The inspection took place on 13 and 14 June 2016 and was announced. We last inspected the hospice on 21 November 2013. The provider met the requirements of the regulations we inspected during this inspection. The Marie Curie Hospice, Newcastle provides specialist care for people with cancer and other life-limiting illnesses. The Newcastle hospice provides in-patient care, day care, out-patient support and short breaks. The hospice is registered for 22 people with 20 people receiving treatment when we visited.
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.
The hospice excelled at providing people with person-centred care that met all of their needs, physically, emotionally and spiritually. Dedicated, committed and compassionate staff provided care that maintained people’s dignity and respect. One person told us, “Its Brilliant, [I am] happy to be here and staff are happy to help.” Another person said, “I am having an absolutely marvellous time, I came in a week ago and wanted to crawl into a hole. This week I feel so much better.”
We found numerous examples where staff had gone the extra mile to meet people's wishes and create special memories for relatives. For example, arranging weddings, other celebrations and supporting people to attend events or fulfil their wishes.
People told us they were totally in control of decisions about their care. Staff supported people creatively to express their views and make choices. Bereavement support and support for families and children was a priority for staff at the hospice.
There was a strong focus on rehabilitation and promoting people's independence for as long as possible.
The provider's values put people at the heart of the care delivered at the hospice. Staff understood the values and how they translated into people's care.
The hospice had an open, transparent culture which encouraged involvement from people and staff. The hospice actively looked for new ways of working and delivering on-going improvements for the benefit of people.
Exceptionally strong governance arrangements were in place to ensure the hospice was safe and providing the best care. People gave positive feedback about the leadership and management of the hospice. One person commented, “It must be well led, as it is brilliant.”
The hospice was keen to not be a stand-alone service and had developed string partnerships with other organisations. They also took part in research projects to help advance palliative care.
People and staff told us the hospice was safe. One person commented, “I feel safe, it is brilliant.”
Staff had a good understanding of safeguarding and the service’s whistle-blowing policy, including how to report concerns. All staff members said they would raise any concerns straightaway. One staff member said, “I would be the first to speak up if I saw anything.”
People were assessed to help keep them safe from potential risks, such as the risk of poor nutrition, skin damage and falls. Where a potential risk had been identified measures were in place to help minimise harm to people, such as providing specialist equipment to prevent people from falling.
Medicines records, systems and processes supported the safe management of medicines.
There were sufficient staff to ensure people's needs, choices and preferences were met promptly. People, relatives and staff all confirmed staffing levels on the ward were good.
Effective recruitment processes, including pre-employment checks, ensured prospective new staff had the relevant skills and attributes and were suitable to provide person-centred care.
There were plans in place to deal with emergency situations. Health and safety checks helped keep the hospice safe.
Staff were very well supported and had the training they needed to be effective in their role. Staff took ownership of the supervision process and agreed the frequency of their supervisions jointly with their line manager. Emotional support was available for staff if they required it.
Where people lacked capacity the provider acted in accordance with the Mental Capacity Act (MCA). Deprivation of Liberty Safeguards (DoLS) had been authorised where required. Staff used a variety of methods to support people with decision making and making choices.
People were supported to ensure their nutritional needs were met in line with their preferences. The hospice was able to cater for a wide range of cultural and dietary requirements. People's views about the meals provided were actively sought to improve people's experiences.
A multi-disciplinary team of health and social care professionals provided people's care. People had access to a doctor 24 hours a day through the on-call system.
People's needs had been assessed and personalised care plans developed. People had discussed their preferences with staff on admission to help ensure they received the care they wanted.
Staff were responsive to people's pain management needs. The provider was developing a more effective pain management tool.
Daily handover meetings and the weekly multi-disciplinary team (MDT) meeting ensured all people were discussed in-depth by a range of professionals. Care and treatment was evaluated every day to reflect people's changing needs.
People knew how to make a complaint if they were unhappy with their care or treatment. One person commented, “Yes I know how [to make a complaint], not had the need.” Two formal complaints received during 2015 had been fully investigated and action taken to address the issues.