Great Oaks Hospice

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question as good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff contributed to completing a health assessment of the patient in a timely manner at or soon after admission to the service. The service added notes to care plans and documents which were used across the different organisations. Staff used the same electronic recording system used by the district nurses and GPs. There was effective multidisciplinary input from various organisations into the health assessments of the patients.

The health assessments were comprehensive and person centred. They met the needs identified during the original assessment. The assessment covered all aspects of patient care, including physical and emotional needs. All patients were asked their preferred method of communication and staff were trained in communication which included demonstrating effective listening, compassionate care and ability to read cues within any given situation. Staff gave examples of communicating with non-verbal patients using visual cards as aides as well as using iPad or boards.

We reviewed 8 patient files and found care plans held the necessary information to keep patients safe.

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The service provided care and treatment based on national guidance and evidence-based practice. Staff protected the rights of patients in their care. Care provided was in line with relevant National Institute for Health and Care Excellence (NICE) guidelines. Staff followed up-to-date policies to plan and deliver high quality care according to best practice and national guidance. The hospice followed the Gloucestershire end of life strategy, 6 ambitions and the NICE guidelines. Staff were able to access this information on the internal intranet.

The team had access to the full range of specialists required to meet the needs of people using services. For example, a palliative care consultant ran clinics once a month from the hospice to see service users. The service had access to specialist clinicians from other agencies who provided support to patients who required dietetic intervention. Feedback from another local service noted there were “great patient outcomes when the hospice at home, district nursing and the community palliative care team co-ordinate”.

Staff took part in clinical audit, benchmarking and quality improvement initiatives. We reviewed recent audits carried out by the service. We saw audits were carried out regularly and learning from audits was shared with staff, communicated at handovers and at the quarterly hospice meeting.

The different hospice teams worked effectively together to ensure positive outcomes for people using services. Managers dealt with poor staff performance promptly and effectively.

We scored the service as 4. The evidence showed an exceptional standard. The service always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

The service worked effectively across teams and services to support people. Staff feedback was positive regarding the way the different hospice teams worked together and staff said there was a positive can do culture. People’s needs were met because the hospice often supported people through their first diagnosis of a life limiting condition until their death. An example of this was a patient and their carer were both given counselling to support them at the time when the patient was diagnosed. When the patient deteriorated and was unable to attend counselling, care was provided to the patient at home at a time which was convenient for the carer to continue receiving counselling at the hospice. This meant the carer could leave the patient, knowing they were safe,

Staff held regular and effective multidisciplinary team (MDT) meetings. There was a fortnightly MDT meeting which included the palliative care team, the district nurses and the hospice leads. At this meeting the patients’ needs and the management of those needs were discussed. Feedback from other providers indicate the hospice has a good working relationship with the GPs and the district nurse teams. If the district nurses require any help or charity night sits then they have the hospice on call number.

Staff shared information about patients at effective handover meetings within the team and between different shifts.

The teams had effective working relationships, including good handovers, with other relevant teams both within and external to the organisation. People said they felt the care is linked together well across different services. Feedback from another local care organisation stated there “was a willingness for collaboration”.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

Staff gave patients practical support and advice to lead healthier lives. Health needs were assessed at the first visit and support was offered for individual needs. For example, staff arranged counselling home visit sessions for a patient and their family.

Staff told us they completed additional training in pain and symptom management so they could advocate for patients with GPs and district nurses. Staff told us they encouraged patients to live well at wellbeing sessions, for example offering fruit and activities like table tennis and cycling.

We scored the service as 3. The evidence showed a good standard. The service had systems and process to check outcomes and compliance with national guidance. It contributed to data collected by the national charity for hospices and was able to benchmark its services against this information.

The hospice kept a clinical dashboard which monitored the number of referrals, which services provided the referrals and whether the patient was able to die in their preferred place be that home, hospital or hospice. It is not always possible for patients to die in their preferred place despite this being a system aim. This is for many reasons, including clinical need and availability of packages for care. For the month of September 2025, the service had 3 patients who died of which 1 patient died in their preferred place of death. In October 2025, there were 5 patients of which 1 patient died in their preferred place of death.

The service reported data to the local integrated care board and attended these meetings to discuss their performance. Feedback from the integrated care board was positive.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff took all practical steps to ensure patients could make their own decisions.

Staff had additional training to enable them to advocate for the patient should they so wish.

Staff asked for consent daily when carrying out home care. We observed 3 home visits and saw staff always explained to patients what they intended to do and asked for the patients consent to carry this out. Feedback from family and carers stated “staff always explain the treatment options and ask about what he wants and obtain his consent”.

Permission to share patient data with the hospice and other agencies was requested at the first patient visit. We were told that consent was reviewed with capacity.