Dorothy House Hospice Care

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

At our last assessment we rated this key question outstanding.At this assessment the rating has remained the same. This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 96 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The evidence showed an exceptional standard. The service was exceptional at making 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.

All assessments were personalised and holistic and placed the person’s wishes, dignity and quality of life at the centre. Staff facilitated early, open and candid discussions about people’s wishes for end of life care and promoted advance end of life care plans to reflect changing needs or wishes.

Admiral nurses who specialised in dementia care advised and supported patients, families and carers living with dementia. Admiral Nurses are specialist dementia nurses supported by the charity Dementia UK, providing life-changing, expert care to families affected by all forms of dementia. Staff had received dementia training and the admiral nurses supported carers by identifying additional information needs across various settings.

The hospice used the supportive and palliative care indicator tool (SPICT) to enhance understanding of dementia, with the goal of enabling more individuals to experience a dignified death at home and had recently appointed a dementia lead role.

The hospice also had a dementia, frailty and learning disability working group who met monthly and completed annual audits with an action plan. We reviewed the meeting minutes for the month of January 2026 which showed discussions around feedback from patient groups and the dementia and end of life care guide.

Staff provided two examples of when the hospices interventions helped people realise their potential in spite of their life limiting condition. One resulted in the Royal Marines Band playing at the hospice whilst a patient’s husband was awarded a service medal. Another involved the purchase of an academic cap and gown for a son so that his frail mother could witness his graduation at the hospice and have family photos taken.

The hospice also employed motor neurone disease (MND) specialist practitioner who supported patients, families and carers living with MND. When reviewing the minutes from the board of trustees meeting for the month of December 2025, we also came across another patient story which involved a patient with motor neurone disease. At the patient’s request, the withdrawal of ventilation procedure was discussed and explained to the patient and their family and through collaborative and coordinated approach by different teams, the patient was able to experience a peaceful and dignified end of life, with their wishes respected.

Spiritual support team was available for people of any or no faith, from the point of a palliative diagnosis, through death and bereavement.

The evidence showed an exceptional standard. The service had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The hospice provided a comprehensive service to improve continuity, this included consultants who worked in the local acute hospital, visiting wards and working with the specialist palliative care team, delivering a joint oncology clinic, employing a discharge coordinator who worked both in facilitating rapid discharge form the local acute hospital and supporting people from the front door of the hospital i.e. the emergency department, a homelessness lead who worked with local charities and providers and the admiral nurses who supported the ICB wide review of frailty.

Additionally, the hospice designed and delivered services around the needs of their local population and used locality‑based and thematic needs analysis, including analysis of rural communities to understand where access, geography or demographic factors may affect people’s ability to receive care. This enabled them to adapt how and where to deliver care so people could access the right support at the right time, including at home, in community settings, through outpatient and virtual models, and through inpatient care when needed. Services were flexible and adjusted quickly as people’s needs change, supporting continuity and reducing unnecessary hospital admissions.

Staff from all disciplines attended the MDT meetings where they shared relevant information and agreed appropriate next steps to support safe and well-coordinated transitions of care and treatment.

The community nursing care team were based at the hospice and worked closely with GPs, district nurses and other agencies to ensure patient care was joined up and coordinated well. The hospice also worked alongside other services and partners and involved them in discussions and decisions around future care of the patient including transfer to another care provider. The hospice played an active leadership role in system‑wide partnerships, including the BSW palliative and end of life care alliance, where they worked with commissioners, acute trusts, community providers and other hospices to agree shared priorities, tools and approaches across the system. The service also collaborated closely with other hospices focusing on access models, joint quality improvement and shared data.

Within the community team, there were community engagement and volunteer coordinators who looked at what the community had to offer and where the hospice could engage with other organisations.

As a result of a scoping exercise which had identified gaps within the service, an EOL working group comprising representatives from Dorothy House, two other hospices and other relevant organisations, the service had developed a dementia guide for families, healthcare professionals including care homes.

The evidence showed an exceptional standard. The service was exceptional at developing appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The hospice offered various services which the patients and their families could access for advice and support depending on their specific needs. These included the community palliative care teams, hospice at home, inpatient unit, day services, open access services, a range of therapies, family support services and children and young people’s wellbeing hub.Additionally, the hospice used digital flags on their electronic records to identify where someone had a specific information format/method need.

