Background to this inspection
Updated
21 August 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection team consisted of one inspector, one assistant inspector and a specialist advisor. The specialist advisor had extensive experience of working in the field of palliative and end of life care.
Service and service type
This service is a domiciliary care agency. It provides personal and nursing care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 72 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 2 July 2019 and ended on 5 July 2019. We visited the office location on 2 July 2019.
What we did before the inspection
We reviewed information we had received about the service. We used this information to plan our inspection.
The provider was asked to complete a provider information return (PIR) prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. This information helps support our inspections. The deadline for submission of the PIR was shortly after the date of our inspection. We took this into account when we inspected the service and reviewed the PIR following our inspection..
During the inspection
We spoke with five people who used the service and two relatives about their experience of the care provided. We spoke with 12 members of staff including the registered manager, head of community services, Hospice at Home and RADS manager and the quality audit and training coordinator.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We also reviewed feedback we had received from nine professionals about their experience of the service.
Updated
21 August 2019
About the service
Hospice at Home is based at St Luke’s Hospice and provides adult palliative care and specialist care. The service supports individuals in their wish to be cared for at home, facilitates rapid discharge from hospital and avoids unwanted hospital admission. At the time of our inspection, 34 people were accessing the service.
People’s experience of using this service and what we found
People received exceptionally good palliative and end of life care and practical support, advice and emotional care from a dedicated staff team who were well trained and placed people and their families at the heart of the service. This support was also extended to people’s families.
People and relatives were extremely complimentary about the service. People and relatives thought of their carers as being like family members and told us they were highly compassionate and caring and treated them with the utmost respect.
Staff were highly motivated, felt valued and enjoyed working at the service. They were passionate about providing outstanding person-centred care to people when they needed it. A holistic approach was taken to assessing, planning and delivering care and support. People were fully involved in how their care was to be provided.
The service had forged strong links with other professionals and worked collaboratively with them to ensure people’s needs were met in a timely way and to ensure continuous improvements in end of life care. Feedback received from professionals was exceptional. One professional said, “The service is outstanding, demonstrating commendable resilience, responsiveness and commitment to all service users, patients, carers, families, and bereaved people, but also to St Luke’s as a partner organisation. The team, from managers to admin support to nurses and carers, are genuine and dedicated. They show high levels of empathy, courage and caring in the face of a difficult and often emotive job/service.”
Staff were safely recruited and well trained. The service had a rapid response team to enable them to respond quickly to any deterioration in people’s health.
People were supported safely, and risks regarding their care were assessed and managed. Staff were aware of how to report any concerns about neglect or abuse and were confident they would be addressed.
Where required people were supported to take their medicines by staff who had been trained and assessed as competent.
Senior management were praised by staff, professionals and people receiving a service for their commitment and passion for care. The service’s visions and values were fully embraced by staff and senior management promoted a culture which was open and inclusive. Staff were aware of their roles and responsibilities and told us and they felt listened to. They also said the management team were caring and supportive.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Effective systems were in place to monitor and respond to any concerns.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 17/08/2018 and this is the first inspection.
Why we inspected
This was a planned inspection.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.