We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
We undertook an inspection on 13 and 14 August 2014 to Trinity Hospice. The first day of the inspection was unannounced and we informed the registered manager that we would be returning on the second day to complete our inspection.
Trinity Hospice provides care and treatment for people with long term, chronic or terminal illness. The service supports people in their own homes, through an outpatient service and at an inpatient centre in Clapham, South London. At the time of our inspection the service was supporting 495 people. The inpatient service can accommodate up to 28 people. At the time of our inspection 15 people were using the inpatient service. At the time of our inspection many of the people using the service were too unwell to speak with us and were being supported with their end of life care.
At our last inspection on 20 January 2014 the service met the regulations inspected.
The service’s registered manager was their inpatient service manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
Processes were in place to identify any risks to people who used the service and preventative measures were put in place to keep people safe and free from harm. One to one nursing was provided to further support people and maintain their safety when required. Staffing numbers were regularly reviewed and adjusted according to the needs of people using the service.
Assessments were undertaken to identify people’s physical, social and psychological needs and these were reviewed regularly to ensure they were in line with people’s current care, treatment and support needs. When required referrals were made to healthcare professionals to access specialist care that was not available at the service. People were transferred to hospital for further treatment in line with their wishes and preferences. People were able to have a dignified and pain free death.
People were involved in decisions about their care, and the service was responsive to their requests and individual requirements. People’s religious, cultural and spiritual needs were met.
People’s privacy and dignity was maintained and the staff ensured information was kept confidential and conversations could not be overheard.
Medicines were managed safely. The service was clean and there were processes to protect people from the risk of development and spread of infections.
Staff were aware of what to do if they suspected someone was at risk of abuse and followed safeguarding adults and children procedures. Staff were aware of their requirements under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff had the skills and knowledge to support people using the service. Training needs were regularly reviewed and staff passed competency tests before being able to undertake any tasks unsupervised. Systems were in place to support staff and reflect on practice and service delivery.
The service regularly reviewed their performance and where further improvements were identified appropriate actions were taken. The service had systems for obtaining the views of people who used the service and there were processes in place to respond to and investigate complaints.
The service followed best practice guidance and were working with other health care providers to share and develop good practice.