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Inspection Summary


Overall summary & rating

Good

Updated 21 June 2016

This inspection took place on 15 March 2016 and was unannounced.

Garden House Hospice is registered to provide specialist palliative care, advice and clinical support for adults with life limiting illness and their families. They deliver physical, emotional, spiritual and social holistic care through teams of nurses, doctors, counsellors, spiritual care team and other professionals including therapists. The service provides care for people through an ‘In-Patient Unit’, Day Service, `Out- Patient Care`, `Drop-in Service`, and `Hospice at Home`. The hospice also offered a 24hour telephone advice line for people and their family carers to request help if there was a need for it.

The inpatient facility catered for up to 12 people, accommodated within a ward or individual rooms. At the time of the inspection there were six people using this service, beds being gradually reduced for refurbishment work. Approximately 10 people received support from the ‘Hospice at Home’. The service provided specialist advice with regards to symptom control and worked in partnership with health and social care professionals to ensure that people received the best possible support.

The services provided included counselling and bereavement support, family support, chaplaincy, out-patient clinics, patient clinics, physiotherapy, complementary therapies and a lymphedema outpatient clinic (for people who experience swellings and inflammation usually to their limbs post cancer treatments).

Garden House Hospice 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.

Staff were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow to make sure people were protected from harm.

People were at the heart of the service and were fully involved in the planning and review of their care, treatment and support. Plans in regard to all aspects of their medical, emotional and spiritual needs were personalised and written in partnership with people. Staff delivered support to people respecting their wishes and preferences.

Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced. Staff reported any concerns so that these could be reviewed and discussed to identify if lessons could be learnt to reduce the likelihood of reoccurrence.

People’s physical, psychological, emotional and spiritual needs were met as the service employed sufficient staff with the appropriate skills to support those needs. People’s needs were regularly reviewed and the service responded to their changing needs. Staff provided spiritual support and complementary therapies as well as caring for people`s physical needs.

The service supported people within the community providing psychological and practical support. People from the community accessed the various clinics held in the day care facilities where staff could review their health. People told us that the day care facility enabled them to meet with people in similar circumstances and was a welcome part of the community support.

People told us that staff understood their individual care needs and were compassionate and understanding and that their cheerful and friendly approach created a welcoming and relaxed atmosphere. Staff told us they undertook training which enabled them to provide good quality care, which supported a holistic approach to care.

The staff provided meals that were in sufficient quantity an

Inspection areas

Safe

Good

Updated 21 June 2016

The service was safe.

Staff knew how to recognise and respond to any actual or potential abuse. They worked closely with health and social care professionals to protect people from harm.

Potential risks to people were assessed and measures put in place to reduce risks. Where accidents or incidents occurred these were analysed and learning was shared amongst staff to prevent reoccurrence.

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

People received their medicines from staff who was trained and qualified in safe administration of medicines and the use of specialist equipment to ensure people received their medicines in time and safely.

Effective

Good

Updated 21 June 2016

The service was effective.

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

Staff felt supported in their role by managers. They were encouraged to develop their knowledge and skills, follow best practice in regular meetings, one to one supervision sessions and yearly appraisals.

Staff were aware of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were involved in making decisions about all aspects of their treatment and care.

People were supported to maintain a healthy balanced diet. The menu provided was varied and offered plenty of choices to people.

People�s health needs were carefully monitored by nursing staff and the consultant in palliative care. If people`s health required, appropriate referrals were made to other professionals.

Caring

Good

Updated 21 June 2016

The service was caring.

People and relatives told us that staff were `very special`, kind and empathetic and they provided excellent care and emotional support which was responsive to their needs.

Staff demonstrated compassion and understanding when caring for people. They were attentive and thorough in every aspect of their work to make people feel valued and well supported.

People�s spiritual needs were recognised. The service worked closely with the spiritual care team which offered comfort to people and families.

Staff supported the emotional wellbeing of people and their relatives with end of life care being provided with sensitivity and compassion. The care people received enabled them to experience a comfortable, dignified and pain-free death.

People`s right to privacy and dignity was promoted and respected in life and in death.

People were consulted about and fully involved in their care and treatment. The service was very flexible and responded quickly to people�s changing needs or wishes.

Responsive

Good

Updated 21 June 2016

The service was responsive.

People and their families were fully involved in assessing and reviewing their needs and planning how their care should be provided, which included their wishes and priorities regarding their end of life care.

The service provided person-centred care based on best practice and focussed on continuous improvement. Staff understood and anticipated people`s needs which enhanced the quality of the care people received.

The service encouraged people with life limiting conditions and their families� early involvement in the hospice by organising diverse activity groups and complimentary therapies.

People�s families were offered bereavement support and counselling as long as they needed it.

The provider had a positive approach to using complaints and concerns to improve the quality of the service and this was closely monitored by the management team.

Well-led

Good

Updated 21 June 2016

The service was well-led.

The service promoted a positive and open culture and provided a range of opportunities for people who used the service, their relatives and people from the wider community to comment and influence the quality and type of service provided.

The Board of Trustees and management teams provided strong, effective leadership and provided a clear strategy for the long term development of the service.

The management team was pro-active in introducing new ways to meet the needs of people in the wider community and promote good practice.

The management team were pro-active in organising fundraising events to ensure they had the finances to provide the services needed by people and their families.

The registered manager worked with other healthcare professionals and other providers of similar services to share best practice and have a positive influence on the care people received.

There were robust auditing systems in place to ensure the quality of the service was constantly monitored and actions were in place to constantly drive improvement.