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Inspection Summary

Overall summary & rating


Updated 9 June 2016

This inspection took place on 6 and 7 April 2016 and was unannounced.

Treetops Hospice is registered to provide palliative care and support to people within their own home that have a life limiting illness, and includes providing a respite service for people’s relatives and carers. The aim of the hospice at home service is to enable people to remain at home as their preferred choice, to be cared for and to die at home, thus reducing unnecessary admissions to hospital. The services offered by Treetops Hospice supplement and complement existing service provision. At the time of the inspection there were 109 people using the hospice at home service. Treetops Hospice as part of its service provides counselling to people with life limiting conditions and those bereaved. And in addition provides complementary therapy and day care.

Treetops 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.

People who used the service and their relatives or carers told us they felt they received safe care from the staff employed by Treetops Hospice; which was confirmed by information gathered from questionnaires we had sent to those using the service.

The provider and staff were committed to promoting people’s safety across all levels of staff within the organisation and included, the meeting of a health and safety committee to review incidents. Policies and procedures were in place to promote the safety of its staff when working alone within the community.

Staff within the hospice at home service followed the risk assessments developed by health care professionals with primary responsibility for the provision of the persons care. Staff when visiting a person at home observed for potential risks. Where these were identified these were shared with the health care professionals who were responsible for assessing and minimising risk. So that people’s plans of care and risk assessments could be reviewed and updated.

Staff spoke positively about their induction and on-going training, which enabled them to meet people’s needs; this was confirmed by the completed questionnaires we had sent to staff. Staff had the opportunity to develop their skills through reflective practice when they met to discuss people’s care. This enabled them to further develop their understanding and awareness to improve the quality of the care they provided.

People’s physical, psychological and emotional needs were met as the provider employed sufficient staff from a range of disciplines to provide holistic care, which included the provision of the hospice at home service, day care and complementary therapies. People’s needs were regularly discussed and changes to people’s health and welfare were raised with health care professionals who had overall responsibility for managing people’s care. People we spoke with told us this was managed effectively so that information was shared amongst all those involved in their care.

The frequency of people’s support was planned by the hospice at home co-ordination team and led by a nurse with the involvement of people using the service and their relatives. The support provided was based upon people’s individual needs and took into account changes to people’s health in order that the service provided was effective.

The service supported people within the community providing psychological and practical support. People in some instances accessed the day care facility, which included complementary therapies, art therapy and social activities. People told us the day care facility enabled them to meet with people in similar circumstances and was a welcome part of their support.

People told us staff understood th

Inspection areas



Updated 9 June 2016

The service was safe.

Staff had been trained to recognise and respond to any actual or potential abuse.

Potential risks to people were managed as staff adhered to risk assessments developed by health care professionals. Where risks were identified these were communicated with the relevant health care professionals to ensure people�s risks were reviewed.

People�s needs were met and they were supported and cared for by staff from a range of disciplines that had the appropriate skills and knowledge.

People were supported by staff where necessary in the administration of medicine or the prompting of medicine dependent upon people�s needs and the designation of staff providing support.



Updated 9 June 2016

The service was effective.

People received support and care from a staff team who were trained to meet their needs. Training was well managed and effective within the service. We found staff were encouraged to develop their knowledge and skills.

Staff were aware of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. They worked collaboratively with other health care professionals where required to ensure people�s rights were protected and promoted.

People were supported to eat and drink and maintain a balanced diet as staff followed people�s care plans.

People�s health needs were carefully monitored and there were effectively and timely procedures for sharing information within the service and the wider health care community.



Updated 9 June 2016

The service was caring.

People and their relatives told us staff treated them with exceptional kindness, care, dignity and respect at all times. Staff demonstrated compassion in every aspect of their work to make people feel valued and supported.

People using the service and their relatives and carers were actively involved in making decisions about the care they wished to receive from the service.

Staff supported the emotional wellbeing of people and their relatives with end of life care being provided with sensitivity.



Updated 9 June 2016

The service was responsive.

The staff responded to people�s physical, psychological and social needs. People and their families were fully involved in assessing the level of support they wished to receive from the service, which responded to people�s changing needs.

People received information on how to raise concerns and complaints.



Updated 9 June 2016

The service was well-led.

The provider and registered manager promoted a positive and open culture and provided opportunities for people who used the service and their relatives to comment and influence the quality of the service provided.

The Board of Trustees and managerial 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 monitoring the quality of the service it provided by the use of internal quality assurance systems and through its reporting to the wider health care community.

The provider worked with other healthcare professionals to develop the strategy for palliative and end of life care, to promote care within the community in order that people could be cared for within their own home.