Oakhaven Hospice

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We looked for evidence that people were always treated with kindness, empathy and compassion. We checked that people’s privacy and dignity was respected, that they understood that they and their experience of how they were treated and supported mattered. We also looked for evidence that every effort was made to take people’s wishes into account and respect their choices, to achieve the best possible outcomes for them.

At our last assessment we rated this key question good. At this assessment the rating has changed to outstanding.

This service scored 90 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The evidence showed an exceptional standard. The service was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

Throughout the inspection, we observed staff and volunteers consistently providing excellent care and support to both patients and their loved ones.

Patients described staff as kind and compassionate and couldn’t praise them enough. A relative told us staff were amazing and treated their family member with kindness and dignity.

We reviewed patient feedback received by the hospice in the last 6 months which was overwhelmingly positive. Feedback from a family member read ‘Thank you to everyone at the hospice for the truly wonderful care you gave to my mum and your kindness to myself’. Another read ‘Your team created an atmosphere of calm and dignity, which allowed us to spend meaningful and precious moments with my father in his final days. Knowing he was in such capable and caring hands provided immense solace to us during a time of great sadness. Words cannot fully capture how much your kindness and dedication have meant to our family’.

We spoke with a patients partner who provided an example of when the hospice had planned a date night with his wife. The husband spoke about how nothing was too much trouble for the staff and described them as caring and supportive.

We accompanied the community team on a visit to a patient’s home and observed staff interacting with the patient and their family in a kind, gentle and empathetic nature. Staff listened to their concerns and worries and provided reassurance in caring manner.

We observed a phone call where a patient discussed symptoms they were experiencing. A visit was arranged to review the concerns raised and provide appropriate care. We saw that this was done in a compassionate, caring and professional way.

The hospice provided counselling and bereavement support to all patients and families when needed. We spoke with relatives of patients who told us they had been supported with their emotional wellbeing and referred to counselling which they had found very helpful. The patient and family support team offered a range of bereavement support, including counselling, coping with grief courses and bereavement cafés. The hospice also ran bereavement groups and activities through the wellbeing hub.

A thank you card from a family member who had used the counselling services read ‘ thank you very much for helping me come to terms with losing my dad, your counselling services have helped me so much and I am grateful to have had this support.’ Another read ‘my counsellor was very attentive and supportive; the sessions have helped me to talk to other and explore my emotions.

Staff gave us examples of when the hospice had supported patients and families to celebrate significant events such as weddings and Christmas. Patients received concerts and recitals from their musical colleagues, for example the hospice had arranged for a local charity to play music in the gardens outside a patients room so that they could enjoy the music and company for one last time before saying goodbye.

The service had a pastoral and spiritual care team who supported patients and families if needed. The team also provided telephone support, chaplain service and visited patients at their homes. The team reported good relationships with local faith leaders and supported access to these for patients and families as needed.

The hospice used ‘Oakhaven Neighbour’ volunteers to provide companionship and a helping hand at home to patients assisting with everyday tasks. The pastoral and spiritual care team also provided a hospice bedside companion service who took time to sit, talk and be present with patients , if loved ones couldn't be there.

The evidence showed a good standard. The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff gave us an example of how a patient wanted their bed and place of death to be upstairs in their home. This posed a challenge due to the space. The occupational therapist team spoke to the patient to confirm their wishes and were able to accommodate this by ordering the equipment accordingly for upstairs delivery.

Patients and families had access to a quiet and calm area called the sanctuary which was inclusive to different religious faiths. We saw books from different religions including Judaism and Buddhism.

The service took steps to ensure patients personal requests and personality were reflected in their care plan. We spoke with relatives who told us how staff had supported them with completing the paperwork and making sure the patient had a purple cushion as this was their favourite colour.

Staff also gave an example of how the hospice had adapted and offered alternative choices to a patient who was gluten free.

The evidence showed an exceptional standard. The service was exceptional at promoting people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Staff told us they encouraged people to be involved in their own care during their initial assessments by advising them of the services, including any limitations and supporting their independence as well as making them feel empowered to make those choices.

Staff provided us with an example of a patient who was not keen to increase their medication. Other less medical options were proposed and discussed such as physiotherapy and complementary therapy which the patient gladly accepted. Staff had also discussed purchasing a handheld fan and other non-pharmacological interventions which supported their choice of minimal medication.

Another example provided was when a patient, who was approaching end of life and could no longer easily swallow, wanted to have a taste of whiskey, to mimic his daily routine of having a whiskey nightcap for many years. By using small amounts of watered down whiskey and using mouthcare sponges, staff were able to support his request so the patient could ‘taste’ the whiskey. This was important to the patient and his family and they described the patient smiling when the nursing staff did this for him.

The day hospice which was open four days a week gave people the opportunity to meet with other patients in a safe and friendly environment and to share experiences. Staff told us that for some patients this was the only time they had the opportunity to interact and socialise. We observed a game activity where people were given the choice to participate and were encouraged to take part and thoroughly enjoyed interacting with other people.

