Halton Haven Hospice

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

At our last assessment we rated this key question good. At this assessment the rating has remained good.

Good: We looked for evidence that people and communities had the best possible outcomes because their needs were assessed. We checked that people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We reviewed 2 patient care records during our inspection. Both care records demonstrated that holistic assessments took place in collaboration with patients, and person-centred care and support plans were in place. Risk assessments were completed for pain management, falls, manual handling, pain scores and pressure ulcers.

Patients told us they had been involved in decision making about their care and care planning documentation to also include reviews of their care.

The service had daily huddle meetings, handovers and daily ward rounds to discuss individual patients. Weekly multidisciplinary team meeting (MDT) which included external partners were held to discuss internal and external professionals involved in patients’ care.

All clinical staff were trained in recognising the signs of changing needs or clinical deterioration, as well as the use of assessment tools and documentation systems to ensure continuity of care and consistency in monitoring.

Staff demonstrated a good understanding of individualised escalation plans for patient deterioration and reviewed treatment plans on an ongoing basis and updated and adjusted as patients improved or deteriorated. 

Staff identified each patients individual communication needs on admission and interpreters were available if required, including British Sign Language (BSL).

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Patients told us that staff had ensured that their care and specific important support needs were respected and adhered to.

Staff described how they supported patients to understand their treatment and had good knowledge of the communication resources, and options available to them.

The hospice completed audits and analysed the trends and shared this with all staff. The audits included patient documentation, IPC, demographics, care of the deceased audits, falls audits, nutrition and hydration audit and management of pressure ulcer audit.

Any audits that were 90% or below had an action plan implemented to make the necessary improvements. The outcomes of the audits were reported to board level to provide assurance.

The staff team had access to the full range of specialists required to meet the needs of patients in the service. This included consultant level doctors and advanced nurse practitioners, physiotherapists, social workers, pharmacists, speech and language therapists, respiratory practitioner and dieticians.

Staff were experienced and qualified and had the right skills and knowledge to meet the needs of the patient group. Management ensured that staff received the necessary specialist training for their roles.

Managers identified the learning needs of staff and provided them with opportunities to develop their skills and knowledge.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Leaders described the hospice as being built on teamwork with a multidisciplinary team working together to support the whole person, physically, emotionally, socially, and spiritually. The collaborative approach allowed the hospice teams to improve patient outcomes by anticipating need, responding quickly to changes, and honouring each patient’s goals and values.

Staff reported an excellent working relationship with all staff and teams within the service. The hospice held bi-monthly clinical staff meetings, twice weekly board rounds and weekly multi-disciplinary (MDT) meetings where information was shared, and next steps discussed regarding the transition of care and treatment.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

Staff had access to the nutrition and hydration policy which outlined the principles, procedures and guidance to be followed in assessing and meeting the nutritional and hydration needs of patients and to enable, with appropriate interventions, holistic individualised management of a patient’s nutrition and hydration needs.

Patients told us they had plenty of choice and variety to eat and drink and were complementary of the food and choice available.

The service supported patients to live healthier lives, they offered complimentary therapies, physiotherapy, breathlessness clinic and spiritual support.

Community engagement initiatives at the service included but not limited to the motor neurone disease (MND) Social Café, Dementia Café and Brighter Days Group.

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The hospice had a regular audit programme and data collection schedule, which showed the service was performing well against targets, data gathered included transferring patients to specialist palliative care services, pressure ulcers, falls, medication incidents and inappropriate referrals. The results and any improvement points were discussed at quality governance meetings. Managers shared and made sure staff understood information from the audits. We were told there were several mechanisms by which staff were informed of changes. These included team meetings, handovers and emails.

Staff used recognised tools to improve the detection and response to clinical deterioration in patients as a key element of patient safety and improving patient outcomes.

We observed a patient being supported to return home, with care that was person-centred and considerate. The patient told us that they would return to the hospice if needed.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When people lack mental capacity to take particular decisions, any decision made on their behalf must be in their best interests and as least restrictive as possible.

Staff had received training in relation to the Mental Capacity Act 2005 (MCA) and were able to explain the main principles. Staff understood the importance of giving people choice in the support they received. We observed staff always sought people's consent before providing any support. People were supported to make their own decisions where appropriate, in accordance with the MCA.

The service had an up-to-date mental capacity policy which was last reviewed in February 2025. Staff had access to this document.

Staff demonstrated good knowledge and understanding of the mental capacity act and patients’ rights in relation to consent and capacity. When patients lacked capacity, staff made decisions in their best interests with family members, recognising the importance of the person’s wishes, feelings, culture and history.

Staff took all practical steps to enable patients to make their own decisions. For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. They did this on a decision-specific basis with regard to significant decisions.