Background to this inspection
Updated
6 April 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 2 and 7 February 2017 and was unannounced.
The inspection was carried out by two inspectors, a pharmacy inspector and a specialist advisor in palliative care.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed notifications of significant events that affect the health and safety of people who used the service.
We spoke with eight people who used the service, ten relatives and one health professional. We also spoke with the hospice director, the registered manager from another location, the service improvement manager, the finance officer, the social worker, one family support officer, one medical practitioner, a ward manager, five nurses, two nursing assistants, a physiotherapist, the spiritual care lead, a befriender, a volunteer, a fundraising officer, the domestic supervisor, the cook and an engagement champion. We looked at seven people's care files, three staff files and other records relating to the management of the service.
Updated
6 April 2017
This inspection took place on 2 and 7 February 2017 and was unannounced.
Sue Ryder Nettlebed Hospice provides palliative and end of life care, advice and clinical support to people with progressive, life limiting illnesses and their families. They provide holistic care including counselling and bereavement support for people and their relatives. There are 12 inpatient beds to support people with complex needs associated with their conditions. People access the hospice to support symptom control and pain management. People are supported with end of life care in the inpatient unit if this is their choice. The hospice supports people in their own homes through their community service and day hospice. On the day of our inspection there were 11 people using the inpatient service.
The hospice has a multi-professional team consisting of medical and nursing staff, social worker, spiritual care lead, family support workers and therapists. The hospice is also supported by volunteers.
There was a 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. On the day of our inspection the registered manager was not available.
Sue Ryder Nettlebed Hospice is an outstanding service. Its aim is to ensure people are supported with palliative and end of life care that meets the needs of each unique individual in a genuinely compassionate and caring way. The hospice understands that recognising the needs of relatives is vital and does this in a supportive and inclusive manner.
Throughout the inspection there was a calm and reassuring atmosphere. Staff spoke with people and relatives in a respectful manner and intuitively recognised people’s moods and anxieties. All staff were welcoming and caring. Staff spoke with great passion about the work of the hospice and were clearly proud to be part of it.
People and their relatives were overwhelmingly positive about the medical care, support and guidance the staff team at Sue Ryder Nettlebed Hospice provided.
Without exception people and relatives spoke in an extremely positive manner about the caring nature of staff across the whole staff team. People and relatives were confident in the expertise of the staff and saw them as experts in their knowledge relating to palliative and end of life care.
Staff had access to training and development opportunities that ensured they had the skills and knowledge to support the complex needs of people using the services provided by the hospice. The emotional impact of working in a hospice environment was recognised and staff were offered a range of support to enable them to manage any potential impact. This included one to one support and the opportunity to reflect in a group environment. Staff were positive about the training and support they received.
People and their relatives told us support was individualised. Care was designed and developed with the individual to ensure their needs were met in the way they chose. The hospice went to great lengths to ensure people were able to receive their end of life care in the place of their choice. People and relatives gave examples of staff going the ‘extra-mile’ to ensure people could achieve their preferred place of death.
People were provided with information and advice to ensure they were able to make informed decisions. Where people were assessed as lacking capacity in relation to a specific decision their rights were protected in line with the Mental Capacity Act (MCA) 2005.
Staff across all disciplines worked cohesively to ensure people’s needs and wishes were met. People moved seamlessly between the services provided at the hospice and multi-disciplinary team meetings ensured people’s needs were understood by all teams supporting them.
Bereavement support was individualised for each family member and was provided with empathy and compassion. Relatives spoke of the enormous difference the support had made to them. Relatives were able to access the support for as long as they needed it and many became involved as volunteers or as part of the service user group.
Everyone we spoke with was overwhelmingly positive about the management of the service. Their commitment was seen by all as the driving force behind the outstanding care provided to people and their relatives at Sue Ryder Nettlebed. There was extreme confidence in the management team which was seen as the reason for the outstanding achievements the hospice made for each individual.
The management team were committed to improving palliative and end of life care both locally and nationally. They encouraged staff to participate in local and national forums to share good practice and to inform developments in practice. Staff at every level were positive about the support they received and were extremely confident they were valued and listened to.
Governance of the service was excellent and quality assurance systems were in place that ensured continual monitoring of the service to identify ways to develop and improve the care people received.