Willow Burn Also known as Maiden Law Hospital, Maiden Law Hospital,DH7 0QS

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice, and continuity of care. People and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality characteristics.

We rated responsive as outstanding.

The hospice was exceptional at ensuring patients were at the centre of their care planning and treatment choices. Staff decided, in partnership with patients, how to respond to any relevant changes in their needs. Services were tailored to meet the needs of individual patients in a way that ensured flexibility, choice and continuity of care. People could access care in ways that met their personal circumstances and protected equality characteristics.

The hospice provided appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service was exceptional at enabling patients to share feedback and ideas, or raise complaints about their care, treatment and support.

The hospice was exceptional at ensuring patients could access timely care, support and treatment, whilst promoting equality and protecting their human rights. Patients did not experience discrimination and staff worked hard to provide equity in access to care and treatment. Staff made reasonable adjustments where required and listened to patients’ concerns to improve the service.

Staff and leaders actively listened to information about patients who were most likely to experience inequality in experience or outcomes and tailored their care, support, and treatment in response to this.

Staff gave patients exceptional support to plan their care and treatment, so they could make informed decisions about their future.

At our last inspection we rated this key question good. At this assessment, the rating has improved to outstanding.

This service scored 89 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service was exceptional at making sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Patients’ care plans fully reflected their physical, mental, emotional and social needs, including those related to protected characteristics under the Equality Act 2010.

Patients and their loved ones were regularly involved in planning and making decisions about their care and treatment, to ensure it was centred around them and their needs. Patients understood their condition, care and treatment options, including risks and benefits, and advice provided. Recent examples shared by Willow Burn of how staff had supported patients’ social needs included arranging and funding new or replacement clothing, nightwear, or toiletries for those unable to do this independently or without local family to support this.

Complementary therapies were routinely included for inpatients and were offered where appropriate. Staff also identified carers and family members who may benefit from time out and relaxation.

A daily newspaper was delivered for patients. Staff would arrange for any specific requests to change the edition or arrange magazines.

Staff paid particular attention to appearance to ensure patients felt their best while possibly feeling their worst. Staff organised and provided services for hair, make-up, perfume, nail polish, usual hairstyles, glasses, shaven/unshaven, their usual dress code and comfort. Staff had arranged for a patient’s own hairdresser to come in as this was particularly important to them.

Staff helped families to celebrate birthdays and anniversaries with gifts and cake. Staff routinely offered help for patients to buy gifts and order online for birthdays of partners and relatives. They made afternoon tea for a family visiting from distance to celebrate.

Staff celebrated Mother’s Day, Father’s Day, Valentine’s Day, and religious events according to patients’ cultural needs, providing cards, gifts, seasonal decorations, and flowers such as roses, daffodils, and poinsettias.

At Christmas the hospice provided all patients with a hamper for their room, appropriate to them, and containing things they liked and required but also with special treats to share with their families. Examples included wine, beers, biscuits, chocolates, nuts, fruit, cheese, crackers, chutney, jams and non-alcoholic festive drinks. The hospice staff offered families to have Christmas lunch or tea with their loved one. Staff arranged an early Christmas in November 2025 for a patient who was determined they would celebrate Christmas together with their young children. Staff dressed up and decorated the family room so the children could visit for their own Christmas Day.

Where possible staff invited patients who were able, to join in other events and celebrations for example,Christmas Carol singing visits,day centre events such as Christmas parties and activities where they were able to socialise and benefit from interaction with others.

Staff arranged an ice cream van for the Summer Nurses’ Fair and inpatients were included where appropriate to either attend first or have a cornet. Staff arranged for a patient’s young family to attend the hospice summer fair. The patient was able to join in with the activities and staff arranged for the patient to ride a pony in the grounds.

Similarly, at the Christmas Nurses’ Fair, patients were given the opportunity to attend first. Staff arranged Santa visits to inpatients and families, if wanted.

Staff said they tried to make every occasion or opportunity which presents a little bit more special. They arranged for afternoon teas and decorations for royal events, sporting events such as cup final day drinks and snacks. They encouraged and supported family participation where appropriate. A family, complete with 2 dogs, came to stay with a patient. The hospice pets policy supported this.

The lead nurse had listened to a patient request for rhubarb for breakfast. They told us how they ran down to the hospice allotments to pick rhubarb in the pouring rain. Staff regularly called at the shops for special requests such as a specific brand of ice cream, certain flavours of mousse or yogurt.

