We undertook this unannounced inspection on the 7 and 8 April 2015. The last full inspection took place on 10 January 2014 and the registered provider was compliant in all the areas we inspected.
Dove House Hospice is situated in a residential part of Hull and provides supportive and palliative care services. The service can provide in-patient care to a maximum of 21 adults and has a day care unit providing therapy for up to 25 people, three times a week; there is also an outpatient clinic. The inpatient unit has five single bedrooms and four bays each of which accommodate four beds and would reflect single sex occupancy. All the bedrooms and bays have doors leading directly into the gardens and patios. There is a range of bathrooms, communal rooms and therapy facilities to meet the needs of people who use the service. On the first day of the inspection there were 12 people using the service as inpatients. Other people were admitted over the two days of the inspection.
The service has recently undergone a building extension. This included the addition of two family suites, outdoor weatherproof spaces, enhanced therapy assessment and treatment areas, new rehabilitation and gym facilities and a new and improved day therapy unit. Beds were increased on the inpatient side to accommodate an additional 14 people. Two of these new bedrooms were for people living with dementia who also had need of palliative care and support. These 14 bedrooms had not been registered with the Care Quality Commission yet and were not in use at present.
The service has a registered manager. 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.
We found staff mostly managed medicines safely and encouraged people to take their medicines independently when this was possible and safe. We found some staff had not always followed the hospice’s policy for recording medicines.
Risk assessments were completed and staff knew what to do to minimise risk in order to protect people and maintain their wellbeing. Some risk assessments had not been updated when people’s needs changed.
We found the environment was safe and had been designed to meet the specific needs of people who used the service. Systems were in place to enhance security of the building.
Staff were recruited in a safe way and full employment checks were completed before they started work in the service. There were sufficient staff on duty to meet the range of care, support and treatment needs of people who used the service. Staff were well trained and had supervision and support systems in place to ensure their practice was monitored and they were able to develop skills and knowledge. We saw staff had completed safeguarding training and knew what to do to keep people safe from abuse or harm. There were policies and procedures for additional information and guidance.
We found people’s health care and nutritional needs were met. There were plenty of choices for meals and fluids and dietetic advice was obtained when required. The service had creative ways to alert staff when people required additional monitoring regarding their nutritional intake.
When people were assessed as lacking capacity to make decisions about their care and treatment, best interest meetings were held with relevant people to discuss options. Assessments and care plans were produced to provide staff with guidance in how to provide care and treatment which met their preferences.
We observed staff provided care and treatment to people who used the service in a kind, compassionate and professional way. People told us staff couldn’t be better, were empathetic and were caring towards them. There was a range of complementary therapies and activities to stimulate people and promote their wellbeing. There were support systems in place for bereaved relatives.
We observed the culture of the organisation was one of openness and sound values based on putting the people who used the service at the centre of what they provided. There was a quality monitoring system to enable checks of the service provided to people and to ensure they were able to express their views so improvements could be made.