12 July 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
We inspected the service on 6 and 7 June 2016. We gave short notice to the registered provider because we needed to be sure that key people would be available during our inspection visit. The inspection team consisted of an adult social care inspector and a pharmacist specialist advisor.
We spent time at the service looking at records. This included two people’s care and support records, five staff and two volunteer recruitment files, policies and procedures and other records relating to the management of the service.
Before our inspection, we reviewed all the information we held about the service. This included looking at any safeguarding referrals received, whether any complaints had been made and any other information from members of the public. Before the inspection we looked at notifications we had received. A notification is information about important events which the service is required to tell us about by law.
We contacted the local authority safeguarding and contracts teams for their views on the service. They raised no concerns about this service.
On the days of our inspection we spoke with four people who used the service, one relative, two trustees, one volunteer, the registered manager and seven staff members.
12 July 2016
We inspected this service on 6 and 7 June 2016 and we gave short notice to the registered provider prior to our visit. This was to ensure that key people were available during the inspection.
The Hospice of the Good Shepherd provides specialist palliative care to persons over the age of 18 years. It also provides respite care for people with complex nursing needs. There is an inpatient unit with 12 beds and a day care facility with 10 places. The Hospice provides specialist palliative care through a multi-skilled and qualified staff team. They are able to offer a range of medical treatment and complementary therapies to address symptoms, enhance quality and life and meet a patient’s holistic needs which include physical, emotional, psychological, spiritual and social needs. Their end of life care provides support, dignity and comfort to those in the terminal stage of an illness. The hospice also provides complementary therapies and counselling services to families, though these services fall outside the regulatory framework of the Health and Social Care Act 2008. The service is situated in the suburbs of Chester, close to a range of local shops and other amenities. Car parking is available to the side and rear of the premises.
During the past year the hospice has provided 358 In-patient stays and had 360 day therapy attendances. There were also over 800 medical consultations in hospice out-patients and day therapy.
At the time of this inspection there were eight inpatients at the hospice.
The previous inspection was undertaken in January 2014 and the service had met the regulations in place at that time.
There was a registered manager in place at this service, who has been registered for two and a half years. 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.
We have made recommendations about the management of medicines because these were not always safe, although the management said they would follow this us this was the findings at the time of the inspection.
People told us that they received very good quality of care from all the staff at the hospice. People told us they staff were kind, patient and caring towards them and that they supported them to meet their physical, social and emotional needs. People described the culture of the service as positive and caring.
People told us they felt safe at the service with the staff team. Staff had been trained to recognise and report any signs of abuse. No safeguarding issues had arisen at the service since the last inspection.
Care plans were person-centred and kept up to date. End of life care was given in sensitive and appropriate ways that acknowledged people’s rights and preferences. The service promoted a “focus on living” approach to care which supported people and their families to enjoy the time they had together and enhance their feelings of well-being.
The staffing levels were good and sufficient staff were seen on the days the inspection took place. Staff were well trained and had access to a variety of training courses to enable them to develop their skills and knowledge base. Good support was given to staff by senior management and regular meetings and supervision sessions were undertaken.
Robust staff recruitment processes were in place which ensured that only staff who met the service’s high specifications regarding experience and qualifications, character and caring abilities were employed. This included the recruitment of volunteers.
People told us the food was very good and that they had access to snacks and drinks whenever they wanted them. Care plans showed that a nutritious diet was encouraged.
The service worked closely with other professionals and agencies to ensure people’s holistic needs were fully met. There was clear evidence of close and effective partnership working between the service, families, carers, and external professionals.
Regular checks were made regarding the safety of the building and equipment. Staff were given training in safe working practices and provided with any necessary personal protective equipment. The building was clean, hygienic and in a good state of repair.