Coventry Myton Hospice

Coventry Myton Hospice provides care and treatment to people over the age of 18 with life limiting conditions who require specialist palliative care (palliative care is comprehensive treatment of the discomfort, symptoms and stress of serious illnesses) in their 16 bedded inpatient unit or their day service. At the time of our inspection 13 people were using the inpatient service. The day hospice is open on Mondays, Wednesdays and Fridays and six people were in attendance at the day hospice at the time of our inspection visit. Initially people attend the day hospice for one day per week over a 12 week period. The hospice services provides people with access a range of care and support which includes, 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.

The leadership team continuously looked at the local community to see how best they could respond to people’s needs. Excellent work was being done in identifying the needs of the local population by developing services to meet those needs.

The registered manager was passionate about raising the profile of the hospice and created opportunities for different ideas to meet the diverse needs of people with palliative and end of life care needs. There was a strong commitment for the hospice services to be inclusive and responsive to the needs of all people including those people who may not have traditionally used hospice services.

People and their family members, staff and the board of trustees were actively informed and involved in developing the service. Their views including complaints and compliments were used to continuously develop and influence the services people received so these remained effective, caring and raised quality where needed. People were involved in the development of the service and asked for their views.

There was a very positive atmosphere within the hospice and people were very much at the heart of the services offered. Staff had developed positive, respectful relationships with people and were kind and caring in their approach. People who attended the day hospice were very appreciative of how staff and volunteers had made their days memorable and filled with therapeutic and fun times. People's privacy and dignity was respected by staff who worked to a set of values around providing care centred on each person.

Staff were supported to develop in their roles through a positive culture and idea of teaching and sharing skills within the service as they had link roles in various subjects and in the wider community. Staff worked closely with the staff at the local hospital to educate and promote high quality palliative and end of life care.

People 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 made sure changes in people’s dietary needs could be effectively catered for and creatively met in different ways.

Staff knew each person well and understood how people may feel when they were unwell or approached the end of their life. People and their relatives were enabled to be involved in the care and staff were motivated in ensuring people were treated as individuals and had a good as life as possible. People were able to see their friends, families and pets when they wanted as there were no restrictions on when they could visit and they were made welcome by staff.

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.

Staff knew how to protect people and reduce accidents and incidents from happening by ensuring people's needs were met in a safe way. Staff knew how to recognise and report any concerns so people were kept safe from harm and abuse. Recruitment checks had been completed before new staff and volunteers were appointed to make sure they were suitable to work with people who used the hospice services. People were supported by sufficient numbers of staff with the right skills to meet their needs and reduce risks to their safety.

Staff practices around the administration and management of people's medicines reduced the risks of people not receiving their medicines as prescribed to meet their health needs. This included making sure all people's medicines to ease their pain and symptoms were consistently available to them should they choose to have these. People also had access to a range of healthcare professionals when they required specialist help.

The provider showed a strong commitment to actively listen and support people who used the hospice services and staff. Staff at all levels were involved in the quality checks where a varied range of methods were used to determine the quality and safety of people’s care and treatment to maintain improvements so people received the best possible care. The leadership team planned to share good practice and initiatives they had developed across the provider’s other two hospices.

The registered manager showed an open and responsive management style. They provided strong leadership to the staff team and encouraged them to be ambitious in continuously improving their knowledge and skills. People were at the centre of the management and staff's core values of personalised palliative and end of life care aimed to provide quality of care and life to everyone.

On the day of our visit to Myton Hospice-Coventry, we saw eight people were using the in-patient service. We spoke with the registered manager, ward sister and deputy-sister. We also spoke with two registered nurses and one care worker.

We spoke with two people who used the service. One person stated, ' The care is absolutely fantastic, its 1000% and the staff are like angels'.

We saw care records for three people who used the service were informative and up- to-date.

We saw equipment provided was safe for people to use and there was an inventory detailing the service history for most pieces of equipment.

We saw the service had a robust staff recruitment process in place and there was a staff training programme to support the needs of the people who used the service. We saw the need for updated specialist training for some staff had been recognised but not yet implemented.

We found that there was an effective procedure in place for recording and responding to complaints.

We looked at the meals and drinks provided to patients during their stay. We were satisfied patients received a nutritious menu. Patients told us they enjoyed the food provided. We saw that the meal times were flexible and responsive to when people felt able to eat.

We looked at the care and treatment of patients using the hospice. We saw that the hospice looked after patients well, and responded quickly to any changing needs. We observed staff being warm, kind and supportive to patients in their care.

We checked medication practice. We were satisfied that medication was being administered and stored safely and securely.

We looked at whether there were enough staff to meet the needs of patients using the hospice. We determined there were good staffing levels, and staff had good skills and experience to support patients with their care and treatment.

We looked at the complaints policy and procedure. We noted this was accessible to all, and the service was pro-active in listening and acting on the views of patients and people who used it.