St Giles Hospice - Whittington

Updated 15 January 2020

St Giles Hospice - Whittington is operated by St Giles Hospice. The hospice opened in 1983. It is a private hospice in Lichfield, Staffordshire. The hospice has a registered manager. The hospice primarily serves the communities of the Staffordshire and North Birmingham. It also accepts patient referrals from outside this area.

Updated 15 January 2020

St Giles Hospice - Whittington is operated by St Giles Hospice and opened in Whittington in 1983. The hospice/service provides care for adults and has 25 beds.

The hospice at Whittington offers the following services:

25 inpatient beds – 19 for specialist palliative care needs and six for patient’s funded by fast track continuing healthcare funding who are less complex in terms of their end of life care needs and who would not usually therefore meet the criteria for specialist care.

Community team – a registered nursing workforce structured around localities which includes advanced nurse practitioners, clinical nurse specialists and staff nurses.

Hospice at home – led by a registered nurse this team of health care assistants provide practical and emotional care in the home for patients in approximately the last two weeks of life.

Care at home – a small team of carers who can provide up to four double up social care packages for people in receipt of fast track continuing healthcare funding.

Day hospice – patients attend for one day per week for eight or 12 weeks. Service operates four days per week. They work with their nominated nurse on personal goal setting and advance care planning as well as benefitting from peer support and reduction in social isolation. There is access to seated exercise and complementary therapy.

Wellbeing day – One day per week ‘step in’ or ‘step out’ service for people to find out more about services, seek advice or information, attend seated exercise or access complementary therapy; benefit from peer support.

Family support and bereavement - pre and post bereavement support offered at a variety of levels of intervention, either on a one to one basis, group or family based.

Advice and referral centre operates 24 hours a day seven days a week, advice for any professionals, patients known to St Giles Hospice or members of the public. Receives and triages referrals including speaking directly with person referred.

Supportive care – broad based team operating internally and externally that includes allied health care professionals; complementary therapy; community engagement and development work.

Lymphoedema - clinic service providing assessment and treatment for all forms of primary and secondary lymphoedema for both adults and children.

Phoenix service - bereavement service developed by and for young people experiencing bereavement and open to anyone across our catchment.

Specialist women’s cancer support service.

Care home Service - a fully commissioned service which supports individual care homes develop and maintain their end of life care registers and proactively plan and manage end of life care for their residents.

In May 2017, the hospice provider launched its new five-year strategy and as part of this underwent a re-brand.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 7 and 8 March 2019.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Services we rate

Our rating of this service improved. We rated it as Outstanding overall.

We found areas of outstanding practice:

• There was strong collaboration, team-working and support across all functions and a common focus on improving the quality and sustainability of care and people’s experiences. The service took a leadership role in its health system to identify and proactively address challenges and meet the needs of the population. Services were developed with the full participation of those who used them.
• There was an embedded and extensive team of volunteers who helped support the service. There was a volunteer strategy, a volunteer induction and training programme. Volunteers were proactively recruited, valued staff who were supported in their role in the same manner as substantive staff. The service regularly updated its policies and processes for using volunteers and innovative practice, and the use of volunteers helped to measurably improve outcomes for people.
• Staff cared for patients with compassion. Feedback from patients confirmed that staff treated them well and with kindness. People who used the service told that staff went over and above what was expected of them. Staff displayed determination and creativity to overcome obstacles to delivering care.

• There were consistently high levels of constructive engagement with staff and people who used services. Rigorous and constructive challenge from people who used services, the public and stakeholders was welcomed and seen as a vital way of holding services to account.

• There was compassionate, inclusive and effective leadership at all levels. Leaders demonstrated the high levels of experience, capacity and capability needed to deliver excellent and sustainable care. There was a deeply embedded system of leadership development.
• There was a commitment to continuing development of the staff’s skills, competence and knowledge. This was recognised as being integral to ensuring high-quality care. Staff were proactively supported and encouraged to acquire new skills, use their transferable skills, and share best practice. The service also used objective structured clinical examinations (OSCE) to assess staff competence in a live manner.

We found good practice:

• The service provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance. There was a holistic approach to assessing, planning and delivering care and treatment to all people who used services. This included addressing, where relevant, nutrition, hydration and pain relief needs.
• Managers at all levels in the service had the right skills and abilities to run a service providing high-quality sustainable care.
• Staff of different kinds worked together as a team to benefit patients. Doctors, nurses and other healthcare professionals supported each other to provide good care.
• The service planned and provided services in a way that met the needs of local people. The facilities and premises were appropriate for the services that were delivered. The services provided reflected the needs of the population served and they ensured flexibility, choice and continuity of care. For example, services for children, young people and their families that allowed them to undertake activities together. There was extensive ongoing support and follow-on family support groups specifically for children and young people after they had suffered a bereavement. There was also a service that worked with local schools to support young people.
• In April 2018, following some building reconfiguration, six continuing healthcare beds were opened, operating on a different referral and care model to the remaining 19 specialist beds. This widened access to people who previously would not have been eligible for a specialist hospice bed.
• People who used the service were encouraged to contribute to improvements and developments to ensure the service was a reflection of the people who used it.
• Staff felt positive and proud to work in the organisation. The culture centred on the needs and experience of people who used services. Staff told us that they felt pride in the organisation and the work they carried out to ensure patients received good quality care.
• The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment. Staff had access to a robust training and competency programme to ensure they had the skills required to provide good quality care. Staff were supported and encouraged in their development and there lots of examples of career progression and gaining accredited qualifications.

However:

• The provider should ensure that allergies were recorded on the main treatment and prescription charts for all patients.

Heidi Smoult

Deputy Chief Inspector of Hospitals

Updated 15 January 2020

St Giles Hospice - Whittington provided hospice care to adults through inpatient, day hospice and community services.

We rated the service outstanding overall because the service was outstanding in caring and well led.