You are here

Archived: St Raphael's Hospice Good

The provider of this service changed - see new profile

Reports


Inspection carried out on 11 to 12 November 2019

During a routine inspection

St Raphael’s Hospice is operated by The Congregation of the Daughters of the Cross of Liege. It is a voluntary organisation, part of the registered charity of the English Province of the Daughters of the Cross of Liege. The hospice will become a charity in its own right in Spring 2020.

The hospice provides end of life and palliative care to people living in the South London Boroughs of Sutton and Merton. The hospice accepts referrals made by GPs, specialist nurses or hospital consultants. A team of specialist consultants, doctors, nurses, health care assistants and a range of other health and social care professionals, therapists and volunteers provide care, treatment and support to people with a life-limiting illness and their families/carers and friends.

The hospice comprises of a 14 bedded in-patient ward, the Jubilee day care centre, overnight family accommodation and a café known as the Orangery that is open to the public. There are various community teams that operate out of the hospice which include the Clinical Nurse Specialist Community Palliative Care Team (CPCT), ‘Hospice at Home’ and ‘Hospice neighbours’ services that provide people and their families care and support at home. The hospice also has a pastoral and counselling service for both people and their families. At the time of our inspection, there were eight people staying on the ward at St Raphael's and approximately 250 people receiving community palliative services at home.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced visit to the hospice on 11th and 12th November 2019.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so, we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Services we rate

Our rating of this service stayed the same. We rated it as Good overall.

  • Staff kept patients safe from avoidable harm and abuse. Risks were assessed, monitored and managed appropriately.
  • Patients care and treatment records were clearly detailed and accurate in content. They were stored securely and managed safely.
  • Staff recognised incidents and knew how to report them. Managers investigated incidents and made improvements to the service.
  • Staff followed best practice in relation to infection prevention and control.
  • Staff had the appropriate skills, training, knowledge and experience to deliver effective care and treatment. Care and treatment was delivered in line with evidence-based practice.
  • Staff involved patients and carers in decisions about their care and treatment.
  • Staff cared for patients with compassion, treating them with dignity and respect. Staff truly respected and valued patients as individuals and empowered them as partners in their care, practically and emotionally, by offering an exceptional service.
  • Services provided aimed to meet the needs of people from their whole community, and the needs of the population served, which ensured flexibility, choice and continuity of care.
  • There were clear processes for staff to manage complaints and concerns.
  • There was an open and transparent culture, with engaged and experienced leadership.

However, we also found the following issues that the service provider needs to improve:

  • The hospice should improve the electronic notes system so that it is more user friendly and easier for staff to navigate.
  • The hospice should replace the worn carpet within the inpatient areas to reduce the risk of slips, trips and falls.

We found the following areas of outstanding practice:

  • Staff within the service demonstrated compassion and dedication to finding innovative ways to support patients with their end of life care. Staff and patients could provide many examples of how the service had ensured patients received care individualised to their holistic needs.
  • People’s individual needs and preferences were central to the delivery of tailored services. The staff were exceptionally caring, compassionate and empathetic towards both the patient and their relatives.
  • Staff completed comprehensive and holistic end of life care plans. The care planning within the service focussed on all elements of the patients care including their spiritual and emotional needs.
  • The service has hospice biographers, who alongside the patients would write patient biographies that they can leave as a memoir of their life for their family and friends.

Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Dr Nigel Acheson

Deputy Chief Inspector of Hospitals (London & South)

Inspection carried out on 19 July 2016

During a routine inspection

This inspection took place on 19, 20 and 22 July 2016 and was announced. The service was last inspected in September 2013 and at that time was meeting all the regulations we looked at.

St Raphael’s Hospice is a voluntary organization, part of the registered charity of the English Province of the Daughters of the Cross of Liege. The hospice provides end of life and palliative care to people living in the South London Boroughs of Sutton and Merton. The hospice accepts referrals made by GP’s, specialist nurses or hospital consultants. A team of specialist consultants, doctors, nurses, health care assistants and a range of other health and social care professionals, therapists and volunteers provide care, treatment and support to people with a life-limiting illness and their families/carers and friends.

