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The Heart of Kent Hospice Outstanding

Inspection Summary

Overall summary & rating


Updated 25 April 2017

The Heart of Kent Hospice is a local charity that provides specialist palliative care, advice and clinical support for adults with life limiting illness and their families in the Maidstone, Aylesford, Tonbridge and Malling area. They deliver physical, emotional and holistic care through a multi-disciplinary team that includes doctors, nurses, physiotherapist, occupational therapist, volunteer complementary therapist, counsellors, a welfare advisor and administrative, catering and housekeeping staff. The service is supported by approximately 600 volunteers. Services are free to people and the Heart of Kent Hospice is largely dependent on donations and fund-raising by volunteers in the community.

The service cares for people in two types of settings: at the hospice in a 10 beds ‘Inpatient Unit’, or in their own home with the support of a community palliative care team. In addition, the Heart of Kent Hospice provides an Outpatient Centre, ‘Magnolia Place’, which is open three days a week, where people can access advice, support, and take part in individual and group therapeutic activities. A weekly Drop-in Centre and a dementia café provide an environment where people and their families can receive support from the team as well as talk to others facing a similar situation.

At our last inspection on February 2016, we issued three requirement notices in relation to three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found that care and treatment was not provided in a safe way for people; medicines were not properly and safely managed; documentation regarding staff training, advance care planning, people's individual likes and dislikes, complaints logs and recruitment was not appropriately completed; systems and processes were not established and operating effectively to ensure compliance; there was a lack of staff competency checks; and staff did not receive appropriate support, training, supervision as is necessary to enable them to carry out their duties. The registered provider sent an action plan to us detailing the improvements they would make. They confirmed they would be meeting the requirements of the regulations by February 2017 and that new systems would be embedded and sustained over time. They kept us informed of their progress.

This inspection was carried out on 20 and 21 February 2017 to follow up on compliance with these notices. At this inspection we found that the registered provider had met the requirements detailed in the requirement notices and had made significant improvements to the culture of the service and the care people received. At the time of our inspection, six people resided in the Inpatient Unit and 575 people were open to the community palliative care team, 170 of whom lived with dementia.

There was a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

Staff knew how to recognise signs of abuse and how to raise an alert if they had any concerns in regard to people’s safety. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or make sure people were protected from harm.

There were sufficient staff on duty to meet people’s needs across the service. New recruitment systems were embedded in practice and ensured relevant checks and records were appropriately completed.

Improvements had been made in regard to the secure storage of medicine, competency checks for nursing staff and records of administration of medicine. People received medicines that were appropriately stored, documented and administered by

Inspection areas



Updated 25 April 2017

The service was safe.

Practices regarding the storage, administration of medicines and regarding staff competency checks were in accordance with current legal requirements..

Consistent and robust recruitment procedures were followed in practice.

Staff knew how to recognise signs of abuse and how to raise an alert with the local authority if they had any concerns in regard to people�s safety.

Risk assessments were centred on the needs of the individuals and there were sufficient staff on duty to meet people�s needs safely.



Updated 25 April 2017

The service was effective.

The system for the monitoring of staff training was effective. Essential mandatory training was provided consistently. All staff received one to one supervision to be supported in their role. All care staff were subject to competency checks to ensure they were competent to carry out their role.

Staff had a good knowledge of each person and of how to meet their specific support needs.

The registered manager understood when an application for Deprivation of Liberty Safeguards (DoLS) should be made and how to submit one. Staff were trained in the principles of the Mental Capacity Act (MCA) and the DoLS and were knowledgeable about the requirements of the legislation.

People were supported to be able to eat and drink sufficient amounts to meet their needs and were complimentary about the quality of the food.



Updated 25 April 2017

The service was outstandingly caring.

People�s feedback about the caring approach of the staff was overwhelmingly positive and emphatic terms such as, �exceptional�, �remarkable�, �amazing� and �outstanding� were used to describe them.

Staff showed kindness and knew how to convey their empathy when people faced challenging situations. They were skilled at giving people the information and explanations they needed in a sensitive manner. People valued their relationship with the staff team who often performed beyond the scope of their duties and pre-empted people�s emotional needs.

Staff communicated effectively with people and treated them with utmost kindness, compassion and respect.

People were consulted about and fully involved in their care and treatment. The service provided outstanding end of life care and people were enabled to experience a comfortable, dignified and pain-free death.



Updated 25 April 2017

The service was outstandingly responsive to people�s individual needs.

People were routinely invited to take part in �advance care plans� (ACP) in the community and the hospice, and were supported during the process.

People�s needs were assessed before support was provided in the community, in the Outpatient centre and as soon as they came into the Inpatient Unit. Care plans and risk assessments were reviewed and updated when needs changed. The delivery of care was in accordance with people�s care plans and was very responsive to people's individual needs.

Specialist dementia care was provided by the service as an innovative response to the increase of dementia in the community.

The service sought feedback from people and their representatives about the overall quality of the service. People�s views were listened to, valued and acted on. People and relatives's comments were overwhelmingly positive about how staff responded to their needs.



Updated 25 April 2017

The service was well-led.

The service demonstrated considerable improvement. New systems and projects had been implemented and embedded in practice.

The staff told us they had confidence in the current management team and were complimentary about the managers, the registered manager and the CEO�s leadership style.

There was a culture that focused on people and people were placed at the heart of the service.