1 March 2016
During a routine inspection
It was an unannounced inspection. There were six inpatients at the hospice on the day of our visit. The day hospice was not open . A further two days were spent speaking to patients and relatives via telephone to gain their views on 24 and 29 March 2016.
There was a manager in post who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 run. The registered manager was also the director of care and operational services and oversaw the running of the service.
We found the ethos and culture of Halton Haven Hospice was positive and caring and staff spoken with were passionate about working at the hospice. They spoke of the importance of treating each patient as an individual which showed us that some aspects of the hospice were outstanding. They supported family and friends of patients with support networks and an innovative and unique support for men in the form of a “mens shed ” which is the first of it’s type in England.
A further outstanding initiative that the hospice was involved with in the local community was working with “Night Stop” a charity for homeless people in Halton to provide information and support.
Staff we spoke with were committed to providing individual care to the patients and relatives who were attending the hospice and put them at the heart of everything. Best practice guidelines were followed to ensure patients received the best care staff could give and patients were well supported by experienced well trained staff. All staff spoken with said they had received good training to help them to understand and care for patients at the hospice.
The registered manager was open and transparent and held a vision for the service.
Staff had received up to date training in how to protect patients from abuse and harm and they knew how to recognise signs of abuse and how to raise an alert if they had any concerns.
Patients we spoke with and their relatives felt that they and their loved ones were looked after by staff who were caring and had training so that they knew what they were doing.
Patients and relatives said the food was very good and there was always something to tempt patients if they were not feeling hungry. The menus were varied and alternatives were always available.
Care records showed that plans of care were person centred and reflected the needs of the individual. This ensured that patients were supported in the way they wanted to be.
The provider had effective procedures for ensuring that any concerns about patients safety were appropriately reported and were constantly striving for improvement.
Patients, relatives and staff felt that the home was very well managed. We found that all the staff team were well led and highly motivated to provide quality individual person centred care and all spoken with said they felt proud to work at Halton Haven Hospice.
Minor complaints had been received by the service since our last inspection. The complaints had been addressed promptly according to the service's policy and to a satisfactory outcome.
We found that risk assessments were centred on the needs of the individual patient and risks were discussed with all of the staff team and the patient.
Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced and patients were supported to be as independent as possible.
Staffing levels were calculated and adjusted according to patients changing needs.
There were thorough recruitment procedures in place which included the checking of references.
The environment was well designed, welcoming, well maintained and suited patients needs.
Training for staff was specific to the needs of the patients they supported such as palliative and end of life care as well as training with regard to moving and handling, safeguarding, Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.
All members of staff received regular one to one supervision sessions and there was a good support mechanism in place to reflect on care given. Trained nurses received clinical supervision.
The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to hospices. Appropriate applications to restrict people's freedom had been submitted and the least restrictive options were considered as per the Mental Capacity Act 2005 requirements.
Patients told us they were very satisfied about the staff approach and about how their care and treatment was excellent and outstanding. We saw positive comments and feedback about the quality of service patients received via surveys forms.
We found that all aspects of medication was managed safely and trained staff had a unique method of reminding them to give controlled drugs.
Clear information about the hospice, the service it provided, the facilities, and how to complain was provided to patients and visitors.
Staff sought and respected patients consent or refusal before they supported them.
We looked at the audit system in place which was comprehensive and identified how the service could improve. When needs for improvement were identified, action was taken which improved the quality of the service and care. The service worked in partnership with other organisations to drive improvements.