Farleigh Hospice

Updated 20 April 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The first inspection visit to the hospice on 6 December 2016 was unannounced and was carried out by an inspection team that consisted of one inspector, a pharmacist inspector, a specialist professional advisor (SPA) and an expert by experience (ExE). The SPA was a qualified nurse with experience of providing end of life services. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The second visit to the hospice was carried out on 14 December 2016 by one inspector. On 10 January 2017 we spoke over the telephone with relatives of people who were using, or had used, the services provided by the hospice.

Prior to the inspection we looked at information we held about the service and used this information as part of our inspection planning. The information included notifications. Notifications are information on important events that happen in the service that the provider is required by law to notify us about. The information also included the Provider Information Return (PIR) that the provider completed in July 2016. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

During our visits to Farleigh Hospice we observed how staff interacted with the people who were using the service. We spoke with 12 people who were using the in-patient service or the day service, seven relatives and four volunteers. We also spoke with a number of staff: seven health care assistants; four registered nurses; one development nurse; two administration staff; the Quality Improvement Lead; the Bereavement Service Lead; a representative from human resources; a chef; and the registered manager. Following our visits we spoke with a further five people who had used the services provided by the hospice, including the bereavement service and the Yo Yo project (a bereavement service for children). Four of these people had also had relatives who had used the in-patient or community/hospice at home services. Two healthcare professionals wrote to us to tell us their views about the service.

We looked at care records relating to four people as well as some other records relating to the management of the hospice. These included the Quality Account, two staff personnel records, complaints and compliments and some of the quality assurance audits that had been carried out.

Updated 20 April 2017

Farleigh Hospice is registered to provide care and treatment to adults and older people who have a life-limiting illness or condition. The hospice’s website states, “Farleigh Hospice exists to meet the needs of local people affected by life limiting illnesses and to support those who have been bereaved.”

The hospice is a registered charity and offers a wide range of services, tailored to meet each individual’s medical, emotional, psychosocial and spiritual needs. Services are delivered in the way that meets the needs of each person and their family and in the place that suits the person and their family best. This can be in the person’s own home, in the day care centre at the hospice or in the hospice’s in-patient facility. The majority of the hospice’s services are delivered to people in their own homes.

We visited the hospice site at Broomfield on 6 and 14 December 2016. On the first day there were five people staying at the hospice. We met the people who were staying at the hospice and their relatives as well as people who received care in their own homes and who were attending the day care centre. On 10 January 2017 we spoke on the telephone with a number of bereaved relatives who also used services provided by the hospice, such as the bereavement service. We also spoke on the telephone with relatives of people who were using the community or hospice at home services.

Farleigh Hospice was purpose-built about 15 years ago, very close to the Broomfield Hospital site. The hospice has an exceptional range of facilities and includes an in-patient ward, facilities for people’s relatives, a restaurant, day centre, shop and reception area. The sanctuary is a multi-faith, quiet space which is open for everyone to use if they wish to. The Lantern Suite consists of a number of rooms where services such as out-patient clinics, counselling, bereavement services, hairdressing, art therapy and a range of other complementary therapies are provided.

Farleigh Hospice had a registered manager in post. 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 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 had been in post for a number of years.

People and their relatives were effusive in their praise of the staff and the services provided by the hospice. Staff were exceptionally caring, kind, compassionate and respectful of people’s privacy and dignity. The hospice fulfilled its values in a culture which kept the person at the very centre of their care and treatment. Everything was based on the needs, wishes and preferences of the individual and how those needs, wishes and preferences could be recognised, supported and met. The hospice strived to give each person the highest quality of care during their life and the best, most comfortable death possible.

Staff supported relatives of the person before, during and after death for as long as, and in whatever way, the relatives needed. The bereavement service offered support to any adults who needed it and who lived in Mid Essex. The YoYo project supported bereaved children across mid-Essex. The services were offered at the hospice, at the child’s home or at their school, which meant the services were accessible to all children. The staff ran workshops for school staff to help them know how to support a bereaved child.

There were enough staff deployed to care for and support people in the way they preferred. Pre-employment checks had been carried out for new staff and volunteers to make sure they were suitable to work/volunteer at the hospice. Staff received a wide range of training relevant to their role, which made sure they had the skills and knowledge to care for and support people who were affected by life-limiting illness. Staff were very well supported by their managers and each other.

All staff had been trained in how to protect people from abuse and harm. They knew how to recognise and report any signs of abuse. Assessments of any potential risks were carried out and recognised people’s changing needs. Measures to reduce risk were put in place as needed. Some aspects of medication management were not always carried out in the safest possible way.

People were at the heart of the service and were fully involved in the planning and review of their care and treatment. Care plans were personalised and based entirely on the individual’s holistic needs, wishes and preferences. Services provided were responsive to people’s needs and included a range of activities, therapies, events and complementary therapies. Meals were of high quality and met people’s dietary and nutritional needs. The hospice worked with a range of external professionals to ensure that people’s health and well-being were maintained for as long as possible.

The CQC monitors the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS), which apply to care services. People were always asked for their consent to any care and treatment they were provided with. If a person lacked the mental capacity to make certain decisions, the staff were clear about their responsibilities in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards.

The service was managed very effectively and was constantly striving for excellence and to be outstanding. People, their relatives, the staff and other healthcare professionals were encouraged to give their views about the hospice and put forward their ideas for improvements. The provider’s complaints procedure was well advertised and any complaints were responded to and addressed. An effective system was in place to monitor and audit the quality of the service being provided. There was a homely, friendly and open culture in the hospice, which put the individual first.

The hospice staff worked in partnership with a wide range of other services and healthcare professionals, who praised the service that was provided to people and their relatives.