Patient Experience Survey Inpatients Quarter 2 2017/18 Introduction This report contains the results of the quarter two (Jul-Sep 17) patient experience survey conducted amongst acute inpatients. A total of 254 questionnaires were completed. The survey has been developed in conjunction with Eastern Cheshire Clinical Commissioning Group and covers key areas including the patient s experience of the ward environment, views on care and treatment and overall views on the level of service and care received. The survey has been updated and includes a number of key questions designed to monitor the delivery of personalised care. The information gathered through this piece of work will allow the trust to monitor its performance in key areas identified in the 2017/18 Quality Schedule. Results are shown at an overall trust level and where applicable can be compared against the trust s results for the 2016 CQC National Adult Inpatient Survey. Data for each individual ward can be found at the end of the report in appendix two. Summary of Results (Figure in bracket represent percentage increase / decrease from Q1) 86% (=) of patients rated the cleanliness of ward as very clean and 78% (+3) rated the cleanliness of the bathrooms as very clean. 50% (+1) of patients were disturbed by noise at night from other patients and 17% (-1) were disturbed by noise from staff. 82% (-6) of patients stated that they were always offered a choice of food. 64% (=) of patients felt that there was always enough nurses on duty to care for them. 63% (-5) of patients felt they were definitely involved in decisions about their care and treatment. 73% (+2) of patients were definitely kept informed in relation to their care and treatment. 68% (+1) definitely found someone to speak to about any worries and fears they may have had. 81% (-2) of patients said that staff definitely made regular checks to ensure that they were comfortable and had everything they needed. 62% (-1) of patients that used the call button said that they received help either straight away or within 1-2 minutes. 77% (-4) of patients always had enough privacy when discussing their condition / treatment. 91% (-1) always had enough privacy when being examined or treated. 96% (+1) of patients said they were always treated with dignity and respect. 95% (=) of patients said they were definitely treated with care and compassion. 80% (+1) of patients rated the overall level of care as excellent with all remaining respondents rating it as good.
Key Differences by Directorate Planned Care Cleanliness of ward perceived to be lower on W10 with 67% stating very clean vs 86% at an overall trust level. Perception of doctors handwashing also lowest on W10 with 57% of patients stating doctors always washed / cleaned their hands between touching patients vs 84% at an overall level. Patients on W1 were again most likely to report being disturbed by noise at night from staff 42% vs 17% overall. However patients on W10 were most likely to report being disturbed by noise from the ward environment 53% vs 25% overall. Patients on W10 were less likely to feel there were enough nurses on duty with 29% of patients stating that there were always enough nurses on duty vs 64% overall. Patients on W2 (87%), W10 (85%) and maternity (84%) were most likely to report definitely feeling involved in decisions about care and treatment vs 63% overall. 100% of patients on W1 reported that they were definitely able to ask the hospital staff any questions they may have had in relation to their care and treatment. For the second quarter lower levels of comfort rounding were reported on W10 67% reporting staff definitely making regular checks vs 83% overall. Response to call bells were also lower on W10 with 48% of patients saying they received the help they needed within two minutes vs 62% overall. 100% of patients on W1 said they were always treated with dignity and respect and 100% of patients on W1 and W said they were definitely treated with care and compassion. Acute and Integrated Care Acute Positive results in relation to ward being rated as very clean on W3 95% and W9 100% vs 86% at an overall trust level. In addition 100% of patients on W3 and W9 also said that nurses always washed / cleaned their hands between touching patients. Patients on W7 were most likely to report being disturbed by noise at night from other patients 67% vs 50% overall. Staffing levels perceived to be lower on W4 with 38% of patients stating they felt there were always enough nurses on duty vs 64% overall. Patients on W4 were also less likely to feel that they / their families were kept well informed about care / treatment 44% vs 73% overall Patients on W3 significantly less likely to feel involved in decisions about treatment 33% vs 63% overall. They were also less likely to feel that care had been personalised to meet their needs 63% vs 79% overall. Patients on W4 (45%) and W7 (31%) were less likely to find someone to speak to about any worries / fears vs 68% overall. Response to call bell positive on W7 with 84% of patients receiving the help they needed within two minutes. However on W4 this figure fell to 36% vs 62% overall. 100% of patients on W7 and W9 said they always treated with dignity and respect and 100% of patients on W4, W7 and W9 said they were treated with care and compassion. Acute and Integrated Care Urgent and Integrated Cleanliness of bathrooms / toilets rated as lower on W11 61% rated as very clean vs 78% overall. Staffing levels perceived to be lower on W11 with 20% of patients stating there were always enough nurses on duty vs 64% overall. Significant drop in relation to patients feeling involved in decisions about care and treatment on 100% in Q1 down to 33% in Q2 vs 63% overall.
