Hospiscare

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

For the safe key question, we reviewed the following evidence categories: safe systems, pathways and transitions; safe and effective staffing; elements of infection control; elements of environment. 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. This meant at times the service reduced the number of beds available but ensured that patients were safely cared for. There was continuity of care provided by the community nursing team. The design of the in-patient environment followed national safety guidance. The service had safe staffing levels and skill mix, and good compliance with mandatory training. The service provided support and supervision to its staff base.

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.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

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.

People we spoke with stated staff were knowledgeable and highly skilled.

The service had enough qualified, skilled and experienced staff to keep patients safe. The service had developed a tool which took into account staff numbers and patient acuity. This helped the service ensure and monitor clinical safety and effective patient care. This tool helped to categorise staffing into four levels and depending on the level, different actions were taken. For example if the service was at level 3 then gaps in the rota would be covered by bank staff or a member of staff from another area, and if the service was at level 4, the service would not accept any new admissions for a period of 48 hours. This helped to ensure staff could take care of the patients already in their care. In the three months from October 2023 to December 2023, the service was at Level 3 in 16 instances and Level 4 for three instances. There was an 8.1% vacancy rate in December 2023 because the in-patient unit was down the equivalent of 5 full time equivalent staff. To ensure patient safety, the in-patient unit was held at 8 beds which ensured it was safely staffed. Staff had a comprehensive induction process that allowed staff to shadow other roles within the service. There were robust and safe recruitment practices to make sure all staff were suitably experienced, competent and able to carry out their roles. Volunteer staff who had patient contact were checked with the Disclosure and Baring Service. 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.

The service had a dignity at work policy and disciplinary policies and procedures. Staff had one recorded personal development discussions in a year, where objectives were set. The service had a clinical competency framework and a programme of training for staff which indicated how regularly staff had to attend training. The service had competency training such as syringe driver training, verification of expected adult death, pain and symptom management, triage and clinical skills training (advice line). Staff completed mandatory training.

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.

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