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Duchess of Kent Hospice Good Also known as Duchess of Kent House - Dellwood Community Hospital

Inspection Summary


Overall summary & rating

Good

Updated 25 February 2016

The Duchess of Kent Hospice is a local service run by the Sue Ryder charity. The in-patient facility covers a catchment area in Berkshire West which includes Reading, Wokingham and Newbury and is located in Reading. The hospice service provides specialist palliative care, advice and clinical support for adults with life limiting illness and their families. They deliver physical, emotional and holistic care through teams of nurses, doctors, counsellors, chaplains and other professionals including therapists. The service cares for people in three types of settings: at the hospice in 15 beds ‘In-Patient Unit’, or in their ‘Hospice day service’ that welcomes up to 14 people per day, and in people’s own homes through their community service. The service provides specialist advice and input, symptom control and liaison with healthcare professionals. Services are free to people and the Duchess of Kent Hospice is dependent on donations and fund-raising by dedicated staff and volunteers in the community.

The services provided include counselling and bereavement support, family support, clinical psychology, chaplaincy, an out-patient clinic, occupational therapy, physiotherapy, dietetics, befriending, complementary therapies and diversional therapies and a lymphoedema service (for people who experience swellings and inflammation usually to their limbs post cancer treatments).

This inspection was carried out on 1 and 2 December 2015 by two inspectors and a pharmacist inspector who was shadowed by a new CQC 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 also managed the community services, the day hospice service on site and the two day hospices located at Newbury District hospital and Wokingham hospital.

People were kept safe by staff who were trained in the safeguarding of vulnerable adults and health and safety. They were able to fully describe their responsibilities with regard to keeping people, in their care, safe from all forms of abuse and harm. It was apparent from discussion with members of the management team that all health and safety issues were taken seriously to ensure people, staff and visitors to the service were kept as safe as possible. There were enough staff, on duty, to ensure people received safe care. People were given their medicines in the right amounts at the right times by properly trained staff. Recommendations were made in respect of fire drills and the use of as required medications in order to encourage improvement in these areas. The recruitment process was robust and the service was as sure, as possible that staff employed were suitable and safe to work with people who were cared for in the service.

People’s human and civil rights were upheld. The service had taken any necessary action to ensure they were working in a way which recognised and maintained people’s rights. The staff team understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people in their care. The Mental Capacity Act 2005 legislation provides a legal framework that sets out how to act to support people who do not have capacity to make a specific decision. DoLS provides a lawful way to deprive someone of their liberty, provided it is in their own best interests or is necessary to keep them from harm. The registered manager had made or was making the appropriate DoLS referrals to the Local Authority.

Clear information about the service, the facilities, and how to complain was provided to people and their relatives. People’s privacy was respected and people were assisted in a way that respected their dignity. Staff sought and respected people’s consent or refusal before they supported them.

People’s health and well-being needs were met. Staff had built strong relationships with people and were knowledgeable about and knew how to meet people’s needs. The service respected people’s views and encouraged them to make decisions and choices. Food was nutritious and of good quality. Staff were appropriately trained to meet the needs of people in their care including end of life care. Staff knew each person very well and understood how people may feel when they were unwell or approached the end of their life. Overall the service was highly responsive to people’s needs and were proactive when people’s needs changed.

People’s feedback was actively sought, encouraged and acted on. People and relatives were overwhelmingly positive about the service they received. They told us they were satisfied about the staff approach and about how their care and treatment was delivered. The staff approach was kind, compassionate and pro-active.

The environment was well designed, welcoming, well maintained and suited people’s needs.

The service was well managed. Meeting people’s needs was the priority for staff and the registered manager. The registered manager was described by staff as supportive. Emphasis was placed on continuous improvement of the service. Comprehensive audits were carried out about every aspect of the service to identify how it could improve. When needs for improvement were identified, remedial action was taken to improve the quality of the service and care. The service worked in partnership with other organisations.

Inspection areas

Safe

Good

Updated 25 February 2016

The service is safe.

Medicines were given to people correctly by appropriately trained staff. People were assessed as competent to safely take their own medicines.

Staff were properly trained and knew how to protect people from abuse or harm. People felt they were safe being cared for in the service.

Any health and safety or individual risks were identified and action was taken to keep people as safe as possible. The registered manager made sure the staff team learned from any accidents or incidents.

Robust and safe recruitment procedures were followed in practice.

The environment was secure and well maintained.

Effective

Good

Updated 25 February 2016

The service is effective.

Staff were trained appropriately and had a good knowledge of each person and of how to meet their specific support needs.

Staff understood how to uphold people’s human and civil rights and took appropriate action if people did not have capacity to make decisions. People were encouraged to make as many decisions and choices as they could.

People were supported to be able to eat and drink sufficient amounts to meet their needs and were provided with a choice of suitable food and drink.

People were referred to healthcare professionals promptly when needed.

Caring

Good

Updated 25 February 2016

The service is caring. People’s feedback about staff and the service was very positive.

Staff treated people with respect, kindness and dignity at all times.

Staff interacted with people positively, with patience, understanding and respect. They showed kindness with people when they faced challenging situations

The service and the staff were very flexible and responded quickly to people’s complex and changing needs or preferences.

People were consulted about and fully involved in their care and treatment. The service provided high standards for end of life care and people were enabled to experience a comfortable, dignified and pain-free death.

Responsive

Good

Updated 25 February 2016

The service is very responsive. People described the service as excellent and where nothing is too much trouble.

People told us staff were amazing and highly skilled. Staff fully understood and anticipated people’s needs which enhanced the quality of their experience.

The service provided person-centred care which was planned and reviewed in partnership with them to reflect their individual wishes and what was important to them.

People’s families were encouraged to remain involved with the service for as long as they wished after their loved ones had reached the end of their life.

The service took a key role in the local community. People, their families and friends were actively encouraged, enabled and supported to engage with events outside of the service.

Well-led

Good

Updated 25 February 2016

The service was consistently well-led.

There was open and positive culture that placed people and staff at the centre of the service.

The provider, registered manager and staff followed principles based on person-centred care which resulted in an approach which supported working in partnership with people.

Staff felt supported, valued and included in decisions about how the service was run.

There was a culture of continuous improvement.

The service worked in partnership with other organisations to ensure they provided a high quality service.