Douglas Macmillan Hospice

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

At our last assessment we rated this key question Outstanding. At this assessment the rating has remained to be Outstanding.

We looked for evidence that people and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality characteristics.

This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 100 (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 making sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Patients received the most appropriate care and treatment, the hospice made reasonable adjustments where necessary and was accessible for all; promoting patients’ independence whilst acknowledging they may require assistance. Patients told us they were supported to receive their end-of-life care in their preferred environment which could be within their own homes or within the hospice or community beds.

People were involved in the planning and regular review of their care, care was personalised to meet their individual needs, and this was carefully considered at first face to face meeting. Care plans fully reflected their physical, mental, emotional and social needs, including those related to protected characteristics under the equality act. Patients and their relatives told us that staff were responsive to their individual needs and ensured their needs and dignity were respected.

Support and advice were consistently available to health professionals and people who used the community services via a 24-hour telephone advice line. A manager told us, “This service is run by a dedicated palliative care nurse specialists and paramedics, 24 hours a day”. Staff and patient, we spoke with told us the service was, “a really good idea and source of support” and “a very good service”. Patients felt they had continuous access to support, which provided them with assurances and eased their fear.

Families and other relevant people were gently encouraged to be involved in the patient’s care, but only when this was important to them and welcomed by the patient. The service ensured that care discussions included those identified by the patient as significant, fostering collaboration and emotional support. Where appropriate, decisions were made in partnership with the patient’s lasting power of attorney (LPA) or legally appointed representative, ensuring that the patient’s wishes remain central to all care decisions.

The evidence showed an exceptional standard. The service had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Effective communication systems were in place that promoted seamless care. All staff within the adult service used the same computerised care records system which meant information about people’s care needs was available to the staff as people accessed and moved across the various hospice services. This innovative data sharing agreement between the service, local NHS trusts and some of the local GP’s meant important clinical information could be shared quickly. This ensured health professionals had up to date and correct information about the people’s health and care needs.

Staff were aware of the potential impact that people’s conditions posed to their mental health and wellbeing. Services were offered to people to help reduce the risk of fear, anxiety and social isolation. These included access to psychological support services, complementary therapies and community support groups. Dedicated community teams supported patients and families in their home over sometimes lengthy periods of time to ensure continuity of care and treatment. Patients benefited from a warm and welcoming environment. Patients had options to have their own bedroom space or a shared room, with access to various communal areas, this included quiet areas where patients could spend time with their family members, a faith room and areas for children and younger visitors and support to the patient and those close to them.

Care and support were inclusive and responsive to the diverse needs of the people who used the service. The service took a proactive approach in understanding the needs and preferences of different groups of patients and delivered care in a way that met those needs.

Staff regularly sought feedback from people who used the service. This was via patient forum meetings and satisfaction questionnaires. The hospice provided information, local people raised funds in a form of charity event to ensure their local hospice was supported. People we spoke with spoke highly of Douglas Macmillan Hospice and were extremely positive and proud to have such a service close by.

The hospice supported patients from outside their immediate catchment area on a case-by-case basis. For example, some patients lived further away, but their families were local. In these cases, the hospice if able would provide care that allowed family members to visit easily during the patient’s final days, ensuring vital emotional support for both patients and those close to them.

The evidence showed an exceptional standard. The service was exceptional at developing appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff ensured carers and families were regularly updated about the patient’s progress. There was an accessible and effective complaints process in place that enabled staff to make improvements when required. Patients and relatives told us they would be happy to approach staff to share concerns or make a complaint, and they knew how to raise concerns. Records showed that complaints were managed in accordance with the service’s complaints policy.

The hospice provided appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Patients could get information and advice that was accurate, up-to-date and provided in a way that they understood, and met their communication needs. Staff had access to communication aids to help patients become partners in their care and treatment.

Staff made notifications to external bodies as needed. CQC received notifications relating to Deprivation of Liberty Safeguards (DoLS), safeguarding/ abuse statutory notification.

Staff made sure patients living with mental health problems, learning disabilities and dementia, received the necessary care to meet all their needs. Patients and those close to them said staff took time to ensure they had the information they needed, and they understood it. The hospice provided a helpline 24 hours a day. During office hours the helpline was separately staffed, evening and weekends. The helpline provided a wide range of advice from symptom management to signposting for benefits.

Staff had access to guidance, tools, and mentoring to respond appropriately to complex or challenging care situations.

The evidence showed an exceptional standard. The service was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. They always involved people in decisions about their care and told them what had changed as a result.

Leaders collected feedback from patients and their families on their experience of care. We reviewed a sample of feedback received from October 2025 and found it to be positive. Relatives thanked staff for their loved one’s incredible care, the compassion, support and kindness staff had showed. We noted there were user feedback forms on display in public areas which people could complete to share the good things about the service or to share any concerns they may have had.

