St Michael's Hospice (North Hampshire)

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

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question as outstanding. At this assessment the rating has remained outstanding. This meant people were truly respected and valued as individuals and empowered as partners in their care.

The service delivered an exceptional standard of care by treating every individual with profound kindness, empathy, and compassion. Staff always prioritised the dignity and privacy of patients and extended this respectful approach to families, deceased loved ones, and external colleagues. By fostering a culture that valued personal wishes and emotional wellbeing, the team ensured that everyone felt safe, understood, and deeply cared for.

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 service demonstrated exceptional kindness and a commitment to dignity by fulfilling personal and spiritual wishes of patients and their families. Staff celebrated patient birthdays with personalised cakes and worked together to facilitate life events under time-critical circumstances. For example, when a patient’s final wish was to attend their daughter's wedding, the chaplain and clinical team coordinated with authorities to secure a wedding license, enabling the ceremony to take place at the hospice just one day before the patient passed away. Similarly, the chaplain ensured another patient’s funeral was conducted with compassion by timing a specific piece of music to meet their request. These actions moved beyond standard clinical care and helped to provide families with lasting comfort during difficult moments.

Staff integrated dignity and respect into every stage of the patient journey, ensuring people felt valued and in control. We observed consistently respectful interactions where staff engaged patients in meaningful, well-informed conversations. In one instance, a nurse who overheard a couple discussing a Valentine’s date surprised them with a bouquet of flowers to make their evening special. These thoughtful gestures helped ensure that bereaved relatives experienced a peaceful, respectful environment where high levels of patient satisfaction were consistently recorded and families described staff as “warm, kind, and professional.” We spoke with 3 patients who stated they could not fault the staff in any way and felt safe and looked after.

The service created an inclusive culture of compassion by considering the emotional and spiritual wellbeing of the entire family unit, including children. They provided specialist bereavement support through its ‘Meerkat’ service, which offered tailored interventions to help younger family members process grief and loss. To help reduce the emotional burden on caregivers, the hospice offered up to 6 free sessions of complementary therapies, such as reiki and massage, to both patients and relatives. This approach to caring helped to support families, including after the patients’ clinical needs had ended.

The hospice staff integrated dignity and respect into every stage of the patient journey, including after death. Staff protected the privacy of the deceased by closing doors and shutting blinds to other rooms while funeral directors were onsite. These actions helped to ensure bereaved relatives experienced a peaceful and respectful environment during a difficult transition.

The hospice staff welcomed families back after their loss, offering dedicated spaces and events to help them remember their loved ones. We saw a memorial wall for donation-led remembrance, and staff held community events like ‘Light up a life’ and ‘Summer Memories’ for anyone wishing to celebrate the life of a loved one. These events featured heartfelt services with readings and music, allowing the wider community to honour their loved ones regardless of whether they had received direct hospice care.

The service treated every patient as a unique person by putting their personal wishes and daily habits ahead of medical routines. Staff empowered patients to lead their own care plans, including the right to refuse treatments or manage their own medicine pumps. We observed this practice during a morning clinical meeting where patient choice was at the forefront of every medical decision. This approach helped to ensure that any medical decision was made in partnership with patients, and care was tailored to individual needs. Furthermore, staff rescheduled medicine rounds to support a patient’s sleep cycle and set a 3am alarm for another individual who wished to remain independent with their own care. These adjustments allowed patients to receive person-centred care that focused on their individual priorities.

Staff were committed to meeting individual needs and accommodated to daily habits to help patients feel at home. For example, patients could request specific meals, such as a full English breakfast, even if this was outside of standard kitchen hours. Staff also facilitated access to the hospice gardens for all patients, including in situations with significant mobility challenges.These small but important actions helped patients maintain their independence and ensured that the hospice environment adapted to the person, rather than the person adapting to the hospice.

The staff protected the social and emotional wellbeing of patients by treating their personal goals as essential care tasks. When one patient prepared for a family visit, the team coordinated an early doctor’s round, assisted with showering, and helped with hair and make-up. Staff purposely timed their visits to avoid interrupting these private family moments. By treating a social event with the same importance as a medical one, the staff enabled patients to focus on meaningful connections with loved ones.

The service tailored communication tools to value the diverse backgrounds of every individual. Staff could provide translators for families who did not speak English and used bedside whiteboards for patients to share their personal histories and preferences. This was particularly effective for patients with dementia, autism, or learning disabilities as it gave them a voice when they might otherwise have struggled to be heard. This level of detail helped to ensure that every person felt understood and respected as an individual.

The team used peer reviews to learn how environmental changes impacted the behaviour of vulnerable patients. In one instance, leaders identified that moving a patient with dementia to a new room had caused distress and altered their behaviour. By acknowledging that they had not initially appreciated the impact of this change, the staff turned the event into a learning opportunity to improve future care decisions. This reflective practice helped to ensure that the team became more sensitive to how the physical surroundings can affect an individual person.

The service provided patients with the specific tools and training they needed to manage their own lives for as long as possible. Occupational therapists visited patients’ homes to install necessary equipment, such as handrails and hoists. The ‘Living Well’ programme taught patients how to manage their breathing and tiredness through exercise. Patients and their relatives reported that having the right equipment and skills empowered them to feel more confident in their daily lives and they didn’t have to ask for help as often. This had a positive impact on their wellbeing.

