Sue Ryder - Manorlands Hospice

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive Rating: Good

Responsive- this means we looked for evidence that the service met people’s needs. At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s needs were met through good organisation and delivery.

This service scored 75 (out of 100) for this area.

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.

The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Patients were seen as individuals, and their care was personal to them and well-coordinated. Staff encouraged patients to be involved in their care, so their individual needs and preferences were central to the care that was provided.

Through robust and person-centred care planning staff saw the whole person, supporting and caring for them and their families as individuals. In-depth assessments were completed using a patient and carer assessment tool, which enabled the service to focus on, and address, any individual support needs the patients and their family or supporters may have.

We heard life stories were important in understanding the needs of individual. We reviewed 4 care and treatment plans, they showed the patients and their family or supporters had been involved in their development and review. The patient’s needs, and preferences were at the centre of these care plans.

Patients had regular one-to-one time with their nurse, and the staff members would regularly attend multidisciplinary team meetings with the wider team. This ensured the individual needs and preferences of the patients and their family or supporters, were central to care and treatment planning.

We heard an example of decision making where staff did not all feel comfortable with the decision a patient had made regarding pain relief at the end of life. We saw that the staff had ensured the person had been provided with all information and fully understood the information prior to making a decision. The staff respected the persons wishes supporting them to weigh up all of the information and empowering them to make the decision that best suited them as an individual.

Person-centred care was observed through discussions at handovers, referral meetings and huddles.

Staff engaged in meaningful conversations to identify what mattered most, documenting individual support needs. Patient and family feedback consistently praised the care quality.

The volunteering team allowed for personalised experiences to align with each person’s preference, hobbies, or background; for example, a builder who volunteered with the maintenance team.

Patients or their relatives could be referred for counselling and bereavement support if required.

Staff understood meeting the information and communication needs of patients with a disability or sensory loss was important. Staff supported patients living with dementia and learning disabilities.

Managers made sure staff, patients, family, friends, and carers could get help from appropriate interpreters when needed.

Staff told us they could print information leaflets in different languages when required.

The hospice supported open visiting for relatives and carers 7 days a week.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service provided joined up care that was responsive to people’s needs. For example, we heard about close working relationships with the local NHS Trust emphasising a focus on reaching people earlier to then support people to live well for longer.

There were links with the Motor Neuron Disease (MND) clinic at the local NHS hospital and the team aimed to have all newly diagnosed patients referred into the day service. They attended monthly MND meetings at the trust.

We heard examples of links that had been made with other services in the community to help facilitate patients receiving seamless care and support. For example, links had been made with a local healthy living group. People were able to move onto this group from the living well sessions. We heard an example of a lady who had attended Thai Chi in the day therapy service and then managed to move on to a community-based course for members of the wider population. We were also told about an example of a very anxious lady using the day therapy service who had been met in the car park initially and supported into groups and then went on to look at volunteer work options within the community.

The community team told us about the Gold Standard Framework Meeting – which they attended with local GP practices. The aim of these meetings was to talk through people in the last year of their life and discuss the patient with other MDT members in the wider community.

We reviewed the improvement plan from July 2025, which included details of a joint project with a range of stakeholders into a review of the local population data and services that delivered support to people in end of life care. This was to identify gaps, better understand future needs and future service improvement.

People who use the service and those close to them, spoke positively about care being well co-ordinated. They told us that staff had involved them and their family with advance care planning and that they felt listened to and valued.

A family member of a recent inpatient told us about continuity of care “I was always worried when we moved to a new place because usually we had to go through all the background of her condition again, drag everything up and it was really upsetting. But here they didn’t do that, they already knew about her, her condition, her family so we could have conversations instead about the best ways to keep her comfortable”.

Manorlands Hospice demonstrated an understanding of the diverse health and care needs of local communities. While the service recognised the need for further engagement with seldom heard from communities, it actively collaborated with local community groups and held public events to demystify end of life care and the services they could offer This included attending local food banks, dementia cafes and a learning disability group.

The community palliative care team, worked closely with the MDT to ensure care was well-coordinated and joined up. They collaborated with external services and partners, involving them in discussions and decisions about future care for people, including transitions to other care providers.

Partners praised the service for their integration with the wider system. They said that collaborative working and support from the hospice had helped patients have the support they required without the need for a hospital admission.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People reported that staff engaged them in comprehensive discussions about their care. One family member told us, “when she was put on a syringe driver, they explained what was in it and how it helped to provide her with the best pain relief. They always asked if there was anything we needed explaining again, they were very patient”.

Staff demonstrated knowledge of peoples’ needs, using tailored techniques to reassure and calm those using the service, prioritising non-medication approaches where appropriate, including complementary therapies, breathing techniques, and mindfulness. This reflected an understanding of preferences and requirements, ensuring information was delivered in a supportive and person-centred manner.

The service had effective ways of providing clear and accurate information to patients and their family or supporters depending on their needs and preferences. Staff used resources available to them when delivering information, and when required referred patients to external communication services to ensure information was available about their care and treatment, and that any information given was understood.

Processes ensured that information was shared in an effective way. The service provided support for patients and their family or supporters who may have communication needs. For example, interpreter services were provided when required to overcome potential language barriers, information was available in different languages, and information was also available in larger print/easy read format. A local blind charity had libraries of resources and had advised the hospice on how they could support them if a blind person was to use the hospice.

