St Teresa's Hospice

The Family Support Team is comprised of social workers and person-centred counsellors, offering patient and family support. The complementary therapies offered to patients and carers include aromatherapy massage, acupuncture and reflexology. The hospice has an Education Department, focussed on workforce development and spreading the hospice ethos. The hospice’s income generation team is based on site and all of the hospice’s services are supported by a dedicated team of almost 400 volunteers.

There were six people using the inpatient service on the day of our visit and approximately 16 people attending the day hospice facility. The Rapid Response team had an active caseload of eight people on the day of our visit.”

The care provided by the hospice is for people that live in the Darlington, South Durham and North Yorkshire areas. The service is a registered charity with a board of trustees. Day to day the service is run by a senior management team drawn from all departments within the hospice.

There was a registered manager employed for this service. 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. The registered manager was very experienced after being employed by the hospice for several years.

People and their families told us that staff were extremely caring , compassionate and listened to them. People we spoke with who received personal care felt the staff were knowledgeable, skilled and their care and support package met their needs not just in terms of physical care but also in relation to their emotional support. . Staff confirmed that they were not rushed and had time to provide the care people expected. People told us about the excellent care they received. People and professionals spoke very highly of the complementary therapies that were available to both people who used the service and relatives. The hospice provided excellent family support, counselling and bereavement support which people told us made a massive impact to their lives.

The staff undertook the management of medicines safely and in line with people’s care plans. The service had health and safety related procedures, including systems for reporting and recording accidents and incidents. The care records we looked at included risk assessments, which had been completed to identify any risks associated with delivering the person’s care and their environment. The hospice environment was well maintained and there were regular checks on safety and equipment.

People were protected by the service’s approach to safeguarding and whistle blowing. People who used the service told us that they were safe, could raise concerns if they needed to and were listened to by staff. Staff were aware of safeguarding procedures, could describe what they would do if they thought somebody was being mistreated and said that management listened and acted on staff feedback.

Staff recruitment processes were followed with the appropriate checks being carried out. There were sufficient staff on duty to meet people’s needs and the service had a team of volunteers who provided additional support. The hospice had a bank of staff who they could contact if they needed additional staff.

The service had an electronic care planning system that we saw recorded people’s admission assessment and on-going plan of care. Care plans were personalised to include people’s wishes and views. Care plans were regularly reviewed in a multi-disciplinary framework. We observed staff caring for patients in a way that respected their individual choices and beliefs. There was evidence on electronic and paper records of advance care planning and specific Deciding Right (this is a North East initiative) which was used to capture peoples choices and planning for future anticipated emergencies.

All staff received supervision individually or as a group and annual appraisals were undertaken. Staff and volunteers received a thorough induction and regular training to ensure they had the knowledge and skills to deliver high quality care.

Staff told us they were very supported by their management and could get help and support if they needed it at any time. Staff members told us they felt part of a team and were proud to work for the hospice.

Staff worked within the principles of the Mental Capacity Act where appropriate. People had choices about their care and their consent was sought by staff.

People were supported to receive a nutritious diet at the service. Their appetite was assessed through talking to them which led to staff being able to give the person the type and amount of food they would be able to eat. There was a choice of menu on the days we inspected and drinks and snacks were available at any time. The service also provided a bistro for people, families and staff to enjoy a meal or snack and the chef provided support on cooking and nutrition for people and their families via the day hospice CHOICES programme.

People were confident expressing any concerns to staff at the service and knew who to approach if they were not satisfied with the response.

There was a good quality assurance system in place to ensure the service and staff were delivering the desired level of quality and safety. There were regular reviews and feedback opportunities with people and families on the quality of their care to make sure they were happy with the service provided. Accidents and incidents were clearly recorded. There was an embedded culture of learning from mistakes and to share action plans for improvement work within the service.

There was a range of patient and carer information booklets clearly displayed and accessible throughout the hospice. People felt they were treated with dignity and respect and welcomed the range of therapies and facilities provided.

People's needs were being assessed and support plans put in place ensuring that people were provided with safe and effective care. The provider appropriately managed the medical equipment including medical devices in use at St Teresa's Hospice.

We saw that the provider had a system in place for the quality checking of systems to manage risks and assure the health, welfare and safety of people who receive care were being met. People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained

People told us they had been 'fully informed' about the treatment and care they would receive. People told us they felt involved and included in their care planning.

All the people we spoke with were unanimous in their positive comments about all aspects of the service and support they received. People described the service as 'wonderful', 'a lifeline', and '11 out of 10'.

St Teresa's employed a wide range of health and social care professionals who provided the assessment, care and treatment of people who used the service. All the people spoke with made many positive comments about the skills, expertise and professionalism of staff.

The hospice provided people with information about its complaints procedure. The complaints procedure was clear and easy to understand. There had been no complaints about the service.