North London Hospice Day Care Service

Updated 3 November 2016

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 22, 23, 24 and 25 August 2016 and was announced. We gave 48 hour’s notice of the inspection due to the complexity of the service. The inspection team consisted of a lead inspector, a specialist professional advisor, another inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of service.

Before our inspection, we asked the provider to complete a Provider Information Return (PIR). The PIR 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 reviewed the information we held about the service. We also received feedback from two external palliative care professionals, Enfield Healthwatch and one commissioning officer.

During the course of the inspection we spoke, either in person or on the telephone, with 15 people who used the service and two relatives. We also spoke with 20 members of staff and two volunteers. This included the chief executive, chair of board of trustees, registered manager, directors of patient services and quality and care, practice educator, associate director of community services and a psychologist. We spent time in the outpatients service, observing care and support. We joined two multi-disciplinary meetings and met with the outpatients and specialist community teams.

We looked at six people’s care records and other records relating to the management of the hospice. This included nine staff recruitment records. We also looked at duty rosters, accident and incident reports, complaints, compliments and health and safety records.

Updated 3 November 2016

This inspection took place in 22, 23, 24 and 25 August 2016 and was announced. When we last visited the hospice on November 2013 we found the service met all the regulations we looked at.

North London Hospice Day Care Services provides a range of outpatient therapeutic and community based services for adults with life limiting illnesses and specialist palliative care needs who are residents of Barnet, Enfield and Haringey. At the time of the inspection there were 100 people using the outpatient services and 200 people were using the community service.

The hospice had a registered manager. 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.

People were supported to make choices about how their needs were met. People and relatives were involved in decisions about their care. Where people were unable to make decisions about their care best interests decisions were made on their behalf.

People were kept safe. Risks to people were identified and staff took action to reduce those risks. Staff were available and had the necessary training to meet people's needs. Staff responded to people’s needs promptly.

There were systems in place to ensure that people consistently received their medicines safely, and as prescribed.

People were supported effectively with their health needs.

Care was planned and delivered in ways that enhanced people’s safety and welfare according to their needs and preferences. Staff understood people’s preferences, likes and dislikes regarding their care and support needs.

People who used the outpatients service were provided with a choice of food, and were supported to eat when this was needed. There was a strong emphasis on the importance of good nutrition and hydration and a commitment to providing people with what they wanted to eat and drink in a flexible manner.

People and their relatives told us that staff were caring, kind and compassionate. The hospice provided people with multi-professional and person centred care that helped to ensure their physical, emotional, psychological, spiritual and social needs were met.

People were treated with dignity and respect. People and relatives told us they consistently received care that met their individual needs.

There was an accessible complaints policy which the registered manager followed when complaints were made to ensure they were investigated and responded to appropriately.

People using the service, relatives and staff said the registered manager was approachable and supportive. Systems were in place to monitor the quality of the service and people and their relatives felt confident to express any concerns, so these could be addressed.