Pilgrims Hospice Ashford

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

We reviewed 5 quality statements for caring: kindness, compassion and dignity, treating people as individuals, independence, choice and control, responding to people’s immediate needs and workforce wellbeing and enablement. People received care and support that was exceptionally compassionate and kind.

At our last inspection we rated this key question outstanding. At this inspection, the rating has remained outstanding.

All bedrooms were on the first floor and had direct access to their own patio area with additional accessible access to a large communal garden with several seating areas.

There were 2 family rooms with ensuite facilities, large and bright. The hospice had recently procured a ‘cuddle bed’ so that partners/family members could share a bed with patient.

There were recently refurbished single sex bays with some private rooms available. The hospice could accommodate 8 in-patients (reduced due to staffing/funding) and always had a minimum of 2 Registered Nurses and 2 Healthcare Assistants per shift . The premises included a number of comfortable private spaces where patients, and their friends and families could spend time. For example, there were counselling rooms available and these included spaces for children where games, toys and art supplies were provided.

Care given to patients was person-centred and staff treated patients with dignity and respect. The hospice took people's wishes into account and respected their choices, to achieve the best possible outcomes for them. Staff treated patients as individuals and made sure their care, support and treatment met their needs and preferences.

Family members and people close to the patient were encouraged to be involved in their care, support and treatment of their loved ones. Patients fed back that care was excellent, and staff were compassionate and caring. The hospice promoted the wellbeing of their staff and supported them to always deliver person-centred care.

Staff went to great lengths to make sure that people’s needs, views, wishes and comfort were their utmost priority. They went above and beyond to anticipate people’s needs and take steps to ensure preventable discomfort, concern or distress for people. For example, we observed staff on the inpatient ward responding quickly to people’s needs. This included answering call bells quickly and anticipating needs in relation to comfort and wellbeing. We reviewed a care record of a patient who was on a modified diet. The staff had gathered information to establish what the patient liked to eat and passed this on to the kitchen staff.

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.

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.

Staff treated patients with compassion and kindness, respected their privacy and dignity.

The hospice collected patient feedback through a number of different methods depending on which service patients used. We reviewed patient feedback comments which were overwhelmingly positive and confirmed that staff treated patients with kindness, compassion and dignity.

We looked at the Medical Examiner’s report for the last 12 months and saw that they had spoken with 16 patients and/or their relatives. All the comments were positive, for example, “They were amazing, they managed to get him out of pain, and he died peacefully. A star they were fantastic”, and “The care was unbelievable, they looked after xx all the way through, you couldn't have asked for better. What they do there is amazing”.

The hospice provided psychological and bereavement support to all patients and families if needed. Feedback for the service was positive as patients commented that the sessions made them feel safe and reassured and helped them grieve. Another patient commented that the sessions helped manage their trauma and taught them ways of coping.

In April 2019 Pilgrims launched Stepping Stones bereavement services, in association with the local NHS hospital . The aim of the service was to provide accessible bereavement support, for adults whose loved one had died.

Monthly bereavement cafes were launched from each hospice site, facilitated by a team of 14 expert volunteers recruited by Pilgrims, and trained in collaboration with east Kent CRUSE (bereavement support). Later that year they extended the service to any adult living in east Kent with a targeted promotion to GP surgeries across the region. In the first year of service, 80 individuals who had not previously accessed hospice care, attended Stepping Stones bereavement support.

Family support was recognised as vital to people's wellbeing and staff were aware of the need to support families through the process of losing a loved one. Family members were offered complimentary therapies, could attend well-being events, support sessions and were offered counselling which could be 1 to 1 for patients and family members or family therapy was also offered. There was a team of therapists which included volunteers. Counselling and therapy were available for individuals, couples, families and children, during illness or after bereavement.

Staff cared for people and each other in a way that exceeded expectations and fully respected their privacy and dignity. The hospice leaders promoted and supported its staff to ensure dignity and privacy were central to the care they provided. At every opportunity, curtains were drawn, and blinds were closed on bedroom doors by staff when they provided intimate care. We saw signs on bedroom doors saying people did not wish to be disturbed as they were resting. Staff demonstrated genuine empathy for the people they cared for. People felt staff listened to them and communicated with them appropriately, in a way they understood.

Throughout the inspection, we observed staff and volunteers consistently providing excellent care and support to both patients and their families.

People were assured information about them was treated confidentially and they knew staff respected their privacy. Conversations between staff and patients were kept private and sensitive information was never shared in the presence of those not authorised to hear it.

Staff gave us examples of when the hospice had supported patients and families to celebrate significant events such as birthdays, weddings and religious events such as Christmas and Ramadan. The hospice had a memory tree where patients could leave notes for their loved ones.

