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Inspection Summary


Overall summary & rating

Outstanding

Updated 5 August 2017

This inspection took place on the 27 and 28 September 2016. The last comprehensive inspection of the Rowans Hospice took place on 19 February, 2014. During this inspection we found the service’s systems for the storage and disposal of medicines were not safe. At this inspection we found that the provider had taken the required action to ensure medicines were stored and disposed of safely.

The Rowans Hospice (aka The Rowans or Rowans) is a charity dedicated to improving the lives of people and their families in Portsmouth and South East Hampshire living with life-limiting illness. The Rowans Hospice provides specialist palliative care to people, carers and families who are facing complex physical, emotional and practical difficulties arising from advanced progressive life limiting illness. This may be cancer or other diseases. The service delivers physical, emotional, spiritual and holistic care through teams of nurses, doctors, counsellors and other professionals including therapists. The service provides care for people through an inpatient unit (IPU), outpatient day service, a hospice at home service and Living Well Clinics.

There are nineteen in-patient beds, all in single room accommodation with en- suite bathrooms. At the time of our inspection there were 15 people using the in-patient service. The hospice at home service offers additional support to people and their family carers, enabling people to stay at home and receive high quality end of life care. The service is available 365 days a year and provides people and carers access to specialist advice and nursing visits on a 24 hour basis. The Rowans Hospice also has a Day Care service which provides short-term placements.

The service had 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. The registered manager at The Rowans Hospice was the Director of Clinical Service (akaThe Matron).

People who used the different aspects of the service told us the quality of care and kindness provided by professional staff made them feel safe. Staff were able to explain their role and responsibility to protect people from abuse.

Care records demonstrated that potential risks to people’s safety were identified and plans were created to mitigate them. Risks to each person's health and well-being had been considered and assessed, for example people's mobility, skin care and nutritional needs. We observed staff supporting people to prevent any identified risks in accordance with people’s risk assessments.

There were sufficient staff to meet people’s needs. The relevant head of department completed a daily staffing analysis to ensure there were sufficient suitably qualified staff available to meet people’s needs. When people’s health deteriorated quickly we observed the staff ability to provide one to one care increased people’s safety and reduced the risks of harm to them.

The provider ensured that robust pre- employment checks were completed on all staff and volunteers as part of their recruitment. People were cared for safely because all staff and volunteers suitability for their role had been effectively assessed before they were appointed.

People were protected from harm because there were safe systems in place to ensure patients were not exposed to the risks associated with medicines.

People spoke positively about the quality of care and support they received from staff. Due to the expertise and knowledge demonstrated by staff, people were confident that they were well trained and supervised.

Staff had been trained to deliver best practice in relation to end of life care. Staff also had to complete regular training in relation to people’s clinical needs. This en

Inspection areas

Safe

Good

Updated 5 August 2017

The service was safe.

People were protected from abuse. Staff had completed safeguarding training and understood the action they needed to take in response to suspicions and allegations of abuse.

Staff understood the risks to people and followed guidance in accordance with their support plans to keep them safe when delivering their care.

There were sufficient numbers of staff with the appropriate skills and knowledge to meet people`s needs at all times.

The provider had appropriate arrangements in place to manage people's medicines safely. Medicines were stored and disposed of safely.

Effective

Good

Updated 5 August 2017

The service was effective.

People received support and care from staff who were well-trained and used their knowledge and skills to meet people`s needs effectively.

People were supported to make informed decisions and choices by staff who understood legislation and guidance relating to consent, mental capacity and DoLS.

Staff encouraged and supported people to have sufficient to eat and drink to maintain a balanced diet that met their individual needs.

People’s health needs were carefully monitored by staff who made prompt referrals to healthcare professionals when required to maintain their health.

Caring

Outstanding

Updated 5 August 2017

The service was very caring

People received outstanding care from exceptional staff who were compassionate, understanding, enabling and who had distinctive skills in supporting people living with a life limiting illness.

Staff were highly motivated and inspired to offer care that was kind and compassionate and were determined and creative in overcoming any obstacles to achieving this.

People valued their relationships with the staff team and felt that they often went ‘the extra mile’ for them, when providing care and support. As a result they felt really cared for and that they matter.

People were actively involved in making decisions and planning their own care and support. Staff listened to and respected people’s views, which they acted upon.

People were treated with dignity and respect at all times and were supported to have a comfortable, dignified and pain free death.

Responsive

Outstanding

Updated 5 August 2017

The service was outstandingly responsive.

The hospice was outstandingly responsive to the needs of people‘s families and the wider community. The hospice used the creative ‘Meerkat service’ to support young people through their bereavement.

The environment in the IPU was dementia friendly and the hospice worked with local care services to ensure people living with dementia received end of life care when needed.

Information about how to make a complaint was available and people were able to raise concerns easily. When complaints had been made, they were used to learn lessons and drive improvements in the service.

Well-led

Good

Updated 5 August 2017

The service was well-led.

Staff spoke with pride and passion about their service and understood the provider’s values, which they demonstrated in the delivery of people’s care.

The service had strong links with the local community and worked effectively in partnership with key organisations to support care provision, service development and joined-up care.

The registered manager provided clear and direct leadership visible at all levels which inspired staff to provide a quality service.

The registered manager effectively operated quality assurance and clinical governance systems to drive continuous improvement in the service.