The Rowans Hospice

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

The hospice had clear vision and values around the patient experience and the quality of care and support they constantly strived to provide. Leaders had the skills, knowledge, experience and credibility to ensure that the service vision could be delivered and risks were well managed.

The service had a culture of openness, honesty and inclusion which encouraged and supported staff in all areas to provide feedback. Where appropriate lessons had been learnt, this drove consistent improvement for the service.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was a transparent and open culture where staff could escalate concerns and report incidents. Staff reported that the team was supportive and helped one another despite changes in staffing numbers due to funding issues.

Staff spoke passionately about the service they provided and were proud of the facilities they worked in and the care they could offer to patients. Staff described the culture as positive with good working relationships with different departments within the hospice.

The hospice had developed a strategic plan for 2025-30 with four objectives around sustainability, financial stability, investing in their staff and extending their services.The hospice strategy was revisited and objectives formulated and shared with the teams. These objectives supported staff appraisals, sharing the vision and direction moving forward.

The hospice had recently launched their new values in March and were in the process of embedding this into their appraisals. The CEO led on values workshops of which staff and volunteers were invited to join. The purpose of the workshops was to identify what was important for the team, organisation especially as the hospice had undergone many changes at senior level and the restructure programme. Following these workshops, the hospice values were developed and shared with the team. This had in turn supported a shared direction and culture of growing together, learning, respecting bringing the organisation together and forms the basis of annual appraisals, staff recognition awards, going over and beyond.
 

Engagement with staff was via meetings, emails and newsletters. The hospice held an open forum for staff every month. This was led by the chief executive officer on teams and provided staff with a transparent view on where things were financially. Emails were sent out to staff who could not attend.

Staff awaydays were planned to engage staff with the hospice strategy and values moving forward.

The hospice had recently appointed a new chief executive, and staff reported the change as good and positive.

Leaders had the integrity, skills and abilities to run the service. They understood and managed the priorities and issues the service faced.

Staff we spoke with told us leaders were approachable and visible and supported staff to develop their skills and take on more senior roles. Staff received regular supervision and debriefed 6 weeks post a difficult event.

Leaders held regular meetings with their teams and 1:1s. A monthly staff forum was led by the CEO and provided updates and key messages. The forum was open to questions and answers followed up with the CEO brief for those who could not attend.

One staff member told us ‘We have supervisions with psychotherapists to discuss individual cases we find difficult.’

Staff told us the communication systems and team working within the service were robust and effective. A staff member told us ‘Everyone works well together, its one of the few places where you can ask any question to anyone from housekeeping to doctors’.

The hospice employed a volunteer manager and managed their volunteers correctly and sufficiently.

The service had a freedom to speak up guardian who was available should staff wanted to raise any concerns. Staff were aware of who this was and told us that they felt they could raise concerns without fear of reprisal. The guardian was provided with protected time to support with this role.

Staff had access to the freedom to speak up policy which provided information on how to speak up and what to expect to happen after speaking up.

The hospice provided staff with professional support with independent and appropriately trained counsellors through an advice helpline called Health Assured who operated an Employee Assistance Programme (EAP). This was an entirely confidential service and any discussions through this route was strictly confidential unless staff chose otherwise.

Whistleblowing policies and procedures were in place to enable people to raise concerns or complaints confidently, knowing they would be supported throughout and informed of outcomes and any actions taken.

The hospice promoted an open culture around feedback from staff through a comprehensive survey, where themes were identified, addressed, and actions were put in place.

The leaders undertook a policy review following concerns raised of which resulted in clearer processes for staff and volunteers to follow.

The hospice valued diversity in their workforce and had an inclusive and fair culture where staff felt heard and supported.

Dignity at work procedures and equal opportunities protocol were in place to uphold the principles of equality and to assist in the avoidance of unlawful discrimination in activities such as recruitment and selection, promotion, transfer, training opportunities, pay and benefits, discipline, redundancy and dismissal.

The hospice made reasonable adjustments to accommodate and support staff in their work where possible.Staff could contact the occupational health via their line manager for added support.

The hospice had a health equalities forum that met quarterly with senior leaders present. The purpose of the group was to consider how to reach out and tackle inequality and widen access to hospice care in addition to considering and diversity and equality with the workforce.
 

There was a clearly defined structure to the organisation, with a board of trustees providing strategic vision and direction for the hospice. The board of trustees met quarterly, and topics of discussion included the key points from the executive report, risk register and management accounts and cashflow.

