St Leonard's Hospice

Updated 22 July 2022

St. Leonard's Hospice York is a 20 bed in-patient hospice care unit (IPU) and a hospice-at-home service. At the time of inspection, the hospice had no more than nine beds open. The hospice holds condition specific clinics, has a social work team, a bereavement support service, therapy services, an education department, a fundraising department and a team of volunteers. The hospice-at-home team provide hospice care in the local community.

The care provided by the hospice is for people that live in the York area of North Yorkshire and Ryedale and some parts of the East Riding of Yorkshire. The service is a registered charity with a board of trustees.

The hospice was last inspected in 2016 and was rated outstanding overall. It was found to be outstanding in the effective and well led domains and good in the safe, caring and responsive domains.

The service is registered to provide:

• Diagnostic and screening procedures.
• Treatment of disease, disorder or injury.
• Nursing Care
• Personal care

We carried out this inspection as a response to concerns raised about the service and the service had not been inspected since 2016.

Updated 22 July 2022

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

• Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, supported them to make decisions about their care, and had access to good information.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it.
• Staff and managers were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

• Not all staff had had an appraisal
• Many staff did not feel aligned to the service’s vision and values and did not understand the long-term strategic view.
• Many staff told us that they did not feel respected, supported and valued and this affected the overall culture within the organisation.
• The service did not have a Freedom to Speak Up Guardian to act as an independent source of advice for staff.
• Although, staff had the opportunity to have contact meetings, there was no system to evidence that all staff had supervision.

Unlike our previous inspection, we did not find substantial evidence of outstanding practice in care and treatment or how the leaders managed the service. However, we did not identify breaches of regulation in the safe, effective, caring and responsive domains. Our inspection found the service now met the rating characteristics of good in most areas.

Updated 22 July 2022