Staff told us that patient’s families, grandchildren and family pets were all made welcome by staff who made "a special effort." to ensure they felt welcome and included.

Staff were encouraged to identify any special wishes and aspirations that could be fulfilled and make them a reality. For example, one patient told staff that she had never tasted lobster and would love to before passing. The chef provided cooked lobster for the patient that day.

There was a chapel where people could reflect or pray, and this space was also used for ceremonies (all faiths) on the ground floor. Spiritual care played a vital part in the holistic care that was offered to people and their families. There were annual memorial remembrance services for loved ones. For example, Pilgrims' summer remembrance was taking place in July 2025, where beautiful sunflower markers dedicated in memory of loved ones, would be used to decorate the gardens. Families and guests would then be invited to a celebration in the garden for a summer tea party. They supported all patients to attend such events – staff could take beds into the garden or if preferred, patients could watch from the balcony with family/friends.

The hospice supported the Blackbird Project -a project that enabled patients to record vocal memories for their loved ones. These recordings, which could include anything the patient wished to share, were then downloaded onto a bespoke blackbird-shaped Universal Serial Bus stick (USB the system for connecting electronic equipment to devices) and given to the nominated recipient.The project also offered a one-year secure storage of the recording with the patient's written permission.

We were shown a patient’s legacy suitcase which all staff had helped to develop. The suitcase included special mementos to remember loved ones such as wooden hearts and the Blackbird project USBs. Hand and footprints could be made into jewellery/ tattoos/ wooden hearts. There were scrapbooks that families could make with special mementos including photographs. The suitcase also included a poster that had been made by a child who'd lost a parent in the hospice.

We saw 2 family rooms with ensuite facilities that were large and bright, which enabled families to stay overnight. Every room had a sofa bed. Pets were also allowed to stay.

The hospice had a cuddle bed which could accommodate 2 adults and 2 children . This enabled families to be together for example, cuddling up to watch a movie as they would do at home.

The premises included several comfortable private spaces where patients, and their friends and families could spend time. For example, there were counselling rooms available and these included spaces for children where games, toys and art supplies were provided.

A portable telephone was available for patients to use. Mobile phones could be used, but this would be at the discretion of the nurse in charge to ensure other patients who may be resting were not disturbed.

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

The hospice took account of the patient’s individual needs. People were encouraged to be involved in their care and treatment planning. The hospice treated patients as individuals and tailored the assessments and reviews to their communication needs and personal preferences.

We observed a handover where staff discussed the patient’s social history which included their likes and dislikes. In addition, to this staff also discussed the patient’s emotional needs.

We reviewed 5 care records which showed personal, cultural, social and religious needs of the patient clearly recorded.

The service respected the diverse nature of everyone. The hospice had a spiritual care team who supported patients and families if needed including patients of any faith and religion. The hospice employed a spiritual lead who liaised with other faith leaders as requested to support religious aspects.

Staff supported people to take part in activities they had been unable to for some time such as, gardening within the specialised adapted garden which catered for their needs. There were many examples of caring and compassionate staff supporting people for example, pets stayed with their owners on the inpatient ward.

People’s communication needs were met. Staff could access translators in various languages including British Sign language. This enabled them to engage in their care, treatment and support.

Staff treated people 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.

Staff received training on the ethos of the service so they had a clear focus on enhancing the lives of people with a terminal illness to provide them with more quality time with their loved ones, and this meant finding out what mattered to them to promote their choices and give them control over what their care should look like.

Patients and where appropriate their relatives were supported to be actively involved in making decisions about the care they received. The service promoted people’s independence and encouraged them to have choice and control over their care and treatment.

The social work team based at the hospice offered patients and families support and advice to help manage their care whilst maintaining their independence. The team worked closely with other teams within the hospice and those in the wider community to provide a wide range of practical and emotional support.

The hospice had onsite spiritual chaplains with both religious and humanist backgrounds. Patients and families had access to quiet spaces should they need this.

Leaders told us the hospice could facilitate rapid death registration and funeral procedures when needed as part of religious or cultural beliefs. The hospice also supported family in personally caring for those at the end of life, including requirements for people of different religious faiths.

The service had a Last Offices Procedure, (the term for the care given to a deceased patient) which demonstrated continued respect for the patient as an individual, focusing on the Health and Safety legal requirements, whilst respecting religious and cultural preferences.

Patients had access to the physiotherapy and occupational therapy team who were based at the hospice. The team supported patients to maintain their independence and helped address symptoms of pain.

The hospice had two therapy suites where patients received complementary therapies which included massage and reflexology.

