care"; “The care and attention is second to none"; and, "I have been very well looked after”.

Other patients told us that their needs were met and reported that they were well treated. Their comments included, “All the staff provide my care and meet my needs”; and, “The staff are very patient and very good. I’ve had no problems with them”.

When we asked patients about their safety they all reported that staff were kind and caring. Their comments included, “I definitely feel safe here"; and, "I have no concerns about staff attitude".

Three patients on the same ward felt able to express some concern over the attitude of one staff member and we were able to pass this on to the ward sister.

Patients on all three wards told us that they felt the staff knew how to care for them and understood what their individual needs were. Their comments included, "Staff are brilliant”; "I find the staff are very helpful, nothing is too much trouble"; and, "The staff always care for you. They have a lot to do and not much time to do it."

• People were truly respected and valued as individuals and were empowered as partners in their care, practically and emotionally, by an exceptional and distinctive service. Staff went the extra mile to support their patients. Emotional and spiritual support for patients and their families was second to none. Patients told us the care they received exceeded all expectations.
• Services were tailored to meet the needs of individual people and were delivered in a way to ensure flexibility, choice and continuity of care. Care and treatment were holistically planned in collaboration with patients, making them active partners in their care at all levels.
• We saw evidence of strong, innovative multidisciplinary and multiorganisational working. There was a robust strategic plan in place which demonstrated how the hospital worked with other organisations to ensure care was planned and delivered to meet the needs of patients in a sustainable, future proof way.
• Specialist knowledge and expertise was readily accessible. Staff were proactively supported to acquire new skills and share best practice. Research and quality improvement were embedded in practice. All staff were actively engaged in monitoring and improving quality and outcomes for patients.
• The leadership, governance and culture were used to drive and improve the delivery of high-quality person-centred care. Leaders set stretching, innovative objectives and conducted in depth analysis and planning as to how they would be achieved.
• Staff were empowered to suggest and deliver changes and were encouraged to be innovative. Staff told us they felt strongly supported and invested in by leadership.