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Inspection report

Date of Inspection: 19 December 2013
Date of Publication: 17 January 2014
Inspection Report published 17 January 2014 PDF | 89.35 KB

People should be treated with respect, involved in discussions about their care and treatment and able to influence how the service is run (outcome 1)

Meeting this standard

We checked that people who use this service

  • Understand the care, treatment and support choices available to them.
  • Can express their views, so far as they are able to do so, and are involved in making decisions about their care, treatment and support.
  • Have their privacy, dignity and independence respected.
  • Have their views and experiences taken into account in the way the service is provided and delivered.

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 19 December 2013, observed how people were being cared for and talked with people who use the service. We talked with carers and / or family members and talked with staff.

Our judgement

People's privacy, dignity and independence were respected. People's views were taken into account in the way the service was provided and delivered in relation to their care.

Reasons for our judgement

Having considered all the available evidence we found that the service could demonstrate that people were respected and involved in decisions that related to their care and support and the way they spend their time at the location.

We spoke to people who visited the hospice, family members, staff, the head of care and the chief executive. People visiting the hospice and relatives told us the service was "brilliant" and staff were "wonderful, my saving grace."

Cotswold Care Hospice provides day services which includes day therapy/out patients, counselling and bereavement support and Hospice at Home service. The day therapy service can include for example, physiotherapy, counselling, complementary therapy and pastoral care. People who wish to use the day service can either self-refer or be referred by their health professionals, families or relatives. Hospice at home provides support and care to people who wish to spend their remaining days at home and referrals are made by healthcare professionals.

After the referral to the day service, people were invited to attend and complete an assessment which included an outline of their present illness, their medical history and physical issues for example, mobility, breathing or eating and drinking. When people's needs are met by the hospice they are invited to attend a twelve week session where they meet with their key worker and work towards their discussed goals. This meant that people were given an informed choice and the opportunity to decide whether they were happy with what the service had to offer. The people we spoke with told us they felt that they were able to express and have their views listened to. People told us they found it was helpful to have a key worker as they had a "point of contact" and it was "someone who knew them" and who they could speak to with any concerns they may have. One person told us that the hospice provided "continuity" which was" what they needed."

The hospice used a computerised system for all their paperwork and we looked at four people's records. We saw the information from the initial assessment had been input onto the system together with copy letters for example, the letter inviting participation to the day therapy and the confirmation letter. The hospice at home's system differed in as much as the assessment was completed by the health professional and not the provider. We looked at three records and noted that each had an assessment in the form of a pen picture which outlined people's personal details, their diagnosis and medical and physical needs.

During our visit we observed people being discreetly supported by staff during lunch which allowed them to make an informed choice which promoted their independence and autonomy. Relatives informed us that they were able to take part in decisions regarding the care and treatment of their family and that they had also used the service of the hospice for example, reflexology sessions which they found really helpful. We saw a sample of the care plans and noted that they incorporated an action plan for the person to achieve during their twelve week sessions. We saw that the care plans were comprehensive and included the person's dignity and choice. We found that the care and action plans were reviewed at six weeks and prior to discharge from the twelve week sessions. We saw evidence within the records of people's involvement in the reviews.

People's diversity, values and human rights were respected. We observed staff discreetly asking people if they required assistance with their personal needs. We saw from the daily records checked that staff attended to people's needs and wishes as identified in their care plans, action plans and care assessments.

During our visit we observed people participating in an "art therapy" session." We observed people becoming involved and noted good interactions with staff encouraging people's social skills. We were informed that pupils from the local school an