Butterwick Hospice

Updated 5 May 2022

Butterwick Hospice is operated by Butterwick Limited. The hospice opened in 1984 and is an independent hospice in Bishop Auckland, County Durham. The hospice primarily serves the communities of the Durham Dales, Easington and Sedgefield clinical commissioning group areas.

Butterwick hospice provides adult hospice services which includes; palliative day care services, physiotherapy and complementary therapies. It also provides a palliative home care team which predominantly provides an overnight service. A family support work team provides support and counselling to those bereaved or affected by a life limiting illness. The family support work team provides services to adults and children and young adults in the wider family. The complimentary therapies provision extends to patients with a life limiting diagnosis and carers.

The hospice has a registered manager in post and is registered to provide the following regulated activities; Diagnostic and screening procedures and Treatment of disease, disorder or injury.

The hospice was inspected using the hospitals framework. CQC last inspection in March 2020 rated the service requires improvement and the provider was issued with three requirement notices.

Early in the inspection process, we issued a warning notice relating to good governance. We issue warning notices when the care falls short of what is legally required, we tell the provider what was not right and explain how long they have to comply with the regulations.

Updated 5 May 2022

Butterwick Hospice is operated by Butterwick Limited. The hospice is purpose built; is fully accessible and has appropriate facilities for day care, therapies and family support. The hospice provides adult hospice services that includes palliative and neurological day care, family support services for adults, children and young people and a home care service for palliative and end of life patients. The hospice does not have inpatient beds. We inspected the service using our comprehensive inspection methodology. We carried out an unannounced inspection on 1 and 2 February 2022. During the inspection we visited the hospice’s day care service at Bishop Auckland and one patient who was receiving care at their home.

Following this inspection. we served the provider a Warning Notice under Section 29 of the Health and Social Care Act 2008. The warning notice told the provider they were in breach of Regulation 17 and gave the provider a timescale to make improvements to achieve compliance. The principles we use when rating providers requires CQC to reflect enforcement action in our ratings. The warning notice identified concerns in the safe and well-led domain. This means that the warning notice we served has limited the rating for safe and well-led to inadequate.

Our rating of this location went down. We rated it as inadequate because:

• The service did not have effective systems to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users.
• There was no clearly defined purpose of the Hospice at Home service provided at Bishop Auckland and staff were not suitably trained to deliver care in line with the purpose.
• Staff did not have appropriate policies and guidance to support them to deliver care in line with the service’s purpose. There was no appropriate oversight of the service provided at Bishop Auckland to ensure staff were delivering care in line with the service’s purpose.
• The service did not have an admissions policy, operational policy, service specification, standard operating procedure or similar document which would identify the remit of the service and identify whether the service was able to meet service users’ needs.
• The service did not have a policy or procedure for staff to follow in situations where service users’ risks had changed, or where a service user had deteriorated or become seriously unwell.
• Not all staff had completed training in the Mental Capacity Act and Deprivation of Liberty Safeguards; Loss and Bereavement; Palliative Care; Incident Reporting; or Lone working.
• Governance systems did not identify or monitor the quality of care provided and there was lack of oversight from senior leaders.

However:

• Staff demonstrated caring, compassionate interactions with patients and their families.
• The service had an open culture and staff felt confident to be able to raise and escalate concerns.
• Service users we spoke with spoke highly of staff and the care that they received.
• People could access the service when they needed it and did not have to wait too long for treatment.
• Patients and families using the service were very happy with the care they had received.

Updated 5 May 2022

Butterwick Hospice is operated by Butterwick Limited. The hospice is purpose built; is fully accessible and has appropriate facilities for day care, therapies and family support. The hospice provides adult hospice services that includes palliative and neurological day care, family support services for adults, children and young people and a home care service for palliative and end of life patients. The hospice does not have inpatient beds. We inspected the service using our comprehensive inspection methodology. We carried out an unannounced inspection on 1 and 2 February 2022. During the inspection we visited the hospice’s day care service at Bishop Auckland and one patient who was receiving care at their home.

Following this inspection. we served the provider a Warning Notice under Section 29 of the Health and Social Care Act 2008. The warning notice told the provider they were in breach of Regulation 17 and gave the provider a timescale to make improvements to achieve compliance. The principles we use when rating providers requires CQC to reflect enforcement action in our ratings. The warning notice identified concerns in the safe and well-led domain. This means that the warning notice we served has limited the rating for safe and well-led to inadequate.

Our rating of this location went down. We rated it as inadequate because:

• The service did not have effective systems to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users.
• There was no clearly defined purpose of the Hospice at Home service provided at Bishop Auckland and staff were not suitably trained to deliver care in line with the purpose.
• Staff did not have appropriate policies and guidance to support them to deliver care in line with the service’s purpose. There was no appropriate oversight of the service provided at Bishop Auckland to ensure staff were delivering care in line with the service’s purpose.
• The service did not have an admissions policy, operational policy, service specification, standard operating procedure or similar document which would identify the remit of the service and identify whether the service was able to meet service users’ needs.
• The service did not have a policy or procedure for staff to follow in situations where service users’ risks had changed, or where a service user had deteriorated or become seriously unwell.
• Not all staff had completed training in the Mental Capacity Act and Deprivation of Liberty Safeguards; Loss and Bereavement; Palliative Care; Incident Reporting; or Lone working.
• Governance systems did not identify or monitor the quality of care provided and there was lack of oversight from senior leaders.

However:

• Staff demonstrated caring, compassionate interactions with patients and their families.
• The service had an open culture and staff felt confident to be able to raise and escalate concerns.
• Service users we spoke with spoke highly of staff and the care that they received.
• People could access the service when they needed it and did not have to wait too long for treatment.
• Patients and families using the service were very happy with the care they had received.