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Archived: St Christopher's Bromley Good


Inspection carried out on 20 September 2016

During a routine inspection

This inspection took place on 15 and 22 September 2016 and was announced. The service was last inspected on 25 November 2013 and at that time was meeting all the regulations we looked at.

St Christopher’s Bromley (Orpington) has charitable status and provides palliative and end of life care to a population of approximately 1.5 million people living in the five South East London Boroughs of Bromley, Croydon, Lewisham, Southwark and Lambeth. The hospice will accept initial referrals from anyone in the community who knows an adult with a life threatening or life limiting condition. Care, treatment and support is provided to people with a life threatening/life limiting illness, their families, carers and friends by a range of multi-disciplinary health and social care professionals including doctors, nurses, health care assistants, physiotherapists, occupational therapists, dieticians, social workers, chaplaincy, welfare officers, art and complementary therapists and volunteers. The hospice also offers information, advice, education/training and research opportunities to individuals, groups and institutions wanting to know more about end of life matters and the work undertaken by St Christopher’s at a local, national and international level.

Although the hospice has two different sites located at Orpington and Sydenham in Bromley, St Christopher’s considers itself to be a single provider with people in the local community, their families/carers, staff and volunteers visiting or working at both sites. This report relates specifically to the Orpington site which comprises of the Caritas day centre, café and garden, numerous clinical and meeting rooms for patients and their families, a large teaching room that forms part of the St Christopher’s education facilities and a dedicated Lymphoedema suite. The Lymphoedema service serves the whole of Bromley and operates both from Caritas House and also offers a home visiting service.

The Caritas centre offers people in the local community, their families and informal carers' physiotherapy, psychological support, social work services, bereavement counselling and spiritual care in an environment where they can relax, socialise, support each other and make use of a range of therapies to explore their experiences. Nurses agree a care plan with each outpatient and can refer individuals to other services such as group work programmes, exercise classes, the pop-up rehabilitation gym or clinic appointments with other members of the multi-professional team. People are offered an initial programme of 12 sessions after which their care plan is reviewed. The centre also provides people with information and trained volunteers are on hand to help people find the information they need. The hospice has increased the levels and range of supportive care services that run from the Caritas centre in 2015/16.

The specialist community palliative care team and outpatient team operates in collaboration with local primary health care teams to provide people, their families and/or carers with end of life care and support. Its primary task is to manage symptoms associated with people’s illnesses and to support them and their families through the illness and into bereavement. The team also provides a 24 hour consultancy service and training for primary health care teams, social and healthcare staff in other settings such as care homes, and domiciliary care agencies.

The hospice clinical nurse specialists work a shift system up until 10pm. Overnight, the advice and visiting service is managed by senior nurses on duty in the inpatient wards at the Sydenham site. Staffing levels for this reflect the need for community support. Medical advice, support and patient assessment is also available from the medical team 24 hours a day/seven days a week. In addition, the hospice has a hospice at home service providing practical nursing care to support patients and families at home in the last days of life. St Christopher’s

Inspection carried out on 25 November 2013

During a routine inspection

We spoke with some people who used the service and some people's relatives. All the people we spoke with were complimentary about the support they received from the community palliative care service. People told us "it's excellent, I can't fault it" and "it is great, especially as time goes on". One person told us "I am very satisfied, it is reassuring for me and my family". People we spoke with said they received support from nursing staff that were familiar to them, and they had contact details if they needed to contact a nurse, including out of hours. People said that when they had contacted the hospice that they received advice and support promptly, for example when they required pain control. People told us that nursing staff had met with them to discuss their end of life wishes and provided appropriate support to them and their families when it was needed.

We found the provider sought people's consent to receive a service and to have their personal information shared with other agencies. The provider also acted in accordance with the Mental Capacity Act (2005) when it was necessary. We found people's care and support needs were assessed and were appropriately planned and delivered. The provider worked effectively with other agencies to coordinate people's care and support. There were appropriate procedures in place to ensure medication was managed appropriately and there was an effective complaints procedure in place which people knew how to use.

Inspection carried out on 16 January 2013

During a routine inspection

People who use the service and their families were very complimentary of the service provided to them. One person told us "I can't say enough to thank the staff for their help" and the person described the staff as "angels". Another person told us the service had been "an absolute lifeline". People told us they and their families had been involved in their assessments and they were encouraged to make decisions about their care and support. People told us the staff were "always empathetic" and they were helpful and friendly. One person told us the staff do a "wonderful job". The provider's survey for people and their relatives showed a high level of satisfaction with the home care service provided to people.

The provider involved people and their families in decisions and people were able to state their preferences and wishes. People received an assessment of their needs which was reviewed as things changed, and appropriate care and support was provided to people. People's conditions were monitored regularly with involvement from other professionals and changes were made where necessary. Procedures were in place to ensure people were safe and staff were knowledgeable about safeguarding arrangements including how to report concerns. Staff were sufficiently inducted and trained and they worked towards relevant qualifications. Staff were supported and their performance was appraised. The provider had arrangements in place to ensure a quality service was being provided.