Ashgate Hospice

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The service provided care and treatment in a way which made patients feel safe, supported, involved and listened to. Patients and their loved ones felt they were treated with kindness, compassion, dignity, and respect. Patients were treated as individuals and encouraged to be involved in their care and treatment planning. Staffing, processes, and equipment were in place to maintain the safety of the patient and to tend to their every need. Staff engaged with patients, and their families in a kind, compassionate, and caring manner. The environment, and equipment was clean, tidy, and well maintained. Information regarding the patients care, treatment, and external resources available were displayed around the ward, and also available to patients and their families who were being supported in the community.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Patients and their families were supported very well and felt staff got to know them, their needs, and preferences. Patients felt they were listened to and encouraged to feedback on their experience of care within the service.

Managers investigated incidents thoroughly with outcomes provided, and feedback was given to all involved in a timely manner. Staff had patient safety, team and de-brief meetings to discuss any incidents and lessons that have been learnt to improve their practice. Managers supported staff to raise any concerns they may have, and they felt very comfortable to do this. In addition, Staff had access to a freedom to speak up guardian (Freedom to Speak Up is about encouraging a positive culture where people feel they can speak up, their voices are heard, and their suggestions acted upon). No issues had been raised to them in the last 3 months.

Learning from incidents and concerns was evidenced in environmental, patient safety and freedom to speak up meetings documentation. Where an issue or concern had been raised, it had been investigated and resolved, with the appropriate actions taken and any learning shared with the wider team.

If patients felt concerned about their mental wellbeing or physical health, they were able to approach staff, knowing they would respond quickly and effectively, with compassion, and care. Patients, and all the people involved in their care were included in decision making around their care and treatment when transferring to a different care setting.

Staff assessed referrals into the service to ensure the care and support available was suitable for the patient. They ensured they were always visible and available for the patients. Staff had excellent relationships and communicated well with colleagues both internally and externally to the service to enhance the quality of care, treatment, and support the service provided, and ensured continuity in the patients care journey.

Staff at the service and external partners worked as one, enhancing the experience of care for people using the service, whilst maintaining continuity. Feedback from partners highlighted that the service worked extremely well with them when planning the admission or discharge of patients. Any information required was readily available, and easy to access. The service was open, honest, and transparent working effectively and collaboratively.

Staff attended weekly ward round meetings that involved the patient, their families, and internal and external partners. All relevant partners had copies of the accurate and up to date information required, including care plans, risk assessments, and discharge plans. This ensured continuity of care when a patient transferred to a different care setting.

Patients felt safe, supported, and listened to and were happy to approach staff to voice any issues or concerns. One patient told us “Staff are always about and often sit with me and my family, I’m very well cared for and always feel safe”.

Staff had a good knowledge of safeguarding, what, how, and who to report too. They were able to identify different forms of abuse and the associated signs. Regular patient safety and safeguarding meetings were held to ensure any safeguarding incidents had been addressed.

Staff were able to explain what actions they would take to safeguard patients on the ward, and in the community. They were confident in making referrals to the local authority. Safeguarding information was displayed on patient information boards on the ward.

A clear process was in place for raising safeguarding concerns. The provider worked collaboratively with the local authority safeguarding team to discuss progress and outcomes of investigations. The service had no safeguarding incidents over the last 12 months.

Patients and their families were involved in managing risks, risk assessments were person-centred, proportionate and reviewed regularly. Patients felt safe, listened to, and supported on the ward, and in the community. Their concerns were dealt with, individual risks were well managed.

Staff maintained patient safety and wellbeing as apriority. They regularly reviewed risk assessments, which were updated to reflect the patients’ current risks and needs. We looked at 8 risk assessments which were fully completed, highlighting individual risk and updated regularly.

There were robust processes to ensure patients risks were assessed, monitored, and managed on a daily basis. Individual patient risks were discussed in patient safety meetings, and multi-disciplinary team reviews. These included signs of deteriorating health, medical emergencies or behaviours that may challenge.

Patients felt the ward environment was always clean, and well looked after. There were plenty of rooms and well-maintained outdoor spaces they could spend time in with their families.

All equipment was well maintained and checked regularly, where issues or concerns were raised, they were reported and acted on quickly. Staff carried out environmental and equipment audits to ensure they were in good working order. Call bells were in place in patient bedrooms to support their safety. Call bells could be used by patients, their families and staff if support or assistance was required.

The ward and environment were clean, tidy and well-maintained. There were several lounges where patients could enjoy time with their families, and also take part in activities. Sufficient bathrooms, shower rooms, and wet rooms were situated around the ward, all were clean, tidy, well-maintained, and accessible. Rooms were available for multi-disciplinary team (MDT) reviews. There was a well-maintained multi-faith room, which could be used by anyone using or visiting the service. The dining area was spacious, clean, and welcoming, and could be accessed by anyone using or visiting the service. The outdoor space was well maintained and inviting and was adapted for sensory needs. The entrance to the outdoor space had been adapted and could be accessed by a wheelchair or bed. All doors were accessed using a key or fob which maintained the safety and security of patients.

Processes were in place to maintain the environment; these were reviewed regularly and clearly highlighted potential risk with the appropriate mitigations in place. Regular environmental and equipment audits identified potential areas of concern, and an appropriate action plan was put in place to address these. Regular cleaning audits were completed, any issues found were resolved.

Patients felt the service had plenty of well trained staff available, who they could approach at any time if they needed to. One patient told us “There’s always plenty of staff available for me and I never have to wait for anything, they’re amazing”

The service was rarely short staffed and always had enough team members to care for and to meet the patient’s needs. Managers increased staffing numbers at short notice, if patient needs changed. The service used regular internal bank or agency staff when required. These staff were familiar with the ward and patients. Staff completed comprehensive mandatory training.

Managers monitored the acuity of the patient needs within the service and then aligned the numbers of staff to it. This ensured that patients had their needs met even when their needs changed. Managers monitored staffs' compliance with mandatory training to ensure they had the required skills to meet the patients’ needs. At the time of the assessment 98% had completed the required training.

Patients did not raise any concerns around infection, prevention and control during this assessment.

Staff knew what actions to take if there were any concerns with infection control, including if there was an outbreak. They knew what actions to take to protect themselves, patients and visitors to the service.

The environment and equipment were clean, tidy and well maintained. Cleaning stations were situated around the ward. The sluice rooms were clean and in a good working order. Regular hand washing, and changes of personal protective equipment (PPE) were observed between interactions with different patients.

There were processes in place which worked well, and ensured that the environment, and equipment was clean, maintained, and audited regularly to ensure they were safe for use. The service involved people in identifying and managing risks relating to infection and hygiene, people were encouraged to report any concerns regarding the environment. Concerns raised were addressed, this promoted awareness and independence.

Patients and their families received information about their medicines, and if they did not understand the information, staff explained it to them. Patients, and their families were encouraged and supported to attend their multi-disciplinary team meetings where medicines and any changes to medicines were discussed.

Staff adhered to the services medicines management policy. They had defined roles, which promoted and maintained accountability. Staff completed medicines reconciliation. When required staff completed physical nursing observations due to the medicines patients were prescribed. Medicines were reviewed on a regular basis.

All clinic rooms and medicines fridges were clean, and well organised. Staff had access to all appropriate equipment. Medicines were stored, managed and dispensed in line with national guidance including the management of controlled medicines. Staff had access to relevant patient medicines documentation, including information on patient allergies.

There were processes in place that ensured staff completed audits to ensure that medicines management was in line with policy. No issues were found in dispensing, administering and reconciliation of medication.