We carried out a review of the data available to us about Warwick Myton Hospice on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Warwick Myton Hospice, you can give feedback on this service.
Warwick Myton Hospice provides care and treatment to people over the age of 18 with life limiting conditions who require specialist palliative care in the 24 bedded inpatient unit, day service and hospice at home service. (Palliative care is comprehensive treatment of the discomfort, symptoms and stress of serious illnesses). At the time of our inspection 10 people were using the inpatient service. Initially people attend the day hospice for one day per week over a 12 week period and on the day of this inspection visit five people attended the day hospice. People were able to access a range of care and support which included, children and family support, occupational therapy, physiotherapy, chaplaincy, counselling and bereavement support.
There was a registered manager in post who was also the director of nursing, care and education. 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.
People were protected from harm and abuse due to the arrangements in place to make sure risks to people were reduced. Where people were at risk due to their health and physical needs these had been identified with measures put in place to help people to manage and reduce any known risks. Staff and volunteers had been suitably recruited and there were sufficient staff with a variety of skills to meet people’s individual needs and to respond flexibly to changes.
Staff received the training and support they needed and were highly motivated to perform their roles and deliver sustained high quality care. This included staff having the skills to effectively manage people’s medicines so these were available and administered safely to people.
People were extremely confident and positive about the abilities of staff to meet their individual needs in the right way and at the right time for them. The leadership team supported staff to undertake relevant training and career development. This was one area the leadership team had focused on to ensure improvements in care when required so that it remained effective in meeting people’s palliative and clinical needs with best practice shared in end of life care.
People told us they were supported with their nutritional needs with the assistance of the catering team who actively sought and welcomed people’s feedback. There was a shared commitment between all members of the staff team to sharing how meals remained nutritious and people enjoyed these in comfort. Staff were also aware of people’s reduced appetite’s towards the end of their lives to make sure changes in people’s dietary needs could be effectively catered for and creatively met in different ways which included fruit smoothies.
Staff were kind and thoughtful to people which reflected the positive comments we received from people about how their experiences felt listened to and were valued. People told us staff spent time listening to them, did not rush them, and did all they could to meet people’s individual wishes and requests whether this was in their own homes, the day hospice and/or as inpatients. This supported people who used the hospice services and their families to make special memories which were of a comfort to both people and families especially towards the end of their lives.
People’s individual needs were assessed and staff always encouraged people to make their own choices about their care and treatment which were written down to help people’s wishes to be followed in life and death. Where this was not possible issues of consent and decisions were made in people’s best interests by people who had the authority to do this.
People were treated as individuals and staff were motivated and committed to providing people with the best possible palliative and end of life care. Staff enjoyed their work and believed the ethos of the hospice movement was about spending quality time with people. This was reflected in staff practices as they had assisted people to overcome obstacles so they could aim for their goals in life.
People were supported to receive end of life care in their preferred place of choice which met with their needs and wishes and to achieve a private, dignified and pain free death. People, their family members and staff were able to access the emotional, psychological, spiritual and bereavement support they needed.
People were at the centre of the leadership and staff teams core values of personalised palliative and end of life care aimed to provide quality of care and life to all people. To achieve this the registered manager led by example since they came into post to raise the profile and reputation of the hospice services in the local community. Close partnerships with external professionals, educators and national organisations involved with palliative and end of life care were being sought and partnerships formed. This helped to ensure people received the right care at the right time and knowledge was appropriately shared and used to influence best practice for people’s care. This included care and treatment planning which looked towards the future to make sure it was inclusive to meet the diverse and changing care needs of the local population.
People and their family members, staff, board of trustees were actively informed and involved in developing the service. There was an open culture where every person was encouraged to share their experiences of the care and treatment the different hospice services provided. This included making complaints which were fully investigated and responded to, with evidence of the leadership team using them as a learning opportunity in order to make improvements to the hospice services. The registered manager showed they were dedicated to the continual development of the hospice services so all people received palliative and end of life care which was inclusive to all and of a high quality.
At the last inspection visit, we found that the provider had introduced a new version of their care record documentation but we found that staff had not received appropriate training in how to complete the new documentation.
There were areas of concern regarding gaps in recording in care records and also about a lack of systems in place to formally audit records. We followed up on this area of non compliance by requesting evidence from the provider to demonstrate that actions had been taken to address these issues.
We spoke with the provider to discuss the actions that had been taken. We were also provided with documentary evidence to confirm that these actions had taken place and compliance achieved.
We read the care records for three people who used the service. Many of the people were not able to tell us about their care because of their complex needs, so we observed care practice and staff's interaction with people when they were delivering care.
During our last inspection of this service in January 2013, we found the provider did not always maintain accurate and appropriate records. During this inspection, we found that some improvements had been made, however there were still areas of concern regarding incomplete records.
We looked at the cleanliness of the service and found that everywhere was clean and tidy. Staff we spoke with explained how they minimised the risk of infection within the setting.
We found that there was an effective procedure in place for recording and resolving any complaints about the service.
When we asked one person about the service they told us, "The staff are 11 out of 10, the care is excellent, I can't fault them.'
Systems were in place allowing patients and their relatives communicate their experiences of the hospice. Positive feedback had been given through patient surveys about the staff and care patients had received. The patients and relatives we spoke with confirmed they had been kept informed and had been given information about what to expect during their hospice stay. We saw a number of information leaflets and booklets available for patients.
We saw patients' needs had been assessed, risks identified and personalised plans of care developed. We observed that full assessments of some patients' needs and risks had not always been completed. This could put the patient at risk as the necessary actions to manage or monitor the situation had not been identified.
We saw that healthcare professionals supported patients in managing their ongoing healthcare needs. The staff and patients we spoke with said there had been sufficient staff available to accommodate patients' needs. People told us that they felt safe.