Updated 11 March 2025
Contextual Information: Saint Catherine’s Hospice is a Scarborough based hospice whose care provision extends to patients over the age of 18 years. their families and / or carers in North and East Yorkshire. The majority of services are provided free of charge. The hospice accommodates up to 18 inpatients; however, the hospice is currently operating 10 beds due to funding shortfalls. The service is funded for 8 specialist beds and 2 nurse led beds. The service has a separate shop and café facility for use by patients, families and the local community. The hospice provides a hospice at home service, specialist palliative care services, outpatient services including a lymphoedema clinic, therapy and counselling services, a specialist palliative social work service and an out of hours telephone support line. Community provision is provided 5 days a week to local areas by community nurses. The service is also supported by a Fast Track service and Clinical Nurse Specialist Team. The well being service provision is fully staffed. The last inspection took place on the 4 November 2021, where the service was rated good overall; responsive was rated outstanding. Prior to this inspection concerns were raised by some anonymous staff members to the CQC. Following the initial concerns CQC met with the hospice and also asked for information. Due to the ongoing contacts from anonymous staff members, the CQC undertook an inspection which was announced the day before the inspection commenced. We were told there had been a high turnover of clinical and non-clinical staff whose positions were currently being recruited into. The Chief Executive Officer and Registered Manager have changed since the previous CQC Inspection. The last inspection took place on the 4 November 2021, where the service was rated good overall; responsive was rated outstanding. Following the 2021 inspection there were several SHOULD actions identified. Following this inspection, we observed these had been implemented. However, there were not enough staff with the right skills, qualifications and experience. Training was available and was accessed by staff, however, staff said there was a shortage of trainers to provide face to face training. Staff had not received regular appraisals and / or clinical and safeguarding supervision. The facilities and equipment met the needs of patients, were clean and well-maintained. However, one oxygen cylinder was out of date and some checks had not been carried out on the resuscitation equipment as hospice policy identified. There were some shortfalls in infection control practices and carpet floor coverings were observed in the inpatient unit, however, the hospice confirmed that this carpet floor covering was to be removed in July 2025. Staff managed medicines well and involved patients in planning any changes. The service demonstrated a learning culture in some areas and patients could raise concerns. Managers investigated incidents thoroughly. Patients were protected and kept safe. Staff understood and managed risks. Patients were involved in assessments of their needs. Staff reviewed assessments taking account of patients’ communication, personal and health needs. Care was based on latest evidence and good practice. Patients always had enough to eat and drink to stay healthy. Staff worked with all agencies involved in patients’ care for the best outcomes and smooth transitions when moving services. They monitored patients’ health to support healthy living. Staff made sure patients understood their care and treatment to enable them to give informed consent. Staff involved those important to patients and took decisions in patients’ best interests where they did not have capacity. Patients were treated with kindness and compassion. Staff protected their privacy and dignity. They treated them as individuals and supported their preferences. Patients had choice in their care and were encouraged to maintain relationships with family and friends. Staff responded to patients in a timely way. The service supported staff well being. Patients were involved in decisions about their care. The service provided information patients could understand. Patients knew how to give feedback and were confident the service took it seriously and acted on it. The service was easy to access and worked to eliminate discrimination. Patients received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. Patients were involved in planning their care and understood options around choosing to withdraw or not receive care. Leaders and staff had worked to develop a shared vision, values and behaviour's expected at the hospice. Leaders were visible, knowledgeable and supportive, helping staff develop within their roles. Cultural concerns which included concerns about leadership behaviour's were raised by some staff who did not feel safe raising these concerns internally. Staff described a lack of engagement at times. The service had and was undergoing a period of change which meant some governance, risk and human resource, training and supervision areas and processes were being developed and were to be embedded. The Workforce Race Equality Standard (WRES) had not been developed. Information received post inspection confirmed 3 actions were identified for 2025 – 2026. These actions included the production of an annual Race Equality Standard by January 2026 and to develop an inclusive practice and policy by October 2025. Managers worked with the local community to deliver the best possible care and were receptive to new ideas. Staff shared information and learning with partners and collaborated for improvement. The service focused on learning, innovation and improvement across the organisation and local system. Staff encouraged creative ways of delivering equality of experience, outcome and quality of life for patients. Staff actively contributed to safe, effective practice and research.