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Compton Care Group Limited Good

Reports


Inspection carried out on 15 to 17 October 2019

During a routine inspection

Compton Care is operated by Compton Care Group Ltd. Compton Care provides specialist palliative care and support services for inpatients, outpatients and community care to people aged 18 years old and above. Services provided included:

An 18 bedded inpatient unit, which includes single rooms with en-suite facilities,

A lymphoedema care centre,

A bereavement care service,

A day therapies centre based at the Compton Hall site.

Most of the care is provided in the community within patient’s homes, care homes and prisons by a combined community service including a community specialist nursing team.

On-call palliative medicine advice is available 24 hours a day seven days a week to healthcare professionals who may be either in the community or in hospital within Wolverhampton, Dudley and Walsall.

Compton Care at Home provides practical support for end of life patients and their loved ones. A new rapid response service was in the early stages of implementation.

A range of social, physical, psychological and spiritual services provide a holistic experience for patients and psychological support is also extended to their carers and families.

We inspected all services provided by the service.

We inspected this service using our comprehensive inspection methodology. We visited unannounced on the 15 October 2019 followed by announced visits carried out on 16 and 17 October 2019.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Services we rate

Our rating of this service stayed the same. We rated it as Good overall.

  • Staff provided exceptional care and compassion and ensured patients privacy and dignity was maintained at all times.

  • The service made sure staff were competent for their roles. The continuing development of the staff’s skills, competence and knowledge was recognised as being integral to ensuring high-quality care. Staff were proactively supported and encouraged to acquire new skills, use their transferable skills, and share best practice. Volunteers were proactively recruited and were supported in their role. The use of volunteers helped to measurably improve outcomes for people.

  • Doctors, nurses and other healthcare professionals worked collaboratively as a team to benefit patients and had found innovative and efficient ways to deliver more joined-up care to people who use services. They supported each other to provide good care.

  • The service planned and provided innovative approaches care, providing integrated person-centred pathways of care that involved other service providers, particularly for people with multiple and complex needs.

  • The service had a proactive approach to understanding the needs and preferences of different groups of people and to planning and delivering care in a way that met their needs, which was accessible and promoted equality. They proactively coordinated care with other services and providers. Staff supported patients to make informed decisions about their care and treatment. They knew how to support patients who lacked capacity to make their own decisions or were experiencing mental ill health Staff provided exceptional care and compassion and ensured patients privacy and dignity were maintained at all times. People were truly respected and valued as individuals and were empowered as active partners in their care, practically and emotionally, by an exceptional and distinctive service.

  • The service had a vision for what it wanted to achieve and a strategy plan which was stretching, challenging and innovative, while remaining achievable and was developed with all relevant stakeholders. The vision and strategy were focused on sustainability of services and aligned to local plans within the wider health economy and there was a demonstrated commitment to system-wide collaboration and leadership.

  • There was a fully embedded and systematic approach to improvement, which made consistent use of a recognised improvement methodology. Improvement was the way to deal with performance and for the organisation to learn. Improvement methods and skills were available and used across the organisation, and staff were empowered to lead and deliver change. There was a strong record of sharing work locally, nationally and internationally.

  • Leaders and staff actively and openly engaged with patients, staff, equality groups, the public and local organisations to plan and manage services. They collaborated with partner organisations to help improve services for patients. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. The service promoted equality and diversity in daily work and provided opportunities for career development. The service had an open culture where patients, their families and staff could raise concerns without fear.

  • Leaders had the skills and abilities to run the service. They understood and managed the priorities and issues the service faced. They were visible and approachable in the service for patients and staff. They supported staff to develop their skills and take on more senior roles.

  • Leaders operated effective governance processes, throughout the service and with partner organisations. Staff at all levels were clear about their roles and accountabilities and had regular opportunities to meet, discuss and learn from the performance of the service.

However

  • Improved arrangements were needed to provide assurance of effective staff hand washing and identification of infections to protect patients, staff and others from the risk of infection.

  • Not all required staff had safeguarding children level 3 training although systems were in place to address this.

  • No safety thermometer or equivalent was displayed although there were plans in place to actively share this information with staff, patients and visitors.

Heidi Smoult

Deputy Chief Inspector of Hospitals

Inspection carried out on 20 April 2016

During a routine inspection

This inspection took place on 20 April 2016 and was unannounced. Further phone contact was made with people using the hospices community services on 27 April 2016.

Compton Hospice provides palliative and end of life care, advice and clinical support for adults with life limiting illness and their families and carers. The hospice delivers physical, emotional and holistic care through teams of nurses, doctors, counsellors, chaplains and other professionals including therapists. The hospice had a 18 bedded in-patient unit that accepted admissions for terminal care, symptom control and respite care, at the time of our inspection 14 people were on the unit. The hospice day service welcomes up to approximately 72 people per week and was being used by 10 people on the day of our inspection. The hospices community services that supported people in their own homes was provided by the homecare team which at the time of our inspection was supporting 14 people and the clinical nurse specialist service who were supporting approximately 275 people.

