St. Raphaels Hospice

Updated 7 April 2020

St Raphael’s Hospice is operated by The Congregation of the Daughters of the Cross of Liege. It is a voluntary organisation, part of the registered charity of the English Province of the Daughters of the Cross of Liege. The Hospice will become a charity in its own right in Spring 2020.

The service has a registered manager who was also the hospice’s Director of Care Services. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

The hospice was inspected last in November 2016 and was rated as good over all. We inspected the service on 11 and 12 November 2019, our inspection was unannounced.

Updated 7 April 2020

St Raphael’s Hospice is operated by The Congregation of the Daughters of the Cross of Liege. It is a voluntary organisation, part of the registered charity of the English Province of the Daughters of the Cross of Liege. The hospice will become a charity in its own right in Spring 2020.

The hospice provides end of life and palliative care to people living in the South London Boroughs of Sutton and Merton. The hospice accepts referrals made by GPs, specialist nurses or hospital consultants. A team of specialist consultants, doctors, nurses, health care assistants and a range of other health and social care professionals, therapists and volunteers provide care, treatment and support to people with a life-limiting illness and their families/carers and friends.

The hospice comprises of a 14 bedded in-patient ward, the Jubilee day care centre, overnight family accommodation and a café known as the Orangery that is open to the public. There are various community teams that operate out of the hospice which include the Clinical Nurse Specialist Community Palliative Care Team (CPCT), ‘Hospice at Home’ and ‘Hospice neighbours’ services that provide people and their families care and support at home. The hospice also has a pastoral and counselling service for both people and their families. At the time of our inspection, there were eight people staying on the ward at St Raphael's and approximately 250 people receiving community palliative services at home.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced visit to the hospice on 11th and 12th November 2019.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so, we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Services we rate

Our rating of this service stayed the same. We rated it as Good overall.

• Staff kept patients safe from avoidable harm and abuse. Risks were assessed, monitored and managed appropriately.
• Patients care and treatment records were clearly detailed and accurate in content. They were stored securely and managed safely.
• Staff recognised incidents and knew how to report them. Managers investigated incidents and made improvements to the service.
• Staff followed best practice in relation to infection prevention and control.
• Staff had the appropriate skills, training, knowledge and experience to deliver effective care and treatment. Care and treatment was delivered in line with evidence-based practice.
• Staff involved patients and carers in decisions about their care and treatment.
• Staff cared for patients with compassion, treating them with dignity and respect. Staff truly respected and valued patients as individuals and empowered them as partners in their care, practically and emotionally, by offering an exceptional service.
• Services provided aimed to meet the needs of people from their whole community, and the needs of the population served, which ensured flexibility, choice and continuity of care.
• There were clear processes for staff to manage complaints and concerns.
• There was an open and transparent culture, with engaged and experienced leadership.

However, we also found the following issues that the service provider needs to improve:

• The hospice should improve the electronic notes system so that it is more user friendly and easier for staff to navigate.
• The hospice should replace the worn carpet within the inpatient areas to reduce the risk of slips, trips and falls.

We found the following areas of outstanding practice:

• Staff within the service demonstrated compassion and dedication to finding innovative ways to support patients with their end of life care. Staff and patients could provide many examples of how the service had ensured patients received care individualised to their holistic needs.
• People’s individual needs and preferences were central to the delivery of tailored services. The staff were exceptionally caring, compassionate and empathetic towards both the patient and their relatives.
• Staff completed comprehensive and holistic end of life care plans. The care planning within the service focussed on all elements of the patients care including their spiritual and emotional needs.
• The service has hospice biographers, who alongside the patients would write patient biographies that they can leave as a memoir of their life for their family and friends.

Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Dr Nigel Acheson

Deputy Chief Inspector of Hospitals (London & South)

Updated 7 April 2020

Hospices for adults was the only activity provided at this location.

We rated this service as good because it was safe, effective, caring, responsive and well-led.