Archived: Lewis-Manning Hospice

Updated 15 February 2017

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 14 and 16 December 2016 and was unannounced on the first date. There was a lead inspector, a pharmacist inspector, a hospice care specialist advisor and an expert by experience in the inspection team. An expert by experience is a person who has had a family who has used this type of service in the past.

We spoke with 11 people attending the day services over the two day inspection, one bereaved relative who was also a volunteer, 10 staff including the registered manager, operations manager medical director and nursing, healthcare, catering and medical staff. We observed the morning handover on the second day of inspection.

We reviewed four people's care records, eight people’s medication records, four staff files and records relating to the management of the service, such as health and safety monitoring and quality audits. In addition we reviewed the policies and procedures in place in preparation for the in-patient unit that was planning to open during December 2016.

Before our inspection, we reviewed all the information we held about the service. This included the information about incidents the registered manager notified us of. In August 2016 the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We contacted a commissioner prior to the inspection and sought the views of 15 professionals involved in the service following the inspection. We received feedback from five health care professionals.

Following the inspection the provider sent us their improvement and development plan.

Updated 15 February 2017

This unannounced comprehensive inspection took place on 14 and 16 December 2016. At the last inspection completed in November 2013 we found the provider had met all the regulations we reviewed.

Lewis-Manning Hospice provides day services for up to 15 people a day, who are living with long term conditions and/or a diagnosis of cancer. They provide people with one day a week programme for 12 or 16 weeks dependent on the person’s medical condition. In addition, the hospice offers ‘better breathing’ and ‘lymphoedema’ clinics and support programmes for people with head and neck and ovarian cancers. The hospice also has a purpose built in patient unit but this was not yet operational at the time of the inspection.

There was a registered manager in post who was also the chief executive. 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.

Staff had an understanding of The Mental Capacity Act 2005 and made sure people gave their consent before providing any care and support. However, people’s consent was not recorded for staff to administer their medicines and this was an area for improvement.

People received care and support in a personalised way. Staff knew people well and understood their needs. People’s care needs were assessed and planned for. However, there was not a consistent way to review outcomes, achievements or goals at a point when action could have been taken to address this. The management team confirmed that immediate action would be taken to review and address this.

Staff were caring and treated people with dignity and respect. People and staff had good relationships and they were relaxed and comfortable with staff. People participated in individual and group activities and therapies during their visit to the day hospice.

People felt safe whilst at the day hospice. Staff had received training to enable them to recognise signs and symptoms of abuse and how to report any concerns. Risks to people’s safety were assessed and managed so that people could be as independent as possible. The building and equipment people used was regularly serviced and well maintained.

Most people managed their own medicines. The medicines that staff administered were administered, managed safely and stored securely. People received their medicines as prescribed.

People told us there were always staff available to help them when they needed support and they were supported promptly by staff who were friendly and caring.

Staff received an induction, core training and specialist training specific to their roles so they had the skills and knowledge to meet people’s needs. Staff were recruited safely. There were plans to provide training for the volunteers at the service.

People told us they enjoyed the food at the day hospice. Specialist diets were catered for and people were able to make choices about the food and drink they had. Staff and volunteers supported people sensitively with their meals and drinks.

The culture within the service was open. There was a clear management structure and people and staff felt comfortable raising any issues. There were systems in place to monitor and drive improvements in the safety and quality of the service provided. However, some of the quality audits had not been completed but plans were already in place to address this. The management team acknowledged and took immediate action on any areas for improvement identified during the inspection.