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The Norfolk Hospice Tapping House Good

Inspection Summary

Overall summary & rating


Updated 5 July 2017

This inspection took place on 16 May 2017 and was announced. We also contacted people, their relatives and professionals for feedback about the service after the inspection visit.

The Norfolk Hospice Tapping House is registered to provide specialist palliative care, advice and support for adults with life limiting illness and their families in their own homes. They deliver physical, emotional and holistic care through teams of nurses, care assistants, counsellors, a specialist doctor in palliative care and other professionals including therapists. The hospice also operated a Day Service. However, the only service which involved an activity the provider was registered for with the Care Quality Commission was the hospice at home service.

At the time of the inspection there were 80 people using this service. The service provided specialist advice with regards to symptom control and worked in partnership with health care professionals, Macmillan nurses and the district nurse team to ensure that people received the best possible support in their own homes. There was a counselling, pre- bereavement and bereavement support service offered to families and relatives.

The Norfolk Hospice Tapping House had 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.

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. The hospice employed a social worker who was also the safeguarding lead in the hospice. Staff assessed the risks involved in delivering a service to people in their own homes. Staff communicated any risks to people`s health and well-being to all health and social care professionals involved in people’s care They followed up and reviewed risks regularly to ensure these were appropriately managed and mitigated.

People were at the heart of the service and were fully involved in the planning and review of their care, treatment and support. Plans in regard to all aspects of their medical, emotional and spiritual needs were personalised and written in partnership with people. Staff delivered support to people respecting their wishes and preferences.

Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced. Staff reported any concerns so that these could be reviewed and discussed to identify if lessons could be learnt to reduce the likelihood of reoccurrence.

Recruitment procedures were robust and ensured that staff working at the service were qualified and skilled to meet people`s complex needs. There were sufficient numbers of staff to ensure people received support when they needed it. There were plans to open an in-patient unit at the hospice in June 2017 and staff had been recruited and trained before the opening date.

People who used the day services told us that this service enabled them to meet the staff and form relationships before their condition progressed to a stage when they would use the hospice at home service. They appreciated the opportunity to meet with people in similar circumstances and was a welcome part of the community support.

People told us that staff understood their individual care needs and were compassionate and understanding and that their cheerful and friendly approach gave them reassurance and made them feel safe. Staff told us they undertook training which enabled them to provide good quality care to people in their own homes.

People’s medicines were not managed by the hospice staff. People had their medicines prescribed by their own GPs and on rare occasions, staff from the hospice administered medicines as and when required. H

Inspection areas



Updated 5 July 2017

The service was safe.

People were cared for by staff who were knowledgeable about safeguarding processes and knew how to report concerns.

People had the risks to their well-being assessed and appropriately managed by staff and other professionals involved in their care.

There were enough staff employed at the hospice to ensure that people received a high quality service.

Recruitment processes were effective and safe in ensuring staff working at the home were fit to do so.

People rarely received their medicines from staff from the hospice; however staff were trained and able to do so if it was needed.



Updated 5 July 2017

The service was effective.

People received support and care from a staff team who were well trained and used their knowledge and skills to meet people`s needs effectively.

Staff felt supported in their role by managers. They were encouraged to develop their knowledge and skills and follow best practice in regular meetings and one to one supervisions.

Staff were aware of the Mental Capacity Act 2005. They involved people and their rightful representative in making decisions about all aspects of their treatment and care.

People were given advice on how to maintain a healthy balanced diet.

People�s health needs were carefully monitored by nursing staff and other professionals working seamlessly together, adopting a multi-disciplinary approach in meeting people`s health needs.



Updated 5 July 2017

The service was very caring.

People and relatives told us that staff were extremely kind and empathetic and they provided excellent care and emotional support which was responsive to their needs.

Staff demonstrated compassion and understanding when talking about people.

People and their relatives told us the care and support they received from staff improved their quality of life.

Staff made every effort to ensure people could be cared for in their own homes. A new in-patient unit gave people another option when choosing their preferred place for care or death.

People`s right to privacy and dignity was promoted and respected.

People were consulted and fully involved in their care and treatment. The service was very flexible and responded quickly to people�s changing needs or wishes.



Updated 5 July 2017

The service was responsive.

People and their families were fully involved in assessing and reviewing their needs and planning how their care should be provided. This included their wishes and priorities regarding their end of life care and preferred place of death.

The service provided person-centred care based on best practice and focussed on continuous improvement. Staff understood and anticipated people`s needs which enhanced the quality of the care people received.

The service encouraged people with life limiting conditions and their families� early involvement in the hospice by organising diverse activity groups as part of the Day Service and complimentary therapies.

People�s families were offered bereavement support and counselling as long as they needed it.

The provider had a positive approach to using complaints and concerns to improve the quality of the service and this was closely monitored by the management team.



Updated 5 July 2017

The service was well-led.

The service promoted a positive and open culture and provided a range of opportunities for people who used the service, their relatives and people from the wider community to comment and influence the quality of service provided.

The management team was pro-active in introducing new services to meet the needs of people in their catchment area.

The registered manager worked seamlessly with others and facilitated a multidisciplinary approach which brought together all the professionals involved in people`s care. This meant people received the same high quality service from everyone involved.

There were robust auditing systems to ensure the quality of the service was constantly monitored and actions were in place to constantly drive improvement.