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St Cuthbert's Hospice Outstanding

Inspection Summary


Overall summary & rating

Outstanding

Updated 21 January 2015

We inspected St Cuthbert’s Hospice on 20 August 2014 and the inspection was unannounced. Our last inspection took place in July 2013 and we found the service was meeting all essential standards.

St Cuthbert’s Hospice is registered to provide accommodation and nursing care for 12 people with life limiting illnesses and also day care services for those who have remained in their homes during their illness. The hospice provides a wide range of specialist services designed to care for people’s physical, emotional and spiritual wellbeing. The hospice and day care facility provide patients with access to family support, physiotherapy and complimentary therapies. St Cuthbert’s Hospice is a registered charity.

The hospice had a Registered Manager who had been in post since October 2008. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

Relatives and people who used the service gave us positive comments about the staff such as “The staff and volunteers are just brilliant” We did not receive any negative comments from people who used the service, their relatives or health professionals involved in people’s care.

On the day of our visit we saw people looked well cared for, staff spoke with them in a calm and respectful way. We saw when staff spoke with people they took time to get to know them better and to listen to their needs.

We saw staff and volunteers working at the hospice understood the needs of people who used the service.

Care staff were appropriately trained to carry out their roles and additional training was provided if staff requested it. Volunteers who worked in the hospice were also given training appropriate to the roles they carried out.

Risks to people who used the service were appropriately assessed and managed.

St. Cuthbert’s Hospice used a ‘workforce planning modelling’ to ensure staffing levels were appropriate.

The hospice had plans in place to deal with unforeseen circumstances such as emergency admissions to hospital.

The hospice building provided an environment and facilities that were welcoming to people who used the service,

All rooms had patio doors which could be opened to allow beds to be wheeled outside if people wanted to gain some fresh air.

The hospice had a family support team which was available to provide pre and post bereavement counselling for patients as well as friends or relatives and they also provided a children’s counselling service if needed.

People who used the hospice and their family or friends were involved in the planning of care. When people were admitted to the hospice staff took time to meet people and get to know them whilst documenting a plan of care.

The hospice regularly reviewed complaints and incidents that had been recorded with an audit of all of these, including actions taken and lessons learned being published in the providers annual quality account.

Inspection areas

Safe

Good

Updated 21 January 2015

The service was safe.

Risks to people who used the service were appropriately assessed and managed.

St. Cuthbert’s Hospice used a ‘workforce planning modelling’ to ensure staffing levels were appropriate. This was done by looking at key elements such as occupancy, patient dependency, skill mix and workload.

The hospice had plans in place to deal with unforeseen circumstances such as emergency admissions to hospital. There were also contingency plans in place to deal with emergencies that may affect the building or the equipment. This ensured people who used the service would continue to receive the care they required.

Effective

Outstanding

Updated 21 January 2015

The service was effective.

People’s needs and preferences regarding their care and support were met. Staff we spoke with talked knowledgably about the people they supported. People we spoke with were complimentary about the service provided.

Staff working at St. Cuthbert’s Hospice were trained so they could provide specialist care including a lymphoedema clinic (lymphoedema is a chronic condition that causes swelling in the body’s tissue) and intravenous infusions. The hospice has also recruited a nurse who specialises in dementia.

Staff received regular training and were aware of their responsibilities in relation to the Mental Capacity Act 2005 and Deprivation of Liberties Safeguards.

Staff had supervisions and appraisals where they were able to discuss training they may want, or concerns they had about their role.

Communication between staff, patients and their relatives was very good. This was confirmed when we spoke with patients and their relatives. We saw staff had three hand overs daily; medical staff saw patients on a daily basis and reviewed their care, treatments and support needs.

The hospice building provided an environment and facilities that were welcoming to people who used the service,

All rooms had patio doors which could be opened to allow beds to be wheeled outside if people wanted to gain some fresh air.

Caring

Outstanding

Updated 21 January 2015

The service was caring.

People who used the service and their families told us they were happy with the care and support they received at the hospice.

Staff supported people who used the service in a way which helped to promote their independence by asking if they wanted help to complete tasks and what help people would like.

All patients who stay at the hospice had their own private room with en-suite allowing them to have time alone and in private with family or friends.

Information was recorded about people’s wishes with regards to end of life care and what they wanted after their death. For example, where they wanted to be buried and music they would like played at the funeral.

The hospice had a family support team which was available to provide pre and post bereavement counselling for patients as well as friends or relatives and they also provided a children’s counselling service if needed.

Responsive

Good

Updated 21 January 2015

The service was responsive.

People who used the hospice and their family or friends were involved in the planning of care. When people were admitted to the hospice staff took time to meet people and get to know them whilst documenting a plan of care. The information was used to create a comprehensive care plan with appropriate risk assessments to ensure people were cared for in the way they would like while keeping them safe.

If a patient lacked capacity then best interest decisions following discussions with their family or their representatives and in accordance with the Mental Capacity Act 2005 and Deciding Right Document. The Deciding Right Document was developed with the support of the North East Strategic Health Authority end-of-life clinical innovation team.

Well-led

Outstanding

Updated 21 January 2015

The service was well-led.

The hospice regularly reviewed complaints and incidents that had been recorded with an audit of all of these, including actions taken and lessons learned being published in the providers annual quality account.

Staff we spoke with told us they felt supported and enjoyed their work. We spoke with three members of staff. One person told us “This is one of the best places I have ever worked in. I believe the care here is first class.” Another staff member said “I really appreciate the time I am allowed to spend time with People and their families.”

Annual quality accounts were produced and measured against key aspirations the hospice had chosen for the previous twelve months. People who used the service, staff and volunteers are consulted about these before they are chosen.