Hospice in the Weald

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

This meant 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.

At our last inspection, we rated this key question outstanding. At this inspection the evidence provided has not supported an outstanding rating and the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

Although the rating has changed from outstanding to good, this reflects the use of a different assessment methodology at this inspection rather than any significant decline in quality.

We assessed all quality statements in this key question.

The hospice provided services that were generally responsive to the needs of people who used them. Care was planned and delivered in line with individual preferences, and staff worked to ensure patients and families received timely support. Feedback mechanisms were in place, and most people reported feeling listened to and involved in decisions about their care. The provider had developed some meaningful engagement with local communities and taken steps to involve people in shaping services. Initiatives such as occasional engagement events and limited outreach activities showed awareness of local population needs.

However, actions taken were often minimal and lacked measurable impact. This meant the service was not fully responsive to the needs of all groups in the community.

This service scored 75 (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 a good standard. The service made 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.

Staff developed care plans that reflected people’s physical, mental, emotional and spiritual needs. People and those close to them told us they were fully involved in planning and making decisions about their care and treatment. A patient told us, “Without a doubt, all my needs have been met with care and attention.”, and a relative told us, “Their loved one’s wishes were heard and respected.”

Staff adapted care to meet individual needs and helped people achieve what mattered to them, while respecting their abilities and limitations. Staff used information boards in patient rooms to display individual preferences, such as food choices and favourite activities, making them visible to all staff.

Audit data showed that discussions about preferred place of care and preferred place of death were held consistently with over 90% of patients.

The service had an end of life matters group, which met monthly and considered feedback, thoughts and ideas from people using the service. The service was in the process of undertaking the living well annual service review for 2023-2024. Feedback from the previous review showed that many people felt the 12-week support programmes were too short, which resulted in the service extending these to 24-week programmes.

The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Managers worked to build links with diverse communities and visited the local mosque to better understand and respond to the needs of Muslim people. These needs were reflected in plans to upgrade the inpatient unit to provide a prayer space and facilities for hand and foot washing. This would enable patients and families to observe their faith while at the hospice.

The service actively sought feedback from people using the service, those close to them and the wider community through the end of life matters group. This group worked together with the local community to ensure service changes actively reflected the palliative and end of life needs of the local community. The group was also involved in reviewing the hospice complaints policy, so it reflected what mattered to people.

The service worked closely with the local acute NHS hospital and introduced a nurse specialist role based at the hospital. This supported early identification of patients who may benefit from hospice care and enabled timely transfers when needed.

The hospice community team worked with local care homes to support staff in managing symptoms for people with palliative care needs. This included visits by the hospice outreach team. They also maintained close links with district nursing and other local hospice teams. Staff shared changes in people’s care needs promptly to make sure care was joined up across the community.

The hospice had built a strong partnership with a transport provider. This allowed for more personalised travel arrangements, helping to keep the focus on each patient’s individual needs. Leaders told us this reduced waiting times for transfers from the NHS hospital and for discharge to people’s homes, improving people’s experience of care.

A large proportion of volunteers at the service had lived experience of the service when their loved ones were cared for by the hospice and returned as volunteers due to how well their loved ones were cared for.

The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The hospice website gave access to information in a variety of formats to support people with differing needs. The website also contained a ‘help hub’ page, where people could search for advice and information, such as managing symptoms or practical advice about what to do when someone dies.

Relatives could contact the hospice 24 hours a day for general enquiries or urgent medical help and advice. The service made sure information about its support was clear and accessible, helping people and their families understand what they could expect from the service.

The service used interpreters and provided translated information when needed, which helped people understand their care and make informed decisions.

Patient rooms contained ‘what matters to me’ boards where their preferences were recorded for them by staff and family. This ensured that their personal needs were always appropriately met.

People had access to accurate information about the services provided by the hospice. However, during our visit we found 1 information leaflet with out‑of‑date contact details, which we fed back to leaders at the time.

