14 December 2016
During a routine inspection
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.