The manager was registered with us as is required by law. The registered manager held the role of Quality and Governance Manager within the organisation. 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. There were sufficient staff on duty. Staffing levels were reviewed and adjusted according to peoples’ changing needs. The recruitment process was robust and the provider was as sure, as possible, that staff employed at were suitable and safe to work with people who were cared for by the service.

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 or make sure people were protected from harm. Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced. Medicines were prescribed, recorded, administered and disposed of in safe and appropriate ways. People received their medicines in a timely manner and in line with their preferences.

The staff team were highly qualified and experienced; people felt confident in the abilities and skills staff displayed and that they were well trained. The provider had its own training team and ensured staff were kept up to date with all their training needs and were supported in keeping their knowledge and skills updated. New staff were provided with a structured induction. Regular supervision and annual appraisal were used to support clinical and non-clinical staff.

Management and staff understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and supported people in line with these principles. Staff established consent from people before providing care and supported people to access independent advice and support when necessary. Resuscitation issues were discussed with people or their representative and the appropriate documentation was completed to a high standard.

People were provided with meals that were sufficient in quantity and met their needs and preferences. Staff knew about and provided for peoples’ dietary preferences, restrictions and reduced appetite. People were supported to access all the support they needed in order to maintain their health and wellbeing, including effective symptom management.

Peoples’ right to privacy was fully protected and they were always treated with dignity and respect by all staff and volunteers. People told us they were extremely satisfied with the staff approach and

Inspection carried out on 20 November 2013

During a routine inspection

We spoke with four people, two relatives, eight staff members and the chief executive of the service.

We found that people�s privacy and dignity was respected. One relative said, �They close the doors and close the blinds to give people privacy.�

People received person centred care that met their needs. One person told us, �This place is amazing for me. I press the bell and they come straight away.�

Arrangements were in place to ensure that people were protected from the risk of abuse. Staff were aware of their duties to protect people and escalate any concerns.

Staff received appropriate support to carry out their role. We saw positive interactions and delivery of care carried out by staff. One person said, �You get instant attention from staff all the time.�

We found that robust systems were in place to monitor the quality of the service. Improvements were made and action was taken when needed. One relative said, �We have never needed to complain, but I would know what to do.�

Inspection carried out on 22 January 2013

During a routine inspection

We carried out this inspection to check on the care and welfare of people. There were 13 people living at the hospice on the day of the inspection. We spoke with three people, five relatives, nine staff, and the clinical director.

Arrangements were in place for people who lacked capacity to make decisions. We found that people were asked for their consent before care was delivered. One person told us, �They always ask me if I want to do things before doing it.�

We found that people received care that met their needs. One person said, �They know all about the little things, and they give that personal touch.� We saw staff being attentive to people�s needs and support them appropriately.

We found that medication was appropriately stored, administered, and managed. One person said, �They are spot on with things like medication.�

We found that recruitment and section processes were consistent. Arrangements were in place to ensure that only staff suitable to work with vulnerable adults were employed.

People and relatives we spoke with knew how to complain. One person said, �If you could get a five plus for a place, this would have it.� People were complimentary about the staff and the service they received.

Inspection carried out on 10 November 2011

During a routine inspection

We spoke with six people who used the service, both in patient and day service. One person was unable to fully comment about their care and treatment, but we were able to speak with their relative. We spoke with five visitors, three volunteers and eight members of staff.

They told us that medical and nursing staff kept them well informed of the care and treatment they needed. One person told us that their treatment had been fully explained with them, what it would entail and why it was needed. They felt very reassured with this as they knew exactly what to expect.

People told us that the food was good and that they were offered choices. We saw people being given refreshments when they requested them. When people needed help and support with eating their meal we saw that staff were available to provide the assistance.

People told us of the many activities that are available each day. They told us how they appreciate and looked forward to receiving the complementary therapies that were available. We spoke with a group of people who told us the comfort they experienced from the religious observance and services that were arranged.

People told us that they were aware that they could speak with staff if they had any concerns or complaints; they felt confident that they would be listened to and any action would be taken. Staff told us how they would deal with any issues or incidents that may place people at risk of harm. Some staff confirmed that they had had specific training in the protection of vulnerable adults.

All people we spoke with were extremely complimentary about the staff, comments included, �Marvellous staff nothing is too much trouble for them�. We saw staff were very attentive to the people using the service. We saw no delays when staff were offering support to people when it was requested. Some staff told us that they were unable to adequately observe people now they were accommodated in single occupancy rooms. They thought that people may become isolated. One person we spoke with stated that they liked the increased privacy and did not feel at all isolated as �there is always someone popping in an out to see if I am alright �.

Staff told us of the many ways that the organisation monitored and checked the quality of the service. People told us that the whole service was �excellent� and they are fully satisfied with the care, treatment and accommodation.

Reports under our old system of regulation (including those from before CQC was created)