87% of patients in said staff definitely kept them / their family informed in relation to their care and treatment vs 73% overall. For the second quarter in a row patients on W11 were less likely to feel that their care and treatment had been personalised to meet their needs 50% vs 79% overall. In addition 44% of patients on W11 found someone to speak to in relation to any worries / fears vs68% overall. 100% of patients on, A%E and W8 said they were always treated with dignity and respect. 100% of patients in said they were treated with care and compassion. Acute and Integrated Care Paediatrics Results for children s ward are above the trust average for all criteria. Positive results that should be noted include: o 95% rating toilets / bathrooms as very clean vs 78% overall o 95% stating always enough nurses on duty vs 64% overall o Involvement in decisions 86% definitely involved vs 63% overall o Being kept well informed 95% vs 73% overall o Being able to ask hospital staff and questions 100% vs 85% overall o 100% of patients stating they definitely treated with care and compassion and dignity and respect o 100% of patients rating their overall level of care as excellent.
Dignity and Respect by Equality Categories The following tables show how the percentage of respondents answering always/definitely for the questions Were you treated with dignity and respect? and Were you treated with care and compassion? vary dependent on equality category. Involved in decisions Always No. of respondents Overall 63% 150 Disability 51% 55 BME 75% 9 Gay / Lesbian 71% 5 Dignity and respect Always No. of respondents Overall 96% 223 Disability 93% 97 BME 91% 10 Gay / Lesbian 100% 7 Care and compassion Always No. of respondents Overall 95% 222 Disability 92% 95 BME 100% 11 Gay / Lesbian 100% 7 NB: Results for BME and gay / lesbian respondents need to be treated with caution due to low patient numbers.
Results by Question Was the ward or department clean? Were the toilets and / or bathrooms clean? As far as you know did the nurses wash or clean their hands between touching patients? As far as you know did the doctors wash or clean their hands between touching patients?
How would you rate the hospital food? Were you offered a choice of food? Three patients in and one patient each on W3, W4, W8, W7 and Ward said they were not offered a choice of food. Comments in relation to hospital food: Comment Ward Little choice for specialist diet e.g. non-dairy, gluten free. 1 Sometimes the food is delivered to your bedside and staff are dealing with you. Therefore the food can go cold. Would be preferable to have 1 hot trolleys to keep food warm. 50/50 - too many stews. More choice. The food can be similar every day. The food could be more appetising. Slightly less but better quality would help. 2 A bit small portions. 3 Food not as good as on my last stay. 3 Not a lot of choice. Doesn't appeal to everyone. 3 Too bland. 3 Very happy. 3 Today unsure whether one item was custard or mashed potato! 4 Better than expected, and reasonable choice. 7 Not enough for greedy me but still excellent. 7 Only problem is if meal that you want is not available. 7 Quality and choice. 7 The taste is often OK but the presentation look poor. The bread rolls and homemade quiche and soups are good. The ice cream very sweet. 7 Excellent but wish we had more tea. 8
More choice for breakfast. 8 We get the dregs on ward 8, room 8. 8 Enjoy the finger food at tea time. Lovely plate of food. 9 I love it because I don't have to cook it myself. 9 Nice food. 9 Nice tea time food. Love the finger food. Will miss it. 9 Bigger portions 10 Could have more choices. 10 Lack of flavour. Soup excellent. Cheese sandwiches better with tomato on. 10 More choices especially for vegetarians. 10 Plenty of choices. 10 The fish is dry. 10 Considering the number they cater for, very good 11 Dinner and supper too close together. 11 Food quality improved during my stay possibly due to key staff returning from holiday. 11 It needs more options and variety. 11 Limited choice for healthy eating menu. 11 A good variety of food offered. Everything has been lovely. Rarely receive what you order been last on the list. Bigger size. More fresh fruit options would be appreciated. More veggie options. Not always child friendly. Bland. Could do with salt and pepper at least or sauces e.g. ketchup/mayo. Great choice. It's rubbish! Poor choice but food ok. Portions could be bigger or have an option to have bigger portions. Veggie lasagne, delicious!!! Did you get enough help from staff to eat your meals? NB: Results calculated out of respondents who required help One patient on W4 and one on stated they didn t receive enough help to eat their meals.
