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St Barnabas House Outstanding

Inspection Summary


Overall summary & rating

Outstanding

Updated 25 May 2016

St Barnabas House hospice is a local registered charity that provides specialist palliative care to adults with advanced progressive life-limiting illnesses, both within the hospice and in the comfort of their homes. Palliative care is the total care of people whose illness is not responsive to curative treatment.

The service includes a 20 bed In-Patient Unit, a Day Hospice with 18 places, a Community Palliative Care team, a Family Services team, a ‘Hospice at Home’ team and an Education Department. The care is delivered through a team that consists of doctors, nurses, social workers, counsellors, a chaplain, physiotherapists, complementary therapists, an artist-in-residence, a Hospice at Home team and volunteers. Services are free to people and St Barnabas House is largely dependent on donations and fund-raising by volunteers in the community.

This inspection was carried out on 22, 23 and 24 February 2016 by two inspectors and one pharmacist inspector. It was an unannounced inspection.

There was a manager in post who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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. The registered manager was also the Director of Adult Nursing and oversaw the running of the service. They were part of a senior leadership team that included a chief executive officer and a deputy, a director of human resources, a finance director and an income generation director.

Staff were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or ensure people were protected from harm.

There was a robust system in place to monitor accidents and incidents and identify how the risks of recurrence could be reduced.

There were sufficient staff on duty to meet people’s needs. Staffing levels were calculated and adjusted according to people’s changing needs. There were thorough recruitment procedures in place which included the checking of references.

Medicines were ordered, stored, administered and disposed of appropriately as per legal requirements. The hospice had opted to be part of a national study on benchmarking of medicines administration errors which meant that it continually reviewed its practices. The hospice shared learning with other local hospices and pharmacists at the local hospital. People could be confident that the service paid particular attention to all aspects of practice relevant to medicines.

There was an effective system in place to ensure people remained as safe as possible from the risk of acquiring an infection. The premises were cleaned and maintained to a high standard.

Staff understood how they should respond to a range of different emergencies and creative thinking underpinned practices in regard to keeping people safe from risk of fire, such as when practising fire drills.

People described the delivery of care as, "Exceptional" and "Second to none." They told us, “The staff are so knowledgeable and incredibly efficient, they are obviously very well trained as they have exceptional skills, they really understand me.”

Staff had appropriate training and experience to support people with their individual needs. Staff told us, “The training we get here is just phenomenal.” The service had creative ways of training their staff that made sure they put their leaning in practice to deliver outstanding care that met people’s individual needs.

There was an effective system of communication between services that ensured effective continuity of care. C

Inspection areas

Safe

Good

Updated 25 May 2016

The service was safe.

Staff were trained to protect people from abuse and harm and knew how to refer to the local authority if they had any concerns.

Risk assessments were centred on the needs of the individuals and there were sufficient staff deployed to meet people�s needs safely.

Medicines were stored, administered and monitored safely.

There was an effective system in place to ensure people remained as safe as possible from the risk of acquiring an infection.

Robust and safe recruitment procedures were followed in practice to ensure staff were suitable for their role.

Effective

Outstanding

Updated 25 May 2016

The service was outstandingly effective.

The service had researched and provided specific and original training that enabled staff to develop coping strategies and resilience, so they could support people effectively. Staff were trained in acquiring specialist communication skills to help people and their families at difficult times. Staff had the opportunity to visit other hospices and learn from different models of care to bring new ideas that could benefit their practice and people.

Staff were effectively trained in the principles of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) and were very knowledgeable about the requirements of the legislation. They assessed people�s mental capacity and held meetings in their best interest appropriately to promote their rights.

There was a very efficient system of communication within the service, with people and with external healthcare professionals to ensure continuity of care and avoid duplications of documentation. Therefore people did not have to repeat themselves unnecessarily. Clear and comprehensive information was provided to people and their relatives to help them make infirmed decisions.

There were effective links with healthcare professionals whose advice was sought and acted on to benefit people.

Caring

Good

Updated 25 May 2016

The service was very caring.

People valued their relationship with staff and gave very positive feedback about the caring approach of the service and staff. Staff were kind, patient and respectful when providing care and treatment for people. People�s dignity and privacy was respected.

People were pro-actively supported to express their views and staff were skilled at giving people face to face information and any explanations they needed to enable them to make informed decisions.

People�s cultural, religious, linguistic were taken into account when care was planned and delivered. The service valued practice that acknowledged diversity and promoted equality.

Responsive

Outstanding

Updated 25 May 2016

The service was outstandingly responsive to people�s individual needs.

People were placed at the heart of the service and were fully involved in the planning of their care, treatment and support. People�s care was personalised to reflect their wishes and what was important to them. Staff delivered support to people in accordance with their unique support plan and responded to their specific needs.

Staff understood how to respond to people�s emotional needs and their sense of creativity. Innovative activities were provided that stimulated their interests, developed their artistic ability and promoted their creativity.

People were actively encouraged to express their views and an innovative way to capture their current experiences of the service was used.

The service provided outstanding end of life care and people were enabled to experience a comfortable, dignified and pain-free death.

Well-led

Outstanding

Updated 25 May 2016

The service was outstandingly well-led.

People�s feedback about how the service was run included, �Really excellent management� and, �Extremely well organised.�

Staff praised the provider and the leadership and management team for their approach and consistent support. They described the registered manager as, �Inspiring.� They felt valued and supported by the service.

The service was actively involved in building further local community links. The service took part in several projects and worked in partnership with other organisations to raise hospice care standards at national level.

The provider's system of quality assurance was very effective in driving continuous service improvement.