A member of staff told us that not long ago they had someone who was deaf, so they requested some training. They appreciated that they were not going to learn sign language in such a short time, so communication pads were introduced. These effectively removed the barrier to communication.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

Manorlands Hospice actively encouraged and supported people using the service to provide feedback on care, ensuring their voices were heard and valued. The service sought feedback from people using the services, staff, and community professionals through various methods, with the responses reviewed being overwhelmingly positive.

A community patient, at an exercise class at Manorlands Hospice told us about feeling listened to and involved in her care “the occupational therapist came to assess me and asked what support I wanted. I said just to keep my flexibility. She suggested this class could be a way to do that and would I like to try it, so here I am. All of us that come have individual exercise plans to help with whatever we need”.

The service viewed concerns and complaints as opportunities for learning and improvement. A staff member told us “it’s seeing what has made the difference- even if its small- so we know and do more, it’s also about what’s not working well, what we could do better”.

We reviewed patient surveys for the previous five months. These demonstrated consistently positive feedback. There were no complaints during this period.

During the admission process, people were encouraged to initially raise concerns with any staff member. If unresolved, people could escalate concerns through a formal complaint process via letter or email. Information about these processes was prominently displayed throughout the service, ensuring transparency and accessibility.

Feedback, both negative and positive was shared monthly with staff. This boosted morale and reinforced good practice.

We saw minutes from the hospice user group meetings which discussed enhancing the patients’ experience by painting rooms. For example, blue for calming and reducing anxiety and yellow to brighten the darker rooms. We saw in the Quality Improvement Group July 2025 minutes where the redecoration of patient’s rooms was mentioned and due to start in September 2025. Other quality improvement projects we saw documented in the minutes included refurbishing the rose garden and the staff dining room.

The service made sure that people could access the care, support and treatment they needed when they needed it.

Patients who accessed the service were usually referred by their GP or district nurse. Services were accessible to patients and their family or supporters, and people who were facing bereavement or had been bereaved.

The hospice ran a clinic from the local GP surgery, this was so patients who felt the hospice was ‘too daunting’ could be seen by the hospice doctor in a more familiar environment. This service also improved access to services for those living in rural areas.

We were told about the use of volunteer drivers, who collected patients and brought them to the hospice to attend the day services, at no cost to the individual. We were told this was especially appreciated given the rural nature of some of the community.

The hospice took part in annual events at the local hospital to promote ‘dying matters’ awareness. There was a focus on engaging with members of staff and the local community to explore how end of life conversations were shaped by background, culture and communities.

The service worked with external bodies to ensure that the service and its premises were accessible to all people. They worked in partnership with disability experts to make the premises more accessible, and learning disability organisations to improve the experience for patients using the service who may have a learning disability.

The hospice had links with different services in the community. A local learning disabilities group visited the hospice to help break down misconceptions and reduce fear surrounding end-of-life care. The visit aimed to create a more open, reassuring understanding of what a hospice is and how it supports people and their families. Staff told us of a recent initiative where they go to the local food bank to get to know people using that service and share information about the hospice and its services.

The service delivered care in a way that met patients’ needs, which was accessible and promoted equality. This included people with protected characteristics under the Equality Act (2010) and people who were in vulnerable circumstances or who had complex needs.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Patients were supported to overcome any potential barriers to care and treatment, they had access to services who supported them to communicate so their voices were heard, their needs met, and feedback on their experience captured.

We were told about some examples where people, with protected characteristics, using the service were supported, for example a vulnerably housed individual was supported with their choice of where to die.

The service supported patients to access communication services to ensure they were listened to and their feedback acted on.

We saw an ‘everyone welcome’ noticeboard with notices about LGBTQ+, diverse cultural backgrounds and rural communities.

The service had access to independent services who supported patients with communication needs. Quality improvement projects were undertaken to enhance the patients experience, projects were audited and monitored for outcomes. The service engaged in collaborative benchmarking initiatives with nationally recognised organisations to measure standards, performance and progress across the relevant sectors.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Patients and their family or supporters were given support with their care, needs, and decisions about their treatment. The service supported advanced care planning where appropriate.

Staff worked closely with patients and their family or supporters regarding their plans for the future, so they had enough time to make informed decisions about their future, including at the end of their life. The service supported patients with palliative and end of life care at home in partnership with their GP or hospital team.

A local GP who referred into the service told us Manorlands Hospice was a highly sophisticated user of electronic health records, using a shared electronic record system. They said “the ability to document a patient's end-of-life preferences directly in the shared system helps ensure their wishes are respected, which families find deeply reassuring”.

Planning ahead sessions were offered by the day services team, covering such topics as conversations with children, wills and lasting powers of attorney and funeral planning and remembrance.

Processes enabled patients and their family or supporters to be supported to make decisions about their care and treatment, sometimes in advance. Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) documentation and Recommended Summary Care and Treatment forms (ReSPECT) were completed after consultation and in line with guidance.

We were told by inpatient unit staff that they used a recognised palliative care outcome scale which helped them identify and track their patient’s physical, psychological, social and spiritual needs. This helped staff assess what concerns mattered most to their patients and helped deliver person centred care and plans for the future.