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St Andrew's Hospice, Adult and Children's Services Good

Inspection Summary


Overall summary & rating

Good

Updated 22 April 2015

We undertook this unannounced inspection on the 17 and 18 March 2015. The last full inspection took place on 23 July 2013 and the registered provider was compliant in all the areas we inspected.

St. Andrew’s Hospice, Adult and Children’s Services, is situated in a residential part of Grimsby and provides supportive and palliative care services. The service can provide in-patient care to a maximum of 12; eight placements for adults and four for children. In addition, the service can provide day care for 16 adults and four children. The service is currently undergoing a new build on the same site which will replace the building used for the adult service. This will be ready for use at the beginning of April 2015 and will increase the number of in-patient placements for adults from eight to 12. The children’s service remains the same. All bedrooms are for single occupancy and the new build has ensured all bedrooms have en suite facilities with specialised beds and equipment. All bedrooms in the current and new build have access directly into the gardens and patios. There is a range of bathrooms, communal rooms and therapy facilities to meet the needs of people who use the service. The children’s unit is light, bright, colourful and appropriate for their needs.

The service has 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.

We found there were safeguarding systems in place, which consisted of staff training and policies and procedures to guide staff if they had concerns. This helped to safeguard adults and children from the risk of harm and abuse.

We saw staff were recruited safely and in sufficient numbers to care and treat adults and children in order to meet their assessed needs. Staff completed training considered to be essential by the registered provider and also had access to specific training relevant to their roles within the service. There were support systems for staff which included supervision and staff meetings. These measures provided staff with the skills and confidence required to support adults and children with life limiting illnesses.

We found people received their medicines as prescribed. Prescription sheets and care plans regarding medicines were correctly completed. Medicines were appropriately obtained, stored, administered, recorded and disposed of.

We found adults and children had their health care needs met and they were supported to make their own choices and decisions about treatment. When adults were assessed as lacking capacity to make decisions, best interest meetings were held with relevant people to discuss options. Assessments and care plans were produced to provide staff with guidance in how to provide care and treatment which met their preferences.

Adults and children’s nutritional needs were met. There were choices and alternatives for meals and we saw catering arrangements were flexible.

We observed staff provided care and support in a kind and compassionate way and promoted privacy and dignity. Staff provided explanations and information about treatment. There was a range of therapies and activities to support people and their family, to include them and to prevent a feeling of isolation. People confirmed this during discussions with them.

We found the service was clean and hygienic. A member of staff had been designated a lead role in infection prevention and control (IPC). Once located in the new build, they were to complete a full IPC audit and develop protocols for managing specific infections.

There was an open culture to encourage adults and children who used the service, their families and staff to raise concerns in the belief they would be addressed. There was also a quality monitoring system to ensure people’s views were listened to, lessons were learned from incidents and practice was improved.

Inspection areas

Safe

Good

Updated 22 April 2015

The service was safe.

People were protected from the risk of harm and abuse. Staff had received safeguarding training, knew how to recognise signs of poor care and abuse and knew how to escalate any concerns.

People received their medicines as prescribed and there were arrangements in place to manage medicines safely.

Staff were recruited safely and in sufficient numbers to provide care and treatment to meet people’s needs.

People were cared for and treated in a safe environment. Risk assessments were completed and areas of concern were managed safely.

Effective

Good

Updated 22 April 2015

The service was effective.

People’s nutritional needs were met and they were provided with a choice of meals and alternatives.

People’s health care needs were met. They were supported to make their own decisions about their health care needs and treatment options. There were systems in place to assess capacity and make best interest decisions when people were unable to make treatment choices.

Staff completed a range of essential training and in areas specific to the needs of people they cared for. There were induction, supervision, appraisal and support systems for staff.

The premises had been adapted to meet the needs of people who used the service. The new build, ready in April 2015, will provide excellent day care and inpatient facilities.

Caring

Outstanding

Updated 22 April 2015

The service was caring.

Staff demonstrated a caring and compassionate approach in their interactions with adults and children.

Staff on the children’s unit had been innovative and spent time developing a monitoring tool and putting this into practice. This had a direct positive impact on a child’s wellbeing.

The staff had developed an ‘at home’ service to support children and parents and to ensure children accessed the service.

A range of methods were used to include and involve people and their carers in the services provided.

The end of life care provided to adults and children was provided in a sensitive and compassionate way.

Staff had developed effective support systems for adults and children who experienced bereavement.

Responsive

Good

Updated 22 April 2015

The service was responsive.

Adults and children had their holistic needs assessed and plans of care were produced to guide staff in how to meet them. The care plans for children were very person-centred. The information in the care plans for adults could be more comprehensive and located in one place.

There was a multi-disciplinary approach to reviewing the care and treatment plans of adults and children.

There was a range of therapies and activities for adults and children to participate in to meet their interests and needs.

There was a complaints policy and procedure and various means of ensuring people were able to raise concerns.

Well-led

Good

Updated 22 April 2015

The service was well led.

There was a well-defined vision and positive culture in the service. All staff were aware of this and demonstrated sound values.

The management infrastructure showed there were clear levels of responsibility and accountability. Meetings were held with the Board of Directors to ensure they had oversight of the service.

There was a quality monitoring system in place that consisted of audits and surveys. Action plans were produced to meet shortfalls.

There was learning and improvement from incidents that occurred within the service and an open culture that encouraged staff to report concerns.

Staff had developed links with other agencies which enabled them to work in partnership to develop the service provided to people.