Teesside Hospice Care Foundation

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Patients received care and support that was exceptionally compassionate and kind.

Staff cared for patients and loved ones in a way that exceeded expectations and fully respected their privacy and dignity. Staff demonstrated genuine empathy for the patients cared for and their loved ones. Feedback was consistently highly positive.

Staff went to great lengths to make sure that patients’ needs, views, wishes and comfort were their utmost priority. They went above and beyond to anticipate patients’ needs and take steps to ensure preventable discomfort, concern or distress for patients.

At our last inspection we rated this key question good. At this inspection, the rating has changed to outstanding.

This service scored 95 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The evidence showed an exceptional standard. The service was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

Feedback given by patients and their loved ones was overwhelmingly positive. For example, patient experience feedback for the previous year demonstrated 100% of Wellbeing Centre patients felt they were treated with dignity and respect. Feedback evidenced the high standard of compassion and care provided by staff. Feedback often included comments about staff throughout the service, for example, but not limited to, housekeeping, kitchen, AHP’s, senior leaders, nursing and medical staff. “The nurses, the cleaners, everybody that works within the unit – they’ve just got time for you, nothing is too much bother.” We saw all interactions were meaningful and time was taken over each interaction.

All staff regardless of role consistently showed kindness, compassion and warmth in their interactions with patients and their loved ones. Staff were discreet, respectful and responsive, providing patients and their loved ones with help, emotional support and advice at the time they needed it. We heard people who had been fearful of going to the hospice describe how very quickly they had been offered exceptional kindness and compassion whilst receiving individualised care and support. They described feeling they had made the best decision in going to the hospice. For example, we heard children’s fears of visiting their father had gone away because all family members were treated with equal kindness, compassion and dignity.

Staff routinely used individualised approaches to support patients and their loved ones to understand and manage their care, treatment or condition. Staff told us they would adapt communication styles or work at a person’s own pace taking verbal and non-verbal cues from people, alongside taking a lead from those such as family members who knew the patient best.

Privacy and dignity were embedded into everyday practice by all staff. Staff sought permission before entering rooms and used dignity curtains within each room. These had been provided following some feedback. The curtains allowed for people to have the door open to feel less isolated but to have a curtain pulled across the doorway to allow for privacy. ‘Do not disturb’ preferences were respected. For Muslim families, there were notices that could be placed on doors to respect prayer times. Patient feedback included comments such as ‘They have this amazing way of giving you 110% hands on care but equally giving you the same amount of privacy. It was remarkable right through until the very end…”

The high standard of care continued after death. Staff placed a candle on the nurse’s station along with a plaque to signify a death. This provided opportunity for a time to reflect and also provided a means of communication that was sensitive to all staff, patients and visitors to the unit.

Confidentiality of information about patients was consistently maintained and care was taken to ensure doors and windows were not open where others might overhear conversations.

Staff understood the individual needs of people and their loved ones and worked as a team to ensure shared understanding. For example, the team recognised when people needed time to adjust at the beginning of an admission and would allow this time. The team communicated well to ensure all staff were aware of individuals preferences.

We heard HCA’s were leading on an innovative approach to ensure a person’s voice was not lost beyond their death. This was called ‘Feather Bed Tales’ and allowed family members to record messages that could be kept forever. For example, this had been used for one person with motor neurone disease and had received positive feedback. Staff were receiving training to use this approach and regular support from the external company that had created the approach. Laminated cards had been placed in each bedroom about it within the IPU for people’s awareness of the project.

Staff understood and respected the totality of individual needs of patients. They always took personal, cultural, social and religious needs into account and found ways to meet them. Staff told us they would spend time understanding people’s goals and find ways to adapt or find innovative versions of what they wanted to do. For example, a Hawaiian surprise party with friends for a younger person who should have been going to Ibiza but was unable to do so.

Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients without fear of the consequences should the need arise.

The evidence showed a good standard. The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service treated each patient as a unique individual by adapting care to meet each person’s individual needs including where there were protected characteristics. This extended to the needs of each persons loved ones, including children. For example, normal routines, strengths and abilities, hobbies and interests were all taken into account when a person’s care was being planned. One example included wi-fi provision to enable family members to work from the hospice, so they did not need to leave their loved one.

Staff were fully committed to working with patients and their loved ones to support them to be active and equal partners in their care. This started from the beginning of the journey with referral to the wellbeing and community team. The team were able to in-reach to the local hospital through face-to-face contact on a regular basis, where possible twice weekly, and through phone calls daily. This enabled the team to begin to form relationships and determine individuals wishes early.

At the point of referral staff routinely ensured patients and their loved ones were given information they needed. Loved ones were provided with their own individualised care options such as complementary therapies.

