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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

Staff should be properly trained and supervised, and have the chance to develop and improve their skills (outcome 14)

Meeting this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by competent staff.

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 were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

Reasons for our judgement

We saw the records of ten staff members, five from the hospice day therapy team and five from hospice at home team.

The provider had an induction programmes in place which included a "departmental induction" which incorporated; values and strategic objectives, ethos, confidentiality and code of conduct, and a "role specific induction" programme which incorporated infection control and the use of personal protective equipment (PPE), fire procedures and the management of medicines. Staff who were employed to provide hospice at home care attended a three day "hospice at home induction programme" which included for example, lone working. We saw the induction followed a case study to support staff through the principles of palliative and end of life care. Staff were given a "palliative care competencies" booklet which they completed alongside their induction programme. The booklet was divided into three sections. Section one looked at "core competencies" for example, clinical practice which incorporated the "principles and practices of palliative care" and the "potential impact of bereavement on relatives and carers" as well as communication needs. Section two of the booklet covered staffs "personal learning and development plan" which outlined the competencies to be achieved and the agreed action plan. Section three was a "reflection on the practice" and looked at what staff did or didn't do well and what steps they could take to "make those improvements." Staff informed us they were assigned a mentor who supported and guided them until they were deemed competent to support people who use the service.

We saw the rota took into account work life balance. Hospice at home staff told us they worked four days on and four days off and had "time to spend with their families."

The provider had a rolling training programme and we saw that training for 2014 had been identified. The records showed that staff training was up to date with staff having covered a variety of topics including moving and handling and food hygiene as well as additional training for example, palliative care, stress awareness and person centred care. We were informed that some refresher training was provided via e-learning which included the Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act.

We looked at ten staff records, five from the hospice and five from "hospice at home." We noted that all staff within the hospice had received six monthly reviews but only one staff was identified as having a six monthly review within the hospice at home team. The head of care informed us they were aware of the shortfall and had recently had a "clinical supervision meeting" and were in discussion regarding the way forward. We saw a copy of the minutes which looked at "suggested routes for supervision" for example, whether to conduct group supervisions or to use an external agency. The records read identified staff completing and "appraisee preparation form" which asked them to reflect on for example, "what you consider as your strengths". We saw the form had been followed by a review with management. Topics covered included; communication skills and quality of work which identified objectives and actions. Staff we spoke with confirmed they had received appraisals and new staff said they had met with their mentor during their induction period. Staff said that the chief executive had an "open door policy" and they were able to "discuss anything."

Staff meetings took place regularly to discuss any concerns. Topics discussed centred around the people who use the service. The chief executive informed us they also had an open house policy at staff meetings to discuss any other related concern. Staff we spoke with told us they were aware of the minutes of the staff meeting and the actions identified. This meant the provider had suitable arrangements in place to ensure that staff received appropriate training, professional development, supervisions and appraisals.