We carried out an inspection of Hospice Care for Burnley and Pendle on 11, 12 and 13 March 2015. The first day of the inspection was unannounced.
Hospice Care for Burnley and Pendle is a registered charity providing specialist palliative care services to adults with cancer and other life-limiting illnesses. Services include in-patient care, day services, hospice at home and family support. Pendleside is located in Reedley near Burnley. There are accessible gardens and car parking spaces available. The entrance hallway includes a staffed reception desk and separate shop.
The in-patient unit provides
assessment and symptom control, rehabilitation and end of life care
, along with access to a range of holistic complimentary therapies and spiritual care. There are 10 single bedrooms with en-suite toilets, all rooms overlook the gardens. There is day lounge with conservatory and a dining room. There are specialised bathing facilities, including a wet room/shower and an assisted hydrotherapy bath with optional sensory lights and music. The in-patient service includes access to the facilities and therapies on day services.
There are separate facilities for day services, this includes a communal lounge and dining room, several therapy/counselling rooms, a gym, conservatory and quiet room. Services available include: occupational therapy, physiotherapy, aromatherapy, massage, reflexology, calligraphy, creative writing, art therapies, exercise classes and presentations from outside speakers.
The hospice at home service offers: personal care and assistance, respite for carers, emotional support/advice, spiritual care and a night sitting service.
The service was managed by a registered manager. 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.
At the previous inspection on 21 November 2013 we found the service provider was meeting the legal requirements.
People using the service and their relatives had no concerns about the way people were cared for or treated. We found arrangements were in place to help keep people safe and secure. Risks to people’s well-being were being appropriately assessed and managed.
Robust processes were in place to manage medicines safely. None of the people spoken with raised any issues around support with their medicines.
Staff were aware of the signs and indicators of abuse and they knew what to do if they had any concerns. Staff confirmed they had received training on safeguarding and protection.
Proper character checks had been carried out before new staff started working at the service. New employees were recruited on a probationary period, this meant their suitability and competence in the role was monitored and considered, prior to a permanent contract being offered or declined.
Arrangements were in place to maintain appropriate staffing levels. We found there was no formal process in place to assess staffing arrangements, to make sure there were always enough suitable staff. However the registered manager agreed to address this matter.
Effective processes were in place to maintain a safe environment for people who used the service, visitors, volunteers and staff. We looked around the premises and found all the areas seen were safe and well maintained. The service had defined contingency procedures to be followed in the event of emergencies and failures of utility services and equipment.
People we spoke with indicated they were satisfied with the services they received. They made positive comments about the skills and abilities of the staff team. All new staff completed an initial induction training programme to a nationally recognised standard. There were systems in place to ensure all staff received regular training as part of a comprehensive ‘mandatory training framework’. All relevant staff were supported to access palliative and end of life care, tailored to their individual experience and qualifications.
The MCA 2005 (Mental Capacity Act 2005) and the DoLS (Deprivation of Liberty Safeguards) sets out what must be done to make sure the human rights of people who may lack mental capacity to make decisions are protected. We found appropriate action had been taken to apply for DoLS and authorisation by local authorities, in accordance with the MCA code of practice and people’s best interests.
We observed staff involving people in routine decisions and consulting with them on their individual needs and preferences. People were involved with their initial assessment, the care planning processes and they had consented to care and treatment.
People made positive comments about the meals provided at the service. Arrangements were in place to provide people with an interesting, nutritionally balanced and varied diet. People’s individual dietary needs, likes and dislikes were provided for. Doctors and dieticians were liaised with as necessary. Various drinks were readily available and regularly offered. People were supported to eat their meals wherever they wished, including dining areas, or their own rooms.
People spoken with gave us examples of how their health care needs had been recognised and sensitively managed. Healthcare needs were monitored and effectively responded to. We observed people being supported and cared for by staff with kindness and compassion. We saw people were treated with dignity and respect and consideration was given to their privacy. Processes were in place to respond to people’s individual faith and cultural needs.
We found people who used the service were made aware of and encouraged to engage with, other support networks which could have a positive impact on their quality of life. People’s needs, preferences and abilities were assessed taking into account their views and opinions. There were detailed care and treatment plans in response to identified needs and preferences, with clear directions for staff to meet people’s needs.
People spoken with told us how much they appreciated the various therapies and counselling sessions which were available to them. We found the counselling and massage therapies were also offered to family members and friends of people using the service. There were various therapies and activities available which included: occupational therapy, physiotherapy, aromatherapy, massage, reflexology, calligraphy, creative writing, art therapies, exercise classes and presentations from outside speakers.
Effective processes were in place to support and encourage people to raise any concerns and make complaints. The service had systems in place for the recording, investigating and taking action in response to complaints.
There was an effective management team to provide strategic direction and support the day to day running of the service. There were governance systems in place to monitor and develop the service in consultation with the people who used it.