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Douglas Macmillan Hospice Good

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Inspection report

Date of Inspection: 13 June 2013
Date of Publication: 12 July 2013
Inspection Report published 12 July 2013 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 13 June 2013, checked how people were cared for at each stage of their treatment and care and talked with people who use the service. We talked with carers and / or family members and talked with staff.

We were supported on this inspection by an expert-by-experience. This is a person who has personal experience of using or caring for someone who uses this type of care service.

Our judgement

People experienced care, treatment and support that met their needs.

Reasons for our judgement

During our inspection we observed staff interacting positively with people who used the service. People told us they were very happy with the care they or their relative received. One person said, “Staff manage to take care of my needs. Anything I need, they do it”. One person’s relative told us, “They treat my relative beautifully. I can’t speak highly enough of the staff”.

We pathway tracked two people who used the service. Pathway tracking helps us understand the outcomes and experiences of people using the service. This helps us to make a judgement about whether the service meets essential standards of quality and safety. Both people were using community services managed by the hospice. One person was receiving this support on the hospice site in a community lodge, and one person received this service in their own home. The community lodge was designed to provide support and personal care to people on site where it may be difficult to provide this in their own home.

The care records we looked at for the person who used the community managed bed contained assessments and plans which described the person’s individual needs. Staff told us about this person’s needs, which matched the information contained in the care records. Risk assessments and management plans were also contained in the care records to guide staff on how to deliver care in a way that was intended to ensure people’s safety and welfare. This meant that this person’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan in a manner that ensured their safety and welfare.

We saw that the Liverpool Care Pathway (LCP) was used in a timely and appropriate manner with regular reviews. The LCP guides members of the multidisciplinary team in matters relating to continuing medical treatment, discontinuation of treatment and comfort measures during the last days and hours of life. We saw that when the LCP was an appropriate treatment option, it was discussed with relatives and took into account the person’s end of life wishes. This meant that staff provided end of life care based on the best available guidance.

We spoke with the relative of the person who used the hospice at home service. They told us, “The staff are fantastic. They have looked after me and my relative superbly”. The relative told us that staff from the Douglas Macmillan provided personal care to their relative. We asked the relative if there was a written plan outlining the personal care support that their relative required. They said, “I haven’t seen one, but the staff come and get on with their job, they are wonderful”.

During our inspection, we asked the senior member of staff for the hospice at home team if this person required support with personal care. The member of staff looked at the person’s care records and we were told that this person did not require support with personal care, as they were independent with this task. Staff told us that care plans were written by staff working for the health trust and that staff from the Douglas Macmillan hospice at home team followed the health trusts care plans. The provider may wish to note that we spoke with a representative from the health trust. They told us they wrote care plans for people’s health needs rather than their social needs, and that support with personal care was classed as a social need. This person confirmed that there was no care plan in place outlining the support the person needed with their personal care.