The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

The service provided a complaints page on its website. This explained how to make a complaint, expected response time, and what to do if people remained unhappy with the complaint response. The service set out that all complaints would receive an initial response within 3 working days, with a full response within 30 working days. In the past 12 months, 80 of 89 complaints were resolved within the 30‑day timeframe.

Between April 2024 and March 2025, the hospice received 89 complaints. The service reviewed themes and monitored response times to ensure timely action. The service identified a lack of consistency in staffing for home visits as a theme. In response, the outreach service split staff into 2 teams improving continuity of care and ownership of caseloads.

Leaders recognised the value of feedback from people, their families and the local community. Leaders heard the views of patients and the community through the end of life matters group.

The service held listening events in response to complaints. People using the living well service which offered groups and activities for patients and families, told leaders they were disappointed with the 3-month limit on access to the service. Leaders listened and looked at how the service was explained, and extended provision. As a result, the service increased programme length from 12 to 24 weeks.

Hospice leaders engaged with patients and the community through questionnaires and an engagement evening to gather views on their planned refurbishment. Designers, patients, volunteers and staff from the living well service attended the workshop, which helped shape designs to better suit people’s needs.

Leaders also asked staff for their views in the upcoming ward refurbishment and kept staff informed at each stage of the planning process.

The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

The service used triage processes to prioritise patients according to need. Referrals came from the hospice outreach team, the local NHS hospital, the palliative care team and other NHS hospitals. Patients, family members, GPs, social workers and other professionals could also make referrals.

The bed allocation meeting used a matrix prioritisation tool to identify people with the highest level of need, with admission within 24 hours if required. The service reviewed average waiting time for beds for people requiring admission and found that during the preceding 6 months the average wait was 1.5 days from a total of 269 admissions. Leaders reviewed this data and they found that delays were not always due to a lack of beds, but were sometimes related to changes in a patient’s condition, complex care needs and delays at the acute NHS hospital over weekends.

The hospice launched a new equity and diversity policy in June 2025 to support fair access and improve outcomes for people with diverse physical and cultural needs. As implementation was at an early stage, assurance about its impact was still emerging. Nonetheless, the policy demonstrated a clear commitment to addressing inequalities in people’s experience of care.

The service provided a 24 hour telephone advice line for patients and relatives. The outreach team answered calls during office hours, and the ward nursing team provided support out of hours.

The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The hospice outreach service provided care for people in their own homes. This meant people could stay at home rather than be admitted to the hospice. The service received feedback from people that staffing had been inconsistent, and they frequently saw new faces. The service responded by changing its model and splitting the workload into 2 teams to provide people with more consistent staffing.

Staff from the hospice community team worked with care home staff to support people with palliative and end of life needs. This helped ensure people living in care homes received the same high-quality palliative care as those cared for in the hospice, while remaining in familiar surroundings.

We saw evidence that leaders sought to address barriers in equity in experience for the local Muslim community. The service had a policy that clearly set out expectations for equitable access for people using the service.

The bed allocation policy set clear expectations to ensure decisions were fair, transparent and free from discrimination. A multidisciplinary team met daily to consider each person’s individual needs so that beds were allocated based on clinical need rather than any non‑clinical factors. The policy explicitly prohibited discrimination on the grounds of race, religion, sexual orientation, gender, age or donation history. This helped promote equitable access to care and supported consistent, fair outcomes for people using the service.

The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff discussed preferred place of care and preferred place of death with over 90% of people. Leaders reviewed this alongside outcome data which reflected high levels of achievement in providing preferred place of care.

Staff recorded conversations about people’s wishes and needs clearly in care records so they could be reviewed and acted on. Staff supported people to share their preferences about cardiopulmonary resuscitation and other interventions. They supported people to make decisions about reducing care interventions if they were less likely to be of benefit. Staff clearly recorded and communicated any changes in decisions with those providing care.

People told us “Without doubt, all my needs have been met with great care and attention.”, and “My wishes have been listened to, respected and fully considered.”