Marie Curie Hospice and Community Services Midlands Region

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that people and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality characteristics.

At our last assessment we rated this key question as good. At this assessment the rating for this key question had improved to outstanding. This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

We assessed 4 quality statements within responsive. The service was exceptional at making sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs. Staff developed appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Staff made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result. Staff ensured people could access the care, support and treatment they needed when they needed it.

This service scored 82 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service was exceptional at making sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Patients were seen as individuals, and their care was personal to them and well-coordinated. Staff encouraged patients to be involved in their care, so their individual needs and preferences were central to the care that was provided.

Staff respected patients’ personal, cultural, social, and religious needs. Services were generally planned and delivered in a way that took the needs of different patients into account.There was a training on understanding the needs of people with dementia, autism spectrum, learning disabilities and mental health conditions and 96.6% of staff had attended this training.

There was a learning disability group which gave patients with a learning disability and their relatives the opportunity to discuss advance care planning. There were opportunities for women susceptible to not attending screening, such as women with learning disability to get screening. Staff created awareness, accountability and created opportunity for people to speak up. Charities worked in conjunction with Marie Curie to deliver the end-of-life workshops for people with learning disability. An evaluation tool from the project which showed positive results fed into the strategy.

Through robust, and person-centred care planning staff saw the whole person, supporting and caring for them and their families as individuals. In-depth assessments were completed using a patient and carer assessment tool, which enabled the service to focus on, and address any individual support needs the patient or their families may have.

People who used services and those close to them were regularly involved in planning and making shared decisions about their care and treatment, so it was centred on them and their needs.Occupational therapists gave an example of a patient who needed to attend a wedding but could not sit due to pressure and pain from their tumour. The team provided a wheelchair and made a personalised cushion which looked in keeping with the wedding chair covers. This enabled the patient to sit through the wedding and achieve their wish.

Managers made sure staff, patients and carers could access interpreters or signers when needed. Information on interpreting services was readily available.

Allied healthcare professionals ran a family support and well-being hub.Peer support groups were available for patients,carers and family members.A crafts afternoon was available for patients and their relatives.

A companion service was available for patients and their relatives. Staff actively supported 56 families across the Midlands. Volunteers provided 3 hours per week support to families.This enabled carers to use this time for their personal appointments.

A hand massage group workshop was offered to up to 8 participants. Patients were taught massage techniques which involved stroking or gently manipulating the muscles and soft tissues in the hands and wrists. The aim was to reduce tension and pain, improve circulation, and help patients relax. This simple sequence could be used during distress to ease anxiety and promote a sense of calm.A patient’s wife commented that she had really appreciated being able to attend the hand massage group with her husband while he stayed on the inpatient unit before he died, and that this had added to her positive memories together during his care.

A horticulture group took place on Thursday mornings to promote a purpose of wellbeing through nature-based activities, such as seed planting, bird feeders,making floral arrangements in pots or using pumpkins for example.The group offered participants a chance to maintain some of their independence in a safe, relaxed environment. It gave them a chance to chat and share their knowledge and thoughts without feeling under pressure.

The motor neurone disease(MND) support group met once a month to provide a safe and supportive environment for people with MND and their carers and families.The aim of the MND group was to provide a place for people in the local area who had MND to meet and learn about their condition from each other and how they managed in the community.

Physiotherapists and a volunteer ran a motivation exercise group. The group was a 12-week rolling group exercise class and each session lasted approximately 1 hour, and group sizes were small ranging from 6-8 patients. This gave opportunity for discussion and tailored exercises in a safe environment. The group offered a chance to discuss changes in mobility with professionals who helped patients and relatives explore and find goals to improve their quality of life.

The family support team supported patients and their families to make memories. We saw an example of how staff provided counselling support to a young family who had been referred to them. They supported with 1:1 counselling sessions and family memory making sessions such as kitting, making hand casts,painting and craft activities.

Children and young people counsellors offered memory making activities. A fairy garden was available for patients and their relatives.This helped to support young patients to create memories and have a reflective outdoor space.

Art therapists and the family support team pulled together resources such as activity packs including cards, dominoes and colouring materials and made them available in the hub and ward area for people with dementia.

There was a support and wellbeing hub that offered various support groups. These included,but were not limited to,a book club, complimentary therapy, creative art group, hairdressing, hand massage and horticulture group and motor neurone disease clinic.

There were qualified hairdressers who volunteered their time to provide this service at Marie Curie hospice. These sessions were provided free of charge in the wellbeing hub to help patients and their relatives look and feel at their best. Sessions were approximately 30-45 minutes and included a consultation with the hairdresser.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

The service were exceptional at developing appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Patients received accurate and up to date information from staff about their care and treatment in a way in which they understood. Patients and their families had access to information in different formats if they needed this.

