Archived: Grove House

Grove 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, doctors, counsellors 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 55 people using this service. The service provided specialist advice with regards to symptom control and worked in partnership with health care professionals to ensure that people received the best possible support in their own homes. There was a counselling, pre- bereavement and bereavement support offered to families and relatives.

Grove 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. Staff assessed the risks involved in delivering a service in people`s own homes. Staff communicated any risks to people`s health and well-being to health and social care professionals. 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.

The service operated a 24 hour service and on-call system to ensure people received the same support and advice during the day as during the night. This gave people great confidence and comfort. People told us they valued this service and they felt reassured to know they could talk to a member of staff any time during day and night.

People who used the Day Service told us that this service enabled them to meet the staff and form relationships before their condition progressed to a stage when they will use 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 administered by trained and qualified staff who had their competency assessed regularly by their manager. Any changes in people`s medication were discussed with health care professionals to manage and support people’s symptoms and pain management. Medicines were regularly reviewed and audited to ensure they met people’s needs.

The registered manager and staff were clear about their responsibilities around the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and were dedicated in their approach to supporting people to make informed decisions about their care.

People and relatives were very positive about the caring and compassionate attitude of the staff delivering the service. They told us they were completely satisfied with their care and thought highly about staff and management. Staff were very motivated and demonstrated a commitment to providing the best quality end of life care in a compassionate way. People’s wishes for their final days were respected.

The management structure showed clear lines of responsibility and authority for decision making and leadership in the operation and direction of the hospice and its services. The registered manager was committed to improve and broaden the services the hospice offered.

The service actively encouraged and provided a range of opportunities for people who used the service and their relatives to provide feedback and comment upon the service in order to continue to drive improvement.

There was a comprehensive auditing programme for all the services the hospice provided carried out by the management team. Action plans were comprehensive in detailing actions taken, time frames and the responsible person for the actions.

We found that the provider was meeting the standards we had inspected. People and their relatives had been consented to their care and support they needed. People's received care and support in line with their agreed care plans. Staff had been provided with relevant training and supported in their roles. There was a quality assurance system to assess and manage the quality of service. Care records had been held electronically and confidential files had been kept safely and securely in the office.

We found that Grove House was meeting the standards we reviewed. People's privacy and dignity was respected and their human rights promoted. People and their relatives had been involved in the decisions about their care and treatment. An assessment of needs had been carried out for each person and care plans had been developed to ensure that people's needs were being met appropriately. Staff were aware of their responsibilities regarding any allegations of abuse. Staff had been provided with support and relevant training for the work they performed. There were systems in place to assess and monitor the quality of service.