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St John's Hospice Outstanding

Inspection Summary

Overall summary & rating


Updated 12 November 2016

The inspection visit at St John’s hospice was undertaken on 26 July 2016 and was announced. We gave 24 hours’ notice of the inspection because of the sensitive nature of the service provided. We wanted to ensure people who used the service, staff and visitors were available to talk with us.

St John’s hospice provides palliative and end of life care for adults with life limiting illnesses. The staff team support people and their families, providing medical, nursing, personal, emotional and spiritual care. They also offer a hospice at home service in the local community to assist individuals living at home and a variety of day and support services. At the time of our inspection, there were four people inpatient at St John’s hospice.

St John’s hospice is situated in a residential area close to local amenities. The service supports people in the main hospice inpatient unit and a day therapy unit. They also support people in their own homes.

A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 led and managed.

At the last inspection on 13 February 2014 we found the provider was meeting all the requirements of the regulations inspected.

We spoke with people who used the service, relatives, staff and other professionals during this inspection. They told us the service provided an exemplary level of care and the leadership was exceptional. They spoke extremely highly of staff. One person told us, “From being in despair I am now able to focus on what matters. All with the help from the staff.” A relative said, “The support from the hospice staff exceeded anything we had hoped for. It was fantastic.”

Care planning was extremely flexible, person centred and proactive. People and their families told us staff championed people’s right to choose how, where and when they wanted their care provided. They said staff were especially proactive and ‘made things happen’ in order to provide exceptional care for people. We saw staff had to support people to attend special family events with staff support and helped patients with arrangements to marry in the hospice.

People said staff were extremely caring and respectful, listened to them and assisted them promptly. They told us staff always ‘went that extra mile and beyond’. We saw end of life care plans were informative and personalised and staff were remarkable in their determination to help people to carry out their final wishes. This included providing advice, support and staff at a person’s home so they could remain in the comfort of their home with loved ones.

Families told us staff were extremely competent and compassionate in the way they assisted people to have control of illness symptoms and pain. They commended staff for the practical, emotional and spiritual support provided and outstanding care that enabled their relative to have a dignified, peaceful and pain free death. Written comments from families included, ‘Thank you for making the end of [family member’s] life so calm and dignified and filled with love’. And ‘You worked miracles and [person] died serenely and comfortably. Thank you.’

The management team and trustees worked collaboratively with other agencies to develop best practice, excellent partnership work and support for people. They carried out innovative research with local and national organisations and influenced best practice and policy-making. This further improved care practices and helped develop innovative support in the hospice and the community

The management team set up numerous forums and support groups to seek people’s views, provide support and information and ensure people received person centred flexible care that fully met the

Inspection areas



Updated 12 November 2016

The service was safe.

Staff recruitment was robust and staffing levels met people�s needs.

Staff understood safeguarding principles, the action to take and how to report concerns if people were at risk from harm or injury.

Medicines were administered as prescribed, safely and promptly at the time people needed them.



Updated 12 November 2016

The service was effective.

Procedures were in place to assess peoples' mental capacity and to assist with decision making where needed.

People were provided with a choice of nutritious meals, snacks and drinks.

People were supported by staff who were skilled and knowledgeable. This helped them to provide support in the way the person wanted.



Updated 12 November 2016

The service was exceptionally caring.

We found staff were committed to providing a non-discriminatory and extremely supportive service.

People who used the service and their relatives spoke very highly of staff and the care and support they received.

Staff were very proactive and compassionate in the way they assisted people to have a dignified, pain free death and the practical, emotional and spiritual support of their choice.



Updated 12 November 2016

The service was very responsive.

Care planning was extremely flexible, person centred and proactive. People were encouraged to make choices that provided them with their care and support when and where they wanted.

Staff responded to changing needs quickly and sensitively and �made things happen� in order to provide personal and specific care for people.

People who used the service and their families were provided with an extensive choice of support groups and complementary therapies to provide information and support and to reduce anxiety and distress.

The provider had a proactive and constructive response to complaints and carried out their duty of candour with a very transparent approach.



Updated 12 November 2016

The service was extremely well-led.

The registered manager acted in partnership with other agencies to develop best practice. They worked with local and national organisations, care and education establishments to influence and improve best practice and national care policy-making. This had an extremely positive impact upon people�s care, safety and welfare.

People who used the service, families and staff, said the service was organised and managed to an extremely high standard. They told us the registered manager was very active in supporting and understanding their requirements.

The management team excelled at managing change in a coherent and cohesive approach. Staff said they felt fully involved, consulted and supported by the trustees and management team about the future of the hospice

People were highly praising of the hospice. The registered manager and management team had outstanding oversight of care, quality and safety.