A large proportion of volunteers at the service had lived experience of the service when those close to them had been cared for by the hospice. They had returned as volunteers due to how well those close to them were cared for.

An equality, diversity and inclusion forum was in place. Members of this forum linked with lesbian, gay, bisexual, transgender, queer, questioning, intersex, or asexual (LGBTQIA+) groups in the community to ensure the voice of the community was heard and services reflected their needs and choices.

We saw examples of Douglas Macmillan Hospice responses to some complaints; we found the letters to be transparent and honest. We saw that 434 people had complimented the services between the reporting period of January 2025 and November 2025 and 5 people had raised a complaint between January 2025 and November 2025.

The evidence showed an exceptional standard. The service was exceptional at ensuring people could access the care, support and treatment they needed when they needed it.

Work undertaken with the integrated care board and local health economy considered the care needs of the local area. A rise in patients living with mental health conditions, dementia and frailty had been identified. In response, the service had implemented a professional health telephone line, clinical outreach, and learning and education for the upskilling of key professionals such as GP's, community nurses, and paramedics.

Patients received timely care, treatment and support in line with best practice, quality standards and legal requirements, including equality and human rights. This included accessing care and treatment, making reasonable adjustments for people, addressing communication barriers and having accessible premises.

Patients were referred as either urgent or non-urgent. Urgent cases were admitted either the same day or within 24 hours, and non-urgent cases were usually admitted within 3 days of the referral. Managers told us priority was given to patients in the community. Urgent admission to the inpatient unit from the community was always prioritised.

Patients received timely care, treatment and support in line with best practice, quality standards and legal requirements, including equality and human rights. This included accessing care and treatment, making reasonable adjustments for people, addressing communication barriers and having accessible premises.

Patient areas were on the ground floor and were fully accessible throughout. In addition, the hospice had large outdoor gardens which were accessible for wheelchair users and people with mobility difficulties.

The evidence showed an exceptional standard. Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. Staff and leaders actively listened to information about patients who were most likely to experience inequality in experience or outcomes. Staff tailored their care, support, and treatment in response to this.

The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage. Leaders proactively sought ways to address any barriers to improving patients’ experience and worked with local organisations, including within the voluntary sector, to address any local health inequalities. Staff understood the importance of providing an inclusive approach to care and adjusted support equity in patients’ experience and outcomes.

Staff trained in equality, diversity, inclusion and human rights. The hospice regularly engaged with local communities to understand the specific issues around palliative and end of life care with a view to improving their understanding and people’s experience and to slowly remove the stigma of palliative care and hospice support.

Douglas Macmillan Hospice ensured that their Inclusion and community partnership coordinator engaged with a wide range of community groups to raise awareness of their hospice, to explain the range of services available, and demystify palliative and end-of-life care. Leaders told us that this reflected the hospice’s commitment to adapting services to meet the needs of people across Stoke-on-Trent, North Staffordshire and the surrounding areas.

The service actively attended the central community events and gatherings, helping people understand who they were and what services the hospice provided, providing information about the support available both at the hospice and in the community. The hospice also worked with local schools and youth groups to increase their understanding among children and young people, fostering early awareness that the hospice was a safe, accessible, and compassionate place that supported individuals and families from all backgrounds.

Staff competence was supported through a communication skills matrix, which identified training needs and ensured access to electronic system, intermediate, and advanced communication skills training. This framework provided assurances that staff were all equipped to deliver high-quality, timely end-of-life conversations.

The evidence showed an exceptional standard. People were given exceptional support to plan for important life changes, so they could make informed decisions about their future, including at the end of their life.

Patients’ decisions and what matters to them were delivered through personalised care plans that were shared with others who may needed to be informed. When patients wanted to express their wishes about cardiopulmonary resuscitation, they were supported to do so and were able to change their mind if they wished. We observed staff speaking with patients about recommended summary plan for emergency care and treatment (ReSPECT) forms and processes during our inspection. Staff provided all the information required in relation to ReSPECT and once patients were ready to make the decision, staff, patient and family were all part for completing the form. ReSPECT isa personalised plan in the UK that records a person's preferences for emergency care. especially if they can't communicate, covering what treatments they want (like CPR) or don't want, created through conversations with healthcare professionals. We reviewed 15 patient records, and all records that required ReSPECT form were all completed and in date, with all relevant information completed.

If or when any treatment was changed or withdrawn, clinical staff communicated and managed this openly and sensitively, so patients had a comfortable and dignified death. We saw example of this during our inspection, we saw one patient had made a decision to have their pacemaker turned off and their wish was to have their body handed over to research, they had made all their arrangements and were providing update to Douglas Macmillan Hospice about their wishes.

When patients’ future care preferences were for greater independence and fewer care interventions that were likely to benefit them, professionals worked together to support them to achieve their goals. Families and carers were encouraged to engage in community-based services and support programmes, creating a wider safety net that extended beyond the hospice environment, and helped reduce isolation and enhanced wellbeing.