This inspection took place on 1 and 2 July 2015. Due to the sensitivity of the care provided within the hospice, the provider was given 24 hours’ notice of our visit. This was so people who used the service could be told of our visit and asked if they would be happy to talk with us.
Marie Curie Hospice West Midlands is a registered charity for the delivery of care and treatment for people across the West Midlands who are affected by life-limiting conditions. Care and support is provided to people by a range of health and social care professionals and volunteers. This is provided through a 24 bed in-patient unit, a day unit and support in people’s own homes. At the time of our inspection there were 19 people receiving care in the in-patient unit.
There was a registered manager in place. 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.
People told us there were enough staff to meet their needs and keep them safe. Staff had the necessary knowledge, information and support to ensure people were kept safe from abuse. Staff told us they reported any concerns to the social work team at the hospice. There was a ‘no blame’ culture with staff encouraged to report any clinical incidents or accidents. These were fully investigated and used as a learning tool to drive improvements in the delivery of care and safeguard people from harm.
People received care from a multi-disciplinary staff team who were qualified, supported and trained to meet their needs. There was a very proactive approach to the personal development of staff and the acquiring of new skills and qualifications. A system of competency based assessments ensured staff could demonstrate the required knowledge and skills to meet people’s needs effectively. Staff received supervision and support and there were also reflective practice sessions where they could discuss any issues associated with their work. Volunteers received training to assist them in their role in giving practical and emotional support to people and their friends and family.
A well-established pharmacy team provided good clinical services to ensure people’s medicines were managed safely. The team regularly attended clinical meetings to discuss people’s individual pain management requirements and ensure good clinical practice was followed.
The rights of people who were unable to make important decisions about their health or wellbeing were protected. Staff followed the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).
People, friends and relatives were consistently very positive about the caring and compassionate attitude of the staff. They told us they were completely satisfied with their care. They spoke of excellent relationships with staff who understood their needs and preferences and who devoted time to them. 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.
There was a holistic approach to people’s care with the physical, psychological, social and spiritual needs of each person given equal importance, together with the needs of those closest to them. Staff respected people’s cultural and spiritual needs and people told us they received the religious and spiritual support they wanted and needed from a multi-faith chaplaincy team.
Relatives told us staff understood their emotional needs and focused on their wellbeing as well as the wellbeing of their family member. Bereavement support was available to people and their families and friends. This provided emotional and practical support to those who required it. A specialist team provided bereavement support to the children and young families of people receiving palliative care.
There were very few complaints and concerns raised. The provider had a positive approach to using complaints and concerns to improve the quality of the service. Each complaint was assessed to establish the lessons learned and where necessary, appropriate action taken to improve the service provision for everyone using the services at the hospice.
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 management team demonstrated a strong commitment to providing people and those closest to them with a safe, high quality and caring service and promoted high standards.
Staff worked closely and in partnership with external health and social care professionals and other national organisations to improve the service within the hospice and health provision in the local community and nationally. Staff were encouraged and supported to undertake research and act as education facilitators to share best practice and ensure the best possible outcomes for people with life-limiting conditions and those closest to them.
The provider continually assessed the needs of people who used the service and the care and support they required. For example, the hospice was working to develop the service it provided to people living with dementia. The provider had a forward plan which involved raising the awareness of what a hospice can provide to people with life limiting conditions, apart from end of life care.