Hospice at Home West Cumbria

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 the service involved people and treated them with empathy, compassion, kindness, dignity and respect.

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 remained good. This meant people were supported and treated with dignity and respect and involved as partners in their care.

This service scored 80 (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 always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

Staff supported patients to understand and manage their care, treatment or condition. Staff attitudes and behaviours when interacting with patients and their families showed that they were discreet, respectful and responsive, providing patients with help, emotional support and advice at the time they needed it.

We saw many examples of positive feedback, which managers shared with staff. For example, ‘’Absolutely wonderful, loving and tender care, went far beyond expectation’’. ‘’The care, support and compassion we received was fantastic. As a family we will be forever grateful and cannot thank you enough’’. ‘’All the carers are very well trained including the holistic therapists. I will always be thankful for the support I received, during an extremely stressful time.’’

Staff directed patients to other services when appropriate and, if required, supported them to access those services. For example, the service’s family bereavement support worker provided additional support to families and carers following patient deaths.

Staff understood the individual needs of patients, including their personal, cultural, social and religious needs.

Staff maintained the confidentiality of information about patients.

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 completed detailed initial individualised and holistic assessments, to ensure they understood people’s uniqueness. The service made adjustments for patients, for example, by meeting patients’ specific communication needs.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on. Staff we spoke with gave examples of how they had used translation services to provide information for patients in their own first language.

Staff ensured that patients had access to appropriate spiritual support.

The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Initial information captured at referral and subsequent detailed and individualised assessments, ensured staff had all the information they needed to promote patient independence, choice and control.

For example, service users and their families we spoke with explained that timing of home visits was planned with them to accommodate their individual routines and preferences as far as possible. Family members were supported to participate in care giving where this was in accordance with the patient’s wishes.

Patients we spoke with who used the lymphoedema service told us how they were shown lymphatic drainage exercises they could do at home, such as deep breathing, gentle movement, and self-massage to help move lymph fluid through the body.

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.

The service adopted a holistic approach to care which also included consideration for the wellbeing of close family members and carers. Staff we spoke with told us how they had helped a very anxious family to cope with heightened emotions which had the potential to cause distress to the patient. In this instance, they provided complementary therapies which were effective in helping to manage feelings of distress. In addition, they utilised complementary therapies to help empower patients to manage issues such as needle phobia so they could comply with blood tests and palliative intravenous therapies.

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 we spoke with felt positive and proud about working for the provider and their team.

Staff accessed support for their own physical and emotional health needs through an occupational health service and a private health assured programme, which enabled them to see a doctor more quickly if needed.

In addition, some staff had received training as mental health first aiders. The service had a strategy health wellbeing group, which hosted afternoon sessions, including mindfulness and practical issues such as finance. Effectiveness was monitored through and a programme of ongoing clinical supervision.

There were processes in place to manage personal safety when staff were lone working. When at risk due to potentially violent and aggressive behaviour, risk assessment included defining what worked for the patient, their preferences and what triggered behaviours. To mitigate risk in such situations, staff attended in pairs, it was flagged with community services, and an alert was put on the electronic records system.

The provider recognised staff success within the service – for example, through nominations for national awards and in staff newsletters.

Staff appraisals included conversations about career development and how it could be supported.