Thames Hospice

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

Responsive – this means we looked for evidence that the provider met people’s needs. At our last assessment we rated this key question outstanding. At this assessment the rating has remained outstanding. This meant services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care.

This service scored 89 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider 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 demonstrated their understanding and commitment to ensuring that people remained at the centre of the care they received. They explained how they provided individuals with appropriate information to support them in making informed decisions about their care and treatment.

Person-centred care was observed through care plans and discussions at handovers and team meetings. Care plans reflected physical, mental and emotional needs. For example, along with documentation for personal care and treatment, they contained information regarding loved ones staying overnight.

The multidisciplinary team meetings were patient-focused, with appropriate time provided to discuss each individual. The team shared concise information, with a holistic approach to understanding and providing for people’s needs.

The service had a catering service who they were proud to tell us offered a varying menu to suit multiple dietary and cultural requirements. Patients’ hydration and nutrition were discussed in daily handovers to share any specific dietary requirements as per care plans and notes, which helped staff to understand the patient’s wishes and requirements. Staff received training for specific nutritional support such as enteral feeding and dysphagia, to ensure they could care for patients safely.

The service understood the importance of patients accessing things which were important to them. We were told of a time when the service supported a service user by helping to facilitate a visit from a friend’s horse, when they were staying on the ward. Staff recognised and respected people’s individual cultural needs as part of a person-centred approach to care. They were aware of specific requirements, such as the need for rapid death certification in line with cultural practices, and there were clear processes in place to ensure this was arranged promptly and appropriately.

Examples were provided which demonstrated patients were treated holistically, with their wishes respected and supported. An example of this was a person who was taking alternative remedies, the family shared that they did not feel the person was treated differently for using the remedies, which supported the persons preferences.

Staff deeply respected end of life care and were committed to providing compassionate individualised care for people.

The provider had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service’s ability to provide continuity of care, especially in the community setting, resulted in a prevention of crisis and admissions. The forward planning and flexible approach of the teams allowed people to continue living their lives to the best of their ability, the way they wished. There were highly effective out of hours arrangements in place. These streams allowed a seamless response to be provided to suit patients’ needs.

Staff leads aimed to allocate staff members to people they had previously supported, promoting continuity of care and to develop consistent and trusted support.

The service was well embedded in the local community, working collaboratively with both internal and external providers. This ensured people received the most appropriate and timely care. Staff spoke about the strong rapport they had with teams they could access to support people. The service co-ordinated care with external providers to ensure a smooth transition between services. This included receiving information about people prior to their arrival. This also ensured that people were appropriately referred to them. Staff demonstrated effective multi-disciplinary working, liaising closely with other healthcare professionals, including General Practitioners (GPs) and District Nurses, to promote positive outcomes for people. For example, staff communicated with District Nurses to ensure appropriate pain relief was administered ahead of a potentially painful dressing change, placing the person’s comfort and wellbeing at the centre of care delivery.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

We observed comprehensive handovers. Staff told us how handovers included information, which was important to people’s lives, such as prayer times, which helped to ensure staff could help support and facilitate these.

Information was accessible for patients and families. We saw leaflets available around the site which provided information about confidentiality and patient records. The leaflets explained how patients could access their health and care records and who to contact for this. The service adhered to general data protection regulation (GDPR) and had a specified Data Protection Officer to support the service to implement compliance with GDPR requirements.

Information could be provided to patients and their families in different formats, such as text, email and large writing, depending on their personal needs. Staff knew how information could be provided to patients to ensure it was accessible.

The service supported people whose first language was not English. Information was made readily available throughout the premises. This included leaflets in the main reception area and at information points on the inpatient wards. These documents were also available to download from the service’s website, which provided access for those who were receiving care in the community or visiting.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

There was a focus on patient comfort, dignity and quality of life. This included listening to the patient’s wishes to avoid situations such as unnecessary admissions to hospital. People could provide feedback in person, via the electronic tablet at reception, as well as via the service’s website.

Staff and leaders listened to patients and their relatives to support and identify individual needs. If people raised concerns in the inpatient unit, staff told us they would try to find an immediate solution. If concerns could not be managed this way, staff would direct the concern to the nurse in charge or manager. Staff also told us they completed an online form to document concerns; this meant an audit trail could be completed to support learning from feedback.

Leaders informed us if things went wrong, they were open and transparent. They offered to meet complainants face to face to offer a more personal and delicate approach. Leaders provided examples of times they had managed and resolved complaints. They evidenced compassion and understanding towards the complexity of people’s emotions and how best to support them.

