6 and 8 March 2019
During a routine inspection
St Giles Hospice - Walsall is operated by St Giles Hospice Group and opened in March 2011.
The hospice at Walsall offers the following services:
- 12 inpatient beds for specialist palliative care needs.
- A ‘Hospice at Home’ service. This is led by a registered nurse and a team of health care assistants, who provide practical and emotional care in the home for patients in approximately the last two weeks of life.
All other services such as, spiritual support, complementary therapy, allied health professionals and community palliative care services were provided by a local NHS Trust.
Furthermore, all back office, education and governance structures were supported from a sister site organisation.
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 6 - 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 hospice service improved. We rated it as Outstanding overall.
Areas of outstanding practice
- People’s individual needs and preferences were central to the delivery of tailored services. There were innovative approaches to providing integrated person-centred pathways of care that involved other service providers, particularly for people with multiple and complex needs. The service made extensive efforts to meet patients and family’s individual needs. 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 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.
- 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 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.
- Services were developed with the full participation of those who used them. The service took a leadership role in its health system to identify and proactively address challenges and meet the needs of the population.
- Staff displayed determination and creativity to overcome obstacles to delivering care. 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.
- 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.
We found areas of good practice:
- 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.
- The service provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance.
- 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 services provided reflected the needs of the population served and they ensured flexibility, choice and continuity of care. The facilities and premises were appropriate for the services that were delivered.
- Managers at all levels in the service had the right skills and abilities to run a service providing high-quality sustainable care.
- 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.
However:
- The provider should ensure that allergies were recorded on the main treatment and prescription charts for all patients.
Heidi Smoult