You are here

Inspection Summary


Overall summary & rating

Good

Updated 17 January 2017

This inspection took place on 19 and 21 October 2016 and was announced. We gave the registered manager 48 hours’ notice of the inspection because we wanted key people to be available.

The hospice at Leckhampton Court has a 16-bed in-patient unit, a day service and a hospice at home team. It provides support for people over the age of 18 who have life limiting conditions such as cancer, heart failure, lung disease and degenerative neurological illnesses. The hospice at home team helps people to stay at home longer or to die at home if this is their preferred place of death. The service also offered respite for carers. The expert care team included doctors, nurses, health care assistants, physiotherapist, occupational and complementary therapist, social workers, bereavement support workers, volunteer befrienders and spiritual care workers. The various services provided by the hospice worked in conjunction with people’s own GP, community district nurses, and other health and social care professionals.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.

A hospice service was provided for end of life care in the last couple of weeks, symptom control, emotional and physical crisis. From the in-patient unit 50 percent of people would go home after a short stay and may return at a later date and 50 percent would die in the hospice. The hospice at home service was mainly provided for people in the last two months of life, however this service had helped people with degenerative neurological conditions for longer periods.

All staff including volunteers received safeguarding adults training and nurses and care staff received safeguarding children training. This meant they would be able to recognise if people and children they came into contact with were being harmed and would know what to do to report those concerns.

The nurses and health care assistants were trained on how to use equipment correctly to safely move and transfer people from one place to another. Any risks were identified and management plans put in place. Any other risks to people’s health and welfare were identified during the assessment of care needs and were then well managed. Safe recruitment procedures were followed to ensure that only suitable staff were employed. The service had the appropriate procedures in place to protect people from being harmed.

The numbers of staff on duty in the in-patient unit were determined by the number of people who were receiving care and support and the complexity of their needs. The hospice at home team had a flexible workforce (bank staff) in order to be able to increase capacity and accommodate the demand for their service. The team endeavoured to always meet any referrals for a service and would pull out all the stops to support those in need.

All staff had a programme of mandatory training to complete. This enabled them to carry out their roles and responsibilities effectively. Volunteers also had to complete some of these training sessions. There was a comprehensive induction training programme for all new staff plus a programme of refresher training for all other staff. This ensured they had the required skills and qualities to provide a compassionate and caring service to people and their families. .

On admission to the in-patient unit people’s capacity to make decisions was assessed and where possible they were supported to make their own choices and decisions. Staff received training regarding the principles of the Mental Capacity Act (2005) and these were understood. They ensured consent was given prior to providing any care and support. Where people lacked the capaci

Inspection areas

Safe

Good

Updated 17 January 2017

The service was safe.

All staff received safeguarding adults and children training and protected the peoples they were supporting from harm. Any risks to people’s health and welfare were well managed. Recruitment procedures for new employees were safe and ensured only suitable staff were employed.

People were assisted with and administered their medicines safely. Qualified nurses had the appropriate skills to enable them to administer end of life medicines.

Sufficient staff were employed at all times to meet people’s needs. The hospice at home service had a flexible workforce and was generally able to meet all referrals for a service. The staffing levels on the in-patient unit varied depending upon the number of people and their care and support needs.

Effective

Good

Updated 17 January 2017

The service was effective.

People were looked after by staff who were well trained and well supported to carry out their roles effectively. Staff had the qualities and skills to provide compassionate care and support.

Staff understood the importance of obtaining consent from people before helping them. They were aware of the principles of the Mental Capacity Act (2005).

People were supported to eat and drink where this was needed and supported to see their GP and other healthcare professionals as required. There was good collaborative working in place between the different health care services.

Caring

Good

Updated 17 January 2017

The service was caring.

People were treated with the utmost respect and kindness and their dignity was maintained until the end. The staff teams were highly motivated to provide a kind and loving service and ensured when people were at the end of their life they had a good death.

Families were also provided with a very caring and supportive service, at a difficult time in their lives.

The service looked after its staff and provided them with emotional support and guidance.

Responsive

Good

Updated 17 January 2017

The service was responsive.

People and their families received the care and support that met their specific needs. The care and support was adjusted as and when required in response to people’s changing needs.

People were listened too and staff were all committed to supporting them if they had any concerns or were unhappy.

Well-led

Good

Updated 17 January 2017

The service was well-led.

People were highly complimentary about the hospice service. External health care professionals said the service was well organised, well managed and provided service to an extremely high standard.

The service worked in conjunction with other hospice services and educational establishments to influence and improve best practice in palliative and end of life care.

Feedback from people using the services and the families of people who had used the service was gathered and used to drive forward any improvements. People were listened to and all staff, including volunteers, were involved and consulted by the management team.