The website for the hospice contained a wealth of information ranging from what services they provided, what support was available, information for volunteers, how to get involved with fundraising or participating and signposting to other channels.,

Additionally the website also contained information on the children and young people’s wellbeing hub which included resources for children and young people as well as resources for parents and carers. Patients and families could also access a wide range of information via the information hub on the website which provided an up to date selection of end of life and palliative care resources for patients, carers, family members and healthcare professionals. Patients also had access to a number of leaflets in different languages which provided information on symptom management and advice in palliative care.

A feedback received on I want great care (IWGC) from a patient stated, ‘the staff were so supportive with all the right information and care for my brother, mum and me.’ Another read as ‘I was blown away the level of support and how many different support options there were’. Patients and families who attended the day patient unit fedback that they found it informative, fun and learned new skills.

Staff took time to explain information to patients and families. A piece of feedback received by the community palliative care team read as ‘very well informed and informative, full of useful tips and advice’.

A telephone advice and support line was available 24 hours a day, seven days a week to those who required this.

The hospice offered a range of complementary therapies and treatments tailored to meet individual needs. The therapists at the hospice provided patients and families with advice on equipment and manual handling techniques.

Feedback from a patient who had received psychological support read as ‘We built a strong therapeutic relationship where I felt heard in mind, well supported and empowered.’

The hospice had co-developed a digital tool, GRACE (Giving Respect and Autonomy for Care at the End of Life), to support the provision of information. This included a patient planner and portal, enabling individuals to access end-of-life planning resources and information, and supporting them to make informed decisions about their care.

Following engagement with local communities, the hospice had completed two validated Death Literacy surveys and used this to understand how people accessed, used and talk about end-of-life care information.

The hospice used this insight to improve how information was shared with patients and the public, and to ensure its strategic priorities remained relevant and responsive to community needs.

The evidence showed an exceptional standard. The service was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. They always involved people in decisions about their care and told them what had changed as a result.

Feedback from patients, families and carers was actively encouraged through a range of accessible routes and was used to inform and drive service improvement.

The hospice had a well-established hospice user group, with representation across key committees including the research committee and the clinical audit and quality improvement group (CAQIG), as well as involvement in interview and stakeholder panels. People using the service were also actively involved in co-designing organisational and care strategies. In addition, patients, families and carers were routinely involved in assessments such as the 15-step challenge and Patient-led assessments of the care environment (PLACE) assessments, ensuring their views and experiences were central to how services were reviewed and improved.

The hospice reported on service user experience to share trends, themes, learning and associated action plans along with examples of feedback that had resulted in learning and improvements and shared this with stakeholders.

The hospice completed after action review following complaints from patients and families. Data provided by the hospice showed that the hospice had received 1 complaint around the lack of information on the package of care to families from July to September 2025. An investigation was undertaken following this and learning taken to ensure families were made aware of information relating to package of care and including this was stated in the next print run of leaflets.

The hospice provided another example of when learning from a hospice at home complaint resulted in a structured action plan and the introduction of regular multidisciplinary huddles, supporting teams to review feedback, share learning from complaints and incidents, and improve consistency in care delivery. This approach demonstrated that people’s experiences were listened to and had a direct impact on how services were developed.

Staff had access to the complaints, concerns and compliments policy which was in date and due for a review in 2027.The hospice used IWGC to gather feedback from people about using their services. Feedback received via this platform read as ‘my experience has been excellent and the staff were kind and considerate and included me and my partner in all decision making.’ Another read as ‘the counselling support was brilliant and made me feel like I mattered and listened carefully.’

The evidence showed an exceptional standard. The service was exceptional at ensuring people could access the care, support and treatment they needed when they needed it.

The hospice employed a homelessness link worker who promoted the hospices services with underrepresented and hard to reach communities. The hospice provided CQC with a homelessness project report for September 2025 which was undertaken by the link worker. The project involved engaging and networking across the community which had led to the hospice receiving 15 referrals and enquiries as a result. The hospice had also facilitated drop in sessions and hosted a homeless partners engagement event which allowed for a co-produced piece of work between different services working in collaboration within BaNES.