Have you ever been disturbed by noise at night? NB: Results calculated out of respondents who had stayed overnight In your opinion, are there enough nurses on duty to care for you? The following table details the wards where patients felt there was rarely / never enough nurses on duty: Ward Responses Ward Responses Ward 3 Ward 10 1 Ward 2 1 Ward 11 1 Ward 4 4 6 Ward 7 3 4 Ward 8 1 Have you been involved as much as you wanted to be in decisions about your care and treatment?
Do you feel that hospital staff have kept you and those close to you well informed about your care and treatment? Individual patients on each of the following wards stated no : W2, W3, W4, W7, W11 and. Are you able to ask the hospital staff any questions you may have in relation to your care and treatment? Individual patients on W4 and W9 stated No. Do you feel that your care and treatment has been personalised to meet your needs and what is important to you? Individual patients on W3, W4 and stated No. Did you find someone on the hospital staff to talk to about any worries and fears you may have had? NB: Results calculated out of respondents who had worries or fears
Are you encouraged to wear your own daytime clothes whilst you are an inpatient? Did ward staff check that you were comfortable and had everything you needed (e.g. a drink, access to the call button etc.) on a regular basis? How many minutes after you used the call button did it usually take before you got the help you needed? One patient on W11 said they never got the help they needed. If you have had an operation or procedure, did a member of staff explain how the operation or procedure had gone in a way you could understand? NB: Results calculated out of respondents who had an operation or procedure
During your stay have you been involved in planning for your discharge? Did you have enough privacy when discussing your condition or treatment? Three patients on W4 and individual patients on W9 and W11 said they never had enough privacy. Did you have enough privacy when being examined or treated? Individual patients on W3 and W10 said they never had enough privacy. Are you aware you can ask for a chaperone to be present during any examinations / procedures?
If you wanted a chaperone present during any examinations / procedures was one available? Overall Were you treated with dignity and respect? During your stay have the staff treated you with care and compassion? Overall, how would you rate the level of care you have received? What has pleased you most about your experience of the hospital? Comment All staff with whom, I have come into contact have been friendly and helpful. They have regularly checked to ensure that I am happy and comfortable. Well done, all. Being able to feel comfortable in using my phone and keeping my curtains closed to help my anxiety at night. Ward 1 1
Care and compassion. 1 Caring nursing staff, the whole team on Ward 1 are amazing. 1 Caring, compassionate staff. 1 Friendly and helpful staff. 1 Staff introducing themselves. Friendly informal approach from nurses. 1 That I'm getting better. 1 The quality of care, understanding and willingness to help you. Wonderful people!! 1 The staff are amazing. 1 The way the staff all work as a team. 1 There is a nice atmosphere throughout the ward and I have met some very kind and nice people during my stay. 1 All the staff are lovely and always help if needed. Being able to have a chat. Being treated as a person. Getting better and going home. Good communication with me and my family, always knew what the plan was. How caring staff are. Overall, excellent care. Staff were so friendly and helpful. The care and consideration of the staff all the time. The dedication of all the staff, despite being at times very busy. The smiles. The staff are very caring from the cleaner to the manager. The staff have been most helpful and always very friendly. Very happy staff. Attitudes of the nurses and staff. 2 Everyone is lovely. 2 Speed of the ambulance service, speed of examination. 2 Staff are excellent kind and understanding. 2 The bed mattress. 2 The food has been excellent. 2 The overall treatment. 2 Excellent staff. 3 Experienced well-mannered staff. 3 Got me back on my feet. 3 Great care - great food. 3 Helpfulness of the staff. 3 Reassurance by the staff. 3 Staff on ward are very good. 3 The café and paper shop. 3 The staff are very kind and caring and although information regarding my treatment was sparse - it was the weekend!!! 3 The staff have been pleasant and friendly and always answered my questions and concerns as best they can. Always been prompt with my 3 pain killers.