Patients and loved ones were able to make their room in the hospice their own space for the time they were there. For example, one couple had taken in blankets, cushions and lamps from home and set up the room as a home from home environment. People told us they were free to make themselves at home and access the sitting room areas or make hot drinks as they chose to do so.

Staff ensured that patients had information on treatment options and considered the much wider social needs. There was a social worker available to support people with wills, benefits and other financial or practical matters. The team worked together to promote hope in the most appropriate way for each individual.

For those accessing the in-patient unit, patients were able to make their own food choices using a home from home approach. Meals were tailored through individual conversations with catering staff to meet individual preferences and cultural needs. Allergies and intolerances were taken into account. Food was adapted to meet needs such as swallowing difficulties.

Staff considered family’s needs including those of children, for example, colouring sheets were provided based on staff knowledge and understanding of children’s interests, likes and dislikes.

Pets were allowed to visit people within the hospice following a risk assessed process. We heard there had been a number of visits to the hospice from donkeys where this had been identified as an individual wish.

Staff ensured that patients had access to appropriate spiritual support. Spiritual needs were explicitly discussed with each individual and preferences shared and reviewed to ensure a joined-up approach for each individual. Staff told us they had begun to work more closely with the local Imam on understanding the more diverse needs of the local population. This was in response to an increased level of access by the local Muslim population.

The evidence showed an exceptional standard. The service was exceptional at promoting people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

The hospice team prioritised people’s individual wishes and made consistent efforts to facilitate them. Routine practice was to empower patients and loved ones to make their own decisions, ensuring an exceptional approach to promoting independence. The right to take risks to maintain independence and choice was balanced with patient safety. Risks were fully explained and detailed conversations took place regarding decision making. Documentation was completed to evidence the thorough discussions around balancing risks and individual choices. For example, one individual had wanted to eat solid food whilst PEG fed. PEG feeding is Percutaneous Endoscopic Gastrostomy Feeding that allows liquids to be delivered through the stomach where people cannot always swallow safely and receive the oral intake of nutrients required.

Staff took time to communicate with and listen to people where communication was challenging, for example when a tracheostomy was in place.

The hospice environment and schedules could be adapted to meet individual needs allowing for maintenance of independence. For example, each bedroom had direct access to a garden area. There were a number of social spaces and lounges both on the unit and in the wellbeing centre. Patients and loved ones could choose the environment where they wished to spend time. This included child-friendly spaces, large screen televisions for events such as watching football matches as a group, a billiard table and an area that could be set up as a bar space.

Inpatients were able to have loved ones stay overnight in their room on beds provided and depending upon preference there were two cuddle beds available for couples. The handover board in the MDT room included a section for ‘who matters to you’.

Preferred place of death was discussed and documented for each individual patient, within a comprehensive and thorough documentation of individual wishes. Audit results demonstrated consistent scores of 100%.

Allied health professionals worked with individuals across community, wellbeing and inpatient services to provide coping strategies to maximise independence. There was a clear focus on maintaining health and wellbeing for as long as possible, to ensure the best possible quality of life. This included considering additional activities for longer stay hospice patients to reduce risks associated with inactivity. For example, we heard about a horticulture approach to bringing the outdoors in. Work was being undertaken to provide cutting patches in the garden for patients with lower energy who could then make flower arrangements or wreaths indoors using cuttings from plants outdoors. Fatigue management and anxiety management techniques were taught. Equipment was available to promote independence at home.

Staff took time to support patients and their loved ones to make memories. Family members told us they had made lots of memories during their time at the hospice. For example, one staff member had taken time to make a clay mould of a husband and wife’s hands together for a lasting memory. There was a post box available for patients to write letters to their loved ones.

We heard of one example where a person had wanted to live independently in their own accommodation at a time when they were very unwell. The team had worked to support the person to secure a flat close to the hospice. The person was able to use the hospice support to find the strength to furnish and arrange the flat in a way they wanted. They were able to have one night in the flat and achieve their goal of living independently.

The evidence showed an exceptional standard. The service was exceptional in how they listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Responding to patients needs and those of their loved ones was embedded as a priority in the culture of the hospice. We observed multi-disciplinary meetings that demonstrated a whole team approach to ensuring all needs were responded to in a timely way. Needs of loved ones were explicitly addressed during these meetings. For example, we heard a discussion surrounding the removal of intrusive equipment from a person’s house in a timely and sensitive way for the whole family.

A call bell system was installed on the in-patient unit that linked to staff mobile phone devices. Named nurses could immediately see where a call had come from and were able to respond promptly to minimise any distress. Staff could respond by speaking to people directly through the call bell system. One family member told us that staff were always on hand to respond to needs and if they could not complete a task immediately, they would still respond to acknowledge the call and say how long they would be. Other feedback included comments such as “You just press that buzzer and they’ll be here”.

