Marie Curie Hospice and Community Services London Region

Marie Curie Hospice Hampstead is one of the hospices in the Marie Curie group providing palliative and end of life care for adults only. The hospice could accommodate up to 34 people. There were 30 people using the hospice at the time of the inspection. Staff specialise in helping people with life-limiting illnesses including cancer, motor neurone disease, heart disease and renal failure. Treatments and care offered include inpatient care and rehabilitation, day therapy and outpatient appointments.

Other services offered by the hospice included complementary therapies, outpatients, physiotherapy, spiritual support and bereavement support for families, friends and carers of people using its services.

The hospice had a registered manager. 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 told us that they were safe and protected from potential abuse. Risk assessments and appropriate management plans were in place where risks were identified to protect people from potential risks from receiving care. Staff were available in adequate numbers to meet people's needs. Staff had the training and support needed to ensure they were skilled and knowledgeable to meet people's needs.

People received their medicines safely and as prescribed. There were appropriate arrangement in place to ensure the safe management of medicines, although we identified a few issues that the management team told us they would address promptly. The hospice worked to ensure that people's health care needs were met by a multidisciplinary team of health professionals.

People were supported to make decisions and choices about their care. Where people were unable to make decisions about their care their human rights were protected as assessment had been carried out to make sure any decisions were in their best interests.

Care plans reflected people's needs and their preferences. Staff understood people's care needs and provided care and support in a person centred way. People had a choice of meals that met their nutritional needs and reflected their cultural or religious preferences.

People were treated with kindness and compassion. Their dignity was respected as care was delivered to meet their individual needs.

People knew how to complain and there was an accessible complaints policy to guide them through the process. People were confident that there concerns would be addressed.

People were consulted and involved in making suggestions for improving the service. The quality of the service was monitored and action was taken to improve the service when necessary.

People, relatives and staff told us that the registered manager and the management team were accessible and listened to them. People and staff were involved in the development of the service as there were ways for them to share their views, and make suggestions to improve the hospice.

Is the service safe?

Records showed people experienced safe and appropriate care. Their needs were assessed and their care and treatment planned and delivered in accordance with individualised care and risk-management plans. For example, staff followed guidance in care plans to minimise risk of falls, infection, and pressure sores. Effective procedures were in place for reporting, investigating, and acting on safety concerns, and for dealing with foreseeable emergencies. Risks were identified, assessed and acted upon to ensure the health, welfare and safety of people using the service and others who may be at risk. A programme of risk based audits was evident. Staff were suitably trained to ensure people's safety and welfare.

Is the service effective?

Feedback from people who used the service was very positive. Clinical records were communicated to all relevant parties in a timely manner to ensure continuity of care. Care plans were personalised and addressed people's physical, communication, emotional and social needs. They showed staff promoted and respected people's diversity, privacy and spiritual beliefs. There were effective recruitment and selection processes meaning that people were cared for by staff with the right qualifications, knowledge and skills. Staff at all levels demonstrated that multidisciplinary relationships ensured people's needs were met and people experienced safe and appropriate care.

Is the service caring?

People and their relatives gave positive feedback about their experience at Marie Curie Hospice. Staff cared for people with warmth, dignity and compassion, creating a nurturing, friendly environment. People were happy and responsive to staff and each other. However, we saw some incomplete care records which meant that there was ineffective documentation to demonstrate that people were always fully consulted about decisions around care and treatment and resuscitation. We brought this to the immediate attention of the registered manager.

Is the service responsive?

We found staff understood people's individual communication methods, enabling choice in their daily lives. Staff worked collaboratively with other health and social care professionals and other agencies, ensuring people received care in a co-ordinated way. Information on patient experience was formally reported to the Board and at service management level. Concerns and best practice were shared with staff at all levels. People, their relatives and staff we spoke with told us the provider was approachable and accessible.

Is the service well-led?

Leadership was visible throughout the organisation. Staff told us there was an effective open door policy, they felt supported by managers and they were listened to. Staff described the organisation positively, and told us learning opportunities were on-going and readily available. There were effective systems in place to regularly identify, assess and monitor the quality of the services provided. There were effective arrangements to support monitoring, review and amendments of policies and guidance.

There was enough equipment to promote the independence and comfort of people who use the service. Equipment to support people was clean and people were protected from infections.

Staff were supported through a programme of professional development to care for people.The provider ensured that people were cared for by qualified and experienced staff.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.

Overall we spoke with twenty patients or their relatives/friends who were visiting, and ten staff in different areas of the hospice. People told us 'I've been very happy here,' 'They are brilliant,' 'Its absolutely fantastic,' 'You couldn't ask for better,' "Everyone here is brilliant ' I can't fault any of them,' 'I'm quite satisfied,' and 'I'd give it five stars.'

All of the people we spoke with told us that they were receiving a good level of care, treatment and support. People were very complimentary about the staff in the hospice and said that they explained and answered questions about their care and treatment. They were satisfied with the choices of food provided to them, and the flexibility of catering services. They spoke highly about standards of cleanliness within the hospice, and the facilities provided. People spoke highly of the skills and attitude displayed by staff. They were aware of how to make a complaint, if they were unhappy about any aspect of their care, and felt that their views were taken into account in the way in which the service was run.