Warwick Myton Hospice

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We reviewed 5 quality statements for caring, kindness, compassion and dignity, treating people as individuals, independence, choice and control, responding to people's immediate needs, and workforce well-being and enablement.

Staff treated patients with compassion and kindness and respected their privacy and dignity.

Staff understood and respected the individual needs of each patient and showed understanding and a non-judgmental attitude when discussing patients care needs.

Staff promoted patient’s choices and gave them control over what their care should look like.

Staff took time to listen to patients and find out what was important to them. Staff worked to meet people’s individual needs and wishes.

There were processes to ensure that staff were supported with their wellbeing which enabled them to continue in their roles of providing care and treatment to patients.

This service scored 90 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were extremely positive about the care and compassion they received from staff. They described how the supportive and empathetic approach by staff had a positive impact on their emotional wellbeing. One person told us, "A lot of the staff go out of their way to come and introduce themselves. They make you feel so at ease, I love that. It is wonderful”, and “It is almost like being with your family and friends”. Another person described the staff as “Magic”.

Staff gave relatives emotional support and advice when they needed it. One relative told us how staff had recognised they were struggling and had arranged counselling to support their mental and emotional wellbeing. This relative explained how the support had enabled them to spend more quality time with their family member whilst maintaining their own wellbeing.

Responses to the hospice at home team survey which was sent to patient’s bereaved nominated next of kin demonstrated people felt their loved ones had received kindness compassion and dignity through their care from staff. The responses included the following comments; “the care received was excellent and always respectful”, “the Myton nurses couldn't have shown my dad any more self-respect than they did”, and “the support we received from Myton Hospice staff was outstanding, we cannot thank them enough for the care support and kindness that was given to our mother in her last days, we are so grateful to them”.

The husband of a patient being cared for by the hospice at home team told us “these guys are just the best, I don't know what I would do without them”. The wife and son of another patient told us the staff provided “an exceptional level of care” and they “demonstrate they care through the time they spend; they do not rush and [name] likes them and always says they are lovely visitors.”

A patient of the hospice at home team told us “my care couldn’t be better, they are so gentle with me.”

During our conversations staff consistently demonstrated an understanding of the physical and emotional impact of living with a life limiting condition on patients, and on their family and friends. Staff spoke of the importance of listening to people and giving them time to talk. One staff member told us, “You have to be a certain person, compassionate, respectful and empathetic.” Another staff member said, “You need empathy and passion to be able to deliver care well enough”. A third staff member explained, “You have to have compassion and be very understanding, and you have to listen. If you didn’t have that compassion and care you wouldn’t be able to do this job”. A volunteer told us, “Staff to a person all care, they all deeply care. I get to speak to a lot of patients and visitors, and visitors universally praise the culture of the place”.

One member of staff told us how nice it was to bathe people. They said as well as helping the patient relax it was a way of demonstrating respect for them and showing their personal care needs matter.

Staff were very welcoming and supported our visit throughout. People and their relatives appeared very comfortable with staff, and we observed some relaxed, friendly, and unhurried exchanges.

The hospice at home staff maintained the dignity of patients while providing personal care. They told patients what they were doing and checked with them to see if they were causing them any pain or discomfort.

People and their relatives did not raise any concerns about how staff treated them and told us respected their individuality. One relative told us how their family member’s dementia could impact on their responses and interactions with people. They went on to explain how staff were very understanding and reassuring, commenting, “How they approach him means a lot because of his dementia.”

We saw a patient who was not wearing their hearing aid have a conversation with a member of the hospice at home team. The staff member spoke clearly and made sure the patient could see their face when they were speaking. They regularly checked with the patient to see if they had understood what had been said.

Staff understood and respected the individual needs of each patient and showed understanding and a non-judgmental attitude when discussing their care with them or other healthcare professionals.

Staff told us they had time to spend with patients, to listen and hear what they valued and what they wanted their treatment to look like. They spoke of the importance of understanding people’s individual preferences and needs. One staff member told us, “Everyone has their own story, their own background and experiences. You can't go into the room and treat everyone the same. The person in room 1 will have a different lifestyle to the person in room 4”.

Staff told us they always asked patients for the preferred name and used this and made sure other staff knew and used their preferred name.

The service benefited from an activities coordinator. The coordinator worked with inpatients on developing meaningful activities while in the unit. This involved, for example, spending time with individual patients to understand what mattered to them and how they might spend their time meaningfully, as opposed to arranging activities for groups of people that may have no value to some of all of the patients.

The provider had a spiritual lead onsite 3 days a week to provide spiritual and bereavement care and support. A spiritual lead provides spiritual care to people of all faiths. Staff also had access to representatives of multiple faiths from the local community to meet the needs of individual patients. There was a sanctuary room for people to use for reflection and as a space to meet their cultural and spiritual needs.

Peoples’ individual lifestyle choices were supported so people were not discriminated against. For example, there was a dedicated room that patients could smoke in. The door was kept closed and this room was away from other rooms to reduce risks for other people.

Inpatients were able to have visits from their pets.

