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Inspection report

Date of Inspection: 9 February 2012
Date of Publication: 2 March 2012
Inspection Report published 2 March 2012 PDF | 53.28 KB

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We reviewed all the information we hold about this provider, carried out a visit on 09/02/2012, checked the provider's records, observed how people were being cared for, looked at records of people who use services, talked to staff and talked to people who use services.

Our judgement

People who come to Cotswold Care Hospice receive care, treatment and support that is effective, safe and appropriate. People's needs are assessed and care is planned to meet these needs.

Overall, we found that Cotswold Care Hospice was meeting this essential standard.

User experience

We met and talked with seven people who were at Cotswold Care Hospice for treatment, support and care on the day of our visit. We asked them about their experience of care at the service. People told us that the hospice had "surpassed expectations" and "when I came here, everything seemed to fall into place". One person who we met in the art therapy room said of the service "it's been a life saver." One person said that the counselling service was "excellent" and "the nursing and care staff are always on hand and so well trained in what they do". We were told that staff were "so kind" and "really know what's important to me now." One person said "as soon as I walked through the door I was a person, an individual."

We observed care and support and found staff to be warm, kind, considerate and respectful to people. Staff demonstrated a good knowledge of the people at the service on the day of our visit and appeared to know them well. We observed lunchtime and saw that staff were encouraging and patient-centred. We met with the chef who took time with people to see what they liked to eat and drink. People told us that the food was "wonderful" and "it's so nice to be looked after so warmly". One person who had varying degrees of difficultly with eating told us that the chef always asked them how their ability to eat was each time they visited, and adapted the food accordingly.

We spent some time in the art therapy suite with patients and staff. People said that the art therapy was something that they "looked forward to more than anything else". One person said that although they had previously had no experience with arts and crafts that they were encouraged to try new things. We heard that "no one minds in the slightest if you are no good at something, but it's great therapy and takes my mind off everything else". People were very proud of the work that they had done, some of which was displayed around the walls.

People told us about the treatment and other therapy that they had received. We were told that staff were "very well trained" and "there's nothing that the nursing staff don't know". We were told that the physiotherapy had "helped me a lot". People said they were assessed before they came to the hospice. They said that staff made sure that before providing treatment that people felt well enough and that the treatment would be beneficial. People said that if, during their stay, they felt that physiotherapy or another therapy might help, they could book in for a session at any time.

We were told that people had a key-worker who was generally the person that managed their care. We heard that people found this "comforting" and "important" to them. People said that when they were at the 10th week of their programme that they had a review with key staff and, if possible, their family or carer, to decide on the next steps.

Other evidence

We talked with staff about the care and treatment provided to people. Staff told us that they felt that the people who came to the hospice, or those people that the staff looked after in their homes, received good care. We asked staff what evidence they had that they were providing good care. Staff told us that they received verbal comments from people, and many letters and 'thank you' cards.

We asked staff how they knew what patients needed and how to meet those needs. Staff said that all patients who come to the service or use the service at home were assessed. This assessment detailed their past history, family and personal circumstances, living arrangements, and current illness. The assessment recorded people's needs and enabled staff to determine what the hospice could offer to the person. The assessment also determined if the hospice and staff were able to meet that person's needs and expectations taking all risks into account.

We looked at five sets of care records. We saw that the records only contained information that was relevant to the person's stay at the hospice, or the period when they were being supported at home. The assessments were comprehensive and included appropriate and important information. This included contact numbers for next of kin, medications being taken, allergies and intolerances and any physical limitations.

People had care plans for their support at the hospice or at home. We saw that the care records assessed people's wellbeing and action plans to improve this if or where necessary. There were risk assessments for people to ensure that they were able to be cared for safely when coming to the service or at home. People had been asked to consent to their care and consent to any information being shared with other healthcare professionals, such as their GP, as necessary.

We were told by the head of care services that the service would provide advocacy for patients if they were no longer able to speak for themselves. The service followed the Liverpool Care Pathway for palliative care. The service therefore aimed for its multi-disciplinary team to be continuous and consistent in their approach. This included anticipatory prescribing of drugs and the options available to the patient such as the removal of non-essential medications and treatments.

We observed a multi-disciplinary feedback session at the end of the day of our visit. We heard staff refer to people who they seemed to know well and showed an understanding of their needs. Staff also referred to other non physical aspects of the person's life, such as problems at home with heating or noise. Staff offered solutions or support to be suggested to the person.