Douglas Macmillan Hospice

On this page

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

At our last assessment we rated this key question as Good. At this assessment the rating has changed to Outstanding.

We looked for evidence that people were always treated with kindness, empathy and compassion. We checked that people’s privacy and dignity was respected, that they understood that they and their experience of how they were treated and supported mattered. We also looked for evidence that every effort was made to take people’s wishes into account and respect their choices, to achieve the best possible outcomes for them.

This meant people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.

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 evidence showed an exceptional standard. The service was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

Without exception, all patients and relatives we spoke with told us they were happy with the care and support provided.

We heard of many examples of patients and their families being treated with kindness and compassion. For example, we heard how the staff had brought Christmas forward for one family and mimicked Christmas at home for another, how weddings had been turned around in 24 hours, and how wedding banners were arranged as well as cupcakes.

On another occasion, an ice cream van and sandpit were brought to the hospice as a patient had wanted to recreate the beach; the patient was then able to put their feet in a sandpit. We also heard of dogs staying overnight and how a patient was able to see a reindeer for the first time as they had never seen one before. The hospice also had a therapy dog who visited every other week.

We observed staff interacting with patients and those close to them in a respectful and considerate way. Patients told us how staff introduced themselves and how they put them at ease.

Patients and their families spoke highly of the care they had received from staff at the hospice. Comments included that the staff were ‘fabulous’, how every single staff member had a pleasant smile and how staff went the extra mile.

Staff demonstrated genuine empathy for the patients they cared for. Patients felt staff listened to them and communicated with them appropriately, in a way they understood.

There were facilities available to allow bad news to be broken in a private setting. Staff followed policy to keep patient care and treatment confidential. The service had an information governance policy and staff were compliant with it. Conversations between staff and patients were kept private and sensitive information was never shared in the presence of those not authorised to hear it. Patients and those close to them were able to share their fears for the future and were confident their concerns would not be shared with those close to them.

Staff were able to anticipate when someone needed urgent end of life care or support and offered this immediately, using the most up to date tools as required.

The evidence showed an exceptional standard. The service treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The service took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

During our inspection there was a programme of events for patients, their families and staff to attend. Events during our 2-day inspection included an inpatient Christmas party, children's choir as well as a volunteer Christmas party.

A spiritual space was available to patients; their families and staff where they could spend time if they wished. Within this space people could light a candle in memory of their loved one, leave messages and listen to music. It also had different artifacts for different religions. We heard positive feedback from a staff member who had utilised this as part of their wellbeing. The hospice had a full-time pastoral lead who was a longstanding member of the team and a Freedom to Speak Up Guardian. There was also a part time volunteer Humanist; a non-religious worker who worked on a Tuesday morning to support the patients at the service.

Patients’ personal, cultural, social and religious needs were understood and met.

Information about what was important to the person were clearly identified. This included information such as how to share bad news with those close to them and their interests.

The pastoral lead told us how had put together a strategy document to recognise all the different faiths. They also told us how they had introduced a spiritual care assessment so that the entire team could understand what was important to the patient as well as being involved in a steering group in addition, they offered staff training on spirituality. They told us how they also had a community practitioner who was involved in the community supporting people in their own homes and places such as nursing/residential homes when needed.

One family member told us how they had been able to stay over with their loved one on a pull-out bed. They also showed us how they had been able to bring in items from home to make their room more personalised for example a Christmas tree.

Complimentary therapies were available, and these took place at the bedside or in treatment rooms. Examples of complimentary therapy included relaxation, reiki, massage, aromatherapy and mindfulness. One staff member told us how this had helped create memories for a husband and wife and to make them feel relaxed.

We noted staff had displayed ‘you said, we did’ notices within the inpatient unit. Examples included that a patient missed their dog, so staff arranged a visit and that a patient liked to listen to birds, so staff took them out into the garden to listen to them.

There was a calendar of diversity on display. Events listed included world AIDS day. We saw there was a Christmas events board which included visiting reindeers, Christmas jumper day and Christmas memory work.

The hospice and its staff had a strong patient centred culture with patients’ individual needs and preferences understood and reflected in their care. Staff had a strong understanding of patients’ human rights to dignity and respect and were able to act uphold these rights, even in challenging situations.

Staff treated patients as individuals, considering any relevant protected equality characteristics. Staff respected the individual needs of each patient and showed understanding and a non-judgmental attitude when caring for or discussing patients with mental health needs. Staff received training in equality and diversity, so they understood, valued, and celebrated difference.

The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

People received their end-of-life care in accordance with their care preferences. One staff member told us, “We offer holistic, individualised end of life care”. “We provide individualised care, not everyone needs are the same, patients and family tell us what they need, they tell us what they want, and we do what we can to fulfil their wishes.”

