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Trinity Hospice and Palliative Care Services Limited Outstanding

Inspection Summary


Overall summary & rating

Outstanding

Updated 28 October 2016

The inspection visit at Trinity Hospice and Palliative Care Services Limited was undertaken on 13 July 2016 and was announced. We gave 48 hours’ notice of the inspection because of the sensitive nature of the service provided. We also wanted to ensure people, staff and visitors were available to talk with us.

Trinity provides palliative and end of life care for 33 children and adults with life limiting illnesses. The service supports people and their families, providing spiritual and holistic care. Furthermore, they offer a hospice at home service in the local community to assist individuals living at home. At the time of our inspection, there were eight people inpatient at Trinity. Additionally, the hospice supported approximately 500 individuals in their own homes within the Blackpool and surrounding areas. The service further employed two teams of clinical nurse specialists in the wider community who worked at the local hospital and with community services. They supported people who were inpatient and worked collaboratively with district nurses for those who lived in their own homes. The nurse specialists provided palliative care management, symptom control advice and facilitated complex treatment discussions with people and their families.

Trinity is situated in a residential area close to local amenities. The service supports people in three different units: the main hospice inpatient unit; Brian’s House (the children’s unit); and a day therapy unit. Bedrooms are for single occupancy, spacious and comfortable. Additional facilities include therapy areas, private consultation rooms and extensive gardens.

A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

At the last inspection on 20 August 2014, we found the provider was meeting all the requirements of the regulations inspected.

During this inspection, staff, people and visitors said the service was organised to a high standard and had exceptional leadership. The registered manager worked jointly with other agencies to develop best practice and foster excellent partnership relationships. For example, they conducted various research studies with the local hospital that influenced and improved best practice and national care policy-making. We saw this had a major impact upon people’s care, safety and welfare.

We found staff, people and relatives were at the heart of Trinity’s quality assurance programme. The management team set up multiple forums to involve and gain their feedback. One comment we saw stated, “Nothing needs improvement.” A relative fed back, “Fantastic support given by the hospice at home team.” The registered manager had remarkable oversight of care provision, service quality and everyone’s safety. This included multiple auditing systems, a range of different staff-level meetings and various structures to review staff, people and visitor’s views.

We observed staff provided outstanding support that had the person at the centre of their care and treatment. Without exception, people and their relatives spoke extremely highly of staff and their experiences of care. One relative said, “I really cannot praise them enough.”

We found care planning enabled staff to work in a highly personalised and holistic approach. People told us staff were efficient at responding to them and their requirements. End of life care plans were very detailed and relatives told us related support was excellent. One relative fed back, “The memory boxes have been overwhelming since my [family member] passed away.”

People and their representatives said staff worked collaboratively with them to ensure they received high standards of care. One person said sta

Inspection areas

Safe

Good

Updated 28 October 2016

The service was safe.

Staffing levels were sufficient to meet people’s needs and individuals we spoke with said there were enough staff to keep them safe. The management team had not always followed their recruitment systems, but took immediate action to address this.

Staff had a good awareness of safeguarding principles and who to report concerns to if people were at risk from harm or injury.

We observed people received their medicines on time and when they were required. Staff were skilled and managed medicines carefully.

Effective

Good

Updated 28 October 2016

The service was effective.

People told us they felt staff were experienced and skilled. Staff files we saw showed they received a wide range of training.

Care files contained nutritional risk assessments and control measures to minimise the risk of malnutrition.

Staff received training about the MCA and DoLS. People told us they were supported to make any decisions.

Staff worked with other healthcare services to monitor people’s ongoing physical and mental health.

Caring

Outstanding

Updated 28 October 2016

The service was exceptionally caring.

Without exception, people and their relatives spoke extremely highly of staff and their experiences of care. We found staff were passionate about providing a non-discriminatory service.

We toured the service and found it was an exceptionally tranquil, warm, happy and welcoming atmosphere throughout. People said this enabled them to feel exceptionally comfortable and relaxed.

The registered manager worked with other healthcare services to provide relatives with dignified end of life care. Care planning was highly personalised and held details about the person’s preferences and how they wished to be supported.

Responsive

Good

Updated 28 October 2016

The service was responsive.

Care planning was personalised and gave staff precise direction to care. People told us staff were efficient at responding to them and their requirements.

The provider maintained the environment to a very high standard to enhance people’s wellbeing and stimulation. This included a range of activities, facilities and holistic therapies.

We saw the registered manager dealt with complaints competently.

Well-led

Outstanding

Updated 28 October 2016

The service was extremely well-led.

The registered manager acted with other agencies to develop best practice and foster excellent partnership relationships. They worked with the local hospital to influence and improve best practice and national care policy-making. We found this had a major impact upon people’s care, safety and welfare.

Staff, people and visitors said the service was organised and managed to an extremely high standard. They told us the registered manager was very active in supporting and understanding their requirements.

The management team excelled at managing change in a coherent and cohesive approach. Staff said they felt fully involved in Trinity’s ongoing development. They added the management team was extremely supportive and approachable.

We found people were at the heart of Trinity’s quality assurance programme. They fed back they would not hesitate to recommend the hospice to others. The registered manager had remarkable oversight of care provision, service quality and everyone’s safety.