Oakhaven Hospice

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that people and communities had the best possible outcomes because their needs were assessed. We checked that people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This service scored 79 (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 a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The hospice used the Australia-modified Karnofsky Performance Score (AKPS), Barthel and Phase of illness to assess needs and for a prompt review of patients alongside a holistic review. The AKPS is a measure of the patient's functional status or ability to perform their activities of daily living.

Patients in the inpatient unit received daily nursing and medical assessments. The hospice held weekly consultant reviews and MDT meetings where each patient was discussed and their condition and symptoms reviewed. The ward used the integrated palliative care outcome (IPOS) for symptom tracking. IPOS is a standardised questionnaire used in palliative care to assess a patient's symptoms and concerns, including physical, psychological, social, and spiritual needs, from the patient's and/or staff's perspective.

All clinical staff were trained in recognising the signs of changing needs or a clinical deterioration, as well as the use of assessment tools and documentation systems to ensure continuity of care and consistency in monitoring.

Staff reviewed treatment plans on an ongoing basis and updated and adjusted as patient improved or deteriorated. The community team conducted regular caseload reviews with a consultant or associate specialist to highlight patients whose clinical needs were changing.

Day hospice patients were reviewed bi-weekly in the day hospice case load review with the sister, community team lead and consultant. Staff told us day hospice patients could also be discussed at the full MDT meeting every week if required for wider MDT input. This meant patients benefited from a holistic, coordinated and more effective and personalised treatment plan.

The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff supported patients to understand their treatment and had good knowledge of the communication resources, and options available to them.

The hospice undertook audits and analysed the trends and shared this with all staff. These were completed annually, every six months and at an ad hoc frequency. Audits the service undertook included care of the deceased audits, falls audits, nutrition and hydration audit and management of pressure ulcer audit. We reviewed the falls audit for February 2025 which reported an overall compliance of 100%.

The hospice participated in local and national audits in order to benchmark themselves with similar services to improve patient care and treatment. These included participating in a pilot audit of the National audit of care at the end of life (NACEL), adapted by Hospice UK. the National audit of care at the end of life (NACEL) adapted by Hospice UK. Following a mock/peer review in July 2023 and May 2025 which had identified areas of development, the hospice had created a ‘Moving to outstanding’ action plan to address and improve these areas. Some of this included rolling out development for nursing and ensuring content of training is up to date.

In addition to physiotherapy and occupational therapy, the hospice provided complementary therapies to patients which included massage, reflexology and aromatherapy in order to create a calming and healing environment.

The evidence showed an exceptional standard. The service always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

The hospice worked well with teams and services to support people.Patients care was well coordinated, and everyone involved in their care worked well together.

Staff reported an excellent working relationship with all staff within the service. The hospice held weekly MDT meetings where information was shared and next steps discussed regarding the transition of care and treatment. Discussing the transition of care for hospice is critical for improving the quality of life for both patients and their families as they navigate the final stage of a life-limiting illness.

The hospice provided an example of how staff had worked together and through cross team working to care for a patient in line with their wishes. This involved extensive communication across different health professionals to ensure care was coordinated and the patient received the appropriate support they required.

We saw another example of teams working together where the hospice had worked with the patient and family support team to support family members cope with the patients decline and expectation of death. Family members were offered counselling, bereavement support and living with loss course. A thank you card from a family member read ‘your counselling services have helped me so much and I am grateful to have had this support.’

The hospice also worked alongside physiotherapists and occupational therapists and referred patients to the physiotherapy team to help manage symptoms of pain, mobility, balance and coordination. Feedback from patients described it as life changing and highly valuable.

Staff reported good relationships with external partners such as the local learning disability team. The hospice provided an example of a scenario where they were able to ensure safe care for an inpatient and their children through a coordinated approach with Hampshire Adult’s Health and Care team.

The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

Staff had access to the nutrition and hydration policy which outlined the principles, procedures and guidance to be followed in assessing and meeting the nutritional and hydration needs of patients and to enable, with appropriate interventions, holistic individualised management of a patient’s nutrition and hydration needs.

Patients and their relatives told us they had enough to eat and drink and were complementary of the food and choice available.

The hospice provided a number of activities through the Coates centre some of which included chair yoga, crafts for wellbeing and puzzle pals. The Coates Centre hub was supported by dedicated volunteers who provided a drop-in service for advice, once per month, which included access to multi agency services. Patients spoke positively about these activities and told us how they enjoyed not only the activity but the social aspect of meeting up with others. A letter from patient who had used the Coates centre stated it had helped her over the last four years and how she was finally getting stronger due to this.

We observed a number of health initiatives leaflets throughout the hospice. Some of these included recommending switching to decaffeinated drinks as this reduced the risk of falls and brought other health benefits.

The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

We found evidence that palliative care outcome measures were used effectively across the hospice. The hospice uses the integrated palliative care outcome scale (IPOS) to measure symptom burden, demonstrate the impact of interventions, and improve care for patients and families. IPOS is a 10-item tool used to assess symptoms and concerns that matter to
patients in palliative care, covering physical, psychological, social, and spiritual aspects.

The hospice used phase of illness (POI), Australia-modified Karnofsky Performance Score, IPOS and views on care (VOC) to capture the effectiveness of treatment and care at the individual level, and also more widely to demonstrate impact of their services.

In the inpatient unit and community settings, IPOS was completed at the beginning and end of episode of care. The measures were part of the nursing and medical handover and staff used it to trigger re-assessment of other nursing assessments.

The hospice was in the process of releasing a new outcome measures policy which outlined the accepted and approved standard of data collection for palliative care outcome measures at Oakhaven Hospice.

For patient experience data, the hospice used an external platform called care opinion and also used real time feedback within the IPU, to capture timely patient feedback and enable responsive action if needed. During our inspection, senior staff from the hospice told us they were working with a university to create a bespoke suite of patient experience surveys to use across the services, which will be easy for patients and families to use and make collecting this information easier.

In addition to this information, themes from complements, concerns and complaints were compiled to form the annual report, which the hospice used to learn and improve. The hospice also sought feedback from their own staff / volunteers and the local community, through engagement events and surveys to ensure services are meeting the needs and expectations of the community.

The hospice reported their outcome data to the Hospice UK quarterly and participated in the hospice UK patient safety network to discuss themes, trends and quality improvement work.
We saw evidence that the hospice have developed a suite of dashboards that focused on activity and outcome measures, which could be triangulated with patient experience data and workforce data to identify areas of focus or improvement. These were discussed routinely through the governance structure.

The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff carefully explained to people what their rights around consent were and fully understood them and always fully respected these when delivering person-centred care and treatment.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

Staff had received training in relation to the Mental Capacity Act 2005 (MCA) and were able to explain the main principles. Staff had access to a dedicated MCA lead and understood the importance of giving people choice in the support they received. We observed staff always sought people's consent before providing any support. People were supported to make their own decisions where appropriate, in accordance with the MCA.

Staff had access to the consent policy and procedure which provided staff with information on how to record consent and when this was not necessary.