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Inspection report

Date of Inspection: 20 March 2013
Date of Publication: 9 April 2013
Inspection Report published 9 April 2013 PDF | 89.05 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 looked at the personal care or treatment records of people who use the service, carried out a visit on 20 March 2013, talked with people who use the service and talked with carers and / or family members. We talked with staff.

Our judgement

People experienced care, treatment and support that met their needs and protected their rights.

Reasons for our judgement

Cotswold care worked in partnership with a range of NHS providers to offer specialist care and provided space to enable these visiting services.

When a referral was received people’s needs were assessed and they were provided a service according to criteria that assessed their level of priority. People we spoke with said they did not have to wait long between referral and being assessed for a service.

The assessment of wellbeing tool was used to record how people felt about their illness and identified their personal goals. We saw care plans that recorded concerns and described the issues people had. They identified what help was already available and indicated the support to be provided by the service and set a date for review.

People were also assessed against a performance scale index (Karnofsky). This allowed them to be classified according to their functional impairment with the lowest scale being the worse for survival of an illness.

Cotswold Care provided a range of services including day therapy, an out-patient therapy service and ‘Hospice at Home’. We saw that once assessment was completed people were sent a letter to confirm the service that had been agreed.

Day therapy was available on three days each week. People attended one day each week for up to 12 weeks. Their attendance was reviewed at the 10 week stage. This was to consider whether people had been sufficiently supported and therapy could be extended following the review, if necessary.

Day therapy included nursing care, physiotherapy, counselling, pastoral care complementary therapy and creative therapy. People were allocated a ‘key worker’ to coordinate their care and act as a point of contact for them. Each time people attended for day therapy they would spend time with their key worker who would later record the discussion they had about the person’s well being.

Counselling was provided in one of the dedicated rooms at the hospice. This was to support people when they had been diagnosed with a life limiting illness and for their families when they were bereaved. The service employed two counsellors and there were specially trained ‘bereavement volunteers’ to support people. Counsellors were registered with the British Association for Counsellors and Psychotherapists. Guidelines produced by the National Institute for Clinical Excellence (NICE) were used to gauge whether people could be supported by the service. Counsellors could support people up to a certain level. If they were considered to need specialist mental health services they were referred to the NHS for support.

In addition to face to face meetings with a councillor there were opportunities for people or their families to join group sessions in the ‘Sanctuary’. These included bereavement counselling. A leaflet was made available to people who were in ‘grief’. The intention of the information was for anyone who had been bereaved and gave guidance to help people understand how they were feeling.

The manager told us that people were encouraged to consider ‘advanced care planning’ for the period leading up to point of their death and beyond.

Complimentary therapies such as Reiki, reflexology, aromatherapy massage and art therapy were provided at the hospice. There were dedicated treatment rooms for Reiki and aromatherapy along with the ‘creative space’. One of the therapy rooms had a specialist couch to enable treatments for larger people (Bariatric).

We saw the range of art people achieved during their time in the ‘Art for Health’ group. This included drawing, painting, pottery, glass craft and silk painting. We looked at the care file for one person who attended the group. When a review had taken place the therapist had recorded the person “said he feels his counselling sessions have helped and he understands himself a lot better. He feels ‘more free’ and more able to have fun with art”. The chief executive told us that art therapy provided people with a focus for the future and enable