You are here

Inspection Summary


Overall summary & rating

Good

Updated 26 January 2015

This inspection was carried out on 29 and 30 October 2014 and the inspection was unannounced. We previously visited the hospice on 19 September 2013 and we found that the provider met the regulations that we assessed.

The service is registered to provide nursing care, including transport services, triage and medical advice provided remotely. The hospice has 16 in-patient beds and we were told that occupancy levels were usually between ten and 12 patients. Accommodation is provided in eight single rooms and two single-sex, four-bedded bays.

The provider is required to have a registered manager in post and on the day of the inspection there was a manager who had registered with the Care Quality Commission (CQC) in January 2011. 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 told us that they felt safe whilst using the hospice. There were sufficient numbers of clinical and non-clinical staff on duty and staff were well supported by doctors and consultants. Staff had been recruited following robust policies and procedures that ensured only people suitable to work with vulnerable people had been employed. Staff had undertaken training on safeguarding children and adults from abuse and other training that provided them with the skills to carry out their role safely and effectively.

The management of medicines was safe and people told us that their pain was being well managed. Patient’s nutritional needs were met and they told us that they were offered choices and that they could have snacks outside of meal times and during the night.

People’s individual circumstances and lifestyle had been taken into account when their care or treatment plan had been devised. In addition to this, people who were important to the patient had been consulted. Relatives and friends were able to visit the hospice at any time; they told us that they were always made welcome.

People told us that their privacy and dignity was respected by staff and that they felt staff really cared about them. Relatives also told us that they were also well supported; this included the bereavement counselling service. Health care professionals who we spoke with described the bereavement counselling service provided by the hospice as being very effective.

Liaison with other health care professionals was described as being effective, including the plans for patients to be discharged home.

There were clinical governance systems in place that monitored people’s satisfaction with the service and ensured that the policies, procedures and practices in place were followed so that people received the service they needed. Staff told us that they were well supported by the hospice and that their views were listened to.

The service was responsive to people’s needs and continually looked for ways to improve. They had taken part in pilot schemes that were aimed at improving care and treatment for people with chronic illness or who were recovering from illness, and had introduced a variety of support groups for people and their relatives / carers.

Inspection areas

Safe

Good

Updated 26 January 2015

The service provided by the hospice was safe.

There were sufficient numbers of staff, both nurses and non clinical staff, to ensure that patients received their care and treatment in a timely way. Doctors were either present at the hospice to support staff, or ‘on call’ over a 24 hour period, seven days a week.

Staff had been recruited following robust policies and procedures, and were clear about their responsibility to promptly report any concerns or abusive behaviour.

There were robust systems in place for the management of medicines.

Effective

Good

Updated 26 January 2015

We found staff were provided with the training needed to carry out their work safely and effectively. This included learning about mental capacity and recognising people’s rights.

Liaison with other health care professionals were effective, including the arrangements made for patients to be discharged home.

Patient’s nutritional needs were met and efforts were made to ensure patients received ample hydration. Patients had a choice of meals and special diets were catered for. Patients were aware that snacks were available outside of mealtimes. 

Caring

Outstanding

Updated 26 January 2015

The hospice was caring.

We only heard compliments about the staff and the care. We found that staff displayed warmth and compassion and a genuine desire to care for patients.

Patient’s privacy and dignity was respected by staff and patients could put a sign on their bedroom door to indicate they did not wish to be disturbed.

Patients were encouraged and supported to make decisions about their care and given time to make their own choices; this included their end of life care. Patients told us that their treatment meant they were free of pain. The hospice provided a bereavement service to patients families and this support was not time limited.

Responsive

Good

Updated 26 January 2015

The hospice was responsive to people’s needs.

Patient records included information about life histories and family trees; this ensured that staff new about patient’s individual lifestyles, wishes and needs.

Efforts were made to meet patient’s specific wishes, including taking them out to significant events and providing special food and drink.

In response to demand, the hospice had initiated drop-in sessions within the Day Therapy Unit. People could access a variety of therapies and were able to arrange to meet health care professionals during these sessions.

Well-led

Good

Updated 26 January 2015

The hospice was well-led.

There was an experienced registered manager in post who people described as approachable, and who clearly knew the staff and the care and treatment patients were receiving. 

Managers and staff carried out regular checks on how the service was operating and the Board of Trustees was updated continually. The hospice consulted with patients and others to get their views about their satisfaction with the service provided.

There had been various initiatives to provide services when gaps had been identified and this had resulted in an improved service for patients and other people who used hospice services.