One family wrote “The staff at Willow Burn were amazing – they didn’t just look after mum, they looked after our whole family. Kind words, cups of tea, sneaked in Chinese takeaways, friendly faces, asking about the photos of mum we brought in so that they could get to know the person she was before she fell ill.”

Staff helped a patient to attend her daughter’s wedding day. They arranged with her daughter to dress her, do her hair and make-up. They transported her to the ceremony and back.

A patient’s son came to stay with his mother over Christmas. He had left his family and travelled to be there. The hospice accommodated him and included him with all of the festivities including gifts and food as if it was his home, until she died. They thanked the staff and said “Words aren't enough to describe how grateful I am for all of your kindness. All of your efforts have been more than appreciated. You have all gone above and beyond for me. Thank you as well for always looking after my lovely mam.”

They also celebrated International Nurses Day with posters, a thank you card and token gift for all of the clinical staff.

Patient feedback was used to continually improve services for individuals, families and all patients.

Patients received the most appropriate care and treatment for them as the hospice made reasonable adjustments where necessary. The hospice was accessible for all, promoting patients’ independence whilst acknowledging they may require assistance.

The service had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff tailored services to meet the needs of individual patients in a way that ensured flexibility, choice and continuity of care. We saw examples of individual therapy sessions for patients or their loved ones. People we spoke with and feedback from families was consistently positive about the care and treatment they and their loved ones received.

People we spoke with during the assessment told us how valuable the specialist doctors, family support coordinator, nurses and managers had been in supporting them through their journey, even after their loved one had died.

Patients benefited from a warm and welcoming environment. Patients had their own bedroom and access to communal areas. This included quiet areas where patients could spend time with their family members, a faith room and a larger area where children and younger visitors could be supported to meet the patient with their loved ones. Relatives told us about the holistic care they and their loved one had received as a family. This included bereavement counselling.

The service took a proactive approach in understanding the needs and preferences of different groups of patients and delivered care in a way that met those needs. The service talked through menus, specific dietary needs, restrictions, and requests, and had a range of multifaith items for use by patients and families. Staff we spoke with gave examples of how patients’ individual needs and preferences were central to the delivery of tailored services particularly for patients with multiple and complex needs. Staff helped ensure that patients glasses were cleaned so they could see properly. We saw examples of communication tools used to support patients and specific staff training in how to support autistic patients or people with learning disability. Staff had access to easy read documents if needed to support patients with learning disabilities. However, staff treated each patient as an individual and made adjustments according to patient needs, rather than an assumption that one particular tool could meet specific needs.

Managers provided training in understanding equality and diversity covering all individual characteristics and provided staff with resources such as “Care Committed to me –palliative and end of life care for people living in Gypsy, Roma, and traveller communities, LGBTQ+ and homeless people, having recognised these as patients who experience barriers to accessing services. Managers also offered transgender awareness training to all staff to support better service delivery. Willow Burn staff delivered information to the local county council staff and local services in the community to talk about the hospice and the services it could offer. They became a sponsor of a local heritage walk to show the charity's commitment to the health and wellbeing of the wider community. Staff also provided ‘’Walks for Wellbeing’’ for carers of hospice patients.

We saw how the service collaborated across the healthcare network to provide timely access to medication and equipment. The hospice kept a small supply of their own but could quickly and easily access any specialist equipment so support a swift admission.

A large proportion of volunteers and some trustees at the service had lived experience of the service when their loved ones had been cared for by the hospice. They had returned as volunteers due to how well their loved ones had been cared for.

Care provision was all inclusive and complexity of care was a key consideration of the service. Work undertaken with the ICB and local hospice network considered the care needs of the local area.

The service worked hard to understand and reflect the diverse health and care needs of patients and local communities. The hospice had close links with the NHS Trust Palliative Care team and other independent hospices throughout the North East. They shared learning and skills with their peers and ensured all people living throughout the area had access to palliative and end of life care, as well as symptom control for long term conditions. Willow Burn staff answered crisis calls from professionals in the community where families suffered urgent needs for care. The hospice used its additional beds with charitable funds or ICB funding to provide this service. The local hospices had clear acceptance criteria and if one hospice was unable to offer a place for a patient, it was likely that another service could meet their needs. For example, Willow Burn was able to offer care for more complex needs such as patients with a tracheostomy when another local hospice was unable to deliver this care.

The hospice provided grief workshops for staff to understand grief and bereavement in adults and young people and how best to support adults or children living with bereavement. Staff could access additional resources such as local children and young people’s mental health teams.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The hospice worked with the local community and encouraged those living nearby to take on voluntary roles. The volunteer gardeners’ group was particularly well attended. The hospice held open days and invited people from the community.

