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Phyllis Tuckwell Hospice Good

Inspection Summary


Overall summary & rating

Good

Updated 19 October 2016

This inspection took place on 19 and 20 July 2016 and was unannounced. The last comprehensive inspection of Phyllis Tuckwell Hospice had taken place in November 2013 and was followed by a focused desk-based inspection in July 2014. During the inspection in 2013 we had found out that not all of staff caring for people had been supported to deliver care and treatment safely and to an appropriate standard. At the inspection in 2014 we found out that the provider had addressed our concerns and met all the required standards.

Phyllis Tuckwell Hospice provides palliative and end-of-life care, advice and clinical support for adults with life-limiting illnesses, their families and carers. The hospice delivers physical, emotional and holistic care with the aid of teams of nurses, doctors, counsellors, chaplains and other professionals including therapists. The hospice runs an 18 beds in-patient unit and accepts admissions for end-of-life care, symptom control and respite care. At the time of our inspection 17 people were in the unit. The hospice also provides community services designed to support people in their own homes. The hospice’s day service welcomes up to approximately 42 people per week and was being used by 10 people during our inspection.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow to make sure people were protected from harm.

People and their relatives told us they were very satisfied with the care. We saw that people were treated with dignity, respect and compassion. People were involved in the planning of their care which meant their care preferences and choices were identified so that they could be met by staff.

Accidents and incidents were recorded and monitored to identify how the risks of their recurrence could be prevented.

Medicines were safely stored and those requiring refrigeration were stored within their recommended temperature range. Nurses recorded the administration of medicines on prescription charts including prescribed creams applied by care workers. Staff had the skills to effectively manage people's medicines so these were available and administered safely to people.

Staff and volunteers had been suitably recruited and there were sufficient staff with a variety of skills to meet people's individual needs and to respond flexibly to changes.

People were supported by sufficient numbers of staff to provide care and support in accordance with the individual needs of people. There was a flexible approach to adjusting the levels of staff required. People who were receiving care in the in-patient unit told us the staffing numbers were appropriate and assistance was provided promptly when requested.

Staff received the training and support they needed and were highly motivated to undertake their roles and deliver sustained high quality care. People were extremely confident and positive about the abilities of staff to meet their individual needs.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least rest

Inspection areas

Safe

Good

Updated 19 October 2016

The service was safe.

People were protected against the risks associated with medicines. The provider had appropriate arrangements in place to manage people's medicines safely.

Potential risks to people were assessed and measures were put in place to reduce these risks. Where accidents or incidents had occurred, these had been analysed and learning was shared amongst staff to prevent reoccurrence.

Robust recruitment processes for new staff ensured they were suitable to work with vulnerable people. These checks were also carried out for volunteers.

Effective

Good

Updated 19 October 2016

The service was effective.

People received support and care from the staff team who were well-trained and used their knowledge and skills to meet people`s needs effectively.

Staff followed the principles of the Mental Capacity Act (2005) for people who lacked capacity to make their own decisions. People's capacity to make decisions and give consent was assessed and recorded.

Staff encouraged and supported people to have a balanced diet that met their individual needs and professional advice was sought if people�s eating and drinking abilities deteriorated. The hospice environment met the specialist needs of people who used the service.

Caring

Good

Updated 19 October 2016

The service was caring.

People were treated with care and compassion. Staff respected people and their choices and they promoted people�s privacy and dignity.

People were consulted about and fully involved in their care and treatment. The service was very flexible and responded quickly to people's changing needs or wishes.

Staff supported the emotional well-being of people and their relatives with end-of-life care being provided with sensitivity and compassion. The care people received enabled them to experience a comfortable, dignified and pain-free death.

Responsive

Good

Updated 19 October 2016

The service was responsive.

People and their families were fully involved in assessing and reviewing their needs and planning how their care should be provided. This included their wishes and priorities regarding their end-of-life care.

The service sought feedback from the people who use the service, their families and the community to monitor and improve the quality of care.

Information about how to make a complaint was available and people were able to raise concerns easily. When complaints had been received, they were used to learn lessons and drive improvements in the service.

Well-led

Good

Updated 19 October 2016

The service was well-led.

The registered manager gave strong and effective leadership and provided a clear strategy for the long term development of the service to its staff and the wider community.

Staff felt supported, valued and included in making decisions about how the service was run.

We saw a number of quality assurance systems and audits to monitor performance and to drive continuous improvement.

We found that the hospice worked in partnership with other organisations at regional and national level which helped the service make continuous improvements to the quality of care.