Patients and their relatives felt information was given to them to enable them to make choices and retain some control of their lives. One person on respite care told us, “They totally listen, and they do change things.” This person went on to explain how the therapies offered had encouraged them to regain some independence and said, “The therapy has been really helpful, and it is good that they have encouraged me to get up and out a bit more. They have been lovely, and they have been trying to help with things I might need when I do go back home.” A relative told us, “They keep coming in and updating us all the time.” People were given opportunities to engage in a variety of activities and social opportunities. One person told us, “I haven’t done any of the activities but she [the activities lead] is always popping in. I love massages, and aromatherapy and I have been taking part in that, and it has made me feel so good.”

Relatives told us they could visit when they wanted to and stay as long as they wished to. They also told us they could stay overnight in their relative’s room.

Staff understood the importance of people retaining as much independence and control in their lives as possible. One staff member described the negative impact on people if they felt unable to make their own choices. This staff member told us, “You can have a person who has a routine and to be put in an environment they are not sure of, or if you try to take over, they will be more unsettled. I wouldn’t want someone to take over my life, so I am not going to take over someone else's.”

Staff said they used communication aids to help people communicate to ensure people remained a partner in their care. For example, they used voice amplifiers and white boards so patients could communicate their wishes.

Therapy staff told us they used specialist equipment to help patients remain independent for as long as possible, for example, to remain mobile and/or meet their own personal care needs.

Staff received training in equality and diversity , so they understood, valued, and celebrated difference. They also received training on the ethos of the service so they were clear the focus of the service was on enhancing the lives of people with a terminal illness to provide them with more quality time with their loved ones, and this meant finding out what mattered to them to promote their choices and give them control over what their care should look like.

People and their relatives told us staff were alert to their needs. One person told us, “I do get privacy, but it is also nice to know that there are people around if you need them". One relative told us staff responded quickly if their family member needed support.

Staff frequently talked about the importance of patients being able to take part in activities that were meaningful for them for as long as possible because the final part of someone's life was as important as their beginning . Staff spent time talking to patients to understand what was important to them and how they could support them to take part and meaningful activities. One member of staff told us it could be something as simple as supporting a patient to blow dry their hair or paint their nails, or something as complicated as arranging a wedding or holding a birthday party for 60 guests on the unit.

Staff had received training on supporting people with learning disabilities and autism. A member of the hospice at home team described how they had developed a relationship with a patient’s son, their primary carer, who had autism. They had sat and played video games together which had helped to break down the barrier of meeting a new person. The staff member said investing this time meant they developed a strong bond which enabled effective communication, including being able to offer the son, as well as the patient, emotional and practical support.

Staff told us they had access to interpreters and a range of tools to improve communication with people whose first language was not English.

All patients had their own rooms although there were single and double rooms. Single rooms had en suite bathrooms. Shared rooms had a bathroom immediately outside of the room. All rooms had two beds and patients were permitted to have a relative, friend, or carer, sleep in their room. If a patient had multiple relatives that wanted to stay to make visiting easier there was two self-contained double rooms that could be used for this purpose.

We saw the activities coordinator working with people on their chosen activities. We also saw evidence of previous activities that patients had taken part in. For example, we saw photos of lifecasted hands made from alginate. Some patients had made lifecasts of their hands as a memorial for their children, others had lifecasted their hand holding the hand of a loved one. These activities had been meaningful for making memories and preserving the connection between loved ones after the patient had passed away. We also saw photos of other activities that had been meaningful for patients, including painting, and having a visit from a penguin.

Staff described a fulfilling but challenging role. They told us the support they received from their managers and colleagues enabled them to perform that role well. Their comments included: “It is a long shift, so we learn how to look after each other" and, “Myton gives a lot of support to their staff members. We know each other and support each other if needed. I love it here; I love the work ethic.”

Staff told us the provider promoted positive physical, mental and financial health with access to support networks and a range of benefits. One staff member told us, “I know there are counsellors on hand and if I need support, and I can go to my manager”. Another staff member told us, “They (the provider) are very practical in their support as well as providing support for our emotional, mental and physical health.”

Score: 3

Staff received clinical supervision monthly and could choose to have either individual or group supervision sessions. Staff told us they had regular unplanned supervision when they felt they needed it. Staff could request a reflective practice session which could be facilitated within 48 hours of it being requested to help manage a clinical incident or complex case. They also received a wellbeing check-in with their manager every three months. This check-in included an assessment of the work life balance and financial wellbeing.

The provider had an employee and volunteer wellbeing strategy that could be easily accessed by staff and volunteers. The strategy set out the wellbeing vision and their wellbeing promise to staff and volunteers.

There was a wellbeing coordinator who had a rolling case load of employees who they provided individual wellbeing support for.

Staff had access to inhouse wellbeing sessions and days. These included talks on the menopause, stress, and fitness. Staff were also able to access wellbeing sessions facilitated by external providers free of charge, including mindfulness, Pilates, yoga, Indian head massages, sound therapy, and a money and pension service drop in.

Staff had access to an external virtual GP service, 24 hours a day, 365 days a year. They also had access to a counselling service that offered virtual or face to face counselling sessions.