At our inspection in June 2013 we found that some staff were not aware of their requirements under that Mental Capacity Act 2005 (MCA). We also found examples of poor recording of consent and discussion regarding key decisions about people’s care such as resuscitation.

At this inspection we found that the service was well-led as the provider had improved training arrangements, effectively raised staff awareness about consent and MCA, and there was evidence in people's care records that consent and capacity had been appropriately managed. We saw that the service was effective and caring because when we spoke with 27 people who used the service we found that people were well informed about their care and had been involved in key decisions. The service was being provided safely as staff we spoke with knew the procedures relating to MCA and we saw evidence in documentation that appropriate procedures were followed when people did not have capacity to make significant decisions.

People told us what it was like to be a patient in West Suffolk Hospital. They described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people in hospitals were treated with dignity and respect and whether their nutritional needs were met.

The inspection team included four Care Quality Commission (CQC) inspectors joined by a practising professional who was an experienced nurse manager.

We spoke with 19 people on six different wards. We spoke with 16 staff including ward managers and other staff in the nursing teams. We also spoke with a senior nurse and dietician in the trust. We did this to gain the views of people who received care and treatment, people who visited the hospital or worked there. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

The three wards where we spent most of our time were chosen as they had a high proportion of older people, as this was the focus of the dignity and nutrition inspection (DANI). We visited three surgical wards to observe the support provided to people at the evening meal.

One person told us “Staff treat me with respect and they talk to me politely. They speak discreetly with me behind a closed curtain.” Another person said about the staff “They are wonderful.” People told us that staff answered call bells promptly and gave them the level of assistance they required. They told us that staff were easy to approach and that they felt able to raise concerns if needed.

People told us they were offered enough food and drink. One person said “The food has been good. I have had a good choice offered to me.” We were told that specific requests for alternative foods were met by the catering service.

We did not speak to people who used this service as part of this review. We looked at a random sample of medical records. This was to check that current practice ensured that no treatment for the termination of pregnancy was commenced unless two certificated opinions from doctors had been obtained.

Over forty people who use the services and some family members were spoken with during the visit to the hospital on 4 October 2011. Overall people spoken with were satisfied with the care received at the hospital

People we spoke with told us that they were well informed regarding their treatment and care. They told us that staff consulted them and that they were involved in decision making about their care needs.

Generally the people we spoke with said that the food was acceptable, however all courses were served together allowing some to go cold before it could be eaten. All people spoken with stated that they felt the hospital was clean.

People spoken with were all complimentary about the staff across the hospital. Whilst they said that the staff were busy at times, they did not get the impression that they were short staffed, however on occasions it would be a “long time” before actions were completed by staff.

This section was not completed for this inspection. More information about what we found during the inspection is available in the report below.

Our rating of these services improved. We took into account the current ratings of services not inspected this time. We rated them as outstanding

A summary of our findings about West Suffolk Hospital appears in the overall summary