Lewis-Manning Hospice Care

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has changed to outstanding.

This meant people were truly respected and valued as individuals. People were empowered as partners in their care in an exceptional service.

This service scored 95 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Patients were consistently treated with kindness, compassion and dignity and staff were caring and respectful. We observed staff engaging with patients in a warm and welcoming manner. Staff introduced themselves to new patients and took the time to build relationships by understanding their personal histories, interests and what mattered most to them.

Staff showed empathy and compassion in their interactions with patients and showed sensitivity to patients’ personal circumstances. They recognised where individuals benefited from a gentle approach to engagement and aimed to build their confidence in accessing different services to meet their health and wellbeing needs. For example, they recognised where a patient was reluctant to engage with services in their own home maintaining regular contact with them through clinic appointments while giving them the time and space to consider their support options. We also observed staff noticing a patient who was waiting for transport after an appointment. Staff went over and sat with them to check on their wellbeing and provide companionship. This demonstrated staff’s ability to notice and respond to patients with kindness and understanding.

Patients were given space to express their experiences and feelings, both in group settings and during individual treatment sessions. Staff actively listened and valued patients’ perspectives, recognising the impact of their conditions on all aspects of their lives. In the breathlessness clinic, we observed a patient being supported to explore how their condition affected them physically and emotionally. Staff listened attentively, responding to both verbal and non-verbal cues to ensure the patient felt heard and understood.

A positive and inclusive atmosphere was evident across the service. Staff created an environment where patients felt comfortable and able to engage socially which contributed to their overall wellbeing. During group activities, patients and staff interacted in a relaxed and supportive way with shared conversation, laughter and participation in activities such as music and exercise. Staff put people at ease by joining in activities themselves enabling staff and patients to share memories and identify common ground as human beings.

Patients’ privacy and dignity were consistently maintained with care delivered in a way that minimised interruptions and respected their confidentiality. Doors to treatment rooms were secured during appointments and staff ensured patients were provided with support discreetly.

Feedback from patients strongly reflected the compassionate care provided. Patients described staff as kind, supportive and respectful, and highlighted the positive impact of being listened to and understood. Comments included:

“When I walk into Lewis-Manning I feel like I am wrapped in a cloud of warmth and happiness”

“The close relationship I have with the nurse feels like I am the only patient she cares for”

“So patient, empathic and full of help and knowledge”.

The hospice provided personalised care that reflected each person’s unique needs, preferences and circumstances. Staff took time to get to know patients, understand their experiences and identify what was important to them. This enabled care to be tailored in a way that supported both engagement and positive outcomes. For example, when discussing activity and movement as a group, staff recognised that patients had different thoughts and experiences depending on their health condition or disability. They ensured conversation remained inclusive and everyone could contribute and reflect on what activity and movement meant to them whether this was going for a walk or making a cup of tea. This person-centred approach showed respect for patients’ differences and helped ensure patients felt understood.

Staff actively listened to patients and adapted care to meet individual concerns and preferences. For example, when one patient expressed anxiety about attending clinical settings due to concerns about cleanliness, staff worked collaboratively with them to reduce this anxiety. They agreed a personalised plan, including cleaning equipment and surfaces in the patient’s presence, to provide reassurance. This approach enabled the patient to feel safe and confident attending the clinic, ensuring they could access the treatment they needed.

The service demonstrated flexibility in how care was delivered, including adapting communication styles to meet individual needs. Staff described how they supported a patient with a learning disability by using non-verbal communication techniques to build trust and rapport. This showed an awareness of individual differences and a commitment to ensuring all patients could engage meaningfully in their care.

We observed staff working collaboratively with patients to ensure care was inclusive and adapted to their abilities and preferences. For example, during group sessions, chair based exercises were tailored to meet patients’ specific mobility needs so that all patients could participate comfortably and safely. The service also demonstrated flexibility in how and where care was provided. For example, staff offered home visits for patients who were unable to attend the hospice due to being housebound and, where a patient lived nearer to a community hub, this was offered as an option for future appointments. Treatment records showed that home visits supported a personalised approach, enabling staff to take into account each patient’s home environment, lifestyle and preferences. Staff described their approach as “meeting the patient where they are”, highlighting a non-judgemental, compassionate ethos which focused on what mattered to each individual.

