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Inspection Summary


Overall summary & rating

Good

Updated 28 June 2016

This inspection took place on 30 and 31 March 2016 and was unannounced.

St Michael’s Hospice provides care and treatment to people using the 20 bedded inpatient unit, day service, community nurses and hospice at home service and outpatient clinics. People may also receive support from the hospice’s transport and a telephone triage service. All these services provide specialist palliative and end of life care to people over the age of 18 with life limiting illnesses. At the time of our inspection eleven people were using the hospice inpatient service.

There was a registered manager in post who was also known as the director of care. A registered manager is a person who has registered with the Care Quality Commission 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.

People were protected from harm and abuse due to the arrangements in place to make sure risks to people were reduced. Where people were at risk due to their health and physical needs these had been identified with measures put in place to help people to manage and reduce any known risks. Staff and volunteers had been suitably recruited and there were sufficient staff with a variety of skills to meet people’s individual needs and to respond flexibly to changes.

Staff received the training and support they needed and were highly motivated to do their roles and deliver sustained high quality care. This included staff having the skills to effectively manage people’s medicines so these were available and administered safely to people. People were extremely confident and positive about the abilities of staff to meet their individual needs.

Staff worked closely and in partnership with external health and social care professionals and providers and health commissioners. They also worked with educators and national organisations concerned with palliative and end of life care. This helped to ensure people received the right care at the right time and that knowledge was appropriately shared and used to influence best practice for people’s care.

People told us they were supported with their nutritional needs with the assistance of the chef. They checked people’s choices with them as they served meals which were both nutritious and presented in a way which met people’s needs so that they could enjoy their meals comfortably.

Staff treated people with care and compassion and were highly motivated and committed to providing people with the best possible palliative and end of life care. Staff were kind and thoughtful to people. People told us staff spent time listening to them, did not rush them, and did all they could to meet people’s individual wishes and requests. People’s individual needs were assessed and staff always encouraged people to make their own choices about their care and treatment. Where this was not possible issues of consent and decisions were made in people’s best interests by people who had the authority to do this.

People received care that was tailored to their individual needs. Both people who used the service and family members were highly complementary and satisfied with the care provided, which they often described as excellent. People and family members felt they mattered and their views were taken seriously and acted on. Staff worked alongside people to enable them to live as full a life as possible and supported people in achieving their wishes with key comments from staff who believed they went the extra mile. People were supported to receive end of life care which met with their needs and wishes to achieve a private, dignified and pain free death. People, their families and staff were provided with the emotional and bereavement support they needed.

People were placed at the heart of the services they received by the strong values held by the management and staff team around supporting people to have quality of end of life care which was responsive to enable people to live their lives as they wished until their died. There was a strong sense of commitment within the management and staff team to source new initiatives and find creative ways of responding to the varied needs of the local population. Education, research and working in partnership was actively encouraged and supported to provide not only care and treatment but therapeutic benefits to people.

People and their family members, staff, board of trustees were actively informed and involved in developing the service. Their views were used to continuously inform service improvements and development and to influence the services people received so that these remained innovative, effective and raised quality where needed. The management team were continuing to make improvements and develop the hospice services further to ensure people received safe and effective palliative and end of life care.

Inspection areas

Safe

Good

Updated 28 June 2016

The service was safe. People were kept safe because there were sufficient staff to meet their assessed needs. Individual risk assessments were prepared with people and measures put in place to reduce the risks of harm. People medicines were stored, available and administered safely.

Effective

Good

Updated 28 June 2016

The service was effective. People’s choices were respected and they were involved in decisions about their care and treatment. People received effective care, treatment and support from a diverse staff team, who received the training and support they needed to be able to undertake their roles. Staff worked closely with external organisations, commissioners and health and social care professionals in a way which made sure people received the right care at the right time. People were appropriately supported and encouraged to eat and drink.

Caring

Good

Updated 28 June 2016

The service was caring. People were supported in a caring way with dignity, respect and kindness. People were supported to have choice and to be involved in all aspects of their care. People were treated with the utmost care and compassion and received a dignified and pain free end of life care and support.

Responsive

Outstanding

Updated 28 June 2016

The service was very responsive. People were treated as individuals and were enabled to live as full a life as possible. People, their families and staff really mattered and their views about the care and treatment provided were sought, respected and acted on. People received exceptional end of life care and support, which met with their needs and wishes from highly motivated and committed staff. People and their families were provided with the emotional and bereavement support they needed, both during and after end of life care. Effective information, communication systems and shared working, meant people’s care and treatment was consistent, flexible and properly informed to meet their needs.

Well-led

Good

Updated 28 June 2016

The service was well led. People believed the service was well managed and they received high quality care which effectively met their needs. The leadership team and staff shared strong values and beliefs centred on offering a personalised service to each person to fulfil their wishes. There was a focus on continual improvement to ensure the services people received were creative, effective, safe and of a high quality.