We carried out a review of the data available to us about Duchess of Kent Hospice on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Duchess of Kent Hospice, you can give feedback on this service.
Duchess of Kent Hospice is operated by Sue Ryder a national charitable organisation which specialises in providing palliative and neurological care to people living with life-limiting conditions.
The hospice has 15 inpatient beds. Facilities include an inpatient unit, day therapy unit, lymphoedema service, community specialist palliative care to patients at home service, and a bereavement service. Duchess of Kent hospice operated from a location in Reading and had satellite centres in Wokingham and Newbury.
The hospice provides end of life and palliative care for adults.
We inspected this service using our comprehensive inspection methodology. We carried out a short-notice announced inspection on 7th and 8th November 2019. We gave staff two days’ notice that we were coming to ensure that everyone we needed to talk to was available. We inspected services at Reading and Wokingham.
To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.
Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.
Services we rate
Our rating of this service improved. We rated it as Outstanding overall.
We found outstanding practice in relation to:
Staff treated patients and their families with compassion and kindness, respected their dignity and privacy, and went above and beyond expectations to meet their individual needs and wishes. Staff were devoted to doing all they could to support the emotional needs of patients, families and carers to minimise their distress. Staff helped patients live every day to the fullest.
Services were delivered in a way to ensure flexibility, choice and continuity of care and were tailored to meet patients’ individual needs and wishes. The service planned and provided care in a way that fully met the needs of local people and the communities served. It also worked proactively with others in the wider system and local organisations to plan care and improve services.
It was easy for people to give feedback. Concerns and complaints were taken seriously and investigated, and improvements were made in response to feedback where possible. Patients could access services when they needed them.
Leaders ran services well using best practice information systems and supported staff to develop their skills. Staff understood the vision and values, and how to apply them in their work. Staff were motivated to provide the best care they could for their patients. There was a common focus on improving the quality and sustainability of care and people’s experiences. Staff were proud to work at the service and felt respected, supported and valued. Leaders operated effective governance processes and staff at all levels were clear about their roles and accountabilities. The service engaged well with patients, staff and the local community.
We found good practice in relation to:
Despite some staff vacancies, the service had enough staff to care for patients and keep them safe. Staff had training in key skills and understood how to protect patients from abuse. The service controlled infection risk well. Staff assessed risks to patients and acted on them. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve services.
The service provided care and treatment based on national guidance and best practice. Staff gave patients enough to eat and drink and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, supported them to make decisions about their care and had access to good information. Key services were available seven days a week.
The service planned care to meet the needs of local people, took account of patients’ individual needs and wishes, and made it easy for people to give feedback. Concerns and complaints were taken seriously and investigated, and improvements were made in response to feedback where possible. Patients could access services when they needed them.
We found areas of practice that require improvement:
Clinical and pharmaceutical waste was not always stored securely.
ReSPECT forms were not audited to check for completeness.
Following this inspection, we told the provider that it should make some improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.
Nigel Acheson
Deputy Chief Inspector of Hospitals (London and South)
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.
People's care plans detailed how they wanted their needs to be met and risk assessments supported the choices that they had made. People told us they felt safe, cared for and listened to by staff. They told us they had 'every faith in ward staff' and were 'very, very happy with the wonderful care'.
Policies and procedures that were followed by staff promoted the safe administration of people's medicines.
There were sufficient numbers of trained staff to care and support the people who used the services. Staff had received an in-depth induction and also received support to develop their skills and knowledge through continual professional development.
Health and safety measures were in place and were monitored by the provider to ensure a comfortable and safe environment.
The provider had listened to people who used the services. People told us, 'you are always involved and asked your views, they always listen to you'.
We looked at commendations that the hospice had received directly or indirectly via their website. One of those read, 'our memories of the oasis of care are still vivid and we know there must be many other families who share our feelings.'
People were provided with information in relation to their treatment and care, which included information on how to make a complaint.
Staff had been given support and training to enable them to deliver care and treatment to an appropriate standard.
There was an effective system in place to regularly assess and monitor the quality of service provided.