Teesside Hospice Care Foundation

Updated 25 June 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We inspected Teesside Hospice on 16 March 2016. The inspection was unannounced which meant that the staff and registered provider did not know that we would be visiting. This inspection was completed by one adult social care inspector, a specialist advisor in end of life and palliative care and a pharmacist inspector.

Before the inspection we reviewed all the information we held about the service, this included notifications of significant changes or events. The registered provider completed a provider information return (PIR) prior to the inspection. This is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spent time with six people who used the service and three relatives.

During the visit we spoke with 11staff, this included the chief executive, the registered manager, two doctors, the nursing sister, a nurse, the ambulance driver, the head of bereavement counselling, a social worker, a maintenance person and a health care assistant. We also spoke with two volunteers. After the inspection we contacted external health care professionals by email to seek their views on the care and service received. This included consultants in palliative care medicine and various other professionals. Their views can be read in the main body of the report.

During the inspection we reviewed a range of records. This included the care records of four people who used the hospice, including care planning documentation and medication records. We also looked at staff files, including staff recruitment and training records, records relating to the management of the hospice and a variety of policies and procedures developed and implemented by the registered provider. We joined a handover staff meeting where people and their relatives’ care and support was discussed.

Updated 25 June 2016

We inspected Teesside Hospice Care Foundation on 16 March 2016. The inspection was unannounced which meant that the staff and registered provider did not know we would be visiting.

Teesside Hospice Care Foundation (in patient unit) provides specialist palliative and end of life care to a maximum number of 10 people. At the time of our inspection visit there were nine people who used the service.

The hospice had a registered manager in place. 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.

There were very good staffing levels which allowed staff to meet people’s care and treatment needs in a safe, timely and personalised manner. The service had recruitment procedures in place. Staff and volunteers had robust recruitment checks, which helped to make sure they were suitable to provide people’s care and support.

Risks to people’s safety were appropriately assessed, managed and reviewed. Care records contained a number of risk assessments specific to the needs of each person.

There were systems and processes in place to protect people from the risk of harm. Staff told us about different types of abuse and the action they would take if abuse was suspected. Staff were able to describe how they ensured the welfare of vulnerable people was protected through the organisation’s whistle blowing and safeguarding procedures.

The management of medicines was safe and people told us their pain was well managed.

Checks of the building and equipment were completed to make sure it was safe. A fire drill had been undertaken in March 2015; however, we could not be sure that this covered all staff and in particular night staff. We asked the registered manager to contact the fire authority to seek advice regarding fire safety. After the inspection the registered manager contacted us to inform that they had made contact with the fire authority and their advice was a minimum of one drill should be undertaken each year. The registered manager told us there was a system of staff rotation from day and night shift and all staff would be involved in a drill. In addition there had been several activations of the fire alarm in in which staff had worked closely with the fire authority. At the time of the inspection personal emergency evacuation plans (PEEPs) for people who used the service were not in place; however, there was a summary report of each person and a moving and handling assessment which together provided important information for staff and others in the event of an emergency. The management team told us that PEEPs would be completed as a matter of importance. Tests of the fire alarm were completed but there was no system to ensure call point were tested as often as each other. The management team told us they would take action to improve the fire safety concerns we raised at the inspection.

Staff had been trained and had the skills and knowledge to provide support to the people they cared for. Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards which meant they were working within the law to support people who may lack capacity to make their own decisions.

People told us the food provided was good. Nutritional assessments were undertaken to identify risks associated with poor nutrition and hydration.

Staff understood people’s individual needs and the support they and their family members required. We saw that care was provided with kindness and compassion. People who used the service and relatives spoke very highly about the care and service received. People said their right to privacy was fully protected, and told us they were always treated with dignity and great respect by all staff. Chaplains of different faith groups visited the inpatient unit regularly to provide support to people and their relatives. The hospice provided good family support, counselling and bereavement support.

People’s individual views and preferences had been taken into account when their care or treatment plan had been developed. However, care plans were not person centred. Relatives and friends were able to visit the hospice at any time; they told us that they were always made welcome.

People and relatives spoke very highly of the complimentary therapies that were available to both people who used the service and relatives.

The registered provider had a system in place for responding to people’s concerns and complaints. People were asked for their views.

There were effective systems in place to monitor and improve the quality of the service provided. Staff told us that the service had an open, inclusive and positive culture.