Shipston Home Nursing CIO

Updated 27 November 2019

Shipston Home Nursing is operated by Shipston Home Nursing CIO. The service opened in 1997. It is a registered local charity in Shipston on Stour, Warwickshire. The service primarily serves the communities of Shipston on Stour,Wellesbourne, Kineton and surrounding villages. It supports people aged 18 and above with incurable (terminal) illnesses who wish to be cared for in their own homes.

The service has had a registered manager in post since April 2019. 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 executive director and nominated individual were supported by a team of registered general nurses specialising in palliative care and a team of health care assistants. The team of staff worked closely with local GP's, district nurse teams and staff from a variety of organisations.

The service provided free of charge care thanks to supporters, donors and fundraising. In addition, the service received a grant from the NHS, which funded approximately 8% of their annual running costs.

We reviewed information we held about the service, including any notifications we had received from the provider. We asked the provider to complete a provider information return (PIR). A PIR is a form which asks the provider to give some key information about their service; how it is addressing the five questions and what improvements they plan to make. We used their comments to support our planning of the inspection.

We spoke with four patients and five family members/carers who used the service. We also spoke with seven members of staff. We looked at a range of records, which included the care records for five people who used the service. We saw health and safety information and other documents relating to the management of the service.

Updated 27 November 2019

Shipston Home Nursing (SHN) is operated by Shipston Home Nursing CIO. SHN provides end of life nursing care and bereavement services to patients in Shipston on Stour,Wellesbourne, Kineton and surrounding villages.

We inspected this service using our comprehensive inspection methodology. We carried out an unannounced visit on 28 August and 25 September 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.

The main service provided by this service was end of life care services for adults.

Services we rate

This was the first inspection of SHN. We rated this service as good overall.

We found good practice in relation to end of life care:

• Staff kept patients safe from avoidable harm and abuse. Risks were assessed, monitored and managed appropriately.

• Staff used safe working practices and followed risk assessments when providing care and support for people.

• Patients care, and treatment records were clearly detailed and accurate in content. They were stored securely and managed safely.

• Staff had the appropriate skills, training, knowledge and experience to deliver effective care and treatment. Care and treatment was delivered in line with evidence-based practice.

• People told us that staff were caring, supportive and respectful.

• The services provided aimed to meet the needs of people from their whole community, and the needs of the population served, which ensured flexibility, choice and continuity of care.

• Staff worked closely with hospitals, community organisations and health and social care professionals to help ensure people received the right care at the right time.

• People made decisions about the care and support they received. Care was person centred.

• The service was delivered and co-ordinated to be accessible and responsive to people with complex needs.

• Staff showed an encouraging, sensitive and supportive attitude to people who use services and those close to them.

• Leaders had the skills and abilities to run the service. They understood and managed the priorities and issues the service faced.

• Leaders were visible and approachable in the service for patients and staff.

• There was a strong emphasis on the safety and well-being of staff. Lone working policies were in date and appropriate.

We found areas of practice that require improvement in services for end of life care:

• At the time of our inspection, the service did not have a robust process in place to monitor audits.

Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Heidi Smoult

Deputy Chief Inspector of Hospitals (Midlands)

Updated 27 November 2019

Shipston Home Nursing provides hospice care for patients in their own homes throughout the last days of their lives. We rated the service as good because staff used safe working practices and followed risk assessments when providing care and support for people. Staff were competent in their roles. They were caring, supportive and planned and delivered care according to individual patient needs. They worked in close collaboration with other healthcare providers to ensure people received the right care at the right time.