The service sought feedback from patients and their families. Staff and leaders told us the service received very few formal complaints, which was validated through the evidence provided to us. We reviewed theFamily Satisfaction with End-of-Life Care (FAMCARE) 2024 national audit. The results were largely very positive about the care people received. We also reviewed documents from service meetings which showed a culture of learning from the views and experiences of patients and their families. An example of this was when the service changed their home support accessibility processes to make first contact with the patient whilst awaiting additional information to support people more quickly, this update happened as result from concerns raised by a patient relative.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

The physical premises and equipment were accessible. Reasonable adjustments included appropriate parking spaces and dedicated spaces for external services to access the areas with minimal disruption. The service also had a route for beds to be safely wheeled outside by the lake.

The service managed their referral times efficiently and discussed patients with partnered providers daily. Data provided by the service demonstrated a responsive service, with most admissions made within 24 hours of being added to the triage list.

The virtual ward service aimed to have triaged and have seen the patient with 24 hours. The service aimed to provide the initial call back response within 2 hours.

People using the service, carers and healthcare professionals could utilise a single point of access telephone line which was available 24 hours a day, 7 days a week. This service ensured people had access to advice and support both in and out of hours. The MDT were involved with virtual ward care to ensure full patient oversight. People were empowered to remain in their home if they wished.

Although the service did not routinely accept new patients over a weekend, a recent case demonstrated appropriate flexibility in practice. The service adapted its usual process to admit a patient whose needs warranted timely intervention, ensuring that individual needs were recognised and responded to. This person-centred approach had a positive impact on the patient’s care and outcomes.

Urgent home response team visits were reduced in 2025 compared to 2024. This was due to the service focusing on advance care planning to reduce the risk of crisis symptom management and an increase to the in-hours symptom control management. This supported equitable access to care by proactively identifying and addressing patient needs, ensuring timely and appropriate support.

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

Staff and leaders promoted a culture to support people using the service to provide their views and feelings. At the initial assessment and throughout the patient journey, staff asked people what mattered to them so they could make people as comfortable as possible.

Leaders demonstrated a strong understanding of the local demographics and how best to support people within the community. For example, the service recognised the high prevalence of homelessness in the area and the associated barriers people could face in accessing healthcare. To address this, the service worked collaboratively with a range of organisations and charities to support people when they came under the service’s care. This included supporting a palliative care patient to fulfil their wish to remain in the accommodation of their choice. These actions demonstrated the service’s ongoing commitment to providing person-centred care to meet individual needs.

The service delivered inclusive and thoughtful care for people with protected characteristics, including those with learning disabilities. One person reported feeling welcomed and included. They also felt that people of all abilities and backgrounds were treated with the same dignity, respect and high standard of care. This support enabled them to maintain independence at home and participate in meaningful activities with loved ones and create positive experiences such as attending music events.

A person with a learning disability was unable to communicate their wishes regarding complex decisions. To ensure the person’s needs were understood and care delivered safely, clinicians provided additional appointment time and consistent senior oversight. The service co-ordinated support with multiple stakeholders to ensure the person’s needs were met. The team included speech and language therapists, care agencies, deprivation of liberty advocates, continuing healthcare professionals and many others. By providing reasonable adjustments and comprehensive care, the service reduced barriers to accessing care and improved quality of life for people with protected characteristics.

The hospice was accessible, with step free access into and around the facility. Lifts were available if access was required to the first floor, which was designated for staff use. This helped promote equitable access for all visitors.

The service followed its strategy to extend into the population it supported. Data insights used to understand the local community provided recognition and response to potential inequalities. One area was recognised to have a more diverse and deprived population. To better understand the population, connections were created with community and cultural leaders to learn and share what support could be provided to achieve equitable outcomes for local people.

People were given exceptional support to plan for important life changes, so they could make informed decisions about their future, including at the end of their life.

Staff provided specialist advice which addressed a person’s changing health. The service used simple language to ensure the shared knowledge was understood by people. Long-standing patients and those with chronic concerns attended drop-in sessions to ensure ongoing support was available. Staff were kind when speaking to patients and understood the complexities of changes in a person’s health. Conversations regarding dignity and comfort around end of life were supportive and sensitive. When significant changes were identified in a person’s health, staff knew to contact the person’s next of kin as soon as possible.

Advance care planning conversations took place regularly and included discussions with the patients and their loved ones around resuscitation status, advance decision to refuse treatment (ADRT) and preferred places of care. Staff understood the use and importance of completed Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) forms. Staff documented decisions and preferences in the patients’ care plans so repeat discussions did not occur. The service was focused on ensuring people’s comfort, dignity and quality of life, avoiding any unnecessary interventions wherever possible.

Multi-disciplinary team meetings discussed patient’s medical requirements as well as things that were important and mattered to them. For example, a person who was preparing to be admitted to the inpatient service had their healthcare needs discussed as well as consideration taken for their family and how to best support them all going forward. The service was proud to be leading on advance care planning and sharing their knowledge and expertise with other services to benefit people.