The service complied with the NHS England Accessible Information Standard. The hospice provided appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Staff provided information on appropriate treatments, local services, patients’ rights, and how to complain. Staff ensured patient information and advice was accurate, up-to-date and provided in a way that they understood, and met their communication needs. Staff had access to communication aids to help patients become partners in their care and treatment.

Patients had information which met their individual needs. This included making reasonable adjustments for them, interpreting and translation for patients who did not speak English as a first language, audio, British Sign Language, large print, and Braille. Information governance systems included confidentiality of patient records and staff we spoke with understood the principles of data protection and the General Data Protection Regulation (GDPR).

Staff provided support for patients who had difficulty with reading, writing or using digital services with accessible information.

Staff made sure patients living with mental health problems, learning disabilities and dementia, received the necessary care to meet all their needs.

Staff ensured carers and families were regularly updated about the patient’s progress.

Patients and their loved ones said staff took time to ensure they had the information they needed, and they understood it. The hospice provided assistance via telephone contact 24 hours a day. The nursing team could be contacted for urgent, out-of-hours advice or support outside of standard business hours. Staff on the inpatient unit would either answer their questions or contact a doctor or specialist nurse to call them back. The hospice provided a wide range of information and advice for patients, families, and other professionals.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

Patients and their families knew how to complain or raise concerns, and when patients complained or raised concerns, they received feedback. Staff knew how to handle complaints appropriately. Staff received feedback on the outcome of any investigation of complaints and acted on the findings.

There had only been one formal complaint received in the previous 12 months, and it was in relation to confidentiality of patient information from an unknown source but considered to be from outside the inpatient unit. Staff took the concerns very seriously. However, the source of the information breach was not found. Managers took action to prevent any further possible breaches and wrote to all staff and volunteers explaining the confidentiality policy and all staff responsibilities. The manager wrote a response letter showing compassion and understanding for the person and their relative’s feelings, with apologies for the upset and stress the incident had caused. Staff offered to meet with the person to discuss their concerns further.

Managers shared only relevant information with staff, anonymised where possible to protect patients who raised concerns or complaints from discrimination and harassment. Staff followed hospice values and behaviour to ensure patients were treated with kindness.

The service was exceptional at ensuring people could access the care, support and treatment they needed when they needed it.

Staff planned for patients’ discharge, including good liaison with families, acute hospitals, and community services. Discharges were never delayed for anything other than clinical reasons.

The hospice was exceptional at ensuring patients could access timely care, support and treatment, whilst promoting equality and protecting their human rights.

Hospital and community staff including GPs and specialist nurses made direct referrals for patient admissions. A registered nurse managed each referral and ensured all relevant information was gathered and any additional needs were discussed prior to acceptance of the patient. Nurses had access to clear acceptance criteria, and this gave them the confidence to question or challenge a referrer to check the hospice could provide the correct care and meet all the patient’s needs. Managers supported staff in making decisions or in refusing an admission and signposting the referrer to a more appropriate service. There was adequate medical cover day and night, a doctor could be contacted quickly in an emergency.

Referrals were arranged following a professional handover from nurse to nurse, from a GP or the palliative care team. Once an admission was agreed, patients could be transferred to the hospice as quickly as necessary and were often admitted either the same day or within 24 hours. Urgent admissions to the inpatient unit from the community were prioritised.

Patients received timely care, treatment and support in line with best practice, quality standards and legal requirements, including equality and human rights. This included accessing care and treatment, making reasonable adjustments for people, addressing communication barriers and having accessible premises.

The inpatient bedroom doors were wide to accommodate wheelchairs and mobility aids. Rooms had bespoke storage to ensure any medical equipment not in use was kept out of sight. Bedrooms all had ensuite facilities with a ceiling lifting hoist. The standard furniture was suitable for people of heavier build, but specialist bariatric equipment was available on loan very quickly if needed. Extra beds could be brought into rooms for loved ones to lie together.

All patient areas were on the ground floor and were fully accessible throughout. In addition, the hospice had gardens accessible for wheelchair users and people with mobility difficulties. There was direct access from patients' bedrooms onto an individual patio area outside each room. The patios had views over the extensive landscaped grounds and onto countryside and doors had one-way glass to ensure privacy. Patients who were too ill to get out of bed could be wheeled outside in their bed if they wished. Families, friends and pets could meet with patients as requested.

There was free onsite car parking, including designated accessible parking spaces, and pleasant landscaped gardens.