Patients were supported to maintain their relationships and networks when being cared for in the inpatient ward. Friends and family were able to visit when the individual wanted them to and there were arrangements in place for overnight stays when required. Patients said staff always made them feel welcomed.

There was a clear focus throughout the hospice on maintaining independence. Community support services were focused on maintaining health, wellbeing and daily living for as long as possible, to ensure the best possible quality of life.

For those patients who wanted additional or alternative management of pain, anxiety or distress staff arranged for patients and those close to them to receive alternative therapies such as massage and aromatherapy which were available within the hospice.

The evidence showed an exceptional standard. The service was exceptional in how they listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Systems were in place that aimed for people to experience comfortable and pain free end of life care. If people received their end-of-life care at home the medicines required to achieve this were put into place in advance so they could be utilised when the person required them.

Family members could access bereavement support services after the death of a loved one. The service had ensured these services were available to people on or away from the hospice site, dependent upon the needs and preferences of the families. Senior staff members told us, “Not everyone wants to come back to the hospice for support because they associate it with the death of their loved one”. Another staff member said, “It’s important that families can access this support away from the hospice too”, staff called people if they wished and provided leaflets and telephone numbers. One staff said they had a family member contact the hospice for support months later, “we are here for families too”.

Staff went to great lengths to make sure patients’ needs, wishes and comfort were their priority. Staff went above and beyond to anticipate patients’ needs and took steps to ensure preventable discomfort, concern or distress for patients. We observed this during our inspection, staff communicated and engaged with patients in discussions about their immediate needs, arranging face to face home visits if patient required a visit. This included asking about their symptoms as well as what was most important to them at that point in time. Regularly checking how they and those close to them were and asking about their pain, potential side effects such as nausea to ensure timely escalation would be made and ensuring they had the food and drink they wanted and updated relevant services of any changes they had seen or heard to ensure all services involved were kept up to date.

People who had chosen to receive their end-of-life care at home and who were approaching this phase of their care, had specialist medicines in their home that could be administered by community staff when required. One staff member told us, “We use anticipatory medicines, these can be administered if anything arises out of hours by the district nurses and hopefully, stop an unnecessary hospital admission and manage symptoms at home”. Anticipatory medicines were used to manage people’s symptoms during their end of life.

Staff communicated well with patients so that they understood their care and treatment, including finding effective ways to communicate with patients with communication difficulties and enabled patients to make advance decisions such as to refuse treatment, or change anything from their original wishes. Staff were aware of and dealt with any specific risk issues, such as falls or pressure ulcers and care planned for those accordingly. Staff were able to identify and respond to any changes or risks to patients and updated all relevant people and documentation as and when needed.

The evidence showed an exceptional standard. The service always cared about and promoted the wellbeing of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care.

Staff felt respected, supported and valued; Staff told us they felt positive and proud for working at Douglas Macmillan Hospice and were extremely proud of their team/colleagues. There was a culture of kindness and respect between colleagues from other organisations. Patients were supported by staff who felt valued by their leaders and their colleagues. They had a sense of belonging and the ability to contribute to decision making. The staff survey was conducted between 9th of June until the 25 June 2025, the survey looked at employee engagement, satisfaction, and overall workplace experience; We saw that 73% of staff had responded.

There were clear policies that supported staff and managers by providing clarity, clear expectations and ensuring consistency, that encouraged a healthy work life balance through flexibility policies. Psychological safety was promoted by means of open communication, Freedom to Speak Up Guardians, regular one to ones with managers, open door access to Senior Leadership. Volunteers were also encouraged to have open conversations with their line managers. Staff appraisals included conversations about career development and how it could be supported, staff were given opportunities to develop in house.

Staff had access to support for their own physical and emotional health needs through various services of well-being provided by the hospice, such as menopause support, yoga and many more, all these services were also available for their volunteer’s colleagues. Supervision and reflective practice sessions took place on regular basis; this ensured that Douglas Macmillan Hospice supported the wellbeing and professional development for all the staff. Staff told us that an established resilience-based supervision was embedded within the hospice.

Patients’ experience of a service was driven by a culture that normalised positive wellbeing through inclusivity, listening, and open conversations. This enabled staff to do their job with passion and providing exceptional support for both patients and colleagues. Patients benefited from staff who had regular opportunities to provide feedback, raise concerns and suggest ways to improve the service or staff experiences. If necessary, leaders provided a timely and considered response. The hospice managers ensured staff were listened to.

The hospice ran various events to thank volunteers for their contribution to the Hospice. These events were important to foster a feeling of inclusion and provided the opportunity for social interactions. The hospice also had a social media group which encouraged community and interaction.

Staff told us they had access to a third party service, that was provided by the hospice if required, this allowed access to financial support, such as help towards dental care, eye care.