Keech Hospice Care

Updated 15 March 2024

Keech Hospice Care is registered to provide treatment of disease, disorder and injury. At the time of the inspection there was a registered manager who had been in post since 2019.

The service was last inspected in June 2016, when it received a rating of good.

The service provides free specialist and holistic palliative and end of life care for adults with life-limiting illness and their relatives and carers in Bedford, Luton and South Bedfordshire. The Luton site has an inpatient unit that cares for up to 8 patients. There were 5 inpatients at the time of the inspection. The service also provides specialist palliative care for infants, children and young people who have a life-limiting condition and living within Bedfordshire, Hertfordshire and Milton Keynes.

• There were 8 adult inpatient beds, a cold room, several quiet rooms for friends and family, a room dedicated for families to stay overnight when patients were near end of life and a cold room. For adults, Keech Hospice Care offered a range of day services, which included rehabilitation, wellbeing and outpatient appointments. The service provided specialist palliative care assistance in the community and supported the local NHS trusts with specialist palliative care and end of life advice. The service offered a 24-hour,7 days a week support call line dedicated to adult patients and their families.
• There were 5 children’s and young people’s inpatient beds. The service also provided play and activity services virtually or at home. There were a wide variety of inpatient therapies and services to help control the child’s symptoms, and to provide emotional support for both the child and family. The service had a children’s community team which provided hospice care to children with a life-limiting condition in various community settings, including the family home, the child’s school or in hospital. The service offered a dedicated 24-hour support call line to support families who have a child with a life-limiting condition.

In June 2023, Keech Hospice Care merged with Bedford Daycare Hospice. The Bedford site provides outpatient and day services, an extensive holistic assessment, tailoring of a treatment plan specific to each person and their loved ones. Patients and their families could access packages of care and support virtually and online and utilise support at the Luton site. We did not visit the Bedford site as part of this inspection.

Updated 15 March 2024

We carried out a comprehensive inspection of this service as part of a follow up for concerns raised to Care Quality Commission.

It is the first time we have inspected the adults and children and young people elements of the hospice separately. We rated Keech Hospice Care as good because:

• Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well and learned lessons from them.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, supported them to make decisions about their care, and had access to good information. Key services were available 7 days a week.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and helped them understand their conditions. Staff took account of patients’ individual needs and went out of their way to make sure patients living with a life-limiting condition could make the most of their time with their families and loved ones. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. The service had a community connector to ensure the local population’s needs were understood and catered to. They went above and beyond to work with local services, improve visibility of services and speak to people in a way they could understand. People could access the service when they needed it.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

Hospices for adults:

• The service did not have regular clinical pharmacy input which meant medicines reconciliation was not always done.
• The service did not have a system in place with the ability for leaders of the service to view the overall training completion rates for all volunteers.
• Audits were not always repeated frequently enough to use the findings to make improvements.

Hospices for children and young people:

• The service had staffing vacancies. In order to manage this, the service operated a flexible model of access which meant people could not always access the service when they needed it.
• The service did not have regular pharmacy input and had room for improvement in their processes of accountability of controlled drug stationary.

Updated 15 March 2024

See the summary above for more details.

It is the first time we have inspected the adults element of the hospice separately.

We rated this service as good because it was safe, effective, caring and well-led. We rated responsive as outstanding.

Updated 15 March 2024

See the summary above for more details.

It is the first time we have inspected the children and young people element of the hospice separately.

We rated this service as good because it was safe, effective, caring, responsive and well led.