The hospice comprises of a 14 bedded in-patient ward, the Jubilee day care centre, overnight family accommodation and a café known as the Orangery that is open to the public. There are various community teams that operate out of the hospice which include the Clinical Nurse Specialist Community Palliative Care Team (CPCT), “Hospice at Home” and “Hospice neighbours” services that provides people and their families care and support at home. The hospice also has a respite care service for people and a pastoral and counselling service for both people and their families. At the time of our inspection there were eight people staying on the ward at St Raphael’s and approximately 250 people receiving community palliative services at home.

The service had a registered manager who was also the hospice’s Director of Care Services (DCS). A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

Management, staff and volunteers were highly motivated and committed to ensuring people and their families received the best possible end of life care, treatment and support. The hospice enabled people to experience a positive, comfortable and dignified death that was delivered in accordance with a person’s personal needs, choices and preferences. Practical and emotional support was provided to people and their families.

People received personalised care, treatment and support. People were supported to make informed choices about their end of life care and to have as much control as possible about what happened to them before and after their death. They were involved in planning their care and supported to make decisions on their preferred place of death. Consent to care was sought by staff prior to any support being provided.

The management team demonstrated a strong commitment to delivering people with high quality and safe end of life care. The management structure showed clear lines of responsibility and leadership. The service had developed effective governance systems and there was a strong emphasis placed on continuous improvement of the service. The service regularly reviewed their performance and where further improvements were identified appropriate actions were taken. Managers used learning from near misses, incidents and inspections to identify improvements that would positively enhance the lives of people receiving a service from St Raphael’s.

The hospice was committed to working collaboratively with others. Staff worked in close partnership with external health and social care professionals and other organisations to deliver and share best end of life practice and care for people affected by a life limiting illness.

People told us they were very happy with the service they received from St Raphael’s. We saw staff looked after people in a way which was kind, respectful and compassionate. Feedback we received from people, their families and external commun

Inspection carried out on 26 September 2013

During a routine inspection

During our inspection we spoke with four people who received services from St Raphael�s and three of their relatives. People told us they were extremely happy with the care and support provided by the hospice and that the staff who worked there were always kind and compassionate. One person told us �the staff are incredible here. I think they are angels without wings. I don�t know what we would have done without them�. Another person said �the support we�ve received has been marvellous. I can�t fault the place�.

We also talked to several members of staff that included the deputy manager, five nurses/carers, a GP, the head of training and three volunteers.

We saw patients received safe and appropriate care and support that was individualised. This was because there were enough suitably qualified, skilled and experienced staff to meet each patient�s end of life care needs and wishes. We also saw patients and their families were treated with respect by staff and were involved in discussions about the care provided by the hospice.

We found patients were protected against the risks associated with poor medication handling practices because the provider had appropriate arrangements in place to manage medicines safely. This meant patients were given the medicines they needed, when they needed them. The provider also had effective quality checking systems in place to regularly monitor the standard of the end of life care patients received from St Raphael�s.

Inspection carried out on 12 December 2012

During a routine inspection

St Raphael�s Hospice provides care for people with cancer and other terminal illness. People may be admitted for respite, for management of their symptoms or at the latter stages of their illness.

In addition to inpatient facilities the service provides care and support to people in their own homes and their families. There is also a day centre providing various activities and courses for people to participate in.

The service provider is a religious organisation, The Congregation of the Daughters of the Cross of Liege, however the hospice cares for people of any or no faith. 25% of its funding is provided by the National Health Service and the remaining income comes from donations and fundraising events.

During our inspection we were able to speak to the medical director, members of the management team, staff and people using the service.

Reports under our old system of regulation (including those from before CQC was created)