East Cheshire Hospice

Updated 15 June 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.

A visit to the hospice was made on 17 March 2016 and was unannounced.

The inspection team consisted of one social care inspector.

Before the inspection we checked the information we held about the service and the service provider, and spoke with the local authority. No concerns had been raised and the service met the regulations we inspected against at their last inspection which took place on 08 November 2013

We spoke with four patients who were staying in the inpatients unit. Two relatives were also spoken with during our visit.

We also spoke with the registered manager, a consultant, matron, clinical lead for inpatient unit, three registered nurses, an advanced nurse practitioner and the art therapist. We also spoke with the chef, the learning and development co-ordinator and governance co-ordinator.

We looked at all areas of the hospice, for example we viewed lounges, bedrooms and communal bathroom/shower rooms.

A range of documentation was looked, which included four care records, four staff files, medication records and audits of accidents and incidents in the hospice and records concerning the monitoring and safety and quality of the service. We observed the administration of medicines.

We sampled the hospices’ policies and procedures which were up to date and available for all staff via their intranet.

Updated 15 June 2016

The East Cheshire Hospice is located in a residential area close to the centre of Macclesfield from where it provides care for adults suffering from life limiting illnesses. There are fifteen inpatient beds as well as a day care centre supporting people to continue to live in their own home. The hospice is staffed by doctors, nurses, other health professionals and support staff as well as volunteers. The services provided include counselling and bereavement support; a Lymphoedema service (for people who experience swellings and inflammations); an outpatient clinic; occupational and art therapy, physiotherapy, chaplaincy and volunteer services. Services are free to people and the Hospice is largely dependent on donations and fund-raising by volunteers in the community.

This inspection was carried out on 17 March 2016 by one adult social care inspector. It was an unannounced inspection. There were 12 inpatients at the hospice on the day of our visit.

There was a manager in post who was registered with the Care Quality Commission (CQC). 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. The registered manager was also the director of care and operational services and oversaw the running of the service.

East Cheshire Hospice had caring and positive staff who said that patients were at the heart of the service and were fully involved in the planning and review of their care, treatment and support.

Plans in regard to all aspects of their medical, emotional and spiritual needs were personalised and written in partnership with people. Staff delivered support to patients according to their individual plans.

Staff had received training with regard to protecting patients from abuse and harm. They knew how to recognise signs of abuse and how to raise an alert if they had any concerns.

We saw risk assessments which were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or make sure patients were protected from harm.

Accidents and incidents were recorded and monitored so that risks of recurrence could be reduced.

There were sufficient staff on duty to meet patient’s needs. Staffing levels were calculated and adjusted according to patient’s changing needs.

There were thorough recruitment procedures in place which included the checking of references.

Staff were enthusiastic about the care they gave and said that patients were at the heart of East Cheshire Hospice and it was important to treat each person as an individual.

Patients were treated with dignity and respect and cared for by staff who knew and understood their needs. Patients and their relatives were involved in making decisions about their care and

support.

Families and friends were supported by trained bereavement councillors and all staff at the hospice.

We saw warm, caring, respectful relationships between patients and staff during our inspection.

Staff had received essential training including end of life care and were scheduled for refresher courses. Staff had received further training specific to the needs of the people they supported.

All members of care and support staff received regular one to one or group supervision and an annual appraisal. This ensured they were supported to work to the expected standards.

Clear information about the service, the facilities, and how to complain was provided to patients and visitors.

Medication was managed safely and processes in place ensured the handling and administration of medication was safe, secure and that patients received medicines when they were prescribed.

Patients were supported to make decisions about their life and treatment plans. Staff were knowledgeable about the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Capacity assessments had been carried out when required.

All of the food was freshly prepared, including home-made cakes, biscuits and ice cream. Patients were supported to eat and drink when required. Patients could ask for what they wanted to eat at any time.

The hospice has a dementia carer well-being programme to support carers of people living with dementia in the local community.

We saw that effective quality monitoring systems were in place. A variety of audits were carried out and used to drive improvements.