Patients and their loved ones could access other areas within the hospice. They could come to the Willows café during opening times and could access complementary therapies and counselling services.

There was a family room where relatives could stay overnight, an onsite café, a small kitchen with snacks and drinks provided. The chef would provide family meals when required making it easier for loved ones to stay close by.

Patients were given support to overcome barriers to ensure equal access. Leaders and staff were alert to discrimination and inequality that could disadvantage different groups of patients accessing care, treatment and support. The hospice complied with legal equality and human rights requirements, including avoiding discrimination, considering the needs of patients with different protected characteristics and making reasonable adjustments.

The hospice used people’s feedback and other information to actively seek to improve access for patients more likely to experience barriers or delays in accessing their care. When there were barriers, they were removed. The hospice provided care to younger adults and listened carefully to their ideas and requests for individualised items. A young, long-stay patient had a request for a fridge and coffee maker for their room so they could have their own things. Staff arranged space for these and ensured all portable appliances were safety tested to support this.

Staff ensured patients knew the service was completely free of charge. There had been several initiatives to fundraise for the charity at schools, fairs, and local groups and these were tailored to include messages about accessibility and breaking down myths about hospice care. Staff had recognised from these events that the consensus was that hospices are still seen as places for people with cancer, that you only come to them to die and that people are still reluctant to talk about death. However, the positive messages staff had taken from the events were that “the reputation for care is second to none”, “everyone has a Willow Burn story”, and “even the sad stories are delivered with a smile”.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff and leaders promoted a culture in which the people using the service felt empowered to give their views. Staff actively listened to information from patients and their families who were most likely to experience inequality in experience or outcomes. Staff tailored their care, support, and treatment in response to this.

Leaders proactively sought ways to address any barriers to improving patients’ experience and worked with local organisations to address any local health inequalities. Staff understood the importance of providing an inclusive approach to care and adjusted support to ensure equity in patients’ experience and outcomes.

Staff and leaders were alert to discrimination and inequality that could disadvantage diverse groups using their services. The service had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage.

Staff regularly engaged with the palliative and end of life care community team and local hospices within the North East Hospice Network with a view to improving their understanding and people’s experience.

The hospice provided support to carers, local groups and other organisations caring for patients with palliative and end of life care needs. This included patients with dementia and those with learning disabilities. All staff had completed training in equality, diversity, inclusion and human rights.

People were given exceptional support to plan for important life changes, so they could make informed decisions about their future, including at the end of their life.

We heard from staff and observed through patient information and on posters throughout the hospice, the overarching message was about “Treasuring Lives”. Life was celebrated, and staff encouraged and enabled patients and their families to enjoy positive and joyous moments and memory- making opportunities. Families provided feedback regarding special arrangements staff had made to enable these such as displaying family photographs, celebrating wedding anniversaries, organising for beloved pets to visit and for family members to stay overnight to provide solace and comfort in patients’ last moments.

Staff supported patients to plan their care and treatment appropriate to their needs, abilities and mental capacity, so they could make informed decisions about their future. Advance care plans were developed from admission with patients and those close to them, outlining preferences for future care and support. This process was based on recognised approaches to ensuring patients received the care they wanted at the end of life; confident their care was focused on what matters most to them.

Staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of people with complex needs. The hospice and palliative care team worked together to ensure any complex needs could be safely provided. When needs changed the teams worked together to accommodate these at Willow Burn or with a referral and safe transfer to a more suitable provider.

Patients’ decisions and what matters to them were delivered through personalised care plans that were shared with others who may need to be informed. Staff supported patients who had a preferred place of death such as in their own home and made arrangements for their wishes to be actioned in good time and in as safe and comfortable way as possible.

Staff ensured care for people who were nearing the end of their life was managed and communicated in a sensitive and dignified way. For example, when patients wanted to express their wishes about cardiopulmonary resuscitation, they were supported to do so. Patients were able to change their mind at any time, and as many times as they wished.

When any treatment was changed or withdrawn, clinical staff communicated and managed this openly and sensitively, so patients had a comfortable and dignified death. Doctors prescribed medicines at an appropriate time to enable staff to manage agitation at end of life, when the time came and bearing in mind the patient’s needs above all others.

When patients’ future care preferences were for greater independence and fewer care interventions that were likely to benefit them, professionals worked together to support them to achieve their goals. Patients were supported to leave the hospice for acute medical care, for admission to a care home, or to return home with domiciliary care or family care. Staff provided information, contact details and made all necessary arrangements for family members to help support and maintain confidence in their ability to manage these goals.