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Inspection Summary


Overall summary & rating

Outstanding

Updated 20 July 2016

This inspection took place on 8 and 9 March 2016 and was unannounced. We previously inspected the service on 11 March 2014 and found no breaches of regulations in the standards we looked at.

The inspection team included two inspectors, a pharmacy inspector, a nurse specialist in palliative care and an expert by experience. An expert by experience a person who has personal experience of using or caring for someone who uses this type of care service.

Weldmar Hospicecare Trust is a registered charity. All services to patients are provided free of charge. Some funding is provided by the NHS but most is provided through fundraising and charitable donations. The service is for adults with life-limiting illnesses or advanced progressive conditions, their families and others close to them.

Joseph Weld hospice is in Dorchester and the inpatient unit is registered for 18 beds, although a maximum of 14 beds are used at any one time.It cares for about 300 people a year. The hospice accepts people with a diagnosis or medical condition that significantly limits their life to less than two years or where they have complex symptom management problems. Also, if the person or other family member has psychosocial, emotional or spiritual needs. Admissions to the inpatient unit were usually for symptom control, and for end of life care.

The hospice is purpose built over two floors. The inpatient unit has four single rooms and a family room, all with ensuite facilities. There are four single sex bays, each with its own bathroom, which can accommodate a maximum of four beds, but are only ever used to accommodate three people. The rooms have lovely views of the landscaped grounds and surrounding countryside. There are ample car parking facilities including disabled access spaces near the main entrance. More recently Joseph Weld has benefitted from the addition of an orangery which provides a bright and welcoming space, with quiet areas for people and relatives to relax in. This includes a café opened to the public at lunchtime each day and a play area for children.

People can access the service in a variety of ways, via referrals from local GP's and consultants in the NHS, or from people and/or family members/carers (with the person’s permission). Services are provided up to and at the time of death, and after death, for the bereaved.

The hospice has three specialist teams of community specialist palliative care nurse teams across central, south and north Dorset, known as Weldmar community nurses (WCN’s). These nurses are skilled and experienced in supporting people with the management of their pain and symptom control. They provide physical, emotional and social support for about 650 people and families each year. It is a five day a week service, with emergency cover at the weekend. The WCN’s visited people at home, in nursing or care homes and in community hospitals. They also worked closely with 45 GP surgeries, district nurses and other community based staff providing advice about managing people’s symptoms and prescribing.

The hospice provides day services to about 350 people each year, which include social respite, social groups and wellbeing services. These services were held on various days of the week, at Joseph Weld hospice in Dorchester, Trimar in Weymouth, and at community hospitals in Blandford, Shaftesbury and Sherborne. Some people we met at these services shared their experiences of being admitted to Joseph Weld hospice for pain management and symptom control.

The hospice has a large team of volunteers, who work in the inpatient unit, day hospice and wellbeing services, and as volunteer drivers. They offered befriending services to people and provided respite for carers. Some volunteers had professional qualifications and offered counselling and complementary therapies.

The service has a registered manager who is the Director of Nursing and Patient Services. A registered manager is a person who has registered w

Inspection areas

Safe

Good

Updated 20 July 2016

The service was safe.

People were supported by enough staff so they could receive safe care at a time and pace convenient for them.

People were protected because staff and volunteers understood the signs of potential abuse. Concerns reported were investigated and dealt with.

People felt safe at the service. Individual and environmental risks were reduced as much as possible. Accidents and incidents were reported with positive actions taken to reduce the risks of recurrence.

People received their medicines on time and in a safe way.

Robust recruitment checks were undertaken before staff and volunteers began to work for the service to ensure they were suitable to work with people.

Effective

Outstanding

Updated 20 July 2016

The service was effective.

People received effective care, based on best practice from staff with the knowledge and specialist skills to manage their pain and physical symptoms.

The hospice education department was a regional centre of excellence. They provided a range of innovative end of life care training, to hospice and other health and social care staff. This meant more people received skilled end of life care, in their preferred place.

People’s human and legal rights were respected because staff understood their responsibilities in relation to the Mental Capacity Act (MCA) (2005) and Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity, advanced decisions were taken account of, and families and other professionals were consulted in their ‘best interest.’

People had access to high quality food and drink, for as long as they were able and wished to. They service had excellent catering services which met people's individual nutrition and hydration needs.

Caring

Outstanding

Updated 20 July 2016

The service was caring.

People received outstanding care from exceptional staff who developed positive, caring and compassionate relationships with them and their families.

A strong, person centred culture shone through when staff spoke about people. They treated people with the utmost kindness, caring, dignity and respect.

People were comforted because they knew hospice staff would continue to support loved ones following their death through a range of bereavement services. In particular, a dedicated child support worker helped children and young people in innovative ways.

Responsive

Outstanding

Updated 20 July 2016

The service was responsive.

People received exceptionally personalised care which responded to their individual needs and preferences.

The introduction of wellbeing services provided people with access to information, advice and sessions and promoted self -management of their symptoms. An extensive support programme was provided for carers.

People were empowered to have as much control and independence as possible. Their views were known, respected and acted on.

People knew how to raise a concern or complaint. Staff were open and honest with people when things went wrong and were committed to learning from people's experiences.

Well-led

Good

Updated 20 July 2016

The service was well led.

The service was effectively led by the senior management team. Staff worked together as a team to provide seamless care for people.

People, relatives and staff views were sought and taken into account in how the service was run.

A range of quality monitoring systems were used to monitor the quality of care. The service continuously made improvements to people’s care in response to their findings.