St Richard's Hospice

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

The effective key question remains rated as good. The service demonstrated it how it monitored and improved outcomes for patients.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

Relatives of patients told us that their loved ones needs were holistically considered and that staff were very keen to regularly check with patients and relatives how care and treatment provided was. We saw that all patients and loved ones were sent a letter after 6 weeks on being in the in-patient unit encouraging them to tell the service how it felt to be cared or supported by the service. The service used the Integrated Palliative care Outcome Scale (IPOS) as a measure of symptoms and concerns which matter to patients therefore helping staff provide the best patient experience. In addition, the service used Goal Attainment Score (GAS) to ensure patients had achieved desired goals.

Staff told us how managers completed audits to monitor and improve upon outcomes. Staff gave examples of actions, good practice and learning being shared with them. These included, steroid audit, opioid toxicity monitoring audit, consent, mouthcare and pressure ulcer audits. A virtual reality audit and evaluation presentation by the service demonstrated plans for the service to support in the research of virtual reality to support palliative care and treatment. We saw feedback to staff about good mouthcare, prescribing and documentation and we also saw emails with information to staff about falls procedures. Staff attended daily huddles where key messages could be shared and a monthly team meeting was held. Also the service shared a weekly email to all staff and had a clinical governance newsletter that went to clinical staff in addition to the weekly brief. This enabled the quality lead to communicate learning from audits, complaints and feedback, and share good practice and feedback from patient safety incidents. Three members of staff were doing an apprenticeship to support the consolidation of a data hub. This meant the service was better able to monitor and report on patient outcomes at a patient, and organizational level.

The service monitored its performance and benchmarked itself against other hospice providers. Data included number of admissions, deaths and discharges, percentage occupancy and length of stay as well as average Waterlow score on admission, number of medication errors per 1000 bed days and the number of slips trips and falls were all monitored and benchmarked at clinical quality and management meetings. A monthly action log from mortality meetings was created, with progress monitored through the clinical quality management review meetings. Audit and evaluation group meetings from January 2024 demonstrated that next of kin, sub cutaneous medicine administration and transcribing audits were presented to the group whilst the National Institute for Health and Care Excellence guidelines for coronary obstructive pulmonary disease, spinal compression and oesopaho-gastric cancer management were reviewed. The service audited care provision in terms of meeting people's individual needs. To support this, electronic patient notes captured details of patients' protected characteristics and communication needs.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.