During this inspection we also followed up on a compliance action we had made at our last inspection which took place in March 2012. This related to the regulated activity of termination of pregnancy and related to outcome 21, records.

We visited 12 wards which specialised in paediatrics, maternity, cardiology, acute medicine, gastroenterology, elderly care, general surgery and rehabilitation & intermediate care. We also visited accident and emergency, two outpatient departments and the main xray department.

We spoke with staff and patients on each of the units we visited. Staff spoken with ranged from reception staff to consultant level.

All patients spoken with said that they were treated with respect by staff employed by the Trust. Some comments included “I have found all of the staff to be kind and courteous” and “I have never felt uncomfortable or embarrassed when I am examined.”

We saw that staff ensured curtains were closed around patients’ bed area when they required assistance or examination. Discussions with patients were carried out in a sensitive manner which ensured that other patients could not overhear conversations. We saw that patients in outpatient departments were seen in private consulting rooms and that they were seen promptly. Any delays in waiting times had been clearly displayed for patients.

Patients spoken with told us that they felt well informed and that they were kept updated about their care and treatment. We saw that they had been provided with information about the hospital, ward and the services available. Patients also told us that they had been involved in discussions about any planned treatment. Comments included “I always know what is going on,” “The nurses explain things when they are writing in the care notes” and “I’m always comfortable to ask questions.”

During our time at the hospital we observed that staff spent time explaining what was happening to the people they were assisting.

The hospital had systems in place which ensured that patients with communication difficulties had access to the information needed to enable them to make an informed decision about their care and treatment. These included specialist practitioners in dementia care and care of people with a learning disability.

The consultant spoken with in the accident and emergency department explained the procedures in place which enabled effective communication with patients where their first language was not English.

Everyone said that staff were polite and respectful. We also saw thank you cards from people who had stayed at the hospital thanking the staff for their kindness and thoughtfulness.

We were told that staff asked people how they would like to be addressed and that this was respected.

On the children’s wards, we saw that all staff communicated directly with the child. This showed that children were fully informed and involved in their care and treatment. We also found that ‘play specialists’ were available to help reduce any anxieties a child might have. An example of this included showing the child photographs of the anaesthetic room and information about the different types of anaesthetic. The play specialist also escorted the child to theatre and were there when the child was ready to return to the ward.

In all of the areas we visited during our inspection, patients confirmed that they were very happy with the care and treatment they received at the hospital.

One patient said “my condition is quite unusual and the doctor has taken time to learn more about it to make sure I get good treatment and am comfortable.” Another patient told us “I’m very pleased with everything.”

Patients on the maternity wards were very positive about the care and support they received. Comments included “the staff have been fantastic and kept me calm throughout” and “the care that my baby and I have received has been excellent.”

Patients confirmed that staff responded promptly for any requests for assistance. They told us that when they used their call bell to summon assistance, staff responded in a timely manner. Comments included “the staff are great. If I need help, the staff are there” and “they check us regularly throughout the day and at night. I can’t fault anything at all.”

We found that patients had access to a range of health care professionals as part of their assessed need and treatment. We observed patients being visited by physiotherapists, speech and language therapists, doctors and consultants. One patient told us that the hospital had arranged for specialised social care support and support from mental health services. They said “they have been great and they are making sure I have all the support I need before I am discharged.”

Protected mealtimes had been introduced throughout the inpatient areas of the hospital. This meant that people were not disturbed during mealtimes. Staff that we asked about this said that they thought that people were able to eat in an unhurried manner. It also ensured that nursing staff were available throughout the meal time to assist those who may require physical support or prompting.

Staff observed and spoken with, demonstrated a good knowledge of the needs and preferences of the people who used the service.

Patients spoken with confirmed that they felt safe and well cared for. No concerns were raised with us during our inspection and patients told us that they would feel confident in raising concerns if they had any.

Patients were very positive about the staff in all of the areas we visited. Some of the comments made included “all the staff are angels. They are there when you need them and they all know what they are doing”, “the skills of the staff are incredible and they don’t seem phased by anything” and “the staff are very caring. They listen to you and explain things really clearly.”

In all of the areas of the hospital we visited, staff morale was noted to be very good. Staff told us that they enjoyed working at the hospital. Some comments made included “I have worked here for many years and I wouldn’t want to work in any other hospital” and “I feel that we all do a great job here and patients receive a very good standard of care.”

All staff spoken with told us that staffing levels were sufficient to meet the needs of the patients they were caring for. They also confirmed that additional staff were made available where required. Comments included “the ward is very busy but we always ensure that patients get the care they need” and “I believe that patients here get good care. I would certainly say if I had any concerns.”

Patients from both wards told us the care they received was very good. Some patients said that staff were “wonderful”, “so kind” and “couldn’t wish for better care”. Patients said that that their care and treatment was fully explained to them. A relative commented on how much time a doctor took to explain care planning and test results to them. The relative was very impressed with the attitude of the doctor who had spent time reassuring them.

Patients said they felt they were treated with respect and staff used their preferred choice of name. People said that curtains were always used around their beds, when necessary, to maintain their privacy. The second ward also used signs that clipped onto the curtains to alert staff that personal care was being delivered.

The majority of patients said that staff attend to their needs promptly and no one had experience of having to wait a long time when they used their call bells. However one patient said that whilst staff were normally prompt, they had observed an incident during the night. They said another patient rang their bell for a long period and no one responded.

The majority of patients spoken with said they were happy with their experiences at meal times. Most patients felt food was provided in adequate quantities. Most said that staff usually asked them if they have had enough to eat or drink and offered second helpings. Although people had said they did not have the opportunity to wash their hands before meals anti-bacterial wipes were provided on their meal trays.

Our inspection of the trust covered only this hospital. What we found is summarised in the Overall summary under the sub-heading Overall trust.