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Wigan and Leigh Hospice Outstanding

Inspection Summary


Overall summary & rating

Outstanding

Updated 4 April 2017

This inspection took place on 5 and 6 October 2016 and was announced. We provided 48 hours’ notice of our visit to ensure the registered manager would be available to facilitate our inspection. The service was last inspected on 8 October 2013 and was found to be meeting all the regulations we reviewed at that time.

Wigan and Leigh Hospice is a registered charity, situated in the Hindley area of Wigan. The hospice was founded in 1982. It is an adult hospice for people aged 18 or over and delivers specialist palliative care to people who have a life threatening illness from any disease and who are thought to be in the last year of their lives. The hospice is a purpose built unit and provides ground level accommodation for up to 14 in patients. Facilities included: 14-bed inpatient unit in 14 separate rooms; a patient and visitor lounge; an overnight room for families; a multi-faith room; three complementary therapy rooms; two counselling rooms; outpatient clinics; free of charge car parking; meeting rooms for hire.

Exceptional management and leadership was demonstrated at Wigan and Leigh hospice. Our discussions throughout the inspection demonstrated that there was an open culture which empowered people to plan and be involved in the high quality care provided at this service. This meant that people continuously had a say in how they wanted their care to be delivered. The strong and positive management approach resulted in people receiving a tailored inclusive service which focused on them receiving individualised care.

There was a hospice in your home service provided by a team of nurses, healthcare assistants and volunteers. The team offered one-to-one time with patients and gives practical as well as emotional support alongside hands-on nursing care, including daytime visits and occasional overnight stays. By providing additional support in this way the team enabled more people to stay in their own homes as they come towards the end of their lives.

There was also a team of clinical nurse specialists employed by and based at the hospice who provided support in person or via the telephone advice line.

Medical and Nurse Specialist outpatient clinics were held in the Hospice’s Woodview Centre. They offered specialist assessment or review for patients with complex or rapidly changing symptoms who needed specialist assessment.

There were five hospice doctors of whom four were very experienced in hospice care. In addition there were two registrars on the on-call rota with one doing a half day a week of daytime clinical work at the hospice as well as some teaching. The medical director was part of the leadership team and a member of three hospice governance committees. There were three consultants working at the hospice.

Wigan and Leigh hospice is registered with the Care Quality Commission (CQC) to provide care for up to 14 people on the inpatient unit. At the time of our inspection there were 12 people being cared for and approximately 250 people receiving care and support in the community. Of these 250 people, the manager told us that provision of personal care was limited and they provided more emotional and practical support.

All the people we spoke with during the inspection told us they felt safe when they received care and treatment from hospice staff. There were appropriate policies and procedures in place with regards to safeguarding and whistleblowing. This told staff how they would be supported if they reported poor practice or other issues of concern.

We looked at the way medicines were prescribed and managed at the hospice and found that medicines were managed safely. There were clear, detailed policies and procedures covering the different aspects of medicines management.

There was an accountable officer who submitted reports to the controlled drugs local intelligence network (LIN) and attended LIN meetings. Controlled drugs were handled safely and nurses checked stocks weekly. The accountable officer audi

Inspection areas

Safe

Good

Updated 4 April 2017

The service was safe.

People said they felt safe at the hospice, with staff having a good understanding about how to report safeguarding concerns.

We found medication was handled safely.

The premises were clean with appropriate systems in place to reduce the spread of infections.

Effective

Good

Updated 4 April 2017

The service was effective.

People said staff were well trained and had good skills.

Staff had access to a wide range of training and received appropriate supervision.

People at the hospice told us about the high standard of food and drink available.

Caring

Good

Updated 4 April 2017

The service was very caring.

People and relatives told us staff were extremely kind, caring and compassionate.

The ethos of care was person-centred and valued each person as an individual. People felt that they mattered. Staff were skilled at helping people to express their views and communicated with them in a sensitive and caring manner.

People received care and treatment which enabled them to have a dignified and pain free death. Families and those that mattered to people were supported to spend quality time with them and were also able to access bereavement support following their family member’s death.

Responsive

Outstanding

Updated 4 April 2017

The service was very responsive.

People received care that was highly personalised to their individual needs, wishes and requests.

Staff worked in partnership with people to develop care plans which enabled them, as far as possible, to fulfil their wishes and goals.

People were encouraged to provide feedback about the care they received from the hospice. Robust systems were in place to share lessons learned from complaints with staff and ensure any required changes in practice took place.

The service was evaluating how the hospice served the lesbian gay bisexual and transgender (LGBT) community and whether or not the hospice services were LGBT friendly. Staff understanding of this area and the literature required was being developed.

Well-led

Outstanding

Updated 4 April 2017

The service was exceptionally well-led. Partnership working was an integral aspect of how the leadership and management of the service sought to improve care provision.

There was a registered manager in post. People commented positively about the quality of leadership in the service. The leadership team promoted an open and positive culture that placed people and staff at the centre of the service.

The leadership team promoted strong values of person-centred care and worked in partnership with other organisations to provide high quality, evidence based end of life care for the local population.

The hospice had a range of robust monitoring systems in place in order to review the quality of people's care and the environment. There was a clear commitment to on-going service improvement throughout the hospice.