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St John's Hospice Outstanding

Reports


Inspection carried out on 26 July 2016

During a routine inspection

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 carried out on 13 February 2014

During a routine inspection

We spoke with a range of people about the hospice. They included the registered manager, staff members, volunteers, patients, relatives and visitors. We also asked for the views of external agencies in order to gain a balanced overview of what people experienced using St John�s Hospice.

We spoke with patients and relatives. They told us they could express their views and were involved in making decisions about their care. They told us they felt listened to when discussing their care needs. Staff confirmed to us they also involved relatives, where possible to ensure people received the right care and support.

We spent time in all areas of the hospice, including the day centre and in-patient unit. This helped us to observe the daily routines and gain an insight into how people's care and support was being managed. Staff treated people with respect and ensured their privacy when supporting them. They provided support or attention as people requested it. We spoke with people about the care and support they received. They said they were happy with the care and support being provided.

We looked at how the service was being staffed and reviewed staff training and supervision. We saw there were sufficient staff on each shift with a range of skills and experience. Staff told us they felt supported, had regular meetings with their manager, and their training was kept up to date.

We found there were good systems and processes in place to monitor the quality of the service being provided. Staff told us they felt this was underpinned by an open reporting culture and strong leadership.

Inspection carried out on 20 February 2013

During a routine inspection

We observed the care and support people received. Staff were supportive and considerate when caring for people. People told us, �The staff are excellent, they involve you in everything.�

Staff supported people sensitively protecting their privacy and dignity. People told us that they had been involved in deciding on their care with staff at the hospice. The care records seen were person centred and informative. They showed how the person wanted their care delivered.

One person said, �The staff really care. It is so different from hospital care.� Another person told us, �The staff are fantastic, they couldn�t be better or do any more for you." A relative commented, �The staff are marvellous. The care is second to none.�

People told us they were happy and had no complaints or concerns. They said they knew how to make a complaint and felt confident in reporting any issues.

St John�s hospice was spacious, comfortable and safe. It was clean and suitable for purpose. There were large pleasant gardens surrounding the hospice.

Recruitment and selection was safe and staff received appropriate support and training to assist them in developing their skills.

Inspection carried out on 2 April 2012

During an inspection looking at part of the service

It should be noted that we only assessed the improvements made in relation to Outcome 4

in this report. We did this by discussing with the ward manager the changes that had been made with staff at the hospice to more accurately document the actual care given to the patients. This took place on the 3rd April 2012.

Inspection carried out on 30 November 2011

During a routine inspection

During our visit to this service we spoke with patients, relatives and staff. We received largely positive feedback from everyone. We were told that a good quality of service was provided with excellent standards being maintained. Comments from patients and relatives included:

�They are lovely people (the staff) I could not have got through this without them.�

�I am fully informed and involved in my care. If I don�t want something that�s fine.�

�The difference between other hospitals and here is phenomenal.�

�Staffing levels are excellent I never have to wait for anything, even at night.�

�The food is excellent, if I don�t like the choice that day I can have whatever I fancy.�

�I don�t always feel my care is as individual as I would like. I want to feel special, and have my needs anticipated more, rather than have to ask what is going on.�

�I never have to wait if I press my buzzer.�

�I know what is happening to me and staff let me know of any changes.�

�The gardens are lovely to look at.�

Reports under our old system of regulation (including those from before CQC was created)