Promoting independence was an integral part of care delivery. Staff provided patients with education and practical advice to enable them to manage their health independently. This included guidance on skin care, exercise, and the use of equipment and treatments at home. Patients described how the hospice’s approach was empowering and helped them regain confidence and control over their daily lives. For example, one patient described how the treatment and advice they received from the service had enabled them to dress themselves and wear tights again which was important for their self esteem and dignity. As a result, they felt motivated to go out and socialise with others. Another patient said, “I can now do things I never thought possible. I am feeling optimistic”, while another shared, “I am very, very happy. This has given me something I can do at home and have wanted to do for a long time.” These responses reflected how the service enabled people to take an active role in improving their own wellbeing.

The service promoted patients’ choice and control by supporting them to be actively involved in decisions about their care and treatment. Patients were offered choices about how their care was delivered including options relating to treatment, appointment times and locations. For example, a patient receiving lymphoedema care was enabled to choose a compression garment that met their preference for comfort and appointments were arranged in a way that took account of patients’ other commitments.

Independence was actively encouraged during treatment. For example, in the lymphoedema clinic, patients were enabled to dress themselves and mobilise independently wherever possible, with staff nearby to provide support if required. This approach promoted their dignity, confidence and self reliance. Care was delivered in a way that balanced support with enabling people to do as much as they could for themselves.

The service demonstrated a consistent approach to meeting patients’ immediate needs, ensuring care was delivered promptly, safely and with compassion. During our visit we observed staff being attentive and proactive, responding to patients in a timely way. For example, patients in the day hospice were offered drinks and refreshments and staff checked on their comfort and wellbeing. Staff ensured that patients had access to mobility aids, such as walking frames and responded immediately when assistance was required, including supporting patients to use toilet facilities safely and with dignity.

Staff were vigilant to patients’ safety and acted quickly in response to potential risks. For example, in a clinic setting, staff responded promptly when a patient attempted to get off a treatment couch while it was still in motion, ensuring the patient’s safety and preventing potential harm. This demonstrated staff’s ability to respond quickly in offering support.

The service responded effectively to patients’ communication needs and physical cues. In the lymphoedema clinic, staff noticed when a patient was experiencing discomfort while undressing and used this as an opportunity to explore their pain levels and current medicines. This enabled staff to adapt the patient’s treatment plan to meet their needs. Staff also demonstrated awareness of patients’ sensory needs, adapting their communication style to support a patient with a hearing impairment by sitting directly opposite them and speaking clearly. Feedback from patients supported this, with one stating, “I feel comfortable and supported whilst in the company of the clinical staff at Lewis-Manning.”

Support was tailored to ensure patients could participate safely in activities. Group facilitators demonstrated awareness of individuals’ abilities and limitations, adapting exercises to meet specific needs. For example, during an exercise session, activities were modified for individuals which ensured everyone could participate safely and benefit from the session. This ensured patients’ immediate needs were met while promoting inclusion and wellbeing.

Staff were enabled to carry out their roles safely and with confidence. A lone working policy provided clear guidance for staff working in the community. Staff demonstrated a good understanding of this policy and described how they followed it in practice, including maintaining accessible and up to date calendars, completing risk assessments and using buddy systems and emergency support processes. Staff told us that additional support could be arranged for complex visits which ensured staff felt supported and able to fulfil their roles.

Staff felt empowered within their roles. They spoke positively about their managers, describing them as approachable and responsive. They told us they felt able to talk with their managers at any time about issues that might be worrying them and were confident of receiving a supportive response. They described how managers showed compassion when checking in with them following periods of absence and they had felt supported during compassionate leave.

Wellbeing support was available and actively promoted, including a 24 hour helpline, counselling services, complementary therapies, health checks and a cycle to work scheme. Staff were aware of these services and told us they could access support promptly when needed. Opportunities for teams to come together and reflect on their work were arranged, including six monthly events to commemorate patients who had died. Staff valued these events as an important aspect of emotional wellbeing and team cohesion and felt that events enabled them to continue providing high quality care for patients.

The organisation had taken proactive steps to support staff’s wellbeing, including menopause awareness training and access to a virtual mental health care programme. Adjustments to roles were made in line with occupational health advice ensuring staff could continue working safely with appropriate support. Staff gave examples of receiving excellent development opportunities which enabled them to deliver high levels of quality care to patients, make links with external organisations and develop services. This enabled them to grow in their roles and within the organisation while feeling respected and valued for their contribution. Additional initiatives to support staff wellbeing included provision of lunch and fruit, access to complementary therapies, fuel discounts and social activities further reinforcing a supportive and inclusive working environment.

Staff described a positive work life balance and a culture where they felt genuinely cared for. They told us, “work life balance is good; we do feel looked after” and “it’s a lovely place to work…a lovely team…I love it here.” Plans were in place to invest further in staff wellbeing initiatives and reward programmes and it was clear from talking with leaders that staff wellbeing was a high priority across the organisation.