The very loyal and caring staff. 3 The visits by the physios, getting off the ward for exercise in my wheelchair, the thought of going home. 3 The ward staff. 3 Thoroughness of investigations into any condition. 3 Cleanliness and good humour. 4 Freedom of movement. 4 Personal attentive care by dedicated and sympathetic staff. 4 Some of the health care workers are fantastic and a credit to this ward. 4 That it was easy to talk to staff and not worried about asking questions. 4 The care and compassion from all grades of staffing Drs, nurses, cleaners. 4 The care from the staff. 4 The fact I have got better. 4 The speed and professionalism used in the period of my stay. 4 Best place. 7 Care of patients. 7 Everything I need to know, I would be happy if I ever have to come back. 7 I feel at all times that my care has been first class. Treated individually. 7 Most of staff have been caring pleasant and helpful in any way required. 7 Observing the compassion and attention given by the staff. 7 People so very kind. 7 The duty to detail. 7 The way staff were so caring and patient with the elderly patients was lovely. 7 There is always someone available to provide information. 7 Very caring. 7 Willingness of staff to help. 7 Brilliant staff. 8 Care and explanation of what is happening. 8 Friendliness and humour providing a light atmosphere. 8 I am very pleased with my stay in hospital. 8 Peace and quiet after chatterers have gone home or moved to another ward. 8 The expertise of the staff. 8 The sincerity of all staff at all times anxious to help my situation. 8 The staff and the food. 8 There's always help when needed. 8 Though rushed off their feet, the staff are always kind. 8 Very friendly and caring staff. 8 All the lovely caring staff. 9 All very nice staff and very helpful in all my needs. 9 Attention great. 9 Excellent caring staff who are always extremely busy but take the time to answer individual patient's needs. The patience and care offered to elderly 9 patients on ward nine by all the staff. Food, tea, chatting with carers, coffee. 9 Staff. 9
The helpful and friendly staff. 9 The nurses and care staff especially Shaymaa, were very caring. 9 The staff are fantastic and all lovely, enjoyed my stay. 9 The staff are fantastic. It s been great. Will miss everyone. 9 Care and food. 10 Clean ward. Very good food. Staff happy. 10 Everything was dealt with in a timely and professional manner with a 10 sense of humour. Food. 10 Having a room to myself. 10 Having been in hospital I'm ready for the intermediate care I'll be going to. My stay in Macclesfield has been a long one and at times I've been depressed. The staff have always tried to cheer me up and if it's not worked on me it's been appreciated. Staff always busy but not too busy to help. 10 Staff brilliant love them. 10 Staff very pleasant even though very busy. 10 The staff are friendly and always ready to help out in any way. 10 Friendly staff, helpful. Own room. Clean. 11 Friendly staff. 11 How good the staff are. 11 Involvement with pharmacist on medicine changes. Involvement and attention of physio in relation to treatment and progress. Involvement with occupational therapists in care plan and discharge. It has made me appreciate the NHS, its workers, its philosophy and the challenges it faces with smiles and understanding. 11 Kindness of staff. 11 Pleasantness of staff. 11 Staff are almost all friendly and caring. 11 The care and attention. 11 The care I have been given. 11 The caring friendly staff and the cleanliness of the wards. 11 The lovely friendly staff who do go above and beyond their job and keep you smiling. 11 The politeness of most of the staff. 11 The staff are nearly always kind and pleasant and I feel I could have a laugh and a joke with them. 11 They do their best. 11 Caring staff who work so hard. Environment and the staff. Everything has been excellent. Everyone is lovely. Hard working staff in difficult circumstances. Helpful and supportive. The care and patience I have received. The level of care being so good. More staff. The good companionship that I can have with others. 10 11
