Ashgate Hospice

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We found the care and treatment provided by the service was effective. The correct processes, equipment and assessments were in place. Care and treatment provided was evidence based, measurable, and monitored for outcomes, which enabled continuous improvement.

Processes and training were in place to support staff to fulfil their roles and responsibilities. Patients and their families were encouraged to be involved in their care assessments and plans which maintained a person-centred approach. Staff demonstrated a good understanding around the importance of capacity to consent. Correct processes and assessments were in place to safeguard the patient and their interests. Patients were supported if they had communication needs and had access to internal and external resources to help capture their voice. Complimentary therapies were available to patients and their families.

This service scored 100 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff treated patients as individuals, and involved them and their families in care, and treatment decisions. They were invited to attend care and treatment reviews. Patients were involved, listened to, and everyone involved worked well together.

Staff prided themselves on having an excellent approach to care and assessing the needs of the patients and their families. Staff encouraged and supported patients and their families to be involved in their care planning and assessments. They understood and valued the patients voice, ensuring excellent quality person-centred care and support, which was tailored to suit individual needs. Care plans were comprehensive, personalised, and captured the voice of the patient.

Processes enabled a truly holistic approach to assessing needs, planning and delivering care and treatment to all patients who used the service. This included addressing, where relevant, their nutrition, hydration and pain relief needs. Clear processes were in place to complete admission assessments and ensure care plans were person centred, kept up to date, and reviewed regularly within multidisciplinary team meetings.

Patients spoke to staff about their care and treatment. Different evidenced based treatment options and complementary therapies were discussed. For example, massages and reflexology which were helpful in treating symptoms of pain or side effects of treatment.

Staff supported patients to understand their treatment and had good knowledge of the communication resources, and options available to them. We reviewed 8 care plans and found they had been written in line with evidence based good practice, for example, medication was prescribed in line with NICE guidance. Complementary therapies were offered which supported their treatment and complimented it in a variety of ways for example, audio relaxation, massage, and reflexology.

We reviewed the services policies and found legislation and best practice sited within them. Treatment was provided in line with legislation and best practice, the service worked closely with recognised organisations, and collaboratively with over 40 other hospice care providers. The service adhered to guidance set by the National Institute for Health and Care Excellence (NICE).

Patients care was well coordinated, and everyone involved in their care worked well together. One family member told us “Can't fault them. Fantastic. When I have a problem because my wife is at home, they are my back up, they talk me through things, so I understand. There is nothing they can do better”.

The service worked well with external partners involved in patients care, supporting local General Practitioners (GP), Pharmacies, and the County Council when sourcing appropriate beds for patients in local Nursing homes before being discharged.

Staff at the service were welcoming and kind when they worked with partners, patients, and their families. The service was open, honest, and transparent, and inclusive of partners. The service utilised the knowledge and expertise of partners and worked collaboratively with them.

Staff had meaningful engagement with patients, their families and external partners who had attended for a multi-disciplinary team meeting review, where information was shared and next steps discussed regarding the transition of care and treatment.

External partners were invited to care and treatment reviews, ensuring continuity of care, treatment, and support for the patients and their families. Within these meetings all information was shared in order for the service and external agencies to work together to support people effectively. There was a thorough approach to planning and coordinating people’s move to other services, which is done at the earliest possible stage. Arrangements fully reflect individual circumstances and preferences.

Patients were supported on how to stay as well as possible. Staff supported them to monitor their health and carried out assessments with them if needed. They had excellent and varied meal choices, and healthy options were encouraged and promoted. Patients could access complementary therapies which promoted good physical and mental health and wellbeing.

Staff supported patients to live healthier lives and encouraged patients where appropriate to participate in complimentary therapies, which supported them alongside their treatments. Patients had healthy nutritional options, these were encouraged and promoted. Groups were provided with the day care service which promoted physical activities and were adapted to suit the mobility needs of the patient, chair-based activities were available.

If required, staff referred patients to specialist services in order to meet their needs. We found evidence in patients notes that staff had referred patients to the following services, psychology, physiotherapy, occupational therapy.

Patients we spoke with told us their health and wellbeing were checked regularly and monitored throughout the day, and night when necessary.

Staff adhered to legislation and good practice guidance. Treatment and assessments were evidence based and monitored for outcomes. Staff continually monitored and assessed the patient’s needs. Changes to treatment and support were discussed and made if needed to benefit and drive improvement for people using the service. Lessons were learned from both positive and negative occurrences, and were shared to help improve the service, what it offered, and the way it was delivered.

All staff were actively engaged in activities to monitor and improve quality and outcomes. This included, where appropriate, monitoring outcomes for people once they had transferred to other services. The service had end of life facilitators who worked closely with local care homes to support them with patient care, and to deliver training to their staff. Opportunities to participate in benchmarking and peer reviews were proactively pursued. The service participates in national clinical benchmarking schemes for hospice care. High performance was recognised by credible external bodies, as the service submits a commissioning statement to the commissioning body.

Patients were always asked for their consent to care and treatment. Where patients did not have capacity to make decisions, the appropriate assessments were completed. Some patients had advanced care plans (ACP) in place, which meant their care and treatment was provided in the way they wanted, and ensured their needs were met.

Staff adhered to the Mental Capacity Act 2005. They always sought consent from the patients using the service and also utilised the support of advocacy services where appropriate. If capacity to consent was in question, staff carried out the required assessment and documented the outcome in the patients care record. Advanced care plans were always referenced and adhered to when required.

Processes were in place to monitor and review the application and adherence to the Mental Capacity Act, this was audited internally to ensure compliance. Engagement with stakeholders, including people who used the service and their families, informed the development of tools and support to help people give informed consent.