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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 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 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

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Reasons for our judgement

Overall from the evidence we reviewed we found that people were supported and assisted to have their needs met in a manner which ensured their safety and well-being.

Cotswold care works in partnership with a range of NHS providers to offer specialist care at the hospice and via the Hospice at Home service. When a referral was received people's needs were assessed and people were provided a service according to their level of priority and placed on a waiting list. People told us that it was a "marvellous place to come to" and said staff were "amazing" and that they "hadn't waited very long" to access the service.

People had an assessment which included their contact details, medical history, current illness, physical and psychological issues which included people's coping strategies. People attended day therapy once a week for up to a three month period. We observed that people's care and treatments were planned and delivered in line with their individual care/action plan. The information contained within the assessment enabled staff to support people's individual needs. Staff who delivered hospice at home care told us they had available all the information needed for their role. Staff told us that it was very important to have details of people's history as it provided them with all the "information needed to do their job" and also it helped them to "chat" with people.

The seven records we read detailed what care and support was needed and how it should be given. We noted the care/action plans were linked to the initial assessment which identified people's anxiety and concerns. The assessment of wellbeing tool was used to assess people's thoughts when accessing day therapy. People were asked to assess if they had these thoughts; never, rarely sometimes and frequently which enabled staff to support people at an appropriate level. We noted staff approached people courteously and with respect. People we spoke with at the hospice told us they were involved in the paperwork and were able to discuss anything with their assigned key worker. People had a review of their needs after six weeks which looked at their care/action plans and a further review prior to discharge. The records showed the care/action plans were regularly reviewed and updated. We found the care plans we read ensured the rights of the individuals to take informed risks were addressed. The seven records we read detailed what care and support was needed and how it should be given. We saw comprehensive risk assessments in place which identified the hazards and the support required. We found the risk assessments provided comprehensive guidelines for staff to follow. This meant that staff had the relevant information to understand and meet people's needs.

The hospice had a range of complementary therapies for example, reflexology, reiki and massages. We saw a collage which had been created by people who use the service and the local junior school. The head of care informed us that pupils from the school and people who attended the hospice worked closely together and the experience had provided a good insight to pupils about hospice care. On the day of our visit the staff had arranged a carol service during people's lunch time and we saw people singing and appearing to enjoy the entertainment.

Day therapy staff completed a de-brief handover twice a day. The morning handover meeting identified who was looking after whom and discussed the needs of people who were visiting for the day. The afternoon handover highlighted how people had got on throughout the day. The volunteers who worked at the hospice attended a morning meeting which identified any specific information for example, a person who may have mobility issues.

The records for those who used "hospice at home" service included the referral completed by the health care professional, which outlined people's personal details, medical condition and care needs. Care plans and risk assessments were in place and were