All staff have been helpful and have explained what was happening with my son's care and treatment. All staff are lovely and helpful. Friendly staff. Very quick and informative. Helpful staff on children s ward. Friendly doctors - we didn't feel treatment was rushed - they had our daughter's best interests as priority always. How friendly all the staff were. Nurses and doctors are the best. Staff have all been kind, caring and understanding. Staff went out of their way to sort out entertainment for my son. Super service. That all of the staff are caring. Been able to play with cars and watch DVDs. The expertise and knowledge of the staff. The explanation made by the consultant - in depth and informative! The lovely clean environment and friendly, happy staff. The staff. The staff are friendly, efficient and very patient as my daughter was quite anxious. The staff are lovely. The staff were very responsive to my son. They were very polite and always had his best interests at heart. All the staff especially Heather Millward. I felt she was my angel from heaven and I am not religious. All staff though have been amazing, I'm so grateful to everyone. Thank you xxxx Amazing staff, super friendly, couldn't have asked for better after having a baby. Everything is super. Fantastic midwives that helped me through a challenging labour and continued to show great compassion, interest and support afterwards during our week long stay. My partner has been made to feel very welcome. Great friendly staff, helpful. My partner being here with me and my baby. Nurse - Anj- nicest person ever. Staff are great, from cleaners to doctors, everyone has been fab! :) The care I received was really amazing from everyone on the ward. The help with getting my twins to reach their sugar levels and eat properly. The staff are amazing. The staff are helpful. Very friendly and caring staff. Very friendly, genuine and helpful. Very thorough monitoring/care - feel well looked after and safe. Staff always in a good mood. Lovely staff. The care is fantastic. Chris the nurse was an asset to the trust. How I was treated with dignity and my family were able to be part of my treatment plan.
My daughter was very quickly seen by the nurse and had her x-ray. Very happy with everyone who spoke to us. The way staff spoke to xxx was outstanding. Quickly X-rayed and reviewed by practitioner. Staff have been helpful and informative. The nurse 'Chris' extremely caring, gentle and ensured dignity was upheld. Very friendly, quickly seen, looked after fantastically. Cheerfulness of staff. Chris the HCA treated us with upmost respect, care and compassion an absolute pleasure. Excellent care, very friendly staff. Feeling better and being well cared for. How happy and caring all the staff were from reception staff to doctors. Speed at being seen. The care received from the nurses was excellent, they took great care of the elderly. The personal qualities of all and their dedications. Do you have any suggestions for improvement? Comment Ward Free Wi-Fi. 1 I have struggled to walk between the bed and toilet, and wheelchair to MRI unit, for example, and was surprised there was little hands on support from staff. I would have appreciated physical support. Need some stimulation for patients - TV room, TVs, radios etc. Wi-Fi is a must really nowadays with no other form of stimulation. It would help keep moral up and now people have smart phones and tablets would be great. TV room would be nice or TV by bed. 1 Food :( More hands would help. More night staff as they were very stretched with the amount of patients they had to look after. More nurses. Toilet sinks need to be bigger. Slightly less food but better quality. Discharge takes far too long. 2 Unfortunately I found some foreign members of staff very difficult to communicate with. Staff need more time for patients. There were times when I felt an inconvenience (by some of the staff). Bigger magazine shop. 3 Communication between staff re treatments and changes to treatments. 3 Don't wake me too early. 3 Food. 3 I think it would be productive if there was some stimulation i.e. radio or some television to pass time more quickly. 3 Just wish I could sleep due to other patients. 3 1 1 2