In addition to complementary therapies and treatments tailored to met individual needs, the hospice also offered physiotherapy and zoom exercise classes which could be access from home.

The hospice had also re-signed with the armed forces covenant and pledged to acknowledge and understand that those who serve or who have served in the armed forces and their families should be treated with fairness and honour in the communities they serve. As part of their support for those serving, the hospice had opened a friends in grief weekly community bereavement drop in at the MOD community centre. The hospice was veterans aware accredited and had received the armed forces employer silver recognition award. In order to easily identify this group of people, the hospice had added a question in the triage process and tailored care to their needs. This work was done as part of an externally funded research project, which was shared across the Southwest hospice community.

The hospice’s mission was to ‘empower collaborate and deliver so that no-one faces death alone'. Staff had access to the equity of access policy and procedure which was in date and provided staff with the legal framework associated with it.

The hospice was accessible to all members of the public and anyone could access their services at any time. Referrals were from GPs and other health care professionals.

The hospice at home team worked with the family to agree a number of visits to meet the patient’s personal care and emotional support needs. Where available, the team could also offer overnight respite care. Additionally, the hospice had a companion service who visited patients in their own homes.

The hospice offered community visits, telephone contact or an outpatient visit to carers in order to increase equality of support to carers and maintain their health and wellbeing.

The CPCT team were in the process of viewing more outpatient venues for clinic appointments. Additionally, the team also offered remote consultations for patients and families.

In order to make creative therapies accessible to all, the team had increased the number of creative therapy boxes which were sent to patients at home who were unable to come into the hospice. The team offered fingerprint jewellery to patients and family members when the patient was too unwell to do a hand cast. Feedback from patients included ‘ as I live on my own and can go days without seeing or talking to anyone, these sessions have been a joy to attend.’

The evidence showed a good standard. 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.

The hospice proactively sought out ways to address barriers in order to improve people’s experience, act on information about people’s experiences and outcomes and allocate resources and opportunities to achieve equity.

To maximise access and collaborate and partner with communities in localities to optimise care for people and continuing to address inequalities in the provision of palliative and end of life care was one of the key priorities of the care services strategy 2025-2028.

The service was part of the Bath and North East Somerset, Swindon and Wiltshire (BSW) Palliative and End of Life Care Alliance, which aims to support adults across BSW to achieve a good death through timely and equitable access to high-quality palliative care, regardless of diagnosis and as early as possible in the course of illness.

Over the past year, the alliance has identified areas for improvement and developed a revised action plan. Key priorities include promoting person-centred care, ensuring equitable access to services, and improving the coordination of care across providers.

In order to support people with dementia, the Admiral nurses worked in partnership and collaboratively with Dementia UK and partner organisation to access resources for people living with dementia and their families.

The hospices website signposted people with learning disabilities to the end of life planning toolkit which included resources and approaches to support staff with end of life care planning with people with learning disability.

The evidence showed an exceptional standard. People were given exceptional support to plan for important life changes, so they could make informed decisions about their future, including at the end of their life.

Staff worked closely with patients and their families regarding their plans for the future and initiated advance care planning discussions in a timely manner and had access to the advance care planning policy which provided them with the principles and process of advance care planning and related national guidance.

Patients and families had access to information on planning ahead and advance care planning on the hospice’s website. This included a peace of mind planner which was co-designed by the hospice staff in partnership with patients and families to help record and easily access important life information and had enabled appropriate future conversations to be had.

Additionally, the website also contained information on Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) form, account closure service and a practical care toolkit which outlined what families could do to practically care for someone who was in their last days and hours of life including communication, pain and symptom management. The hospice had led the work to develop a local digital ReSPECT form and had rolled it out to the wider workforce across the ICB and all system providers standardising practice and ensuring patient wishes and preferences at the end of life were available. Additionally, the hospice offered a will service and access to a legal advisor for patients and families.

The ReSPECT form is a personalised document outlining a person's wishes and preferences for clinical care when they are no longer able to make decisions.

The hospice’s information hub also hosted additional resources for patients, families and healthcare professionals which included videos, downloads and links to other sites.