This inspection took place on 28 and 29 September 2016. We gave the service 48 hours’ notice of the inspection because we needed to make sure that the registered manager was present. Rossendale Hospice Integrated Health Care Centre provides care for people living with cancer and other life-limiting conditions in their own homes. They also have a day therapy service where people have access to a wide range of therapies and support. These included nurse assessment, reviews, complementary therapies, psychological support and access to a consultant clinic each week.
The service had registered manager in post. 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. At the last inspection on 23 March 2014, we found the service was meeting the regulations that were applicable at the time.
During this inspection we found the service was meeting the requirements of the current legislation.
People who used the service told us they felt safe and raised no concerns about the care that they received. Staff had been given training in recognising the signs of abuse and how to report any possible concerns. Staff we spoke with told us the appropriate measures they would take when dealing with any allegations of abuse.
Effective recruitment systems were in place. This helped ensure the provider recruited staff appropriate for the position with which they were employed. Appropriate checks such as references, disclosure baring services checks, proof of identity and professional qualification’s had been completed. Duty rotas and staff we spoke with confirmed there was appropriate amount of suitably qualified staff to meet people’s individual needs. The rotas included assessments that identified if more staff were required and if it was the case then additional was provided.
There were systems in place to assess and manage risks. One example was supporting staff in the event of a person bleeding. The provider demonstrated their commitment to ensuring risks in the service were identified and measures had been put into place to mitigate these risks.
People who used the service and relatives were positive and complimentary about the knowledge and skills of the staff team. All staff we spoke with confirmed that there was a robust training programme in place. The clinical services manager told us online training had been introduced. We observed a staff member completing online training during our inspection. The training matrix confirmed relevant training had been undertaken by the staff team.
Staff told us the management team were approachable and supportive and operated an ‘open door policy.’ Clinical supervision was available and accessed by staff. Staff we spoke with confirmed regular appraisals of their roles took place.
It was clear the involvement of the multi-disciplinary team was an integral part of the care provided by the service. Staff and professionals who worked with the service confirmed systems were in place to ensure a seamless service. The care delivered clearly met people’s individual needs. .
There was an established befriending service that received very positive feedback about the support it offered to people who may be socially isolated.
They also offered a range of complimentary therapies and a counselling service to people who used the service and families. Complimentary therapies, aim to treat the whole person, not just the symptoms of disease. People told us they enjoyed the therapies and a relative of one person told us this was also offered to them after their loved one had died.
Relatives and people who used the service were involved in the development and planning of their care. A range of health professionals took an active role in planning and reviewing peoples care. There was evidence of regular Multi-disciplinary team meetings where people’s conditions would be discussed. People had access to a well-supported day therapy service. We received positive comments from people about the positive impact this service had on their reviews and social interactions.
Systems were in place for responding to concerns and complaints. People who used the service and relatives told us they had no concerns. There was a complaints policy and procedure in place to guide staff about the appropriate procedure to take.
Feedback in thank you cards and completed surveys demonstrated how positive people were about the service.
We received positive feedback about the leadership and management of the service. Staff told us that the registered manager was approachable and supportive. Systems were in place to ensure the quality of the service was maintained. Audits were completed regularly and the outcomes were monitored and reviewed.
The registered manager told us they regularly submitted evidence of audits to the local Clinical Commissioning Group. The service valued and encouraged feedback from people about their experiences of care. This approach placed the voices and preferences of the people using the service at its centre.
Evidence of close partnership working was taking place with a variety of professionals. A range of accreditation schemes were noted. These included the dementia initiative and the Lancashire well-being service.