Lindsey Lodge Hospice

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We assessed 3 quality statements in the safe key question and found areas of good practice. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good. Lindsey Lodge Hospice worked with people and their partners to establish and maintain safe systems of care, in which safety is managed, monitored, and assured. They ensured continuity of care, including when people moved between different services. Lindsey Lodge Hospice made sure there were enough qualified, skilled, and experienced people, who received effective support, supervision, and development. They worked together effectively to provide safe care that met people’s individual needs. Lindsey Lodge Hospice made sure that medicines and treatments were safe and met people’s needs, capacities, and preferences by enabling them to be involved in planning, including when changes happened.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

The service obtained feedback about people’s experience after admission. Feedback was reviewed and the responses were positive. Senior leaders stated that they had only one complaint in the year prior to assessment. The hospice provided resources for patients with breathing problems. The hospice provided resources for patients with fatigue and breathlessness, lymphoedema and offered a 5 day Wellbeing service (outpatient focused) for those with life limiting conditions and those nearing the end of their lives. Patients and their families we spoke with confirmed they saw the same people for their care and they were reliable, knowledgeable and caring.

Staff followed hospice guidelines on how to identify and report incidents. The service used an online incident reporting system. Staff told us that they had received feedback when they reported incidents. Policies and procedures were held digitally and staff knew how to access these. Staff described positive working relationships with consultants and told us they were readily available for support. The hospice usually had a consultant in-house Monday to Friday, and they were also available every day via telephone support. Similarly, leaders described positive relationship with partners which included the Integrated Care Board (ICB), social care, community nursing teams and the local acute trust.

The hospice worked with external partners to ensure continuity of care, including when people moved between different services. This included the ICB, social care, community nursing teams and the local acute trust. The hospice shared their quarterly quality reports with the ICB. Staff described a collaborative environment where people felt empowered to raise concerns and contribute to providing better care. Additionally, the hospice was part of a regional hospice collaborative network. The hospice partnered with NHS palliative care teams in hospitals and the community, offering specialised services and support. The service worked well with partners such as the local trust, GP’s, the ICB and district nursing teams. There were daily meetings between the local trust and the service to discuss the care plans of patients.

There was a fast-track system used for urgent and end-of-life referrals. Staff used a scoring tool to assess the urgency of referrals. They had an electronic dashboard that was used to monitor need and gave oversight of care needs. The service managed safety well. The inpatient unit used a tool that measured the acuity of its service users to ensure that the unit was adequately staffed and only admitted patients when it was safe to do so. The hospice used a web-based risk management system for incident reporting. This system allowed staff to respond to issues such as safety alerts issued about medicines and to link incidents together. Data relating to incidents and their actions was provided to staff and volunteers via a bulletin. The quarterly quality assurance subcommittee escalated actions, themes and trends to the board. Patients and families were able to access advice, care and information via the ‘Butterfly’ line. This telephone number was made available to patients, families and friends giving them access to a senior member of the nursing team 24 hours a day. This initiative helped with admission avoidance, which supported people to remain at home, rather than admission to an inpatient bed, and meant that patients could contact staff when the usual daily resources were not available to them. Senior Leaders acted to drive improvements for the service.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

Patients and their families we spoke with confirmed the staff were reliable and knowledgeable. Many compliments were received in the 12 months prior to inspection. Feedback used such words as excellent care and guidance, exemplary, understanding, compassionate, dignity, in safe hands.

There were enough qualified, skilled and experienced staff. Staff said they worked together to ensure they provided safe care that met people's individual needs. All senior leaders could explain the principles of safer staffing.

There were enough qualified, skilled and experienced staff. The hospice had robust and safe recruitment practices to make sure all staff were suitably experienced, competent and able to carry out their roles. Staff received the support they needed to deliver safe care which included supervision, appraisals and support to develop their skills. There was a clear performance management system. Mandatory training compliance was 100% for clinical staff. Managers were able to demonstrate how they ensured all staff received appropriate training. Managers regularly reviewed and adjusted staffing levels and skill mix. A recognised acuity tool was used daily. The tool identified when there was a gap in staffing and staffing was adjusted to meet the needs of patients.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

Patients and family members said they were involved with their treatment plans and were kept informed about any changes in medication.

Medicines and treatments were safe and met people’s needs, capacities and preferences. Staff received and kept up to date with their medicine management training. Methods of training could be on-line or face to face; staff received reminders when medication training was due. Assessment competencies reviewed during our assessment were in line with national guidance. The service had systems to ensure staff knew about safety alerts and incidents, to ensure patients received their medicines safely.

The service had clear processes for medicine management. Oxygen cylinders were stored safely.

There were regular audits and monitoring of clinical incidents. Medicines management meetings and governance meetings were reviewed during our assessment. These reflected practices and implementation of processes following medication incidents. Policies were in place for medicines management within the hospice. There was also a protocol for the safe dispensing of medicines. Medicines were managed in a safe way for the benefit of people who were inpatients. The service had a policy for medicines bought into the premises. The hospice used an electronic prescribing system. This reduced the risk of medication errors and increase safety. Staff reported medication errors and analysed them for trends. Implementation of new policies and standard operating procedures reflected that learning had been identified and acted upon. The service had a controlled drugs accountable officer. The accountable officer was responsible for the management of controlled drugs and related governance issues in the organisation.