Staff placed emphasis on the importance of managing pain and recognised that families did not want to remember the end of their loved one’s life as one where pain and discomfort was experienced. The highly effective MDT working and single nurse administrator processes meant symptom control medications were available promptly.

Changing risks and needs were routinely anticipated by staff. This meant staff could work with patients and loved ones to plan for proactive and responsive changes to care provision. Patients described feeling safe and cared for. People experienced this as being able to have peace at a time when it was most needed.

In clinic and wellbeing areas there were private spaces available should people require it. Reception staff or volunteer group facilitators were always on hand to offer support.

Responding to needs extended beyond clinical need. For example, staff were skilled in recognising anticipatory grief. The relationships staff formed with the whole family allowed them to respond to needs immediately. Anticipatory grief work was available through the counselling service at a time when it was needed. We heard examples of dedication towards responding to sensory needs regardless of the stage of dying. For example, staff had access to complementary therapies and could use a range of smells for sensory experiences.

Staff supported people to access spiritual support at a time when it was most wanted. The thorough individualised assessments and detailed MDT conversations ensured that appropriate pastoral and spiritual support, for example a priest, could be called at an appropriate time.

Emotional support and companionship were offered by all members of the team including housekeeping and catering staff. No interaction was rushed and all staff made themselves available for meaningful conversation. One staff member told us staff did not realise how much they went above and beyond on a regular basis in their routine day to day care.

We observed MDT discussion evidencing consideration of the most appropriate room for each individual, for example, plans to move a patient to a larger room when available to accommodate for family with children visiting.

Thorough assessment processes ensured staff were aware of and dealt with any specific risk issues, such as falls or pressure ulcers and care planned for these accordingly. Assessments began in people’s own homes or hospital depending upon the location of the patient.

The in-patient unit was set out to support staff to respond quickly to needs, for example beside each bedroom there was a store cupboard of necessary equipment such as dressings. Each store cupboard was set out in a uniform way enabling staff to quickly find needed equipment.

The evidence showed an exceptional standard. The service always cared about and promoted the wellbeing of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care.

Staff told us they felt positive and proud about working within the hospice and to ‘be able to make a difference to someone’s last days of life’. We consistently heard staff speak passionately about the work they did, stating they ‘enjoyed their job’, ‘it was not a chore to come to work’ and ‘patients and safety are the foundation’. Staff were supported to bring their own experiences in a positive way to enable them to deliver person centred care.

All staff we spoke with told us they felt respected, supported and valued. This included kitchen, estates, domestic, HCA, nursing, AHP and medical staff as well as leaders. All staff we asked told us they felt their opinions and suggestions were valued and respected. We observed interactions and MDT meetings and saw that all staff regardless of role received equal respect and were able to input into the care of patients and their loved ones.

All staff we spoke with recognised the challenges of working within the hospice environment and how staff would have their own individual responses to working with patients and their families depending upon any one set of circumstances. Staff told us they consistently worked well as a team to support each other’s wellbeing. Staff would allow others the time they needed and were responsive to changes in each other’s wellbeing.

Staff told us they did not need formalised systems to support wellbeing because of the positive team working approach and ability to recognise and respond to changing circumstances. However, processes were in place, and support was available on a regular more formalised basis. For example, there was a monthly meeting for sharing experiences of all deaths over the previous month. This allowed for sharing of positive and negative thoughts and reflections. This also supported all staff to feel valued and to celebrate their input.

Debriefs took place following incidents such as catastrophic bleeds or seizures. The team told us the debrief often didn’t feel formal due to a very open and comfortable relationship. The team were committed to providing evidence-based support and debrief processes for staff. For example, the team were actively involved in a research trial looking at a resilience-based approach to improve mental wellbeing in staff caring for terminally ill people and their caregivers.

Staff could also access optional 15-minute pause and reflect sessions. Some staff were trained as mental health first aiders.

Staff had access to support and counselling for their own physical and emotional health needs through an occupational health service. In addition, a focussed staff wellbeing survey had been carried out in early 2026 with actions from the findings including a mental health talk for staff, menopause advice, introduction of a ‘little book of Wellbeing’ and weekly lunchtime walks.

The service had achieved silver for the Better Health at Work award and were aiming to achieve gold in 2026.

Staff had access to a range of spaces within the hospice environment. These included the staff room close to senior leaders who made themselves available regularly. Staff could also access other comfortable spaces throughout the ground floor, garden areas and within the counselling building as they needed.

The provider recognised staff success within the service, for example, through long service awards, team shout outs and away days. Each member of staff was also individually recognised on their birthday.

Regular appraisals and 1:1 discussion supported staff wellbeing. Staff appraisals included conversations about career development and how it could be supported. Each individual staff member had their own training budget to access training that was relevant to their role and development goals.