28 July 2017
During a routine inspection
Marie Curie is a registered charity which provides end of life care via nine hospices and community nursing across the country. Marie Curie Nursing Service (South West) (shortened to MCNS) is a registered provider of palliative and end of life care services to adults with terminal illnesses across the South West. At the time of our inspection there were 148 people receiving care.
There was a registered manager in post. 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.
People were referred to the service by healthcare professionals but the main referrer source was District Nurses. Clinical Commissioning Groups (CCGs) commission the service. Staff worked as an integrated team with other health professionals such as District Nurses and GPs. Most of the care provided for people was nine hour overnight care in their own homes. Relatives told us this meant they could get some sleep at night. Feedback from commissioners was very positive.
Staff knew the people they supported and provided a personalised service. Staff used care plans provided by district nurses detailing how people wished to be supported. District nurses also provided risk assessments for any risks to the person and to the staff supporting them. This included environmental risks and any risks due to the health and support needs of the person.
Everyone told us staff were very caring and they were treated with kindness and compassion. People and their relatives told us staff respected people’s privacy and dignity.
Relatives told us people were kept safe and free from harm. Staff received safeguarding training for both adults and children. There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service.
Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.
Systems, processes and standard operating procedures around medicines were reliable and appropriate to keep people safe. Monitoring the safety of these systems was robust.
People’s capacity to make decisions was assessed and where possible they were supported to make their own choices and decisions. The staff understood their role in relation to the Mental Capacity Act 2005 (MCA).
The registered manager and provider undertook audits to review the quality of the service provided and made the necessary improvements to the service.