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Archived: Hospice at Home Carlisle and North Lakeland Good

This service is now registered at a different address - see new profile

Inspection Summary


Overall summary & rating

Good

Updated 16 December 2015

This inspection of the Hospice at Home Carlisle and North Lakeland took place over three days 19, 21 and 22 October 2015. This was the first comprehensive inspection of the service following its registration in October 2014.

Hospice at Home Carlisle and North Lakeland (the service) is a registered charity providing 24 hour nursing and personal care services to people in their homes who are suffering from a life limiting or terminal illness. The service operates from offices with The Eden Valley Hospice.

The service aims to provide care and support to adults who have palliative and end of life care needs and also for their families and carers.

The hospice at home service provides a nursing service, occupational therapy and a Lymphoedema service.[Lymphoedema is a chronic condition where excess fluid is retained in the tissues causing a painful swelling]. There is a complimentary therapy service provided that includes massage, Reflexology, Reiki, aromatherapy and breathing and Yoga techniques. [Complimentary or ‘holistic’ therapies are therapies that aim to treat the whole person, not just the symptoms of a disease]. There is also a family support service and a bereavement care service available. All services are provided free of charge.

The agency 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.

People using the service and their relatives told us they had “confidence” in the skills of staff and that staff were “caring” and “professional”. People said their privacy was respected and told us they made choices that suited their care needs and personal preferences.

Staff had been given training in recognising abuse and how to report any possible abuse or poor practices. The service provided staff with a broad range of training relevant to their roles and they were kept up to date with all training needs and supported in keeping their knowledge and skills updated. New staff had been given structured induction and mentoring in their roles. Training was given a high priority in the organisation and staff were encouraged to fully develop their skills and knowledge.

Effective staff recruitment systems were in place and these ensured that only applicants who met the service’s job specifications regarding qualifications, experience, character and caring abilities were employed. There were registration and security checks done to make sure all staff were still suitable to work with people in their homes.

Regular supervision and annual appraisals were used to support staff in their work. The staff and management team used reflection and incident analysis to help them make changes to improve the care and support they gave so that they responded quickly to a person’s needs. All accidents and incidents were recorded and analysed to allow for lessons to be learned and appropriate steps be taken to prevent any recurrence.

The service worked very closely with the hospice and hospital palliative care teams, GPs, the Macmillan team, community nursing services, social services and charitable organisations. This helped to make sure there was smooth cross service working to provide appropriate care to meet people’s different physical, psychological and emotional.

There were systems in place to assess and to manage risk. For example, to protect people from the risks associated with medicines, falls, pressure sores and moving and handling. For staff the lone worker procedures and risk assessments for work place stress and specific training needs helped keep staff safe as well.

Systems were in place for responding to concerns and complaints. Relatives told us they could raise any concerns or make suggestions and be listened to. Staff were also clear about how to raise any safety or practice issues with the management team and said they felt they would be well supported. Regular reviews of people’s care were held and people were encouraged to take full part in discussing how their needs were being met.

The service had policies in place in relation to the Mental Capacity Act 2005 (MCA). The MCA provides legal safeguards for people who may be unable to make decisions about their care. We spoke with staff that showed a clear awareness of the importance of supporting people to decide for themselves about their care and treatments.

There were clear and effective systems in place to continually monitor the quality of the service being provided and to identify and implement areas for further service development.

Inspection areas

Safe

Good

Updated 16 December 2015

The service was safe.

Systems were in place to protect people from the risk of abuse. Staff were aware of safeguarding adults’ procedures and how to use them.

Safe recruitment practice was followed, which minimised the risk of appointing anyone unsuitable for the role.

Staff handled people’s medicines safely.

Effective

Good

Updated 16 December 2015

The service was effective.

Staff of all levels had access to on going training to meet the individual and diverse needs of the people they supported.

People’s healthcare needs were being monitored and discussed with people who used the service and their family members.

People had access to appropriate health, social and medical support.

Caring

Good

Updated 16 December 2015

The service was caring.

People who used the service and their family members spoke very

highly of the care and support they received.

People were encouraged to be as independent as possible, make their own decisions and maintain control of their lives.

Responsive

Good

Updated 16 December 2015

The service was responsive.

People and their family members had been involved in planning what they wanted in their care and making decisions about what was important to them.

The hospice had systems agreed with other community and medical professionals in place to ensure the continuity of care for people moving between care settings.

People’s care needs were kept under review and staff had responded quickly when people’s needs changed.

Well-led

Good

Updated 16 December 2015

The service was well-led.

There was a clear management structure within the service. Clear governance and management strategies informed and involved people, their carers and stakeholders in service development.

The management team gave effective and innovative leadership and provided a clear strategy for the long term development of the service.

Staff told us the service was very well managed, that they were supported to develop and were valued by the organisation.