The team adapted clinical schedules and environments to respect the unique habits of each person. For example, staff arranged a private afternoon tea in a family room so a patient could host guests in a comfortable, familiar way. Patients told us that being able to choose their daily routines helped them feel more relaxed. This flexibility meant patients retained control over their environment and continued to participate in activities that were important to them.

Staff balanced patient safety with the right to take risks to maintain a person’s independence and mobility. Staff told us a patient experiencing confusion and at risk of falling wanted to continue to use the bathroom independently. The team supported this choice by conducting hourly safety checks and used an alarmed falls mat to alert staff to movement. Family members were included in this plan (which was reviewed daily). This meant the patient was able to maintain their independence with what mattered to them, whilst remaining safe and allowed them to make their own choices.

The team made reasonable adjustments to support patients with complex needs to manage their own symptoms. When a patient with a learning disability struggled to communicate their pain levels, staff worked with a specialist nurse to create a visual tool using emoji-style faces. They also co-designed a pictorial flowchart that helped the patient recognise when they needed medication. These simple but creative adaptations gave this person greater independence, choice and control.

The service recognised that supporting a patient’s immediate needs required a holistic approach that included their family and caregivers. We observed handover meetings that explicitly addressed relative and carer stress, leading to practical actions like providing camp beds for family members who wanted to stay with their loved ones. Nurses also conducted pre-visit phone calls to check on the wellbeing of relatives at home. By supporting the emotional health of caregivers, the service helped to reduce the risk of family burnout during a crisis.

The service demonstrated an outstanding commitment to patient choice by actively removing clinical barriers to allow a patient to spend time with their family outside of the hospice. During our inspection, we spoke with a patient who wanted to spend the day away from the hospice to visit their family. To make this possible, staff responded quickly to enable this to happen by supplying additional medicines and providing a wheelchair to ensure the family could support them safely. By providing clear instructions on pain management and the necessary equipment at short notice, the team ensured the patient could have a meaningful day out without risking their physical comfort. This responsive approach significantly boosted the patient’s morale (as they told us how excited they were) and proved that their medical needs did not have to limit their personal freedom.

Staff maintained a monitoring system that ensured no physical or safety needs went unmet for long periods of time. We observed a 12 second call bell response time, and staff conducted 2 hourly checks using the Patient Assistance Chart to offer mouthcare and toileting. Staff used a ‘whiteboard at a glance’ to visually track whether a patient’s condition was stable or deteriorating. This level of attentiveness helped to prevent minor discomforts from escalating and gave patients the reassurance that help was always available quickly.

The service set up proactive medical protocols that allowed staff to react immediately to worsening symptoms or emergencies. We looked at medicine prescription charts and found doctors prescribed multiple PRN (as required) anticipatory medicines. This meant nurses could administer medicines the moment they saw a patient was uncomfortable, rather than having to call a doctor and wait for a new prescription. During the hospice’s daily meetings, the team identified the level of urgency for each referral, and the Hospice at Home team could respond to patient needs any time of the day or night. These measures helped to remove clinical delays, ensuring patients remained comfortable and safe regardless of the time of day or how quickly their condition changed.

The clinical team adapted their communication and care style to meet people’s specific emotional and personal needs. We observed nurses kneeling to eye level when talking with patients in both the Inpatient Unit and during a home visit and using simplified language to ensure patients remained the focus of the conversation. Similarly, when a patient could no longer swallow, staff switched medicine routes to accommodate this change. These personalised adjustments preserved patients’ dignity and ensured that care felt supportive and human rather than purely clinical.

The service adapted its clinical supervision and support models to meet the changing needs and schedules of the workforce. Leaders originally held closed supervision groups but opened them to all staff in March 2025 to increase flexibility. When attendance dropped, they launched an anonymous questionnaire and action plan to fix any barriers. The Clinical Director offered one to one meetings, enabling staff to speak privately and openly without the pressure of formal documentation. These adaptations ensured staff had a safe space for reflection, which helped reduce feelings of isolation and allowed colleagues to be heard and raise sensitive issues in a way that felt secure.

The service provided a safety net for staff’s mental health by offering professional resources and personal check-ins. Staff benefitted from an Employee Assistance Programme which provided a 24-hour advice line, legal guidance, and up to 6 sessions of face-to-face counselling or Cognitive Behavioural Therapy. Staff told us they could access free counselling services through 2 onsite counsellors. Additionally, managers ensured one to one supervision sessions occurred regularly. Staff reported leaders listened, and nurses highlighted feeling well supported by their managers. We observed staff appeared to be relaxed and happy. The environment was controlled and calm and staff told us they had enough time to provide care for patients.

The service used away days and collaborative sessions to reinforce a sense of pride and shared purpose among the team. The organisation hosted an away day featuring sessions on the Meerkat Services and patient case studies, which staff described as “inspiring” and the “best away day yet”. Colleagues also participated in ‘air and share’ sessions and used the Thrive Award monthly recognition scheme to celebrate their peers’ successes. The service offered specific programmes to keep staff healthy and balanced. This included the CIRCLE Lunchtime Group for doctors and special training sessions on how to handle work stress. These efforts, backed by a formal Wellbeing Policy, helped to ensure employees looked after themselves just as much as they looked after patients. This helped to boost staff morale, and staff told us they felt proud to work there and that they were making a difference.