We inspected Springhill Hospice on the 16 and 17 August 2016. The first day of the inspection was unannounced. We last inspected Springhill Hospice on 15 October 2013 where we found all the regulations that we looked at had been complied with.Springhill Hospice is a charitable organisation that provides a range of hospice services for adults with a life-limiting illness. The hospice is purpose built and provides accommodation on the Inpatient Ward for up to 16 people. The hospice also has a Specialist Palliative Care Community Service, a Day Hospice, and a Hospice at Home service. In addition the hospice offers a 24 hour telephone advice line for professionals, people who use the service and their families. The hospice is close to public transport routes and is situated in a residential area of Rochdale, not too far from the town centre. It is set in large well-maintained gardens with adequate parking and clearly defined parking areas for disabled visitors. Services are free to people, with Springhill Hospice receiving some NHS funding and the remaining funds achieved through fundraising and charitable donations.
There were 16 people being cared for in the Inpatient Ward during our inspection, 16 people in the Day Hospice and approximately 240 people in the community.
The hospice had a manager registered with the Care Quality Commission (CQC) who was present during the inspection. A registered manager is a person who has registered with CQC 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 and associated regulations about how the service is run.
We found there was one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Medicines were not always given as prescribed, appropriate systems were not in place for the management of medicines requiring refrigeration and relevant information to enable staff to administer ‘when required’ medicine safely was not in place. You can see what action we have told the provider to take at the back of the full version of the report.
The expressions of gratitude relayed to us demonstrated that people were cared for with the utmost compassion, kindness, dignity and respect. People spoke highly of the kindness and caring attitude of the staff. People told us they received the care they needed when they needed it and that staff were knowledgeable and committed. Visitors were made welcome and the staff recognised and considered the importance of caring for the needs of family members and friends.
People were supported at the end of their life to have a comfortable, dignified and pain-free death. The nursing and medical staff showed they were highly skilled in pain and symptom control. Staff were passionate about the need to spread awareness and knowledge of end of life care by introducing an innovative and creative programme of training for staff caring for people in care homes.
We found that people received outstanding care. People's privacy was respected and people were assisted in a way that respected their dignity. We observed respectful, kindly and caring interactions between the staff, the people who used the service and visitors. People looked well cared for and there was enough equipment available to ensure people's safety, comfort and independence were protected.
The way that the hospice staff worked in partnership with other organisations was outstandingly effective. The staff were passionate about the need to spread awareness and share their knowledge of end of life care with other services that were involved in supporting people in the community.
We saw how the cultural and religious needs of all faiths was considered and respected. Staff told us they strived to ensure that people’s spiritual needs were met. There was a Spiritual and Pastoral Care Co-ordinator who was available to spend time with people in the Day Hospice, the Inpatient Ward and to people in the community.
The care records showed people were involved in the assessment of their needs. A person's preferred place of care at all stages of their illness and the arrangements in the event of their death were documented. The care records we looked at showed that risks to people's health and well-being had been identified, such as poor nutrition, the risk of developing pressure ulcers and the risk of falls. We saw care plans had been put into place to help reduce or eliminate the identified risks.
Suitable arrangements were in place to help safeguard people from abuse. Staff knew what to do if an allegation of abuse was made to them or if they suspected that abuse had occurred.
We found people and their families were cared for and supported by sufficient numbers of suitably skilled, competent and experienced staff that were safely recruited. Staff received the essential training and support necessary to enable them to do their job effectively and care for people safely.
All areas of the hospice were secure, well maintained and accessible for people with limited mobility. In addition good infection control procedures were in place;, making it a safe environment for people to live and work in. We saw that appropriate environmental risk assessments had been completed in order to promote the safety of people who used the service, members of staff and visitors. Systems were in place for carrying out regular health and safety checks and equipment was serviced and maintained regularly.
Staff were able to demonstrate their understanding of the principles of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions. Staff sought people's consent before they supported them. The staff we spoke with had an in depth knowledge of the care and support the people who used the service required.
People were provided with a choice of suitable and nutritious food and drink to ensure their health care needs were met. People who were at risk of malnutrition and poor hydration had their food and fluid intake monitored to help ensure their well- being.
The management structure within the hospice enabled staff and volunteers to understand the clear levels of responsibility and accountability. Management sought feedback from people who used the service and also sought feedback from staff and volunteers. Action plans were implemented to address any issues of dissatisfaction that were raised.
To help ensure that people received safe, effective care and support, systems were in place to monitor the quality of the service provided. Systems were also in place for receiving, handling and responding appropriately to complaints.