Hospice at Home West Cumbria

Updated 29 December 2023

Hospice at Home West Cumbria provides high quality, palliative and end of life care to people living in West Cumbria.

Hospice at Home West Cumbria is a registered charity providing 24-hour nursing care with personal care interventions. The hospice provides skilled nursing care on a one-to-one basis to adults within their own home or alternative residential settings, enabling them to remain in their chosen place of care at end of life.

Hospice at Home West Cumbria provides care and support to people in the community, services offered cover home nursing, domiciliary care, family and bereavement support, complementary therapies and lymphoedema care) to people in their own homes.

The provider covers 400 square miles along the western side of Cumbria, covering a scattered rural population from Maryport, to Millom and into the Eskdale and Wasdale valleys (Copeland, South Copeland and Allerdale), serving a population of around 137,000 people.

Care is delivered to people in their own homes and communities and includes those in nursing homes and hospitals including:

• 3 Integrated care communities and Millom

• GP practices

• 3 community hospitals

• 1 district general hospital

• All care homes; nursing and residential homes

Services are delivered free of charge to those who need them. Around one fifth of the provider income comes from the NHS with the remainder raised through income generating activities, legacies, trusts and grants.

The provider offers a home nursing and support at home service.

The provider is the sole provider of specialist lymphoedema care in West Cumbria. A challenging condition that affects many people (Lymphoedema is a chronic condition where excess fluid is retained in the tissues causing painful swelling). It can be as a result of cancer or cancer treatment, but it can also be caused by other non-cancer related conditions.

The provider also delivers a range of family and bereavement support services for families, carers and those bereaved; these include one-to-one support, group support and complementary therapy. The bereavement team help with loss, grief and bereavement concerns. Qualified staff and volunteers, support service users, carers and families by providing complimentary therapies, one to one sessions and group support.

Hospice at Home West Cumbria is an independent provider registered to provide the following regulated activities:

• Treatment of disease, disorder or injury.
• Diagnostic and screening procedures.
• Personal care.

For the period April 2022 to March 2023

• 243 new service users received home care.
• 207 lymphoedema referrals were received.
• 134 service users were supported by the family and bereavement service including complimentary therapy through a range of therapies and interventions provided by staff and volunteers.

We last inspected this service in August 2015 and rated the service as good overall.

Updated 29 December 2023

Our rating of this location went down. We rated it as requires improvement because:

• The provider did not clearly define mandated training, including levels of safeguarding training required by job role.
• The provider did not ensure all staff completed mandatory training in accordance with the provider’s policy and target compliance rate.
• Not all staff received appropriate levels of safeguarding training in accordance with Intercollegiate guidance (2019).
• The provider did not ensure all staff including but not limited to trustee and volunteer reception staff had barring and disclosure (DBS) checks in place.
• The provider did not have clear, documented ceilings of care in place, and we saw limited intervention or care planning used by the registered general nurses, providing nursing care.
• The provider had a lack of appropriate systems and processes in place to evidence robust HR management of trustee and volunteer files. The provider did not always ensure staff were competent for their roles.

However:

• The provider had enough staff to care for patients and keep them safe from harm and abuse.
• They managed medicines well. The service managed safety incidents well and learned lessons from them.
• Staff provided good care and treatment and gave patients pain relief when they needed it.
• Staff worked well together for the benefit of patients, supported them to make decisions about their care, and had access to good information.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families, and carers.
• The provider planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it.
• Staff understood the providers vision and values, and how to apply them in their work. Staff felt respected, supported, and valued. They were focused on the needs of patients receiving care. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

Updated 29 December 2023

Our rating of this service went down. We rated it as requires improvement because:

See the summary above for details.

We rated this service as requires improvement because safe and well led requires improvement. Caring, effective and responsive were rated as good.