St Rocco's Hospice

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

At our last assessment we rated this key question good. At this assessment the rating has remained good.

The service effectively assessed and reviewed patients’ needs through holistic, person-centred care planning and regular multidisciplinary meetings. Staff collaborated well across teams and with external partners, ensuring continuity of care. Outcomes were monitored through audits and benchmarking, with high scores in emotional support and dignity. However, there were shortfalls in delivering evidence-based care, with some policies not aligned to current standards and appraisal compliance below target, though improvement plans were in place.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We reviewed 5 patient care records during our inspection. All these Care records demonstrated that holistic assessments took place in collaboration with patients, and person-centred care and support plans were in place. Risk assessments were completed for falls, manual handling, pain scores and pressure ulcers.

The service had daily multi-disciplinary meetings for those on the palliative virtual ward and in-patient unit, and weekly MDT meetings which included external partners.

Staff used a nationally recognised tool to identify deteriorating patients.

Staff identified patient’s communication needs on admission and interpreters were available if required, including British Sign Language (BSL).

We scored the service as 2. The evidence showed some shortfalls. The service did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Staff assessed and met patients’ needs for food and drink and for specialist nutrition and hydration.

The service had policies in place that were in line with current evidence-based practice and standards such as NICE, however they did not follow national guidance for early warning scores. Policies the service did have were regularly reviewed and staff told us that policies were accessible and knew how to access them.

Regular staff meetings and appraisals were in place. However, appraisal compliance was below target, with an overall rate of 83% and 74.3% for clinical nursing staff. These figures had been reported to the board, and leaders had implemented an improvement plan.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff held regular and effective multidisciplinary meetings to discuss admissions, patients and staffing levels. Staff shared information about patients at effective handover meetings within the team (for example, shift to shift).

Staff told us they worked well with external teams such as the single point of access team which had a social worker, and there was a Macmillan nurse based in the hospice daily which all ensured continuity in patient’s care.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service had a regular audit programme, which showed the service was performing well against targets and that the results and any improvement points were discussed at quality governance meetings.

The hospice benchmarked with Hospice UK and FAMCARE (this is a national audit run by the Association of Palliative Medicine, which looks at the service evaluation of bereaved families). FAMCARE had most responses at 100% for areas including multidisciplinary meetings, being involved in care decisions, the availability of medical staff and the explanations given regarding treatment decisions and outcomes. They also score at 100% for emotional support for both the person and relatives, alongside respecting people’s dignity.

Managers shared and made sure staff understood information from the audits. We were told there were several mechanisms by which staff were informed of changes. These included team meetings, emails and newsletters.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.