The hospice collected feedback from patients who used the day hospice. We reviewed the 12 week review from patients which showed how much patients benefitted from this. Feedback from a patient read ‘I look forward to attending every week and would feel gutted if I could not attend.’ Another patient stated that coming to the day hospice helped them with their symptoms by making them feel safe to discuss sensitive issues with honest straight-talking staff.

Patients had access to the therapy team, consisting of a physiotherapy and an occupational therapist, who were based at the hospice. The team supported patients to maintain their independence and saw patients at their outpatient facility when they visited the day hospice, in the IPU or at their homes.

The hospice provided an example of how the therapy team had delivered a training session with a member of their patient population about the importance of having choice and being asked about 'what mattered to them'. Through the session the patient was able to reflect on how important simple things were like being asked 'would you like someone to support you or are you able to manage independently' as this promoted their independence and gave them control over their own care, treatment and wellbeing.

Patients could also receive complementary therapies to help improve their emotional, physical and spiritual wellbeing.

Feedback from a relative read ‘the complementary therapy was life changing and valued it hugely’. Another read ‘I’ve learnt to hand massage and will be able to help my husband with dementia and pass on my knowledge on to friends whom I feel may benefit from it.’

The evidence showed an exceptional standard. The service was exceptional in how they listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Oakhaven Care was a domiciliary home care agency that was a social enterprise set up by the hospice, for patients who preferred to receive care within the comfort of their own home. Patients could choose from a 30 minute drop in visits to multiple day visits, extending to live-in and 24-hour care as and when required. Staff worked with patients and families to establish their needs and preferences and supported them to remain in the comfort of their own home whilst maintaining their chosen lifestyle.

Oakhaven care also provided regular, allocated crisis care for hospice patients that could be allocated on a daily basis in the home, in response to patients in urgent need.

Throughout our assessment we observed staff responding to people’s needs quickly without delay. Staff were responsive to patient family members when approached for assistance, information or reassurances.

Patients told us staff responded quickly to pain and provided pain relief in a timely manner. A patient we spoke with told us a doctor had sat with them and held their hand and spent time talking to them when they were in pain.

The hospice provided us with an example of a patient who wished to be resuscitated in the event of a cardiac arrest, despite the understanding that the likelihood of a successful outcome was extremely limited. His decision was rooted in his strong religious faith and belief that resuscitation might offer a pathway to healing. Following an MDT discussion, the hospice was able to honour his wishes.

A thank you card from a family member read ‘you all gave mum the best care, kept her comfortable and pain free and made an unbearable time a bit easier.’ Another email from a patient read ‘I was told that Oakhaven were the masters of pain control and this was certainly true over the past few weeks.’

Staff conducted regular pain assessments appropriate to each patient’s communication abilities. For patients who did not communicate verbally the hospice used behavioral pain assessment tools such as the Abbey Pain Scale. This evaluates indicators including facial expressions, body language, vocalisations, breathing patterns and restlessness. The Dis-DAT (Disability Distress Assessment Tool) tool was also used when required The DisDAT isa tool to help identify distress in individuals with severely limited communication by documenting their usual signs and behaviours when content versus when distressed.

All staff received training in recognising pain indicators in non-verbal patients, including subtle changes in behavior, sleep patterns and psychological responses. The team were supported by a clinical nurse specialist with a dual role as an admiral nurse who provided guidance and delivered training which helped staff support patients and their families affected by dementia.

The hospice utilised a translation service for those patients for whom English was a second language. The hospice provided an example of when staff in the community had recently cared for a Ukrainian gentleman and had been supported to learn basic Russian phrases as well as work with the interpreter to facilitate a relationship.

For patients where the communication difficulty lies with being dysphasic, staff were trained to use adaptive technologies to improve communication. Staff also had access to tablets and handheld white boards to help improve communication. The hospice provided a recent example of when a member of the community CNS team had brought a stock of simple children’s writing boards for a head and neck patient who was unable to communicate verbally but found technologies off putting preferring to use pen and paper. Staff found this was invaluable in opening up his ability to communicate and increased the speed of communication reducing his frustration and allowing him to re-engage with his own care planning.

The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Staff told us they could seek advice from senior nursing and medical colleagues when they were out in the community. Staff also had access to a knowledge hub app which contained the national guidelines from a variety of sources.

Staff told us they received supervision, and clinical incident reviews and debriefs following a difficult event.

Staff had access to an employee assistance program which provided support 24 hours, 7 days a week. The hospice also provided staff with clinical psychology and counselling sessions through their occupational health program.

Staff felt supported, respected and valued by their managers in all areas we visited. Supervision was seen as supportive and managers approachable. We saw that staff were encouraged to speak up.

We reviewed the staff survey results from December 2024 which had a 54% response rate. 88% of staff felt their concerns were listened to and understood by their line manager and 92% felt respected by colleagues. Following this, the hospice had identified areas of improvement with an action plan which included starting a staff forum with representatives from each function to work through areas for improvement.