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Inspection Summary


Overall summary & rating

Good

Updated 12 January 2017

St Rocco’s Hospice provides in-patient hospice care, a hospice at home service and a day hospice from one site. The hospice holds clinics, has a family support service, therapy services, a fundraising department and a team of volunteers all based on-site.

The service is a registered charity with a board of trustees. Day to day the service is run by a management team drawn from all departments within the hospice.

There was a registered manager employed for this service. 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. The registered manager was experienced in providing palliative care and had worked at the hospice for a number of years.

People and their families spoke highly of the complementary therapies that were available to both people who used the service and relatives. The hospice provided family support, counselling and bereavement support and had recently appointed a non-denominational chaplain to strengthen their team.

People told us that staff were caring, compassionate and listened to them. People we spoke with who received personal care felt the staff were knowledgeable, skilled and their care and support met their needs.

People’s health care needs were met by the in-house medical team. This included consultants, GP’s with a special interest in palliative care, an occupational therapy team and a physiotherapy team. We saw the service was developing staff by developing the specialist nurse role and supporting nursing staff to undertake a non-medical prescribing course.

Care plans were personalised to include people’s wishes and views. People and relatives told us they were consulted about their care and treatment and that they regularly had the opportunity to speak to medical and nursing staff. Care plans were regularly reviewed in a multi-disciplinary framework. We observed staff caring for patients in a way that respected their individual choices and beliefs.

Staff recruitment processes were followed with the appropriate checks being carried out. There were sufficient staff on duty to meet people’s needs although had experienced some shortness of staff recently although this had not impacted detrimentally on the people using the service. The hospice had a bank of staff who they could contact if they needed additional staff. The registered manager told us they were working on a project to look at the skill mix of staff. Staff and volunteers received a thorough induction and regular training to ensure they had the knowledge and skills to deliver high quality care and support.

Staff followed risk assessments and guidance in management plans when providing care and support for people in order to maintain people’s safety.

People were protected by the service’s approach to safeguarding and whistle blowing. People who used the service told us that they were safe, could raise concerns if they needed to and were listened to by staff. Staff were aware of safeguarding procedures, could describe what they would do if they thought somebody was being mistreated and were aware of who to report safeguarding concerns to.

Staff gave us mixed views about how they felt supported. We explored this with the senior management team who were aware of staff feelings and showed us how they were communicating and engaging with staff over issues they had raised. Staff did tell us they felt optimistic about the outcomes of these issues.

Staff worked within the principles of the Mental Capacity Act where appropriate. People had choices about their care and their consent was sought by staff.

People were supported to receive a nutritious diet at the service. Their appetite was assessed through talking to them which led to staff being able to give

Inspection areas

Safe

Good

Updated 12 January 2017

The service was safe.

Checks of the building and equipment were completed to make sure it was safe.

Staff we spoke with could explain indicators of abuse and the action they would take to ensure people’s safety was maintained. This meant there were systems in place to protect people from the risk of harm and abuse.

On the day of our visit we saw staffing numbers and skills mix were sufficient to provide a good level of care to keep people safe. Robust recruitment procedures were in place to make sure staff were suitable to work with vulnerable adults.

Medicines were safely stored and managed.

Effective

Good

Updated 12 January 2017

The service was effective.

People’s healthcare needs were carefully monitored and discussed with people who used the service and their family members.

Staff told us they had appropriate supervision.

Staff of all levels had access to on-going training to meet the individual and diverse needs of the people they supported. Staff were trained to provide the specialist care people required.

People were assessed to identify risks associated with poor nutrition and hydration and spoke highly about the quality and choice of food

Caring

Good

Updated 12 January 2017

The service was caring.

People told us that staff were kind and compassionate at all times and treated everyone with dignity and respect.

The service provided emotional support to people, their family and friends via a team of dedicated counsellors, nurses and healthcare staff on an on-going basis.

People were supported spiritually. People were encouraged and supported to make decisions about their care and given time to make their own choices; this included their end of life care

Responsive

Good

Updated 12 January 2017

The service was responsive.

People told us they felt confident to express any concerns or complaints about the service they received.

People and their families were fully involved in assessing their needs and planning how their care should be given.

Staff delivered people’s care in a person-centred way, treating them as individuals and encouraging them to make choices about their daily lives.

Well-led

Good

Updated 12 January 2017

The service was well led.

The management team gave effective leadership and provided a clear strategy for the long term development of the service.

There were clear management structures and lines of accountability. Staff told us the service was well managed, that they were treated with respect and were actively involved in decision-making.

Systems were in place to monitor the quality of the service provided to ensure the service was run in the best interest of people.

Staff did raise some concerns over feeling listened to and we saw that the management team had pro-actively addressed this with the whole staff team.