Staff made sure patients living with mental health condition received the necessary care to meet all their needs. Staff could make referrals to the local mental health teams for patients in need of support and there were other support services available.The service had a clear referral process for patients in need of support for mental health problems and staff were able to explain the process to us.

People who used the service, their family, friends, and carers received information that it was accessible, safe and secure and supports their rights and choices.

The service had effective ways to provide clear and accurate information to patients and their families depending on their needs and preferences. Staff used resources available to them when delivering information, and when required,referred patients to external communication services to ensure information was available about their care and treatment, and any information given was understood.

Processes ensured that information was shared in an effective way. The service provided support for patients and their families who may have communication needs. For example, interpreter services were provided when required to overcome potential language barriers, information was available in different languages, and information was also available in larger print/easy read format. Information was handled in line with the General Data Protection Regulation (GDPR) guidance. The service engages in a nationally recognised data security and protection toolkit and achieved green level by meeting the required standards.

We scored the service as 3. The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

Patients,relatives and their carers knew how to give feedback about their experience including how to raise complaints or concerns. The service clearly displayed information about how to raise a concern in patient areas. Patients told us they felt comfortable raising any issues with the staff caring for them at the time.

Staff understood the policy on complaints and knew how to handle them.Data showed there had been 29 formal complaints and 190 compliments from April 2024 to April 2025.The service aimed to respond to formal complaints within 20 days or an agreed timescale with the individual.

Staff knew how to acknowledge complaints and patients received feedback from managers after the investigation into their complaint.Complaints were investigated and a rapid review carried out and managers would speak to all staff, patients and those close to them.

Staff assessed and met patients’ needs for food and drink and for specialist nutrition and hydration.Staff consistently made sure all patients had the right amount to eat and drink, particularly those with specialist nutrition and hydration needs. We also saw that the needs of those visiting patients were catered for.

All food preparation was carried out on site by a dedicated catering team. Preferences were considered in conjunction with the patient food requirements form completed by clinicians to ensure individual requirements were fully met. Textured or pureed diets were provided for along with any other specialist or cultural dietary requirements.

The information provided was in a form accessible to the particular patient group. Patients had dementia friendly clocks installed which showed the time of the day in their rooms. This was facilitated as an improvement following learning from a patient with dementia.

The evidence showed an exceptional standard. The service was exceptional at ensuring people could access the care, support and treatment they needed when they needed it.

Staff provided high quality, well-coordinated,flexible and responsive palliative care and advice in the community at short notice. The service was able to provide care for patients in their usual place of residence, whose needs can be met by rapid, short-term intervention in the palliative phase of their illness.

Leaders and staff were alert to discrimination and inequality that could disadvantage different groups of people in accessing their service whether this was from wider society, within organisational processes and culture or from individuals.

Reasonable adjustments were made to ensure equal access to the service for all. This removed barriers for people who may find it hard to access services. For example,they ensured the premises was accessible for people who used wheelchairs and staff worked to ensure communication barriers were removed.

The service complied with legal equality and human rights requirements, including avoiding discrimination, considering the needs of people with different protected characteristics and making reasonable adjustments.

Staff had undertaken transgender awareness training.A booklet was available for lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ+) who were living with a terminal illness. This enabled LGBTQ+ people get the best care and support to make decisions for the future.It demonstrated an acceptance of LGBTQ+ people enabling them to be themselves.

Staff undertook a 15 steps challenge with LGBTQ families, and a Birmingham LGBT 15 steps action plan was in place. LGBTQ+ board was available with easy-to-read displays. The service had gender-neutral bathrooms which made the rooms feel inclusive.

Managers monitored waiting times and made sure patients could access services when needed and received treatment within agreed timeframes and national targets. The service continuously monitored patient outcome data; for example, they collated patient length of stay, number of patients treated,incidents and audit results.We requested for recent audits of waiting times for people waiting to access the service. The provider shared audits from September to November 2024 which showed people waited between 0-15 days to access the service. There were currently no waiting times for the community services as patients were added to the appropriate caseload at the point of referral.The average length of stay was 12 nights for inpatients.

People could access care, treatment and support in a way that worked for them.Patients accessed the service usually by referral from either a GP or district nurse. Services were accessible to patients, their families or carers, and people who were facing bereavement or had been bereaved.

We spoke with a community engagement and development manager for Midlands who raised awareness of services provided by Marie Curie, GPs and community groups. They looked at barriers to assessing care as part of their role and worked with people who were not yet using in Marie Curie services but wanted to start planning for the future.

The hospice had capacity to utilise 24 beds but was currently commissioned to deliver 12 inpatient beds. They used 8 inpatient beds at the time of our assessment, 2 patients were being admitted on the day of the assessment and 2 the following day.

A social worker worked closely with the hospice to ensure patients who were vulnerable because of their circumstance such as homeless people received appropriate and safe care.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.