More comfortable beds. When nurses change shifts and new ones take over they really ought to know what pills you need/take. I thought it was all 3 on my sheet but who knows?! More variety with food, like in the old days. 3 TV - would be terrific, radio also. Very boring and nothing to occupy your mind!! 3 Doctors should be here at weekends. 4 More regular cleaning and especially over the weekend. 4 Staff who speak English. 4 Cut down time and effort with stopping duplicating paperwork. Use ipads more effectively for recording obs/notes. Fewer doctors for each patient so that the treatment is co-ordinated and everyone knows the whole picture save money by reducing the length of paper towel issued automatically in 7 the toilets. It could be reduced by at least a third. Have more regular nurses on I felt that there were too many who knew nothing about the ward or patients. Time lost showing new agency staff what to do. Difficult one. There seems to be a high proportion of dementia patients and it is challenging for the staff to care for the ward patients in general 7 when one 'kicks off'. This is a particular problem during the night. I'd have liked my wife to have been kept informed as to where I am but realise a report as to my exact position health/treatment wise isn't possible 7 whilst still being investigated. Larger car park. 7 More nurses. 7 More openness with respect to results and procedures. 7 Not to be moved from one ward to another in the early hours of the morning. I have been moved 3 times. Result sleepless nights. 7 Not to be rushed when eating! Would be preferred to be looked after by female nurses. 7 Put more money into the hospital and improve the equipment. 7 Sorry no bibles. 7 Better food. 8 When cleaning use a separate cloth for table tops and bins, not use the same one. The cleaner - not the nurses. 8 Give the staff a rise! 9 Improve toilets. 9 The patient in the next bed was shouting out and making gargling noises almost constantly. It was very disconcerting and made it difficult to sleep. 9 More staff. 10 More staff. 10 Possibly more staff. 10 Tastier food and TV access - for a long term patient the days are long and boring. The volunteers with the papers are a special treat. Sad it's not an everyday service. Lack of a signal made a radio useless. Great pity!! Get more staff. Nurses, health care assistants, physios, etc, etc. 11 More staff. 11 More staff. 11 More staff at all lower levels. 11 More staff at weekends. 11 10
More staff available. 11 Respect sleep! Don't wake unless necessary. Keep noise down at night. 11 Get sleeping tablets at a reasonable time. Television. 11 The diversity of patients on Ward 11 makes it difficult to be specific. The apparent lack of admin staff at weekend leads to constant interruption of nurses during patient treatment for routine queries. Is the priority of patients' needs clearly stated and understood? My view is that nurses are doing a difficult task in frustrating circumstances and this needs to be 11 understood by the interrupting staff. A value administration program could reduce unnecessary requests and frequency of recording. Ward 11 is very stuffy, the air is dry and the number of air changes needs to be checked. The lighting could also be improved. More staff. More staff. One or two of night staff not very pleasant. It may be helpful to inform parents on the children's ward of facilities. On a particular visit I was not aware that there was a kitchen facility to make a cup of tea until we were about to be discharged. Make the ward darker at night. More staff. Pizza for dinner!! A labour plan put in place sooner for twins including anything that could go wrong and after care. Better food. Costs for a private room are high - some patients noisy - can't be helped but the cost of room 100 per night is a lot. More help available from staff at nigh time. After having a c - section I struggled at night time changing the baby and bedding when she was sick. When asked for help, staff gave me clean sheets and left me to try and sort myself 1 day after a C-section. As a first time mum I asked for guidance at night time and help and didn't really receive any. One person used her phone after midnight and it was loud. When asked to move away from mental lady shouting - nurse said we have nowhere for you to go. So I said I am not putting up with her shouting all night again so went to bedroom 8 where there were only 2 beds taken. Obviously felt too much trouble to move me for the nurse Should be a place for partners to stay. When I arrived on the ward I was sat in my bay for 3.5 hours before anyone came and spoke to me/ acknowledged me. Doctors could show more empathy with the elderly.
Appendix 1 Sample breakdown by ward. Ward Responses Ward Responses Ward 1 19 Ward 10 Ortho 15 Ward 19 Ward 11 20 Ward 2 15 Unit 15 Ward 3 19 CCU 0 Ward 4 21 16 Ward 7 19 20 MAU / Ward 8 17 Ward 21 Ward 9 18 Total 254 Appendix 2 Data by ward: Data by ward.xlsx