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St Julia's Hospice Outstanding

Inspection Summary


Overall summary & rating

Outstanding

Updated 3 September 2016

The inspection took place on 10 and 11 May 2016 and was unannounced. We previously inspected the service on 14 December 2013 and found no breaches of regulations in the standards we looked at.

The provider, Cornwall Hospice Care Limited is a registered charity committed to providing specialist palliative and end of life care for people, over the age of 18 years, irrespective of diagnosis. The provider runs two hospices in Cornwall, Mount Edgcumbe in St Austell and St Julia’s in Hayle. St Julia’s Hospice, is registered for 10 beds, and provides specialist care for people with life limiting illnesses. It is purpose built and located adjacent to St Michael's Hospital in Hayle. It provides inpatient care for people needing help with complex symptom management, pain control and end of life care. People are referred to the hospice by health professionals, in liaison with their GP or hospital consultant. At the time of the inspection, eight people were being cared for at the hospice.

Services included physiotherapy and lymphoedema clinics. (Lymphoedema is a chronic long term condition that causes swelling in body tissues. It can be a primary or secondary condition). The service had built a dedicated outpatient suite so they could provide more day services nearer to people's home, but this facility had not yet been commissioned for use.

The hospice had a team of about 50 volunteers, who worked in various roles such as greeting people and visitors at reception, chatting to people, serving lunch and making drinks and snacks. They also helped with laundry and flower arranging.

The service had a new registered manager, the Director of Patient Services who registered in December 2015. They managed both hospices, supported by a unit manager at each location. 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 received outstanding care from highly motivated staff who developed exceptionally positive caring and compassionate relationships with them. The service had an open and positive culture that placed people at the heart of everything they did. Staff treated people with sensitivity, dignity and respect. People’s emotional and spiritual needs were met by staff who were knowledgeable and confident to care for and comfort them. Families and those that mattered to the person were supported to spend quality time with them.

People received excellent care, based on best practice from experienced staff with the knowledge, skills and competencies to support their complex health needs. For example, the hospice used national best practice tools to assess people’s symptoms each day. This helped staff address each person’s physical and emotional needs which improved their quality of life. People received their medicines on time and in a safe way, and were kept peaceful, comfortable and pain free.

Hospice staff were committed to promoting excellent end of life care for people in Cornwall, by providing a programme of education and training for a wide range of health and social professionals working in hospitals, care and nursing homes and in the community. This meant more people received high quality end of life care from skilled staff in their preferred location and avoided hospital admissions. The hospice used link roles to lead and actively champion staff to provide people with evidenced based, best practice care. For example, for Motor Neurone Disease (MND), foot care and falls prevention.

The service was committed to excellence through research to identify ways to further improve their service. The hospice was awarded a prize by the Royal Society of Medicine in the research category section in 2015, for pioneering work in spinal pain relief. T

Inspection areas

Safe

Good

Updated 3 September 2016

The service is safe.

People were supported by enough staff so they could receive safe care at a time and pace convenient for them.

People were protected because staff were trained on recognising potential signs of abuse. They knew how to report concerns and were confident any concerns reported would be investigated and dealt with.

People felt safe because individual and environmental risks were assessed and reduced as much as possible.

People received their medicines on time and in a safe way.

Robust recruitment checks were undertaken before staff and volunteers began to work for the service to ensure they were suitable to work with people.

Effective

Outstanding

Updated 3 September 2016

The service was effective.

People, relatives and healthcare professionals consistently praised the excellent standards of care, treatment and support provided by hospice staff

People received excellent care, based on best practice from experienced staff with the knowledge, skills and competencies to support their complex health needs.

People benefitted from pioneering pain relief treatment and the hospice had been awarded a prize for innovation.

Staff had an excellent understanding of their responsibilities in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People had access to high quality food and drink, for as long as they were able and wished to.

Caring

Outstanding

Updated 3 September 2016

The service is caring.

People and relatives said staff developed exceptionally caring and compassionate relationships with them. People mattered and staff went over and above their role to provide exceptional care for each person.

The ethos of care was person-centred and valued each person as an individual. Staff were exceptionally skilled at helping people to express their views and communicated with them in ways they could understand.

People�s emotional and spiritual needs were met by staff who showed empathy and were confident to care for and comfort them.

People having end of life care were kept peaceful, and pain free. Families and those that mattered to the person were supported to spend quality time with them.

Bereavement services were tailored to people�s individual needs and supported loved ones to come to terms with their loss after the person�s death.

Responsive

Outstanding

Updated 3 September 2016

The service is responsive.

People received exceptionally personalised care that responded to their individual needs.

Staff worked with each person in innovative ways to improve their quality of life and maintain their independence.

People�s care and support was planned proactively in partnership with them.

The service had a complaints process and written information about how to complain. No complaints had been received in the past 12 months.

Well-led

Outstanding

Updated 3 September 2016

The service is well led.

People, staff and external professionals gave us exceptionally positive feedback about the excellent quality of end of life care at the hospice.

The leadership team promoted strong values of person-centred care and worked in partnership with other organisations providing high quality, evidence based end of life care for the people of Cornwall.

The leadership team promoted an open and positive culture that placed people and staff at the centre of the service.

People, relatives and staff views were sought, and their suggestions and ideas were implemented.

The service had a range of quality monitoring systems to monitor the quality of people�s care and the environment. Staff continuously made improvements in response to their findings.

Checks on specific services

Hospice services for adults

Updated 29 November 2018

The hospice provided care and treatment to patients 18 years and

older with a life limiting condition.

The hospice was managed by Cornwall Hospice Care Limited who

also provided services at a hospice located in St Austell.

Staff were mainly based at this hospice but could work across

both sites when required.

We regulate hospice services but we do not currently have a legal duty

to rate them when they are inspected

as a focussed inspection. We highlight good practice and issues service

providers need to improve and take regulatory action as necessary.

We

inspected the safe and well led domains as part of this focussed inspection.