Willow Wood Hospice

The inpatient facility accommodated up to twelve people and provided 8 single rooms and 2 double rooms. At the time of the inspection there were eight people using this service. The service also had its START day clinic where people could attend for a variety of therapies and activities.

The service is a registered charity with a board of trustees. Day to day the service was run by a management team drawn from all departments within the hospice.

There was a registered manager employed for this service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was experienced in providing palliative care and worked for the organisation for a number of years.

People and professionals spoke highly of the complementary therapies that were available to both people who used the service and their relatives. The hospice provided family support, counselling and bereavement support. We also saw the service helped people carry out specific wishes such as helping someone get married and providing a wedding dress from one of their hospice charity shops to ensure people and their relatives could achieve their wishes.

People told us that staff were caring, compassionate and listened to them. People we spoke with who received personal care felt the staff were knowledgeable, skilled and their care and support met their needs. We found during the inspection that the people using the hospice services were placed at its centre and were treated very much as individuals and with respect and compassion. People and their relatives told us staff understood their specific needs.

Care plans in regard to all aspects of people’s medical, emotional and spiritual needs were personalised and written in partnership with people so their preferences were made clear. Staff delivered support to people respecting these wishes and preferences about their care and life choices.

People’s health care needs were met by the in-house medical team. This included consultants, GP’s with a special interest in palliative care, an occupational therapy team and a physiotherapy team. We saw the service’s medical team had established links with international services in relation to sharing knowledge and experiences about palliative care and regularly published research in the field.

Care plans were personalised to include people’s wishes and views. People and relatives told us they were consulted about their care and treatment and that they regularly had the opportunity to speak to medical and nursing staff. Care plans were regularly reviewed in a multi-disciplinary framework. We observed staff caring for patients in a way that respected their individual choices and beliefs. We did feedback to the service that information about the hospice for people of different faiths and ethnicity could be displayed more prominently.

Staff recruitment processes were followed with the appropriate checks being carried out. There were sufficient staff on duty to meet people’s needs. We were told by some patients that they sometimes had to wait longer for pain relief or support at night time. Staff we spoke with told they felt there were enough staff and that the registered manager would step in if needed. The hospice had a bank of staff who they could contact if they needed additional staff. Staff and volunteers received a thorough induction and regular training to ensure they had the knowledge and skills to deliver high quality care and support.

Staff followed risk assessments and guidance in management plans when providing care and support for people in order to maintain people’s safety.

People were protected by the service’s approach to safeguarding and whistle blowing. People who used the service told us that they were safe, could raise concerns if they needed to and were listened to by staff. Staff were aware of safeguarding procedures, could describe what they would do if they thought somebody was being mistreated and everyone knew who the safeguarding lead was within the service.

Staff told us they were very supported by their direct line management and could get help and support if they needed it at any time. Staff received regular group supervision and appraisals, but feedback told us the group supervision called ‘well-being meetings’ could be more structured. Staff members told us they felt part of a caring team and were proud to work for the hospice.

Staff worked within the principles of the Mental Capacity Act where appropriate and explained to us the process for making any best interests decisions with people. People had choices about their care and their consent was sought by staff.

People were supported to receive a nutritious diet at the service. Their appetite was assessed through talking to them which led to staff being able to give the person the type and amount of food they would be able to eat. There was a choice of menu on the day we inspected and drinks and snacks were available at any time. The service also provided a café for people, families and staff to enjoy a drink or snack.

The staff undertook the management of medicines safely and in line with people’s care plans. The service had health and safety related procedures, including systems for reporting and recording accidents and incidents. The care records we looked at included risk assessments, which had been completed to identify any risks associated with delivering the person’s care and their environment.

The registered provider had a system in place for responding to people’s concerns and complaints. People and families were asked for their views and were involved in a group that considered ideas and developments at the service.

There were effective systems in place to monitor and improve the quality of the service provided. Staff told us that the in-patient unit had a very positive culture and the registered manager who was called the matron was very approachable and supportive. Feedback we received from in-patient staff indicated relationships could be improved in relation to communication with senior hospice management.

We were able to speak with three people who were receiving care and treatment as in patients, and two patients visiting the day unit for a range of therapy and treatments. All feedback was very positive and comments we received included the following:

"It is so nice here. All the staff greet you with a smile, right from the receptionist to the care staff. It's a lovely feeling to feel like a person. The staff are wonderful and it means so much to me."

"The staff put me right at ease."

"I feel well supported by the staff and I feel tons better. The nicest part is knowing I have got support."

From speaking with patients we saw that their views and experiences were taken into account in the way the service was provided and delivered. People we spoke with told us that they felt all their needs were responded to appropriately.

Patients' records were clear, comprehensive and contained relevant information to assist and support staff in providing care in a safe and appropriate way to the individual person. We saw that families were fully involved.

We were able to speak briefly to one patient during our inspection, and we saw a selection of recently completed day hospice satisfaction questionnaires. All feedback was positive, with patients telling us they liked their room and the staff were very caring. Patients said they knew how to make a complaint.

Patients' records were very clear and contained a full history of patients' illness and the current treatment and care required. Evidence was seen of patients, and families if patients requested it, being involved in discussions about their care and treatment. They were given honest information and were able to make decisions about what care and treatment they preferred. We saw that consent was given before any treatment or care was carried out.

A variety of appetising food was provided, and staff told us they tried to give patients small meals of what they wanted at the times they wanted it.

The staff records we saw showed that a robust recruitment process was followed to ensure staff had the required skills and experience.