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Inspection Summary


Overall summary & rating

Outstanding

Updated 9 July 2016

This inspection took place on 18, 19, 20, 21 and 26 April 2016 and was unannounced. The service was last inspected in February 2013 and at that time was meeting the regulations we looked at.

Saint Francis Hospice is an independent charity and one of the largest adult hospices in the UK. A team of specialist consultants, doctors, nurses, a range of other health and social care professionals and volunteers provide care and support to people with a life-limiting illness, their carers and family members. This is provided through an 18 bed in-patient unit and a day therapy unit. There were also two community teams based at the hospice, a “Hospice at Home” team, and a “Specialist Community and Crisis Support” team and these provided support in people’s own homes. At the time of our inspection there were 17 people receiving care in the in-patient unit and approximately 120 in the community and day therapy services.

The service had a registered manager. 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 and associated Regulations about how the service is run.

The service provided outstanding care and support. Management, staff and volunteers were highly motivated and committed to ensuring that people had the best possible care. The staff provided people with positive care experiences and ensured their care preferences were met. The hospice website contained feedback from people who used the service and comments included, "Coming to the hospice is the best thing that has happened to me in a long while. I look forward to seeing my friends, having a laugh as well as discussing my problems.” “I had no idea that a hospice was anything more than a place to spend your last couple of weeks in care, but after coming here I realised it was such an uplifting experience.” “You are not made to feel like you are ill and you get to see a doctor or a nurse if you need to. It is a really great asset.”

People received a strongly person centred service. They were supported to make choices and to have as much control as possible about what happened to them both before and after their death. They and their family members were consulted and involved in planning their care and supported to make decisions on their preferred place of death. People who used the service, their families and carers, staff, volunteers and outside organisations were all involved in developing the future of the service.

Staff were clear about their roles and responsibilities. People received care from a multi-disciplinary staff team who received excellent and effective training and good support from the management team. This provided them with the knowledge, skills and confidence to meet people’s needs in an outstanding and individualised manner. There was a very proactive approach to the personal development of staff and the acquiring of new skills and qualifications. A system of competency based assessments ensured staff could demonstrate the required knowledge and skills to meet people’s needs effectively. Volunteers also received training and support to assist them in their roles in the hospice and in the community.

The services were committed to deliver excellent care and to work collaboratively with partners to deliver and inspire better care for those affected by life limiting illness. Staff worked closely and in partnership with external health and social care professionals and other organisations to improve the service within the hospice and in the local community. Staff were encouraged and supported to undertake research and act as education facilitators to share best practice and ensure high quality outcomes for people with life-limiting conditions and those closest to them.

There was strong emphasis on the importance of good nutrition and hyd

Inspection areas

Safe

Good

Updated 9 July 2016

The service provided was safe. People received safe care both at the hospice and in their own home. Staffing levels ensured that people received a safe service that met their needs.

Systems were in place to ensure that people received their medicines safely and when they needed them.

The provider had robust strategies to minimise risk and enable staff to support people as safely as possible both in their own home and in the service.

The recruitment process was safe and effective. Staff and volunteers were appropriately checked to ensure that they were suitable to provide care and support to people who used the hospice service.

Effective

Outstanding

Updated 9 July 2016

The service was effective. People received support from a very skilled, experienced and committed staff team. The team was able to meet people’s assessed needs, preferences and choices. Staff received well co-ordinated and comprehensive training which was monitored to ensure their knowledge was kept up to date.

People were involved in making decisions about their treatment and care needs. Safeguards were in place to ensure that people who were unable to make decisions about their care had their human rights protected.

There was strong emphasis on the importance of good nutrition and hydration and a commitment to providing people with what they wanted to eat and drink in a flexible manner.

People were supported to receive good healthcare both from the hospice and other health and social care professionals.

Caring

Outstanding

Updated 9 July 2016

The service was caring. People and their relatives spoke consistently about the caring and compassionate attitude of staff.

Relatives told us staff understood their emotional needs and focused on their wellbeing as well as that of their family member.

Staff were respectful of people’s cultural and spiritual needs.

The service provided excellent end of life care and people were enabled to experience a comfortable, dignified and pain-free death.

Responsive

Outstanding

Updated 9 July 2016

The service was responsive. People benefitted from person-centred care. The service was flexible and responded quickly to people’s changing needs or wishes.

Advice for people, their families, carers, GPs and healthcare professionals available 24 hours a day via a dedicated helpline. People told us that this lessened their anxiety and helped them to receive better care when they needed it.

Systems were in place to ensure that people’s needs were comprehensively assessed. Detailed and current information about people’s needs and wishes and what was important to them was recorded and communicated to staff.

The provider had a positive approach to using complaints, concerns and feedback to improve the quality of the service.

Well-led

Outstanding

Updated 9 July 2016

The service was well-led. The management team demonstrated a strong commitment to providing people with a safe, high quality and caring service. They worked to continually improve, extend and develop the service to reach as many people as possible.

The service had a strong commitment to deliver excellent care and to work collaboratively with partners to deliver and inspire better care for those affected by life limiting illness.

The service was robustly monitored by the management team and the provider to ensure that people received a safe and effective service that reflected their needs and wishes.

People’s views were sought and valued. They were involved in developing the service. They used a service where staff felt valued and listened to and were involved in shaping improvements. Staff were proud of the service.