The hospice held quarterly clinical governance meetings to drive continuous improvement for the benefit of people who use the service and staff. The clinical governance group monitored significant events, critical incidents such as medicine incidents, falls, safeguarding reports and DoLS applications. The clinical governance group was also responsible for the review of national guidance documents, policy review and review of audits and satisfaction surveys.

Leaders told us clinical managers awayday was planned to consider understanding the hospice values and managers felt involved, valued and supported the leadership team moving forward.

The management team consistently operated systems to ensure they shared information with external organisations effectively, in a timely way, for example, accidents and incidents were reported to the relevant authorities, including the CQC.

Managers were able to carry out quality improvement projects, and audits to improve communications and avoidance hospital admissions.

Staff at all levels were clear about their roles and understood what they were accountable for, and to whom. There were clear responsibilities among staff which interconnected and ensured governance was fundamentally strong.

The people and remuneration governance group (PRGG) met quarterly and discussed human resources (HR) vision and pillar strategy, HR budget and workforce projects.

The hospice published their annual quality account on their website, and this set out the priorities for the service which were focused on patient safety, patient experience and clinical effectiveness.

There were procedures to safely manage sensitive data which allowed them to maintain people’s privacy, dignity and confidentiality. Governance meeting minutes reviewed showed staff from different areas of the service attended and were involved in discussion about the service and how improvements could be made.

The hospice collaborated and worked in partnership with external partners to support people’s health and wellbeing. They shared information and learning with partners to improve the service.

The hospice worked with local care providers, GPs, district nurses, macmillan nurses, specialist nurses and other health and social care professionals to coordinate and provide the best possible care.

Patients and families could access the palliative care support hub which was hosted by the hospice in partnership with Hampshire and Isle of Wight Healthcare NHS Foundation Trust and Portsmouth Hospital University Trust.

Through living well centre, the hospice engaged and supported people in the community who were living with a life-limiting and progressive illness. The centre hosted and organised classes and activities and encouraged patients and their families members to take part in fundraising events within the local area. A comment read ‘without your support I would have really struggled. We raised over £2000 for Rowans. Keep doing what you do.’

Feedback from people using the centre was overwhelmingly positive with one commenting how an expressive writing course had supported her with her anxiety and now had become a positive creative outlet for her.

The hospice was supported by over 780 volunteers who performed a vital role in delivering widespread service into the community.

The hospice worked strategically with Hampshire and Isle Of Wight commissioners to unite specialist palliative care to a service which included the hospice to support delivery and demonstrate over and above partnership working.

The living well centre itself has formed many partnerships with other organisations and communities some of which included heart failure, veterans, sparks community and local colleges.

The hospice focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people.

The service monitored themes and trends that were relevant to them, the patients they supported, and the service they provided.

An open forum was held for staff every month which was led by the CEO on teams. The forum provided staff with a transparent view on where things were financially. Staff presented a case study once a month as part of the open forum for shared learning. Emails went out to staff who weren’t able to attend.

The hospice achieved high standards through auditing, benchmarking, risk management and compliance with all aspects of health, safety and welfare for patients, families, staff and volunteers.

Through Hospice UK, the service benchmarked their standards against other hospices and accessed a range of support services. The service provided educational opportunities to staff which enabled them to share their expertise and experience with other healthcare professionals.

The service undertook several Quality Improvement (QI) projects and shared learning from this to help drive improvement and strive for excellence. The outcome of a quality improvement project on the withdrawal of assisted ventilation resulted in highlighting the need for an earlier communication with the team. As a result the team developed a protocol which detailed guidelines for achieving well-coordinated continuity of care for these admissions which led to an improvement in the services they offered.

The service had an ethics advisory group which reviewed research proposals quality improvement projects. Other projects included Friendship at Work, service review linking ambulance services with palliative care support.
 

The hospice was part of the quality improvement programme which involved setting up a falls management group linking with those hospices of similar size and learning from each other what processes, systems, equipment and how they managed the prevention of patient falls.

Leaders told us clinical staff produced posters of quality improvement projects, audit, service review within their areas of which was then shared with the wider hospice team. The posters would go on display for a calendar month and then a plenary session would be held where three poster authors were asked to present further on their work. This had been an annual programme, which was halted during covid and then reignited in 2024.