The hospice provided a hospice at home service for those who preferred to receive hospice care within the comfort of their own home. This service was available 24 hours a day, 7 days a week with a combination of planned and responsive visits.

Staff told us they received referrals from the community and worked together with district nurses to provide care for patients in their homes. Staff visited up to three times a day and focused on the last two weeks of the patient’s life.

Feedback received by the hospice was overwhelmingly positive. A comment read ‘Thank you for your support and guidance, with your help we were able to keep him at home just where he wanted to be’.

Staff went to great lengths to make sure people’s needs, views, wishes and comfort were their utmost priority. They went above and beyond to anticipate people’s needs and took steps to ensure preventable discomfort, concern or distress for people. We observed staff communicating and engaging with people in discussions about their immediate needs. 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 their loved ones 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.

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

We spoke with the lead complimentary therapist, who told us that they taught staff touch therapy (a half-day training course for health and social care professionals). This course taught participants how to provide hand massage as a means of soothing and caring for individuals. The course focused on techniques for a simple hand massage, and participants got to practice with real-life models.

Leaders and staff considered how environments kept people safe from psychological harm as well as physical harm, for example, access to the premises and facilities to promote their mental wellbeing. Their Wellbeing Programme was free if you lived in East Kent and you had been diagnosed with an incurable illness. It aimed to enhance people’s wellbeing in mind and body.

On the day of our visit, we were introduced to a Therapy dog, Rex who had been visiting the hospice for 10 years. We saw that a photograph of Rex was also on the staff notice board and that he was sitting outside of a patient’s room. Staff told us that the patient found this very calming. We spoke with Rex’s owner who said he loved bringing him to the hospice and “he's always been made to feel very welcome and that this service was very valuable”.

Staff were able to anticipate when someone needed urgent care or had entered the dying phase to provide timely and appropriate support. Managers and staff had worked hard to identify when patients were in their last hours of life this included a Recognition of death audit and reviews of patient deaths which included whether staff had recognised the patient was in the dying phase and had taken appropriate action. Associated learning was shared across the hospice. Recognition that patients were in the dying phase not only ensured their ongoing comfort but also alerted loved ones to enable them to be with the person if they wished when they died.

Leaders promoted the wellbeing of their staff to enable them to deliver excellent quality person-centred care.

The hospice had an employee assistance programme and provided counselling sessions for all staff at the hospice. Staff also had access to the inhouse support and advice with the psychology team.

Staff told us they received supervision, and clinical incident reviews and debriefs following a difficult event. We looked at an email dated June 2024 from a senior ward sister, that showed that in addition to clinical supervision, debriefs were set up on an ad hoc basis when there had been a particularly difficult case. The hospice ran regular “Self-Care and Development” sessions to support staff. The hospice’s ACT (All Come Together ) sessions often focused on wellbeing. We were shown a flyer of “Stress in the workplace” session open to staff. We saw an email from the hospice Services Manager titled “Keep Cool - Fans/Ice Lollies and Fetching Hats” reminding staff that during hot weather to stay cool and that there were ice lollies in the staff room freezer.

The hospice also provided a health and wellbeing programme to staff which included confidential counselling and eyecare for frequent users of display screen equipment.

The hospice at home staff went out in pairs and kept a phone with them. The phone was connected to the call centre for emergencies and staff could raise an alert when shaking it.

Reasonable adjustments were made for staff where possible to enhance their social activities away from work, promoting a healthy work life balance.

Staff we spoke with staff told us that they felt valued by their leaders and their colleagues. They had a sense of belonging and the ability to contribute to decision making. For example, we were told about improvements made from a Healthcare Assistant meeting. Staff had multiple ways to feedback alongside the staff survey. Every month the Local Management Team conducted Claims, Concerns and Issues exercise whereby, any concerns and issues that cannot be resolved on site gets escalated.

All staff we spoke with were very positive about working at the hospice and described a very healthy culture and philosophy of providing compassionate, personalised care and giving people the‘’best death possible.’’

We spoke with a student nurse who reported they were loving the experience and advised they had a good induction. They told us that they had been given a staff booklet on starting and knew how to access policies on the intranet, was supernumerary to support their learning and development. They had a buddy/supervisor and had regular 1-1s and feedback. They told us staff of all grades and disciplines were approachable, inclusive and very keen to teach and support.

We spoke with a receptionist who told us that their role was a patient administration coordinator (there were three of them) to provide around the clock service. They managed referrals /booked the first assessment for patients. Each site had its own team. They advised us that they loved working at the hospice, and it had been their favourite job. The reason they loved it was ‘’because of the team and the difference they made.’’ they told us that there was no hierarchy, and all the staff were very approachable and that the culture was inclusive and all about learning and support and making a difference for patients and their families.