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We are carrying out a review of quality at Severn Hospice Apley Site. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary

Overall summary & rating


Updated 18 June 2016

This inspection took place on 21 March 2016 and was unannounced.

Severn Hospice Apley Site is registered to provide specialist palliative care and clinical support for adults with life limiting illnesses. The service provides care on their in-patient facility which catered for up to eight people. At the time of the inspection there were five people using the service. People within the locality of the hospice could also access support from the hospice at home and clinical nurse specialist services in their own homes and or community which were based at the provider’s sister site in Shrewsbury.

The services provided included counselling and bereavement support, day hospice care, family support, chaplaincy, out-patient clinics, occupational therapy, physiotherapy, complementary therapies and a lymphedema service (for people who may experience swellings and /or inflammation following cancer treatment).

The manager was registered with us as is required by law. 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.

People were kept safe by staff who were trained in the safeguarding of adults and health and safety. They were able to fully describe their responsibilities with regard to keeping people, in their care, safe from all forms of abuse and harm. There were safe systems in place to safely manage and administer medicines to people. Medicines were prescribed, recorded, stored, administered and disposed of in safe and appropriate ways. People received their medicines in a timely manner and in line with their preferences.

Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow to make sure people were protected from harm. Recruitment practices were safe and ensured staff employed were safe and appropriately skilled to care for people using the hospice. Systems were in place to ensure records related to accidents and incidents captured the relevant information and this was considered and analysed without delay. Appropriate remedial actions were taken following such occurrences and action was taken to minimise any immediate or future risks to people.

Staffing was at a level which allowed staff to meet people’s needs in a safe, timely and personalised manner. Staff were well supported with the provision of a wide range of support in the form of training, a comprehensive induction, ongoing supervision and appraisal along with peer support and debriefs. Learning within the service including adopting and sharing best practice was highly prioritised. People were supported to access the nutrition they needed and were monitored for any changes in their dietary needs.

Management and staff understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and supported people in line with these principles. Staff established consent from people before providing care and supported people to access independent advice and support when necessary. Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) were flexible and could be transferred for use within the hospice and also applied when people were at home, thus reducing any unnecessary distress and repetition.

Staff were very caring and showed people and their families kindness. Staff demonstrated they were both motivated and passionate about their work and had a clear commitment to providing the best quality care in a compassionate way. People were encouraged to remain as independent as possible by staff. Staff acted in a way that maintained people’s privacy and dignity whilst encouraging them to remain as independent as possible.

People were fully invol

Inspection areas



Updated 18 June 2016

The service was safe.

Staff knew how to recognise and report any allegations of abuse.

Risk assessments were centred on the needs of the individual and there were sufficient staff on duty to meet people's needs safely.

Robust and safe recruitment procedures were followed in practice.

People received their medicines from staff who were trained and qualified in safe administration of medicines.



Updated 18 June 2016

The service was effective.

Staff had effective training and support to carry out their roles.

People’s rights were protected under the Mental Capacity Act 2005 and no one was being deprived of their liberty unlawfully.

People were supported to be able to eat and drink sufficient amounts to meet their needs and were provided with a choice of suitable food and drink.

People were supported in all aspects of their health and well-being and referrals to healthcare professionals were made promptly when needed.



Updated 18 June 2016

The service was caring.

Staff were kind and compassionate and people and their families with dignity, supporting them wherever possible to maintain their independence.

The service was very flexible and responded quickly to people's changing needs or wishes.

Staff communicated effectively with people and treated them with the utmost kindness, compassion and respect.



Updated 18 June 2016

The service was responsive.

People and their families were fully involved in the assessment of their needs and planning how their care should be given.

People's care was personalised to reflect their wishes and what was important to them.

People knew how to make a complaint and felt confident that any issues they raised would be dealt with effectively.



Updated 18 June 2016

The service was safe.

The service was well-led by a management team who placed people and staff at its heart.

There was an open and positive culture evident within the service which fully involved people, families, staff and the local community in its development.

Staff felt very well supported in all areas and felt involved, listened to and appreciated at all times.

There were systems in place to monitor safety and drive improvements in the quality of the service, including learning from accidents, incidents and complaint investigations.

The provider practiced within the relevant national key guidance and shared and adopted best practice.