Updated 21 October 2024
Our view of the service
We undertook an assessment of Ellenor Gravesend on 4 December 2024.
Ellenor Gravesend provides hospice care for adults and children living in North Kent and Bexley. At the time of our assessment the hospice provided inpatient care for up to 8 patients. They also provided hospice at home and care home support services to adults and clinical nursing support to children in the community. There was a wellbeing service delivered from a newly purpose built centre on site at the hospice. The wellbeing centre offered services such as bereavement support, falls prevention, seated exercise, gardening, yoga, arts and crafts and breathlessness support. We carried out the on-site assessment on 4 December 2024 which focused on the assessment of the hospice services for adults. The assessment was undertaken due to the age of ratings and time since the previous inspection. We rated Ellenor Gravesend as outstanding overall and in caring and responsive. We rated safe, effective, and well led as good.
Safe:
The service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly and shared learning both internally and externally. People were protected and kept safe. Staff understood and managed risks. The facilities and equipment met the needs of people, were clean and well-maintained and any risks mitigated. There were enough staff with the right skills, qualifications and experience. Managers made sure staff received training and regular appraisals to maintain high-quality care. Staff managed medicines well and involved people in planning any changes.
Effective:
People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Care was based on latest evidence and good practice. People always had enough to eat and drink. Staff worked with all agencies involved in people’s care for the best outcomes and smooth transitions when changing services. They monitored people’s health to support their quality of life. Staff made sure people understood their care and treatment to enable them to give informed consent. Where people lacked mental capacity, staff involved those close to them when making decisions in people’s best interests.
Caring:
People were treated with kindness and compassion. Staff protected their privacy and dignity. They treated them as individuals and supported their preferences. People had choice in their care and were encouraged to maintain relationships with family and friends. Staff responded to people in a timely way. They went out of their way to ensure that people’s needs were met at the end of life went above and beyond what would have been expected to meet individual needs and wishes. The service supported staff wellbeing.
Responsive:
People were involved in decisions about their care. The service provided information people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it. The service was easy to access and worked to eliminate discrimination. This included work with the community to raise awareness of hospice services in underrepresented groups, developing an understanding of cultural and other differences in order to ensure members of the diverse population viewed the hospice as appropriate to their needs. People received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. It also worked proactively with others in the wider system and local organisations to plan care and improve services People were involved in planning their care and understood options around choosing to withdraw or not receive care.
Well-led:
Leaders and staff had a shared vision and culture based on listening and learning. Service leads were visible, knowledgeable and supportive, helping staff develop in their roles. Where staff had provided feedback on how leadership of the service could improve including senior leadership visibility, the hospice leads had taken action. Staff had the opportunity to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. Managers worked with the local community to deliver the best possible care and were receptive to new ideas. There was a culture of continuous improvement with staff encouraged to try new ideas.