The Care Quality Commission
  • Hospice service

Keech Hospice Care

Overall: Good read more about inspection ratings

Great Bramingham Lane, Streatley, Luton, Bedfordshire, LU3 3NT (01582) 492339

Provided and run by:
Keech Hospice Care

All Inspections

During an assessment under our new approach

Date of assessment 17 July 2024

The service provides free specialist and holistic palliative and end of life care for adults with life-limiting illness and their relatives and carers in Bedford, Luton and South Bedfordshire. The service also provides specialist palliative care for infants, children and young people who have a life-limiting condition and living within Bedfordshire, Hertfordshire and Milton Keynes.

We carried out this assessment to follow-up on concerns identified at our last inspection in November 2023 regarding the processes of medicines reconciliation, prescription stationery management and clinical pharmacy service.

This assessment was focused on the quality statement of medicines optimisation.

We rated medicines optimisation as good during this assessment because we found that the service had robust processes in place for medicines reconciliation and prescription stationary management. A contract was in place to provide a clinical pharmacy service.

During an assessment under our new approach

Date of assessment 17 July 2024

The service provides free specialist and holistic palliative and end of life care for adults with life-limiting illness and their relatives and carers in Bedford, Luton and South Bedfordshire. The service also provides specialist palliative care for infants, children and young people who have a life-limiting condition and living within Bedfordshire, Hertfordshire and Milton Keynes.

We carried out this assessment to follow-up on concerns identified at our last inspection in November 2023 regarding the processes of medicines reconciliation, prescription stationery management and clinical pharmacy service.

This assessment was focused on the quality statement of medicines optimisation.

We rated medicines optimisation as good during this assessment because we found that the service had robust processes in place for medicines reconciliation and prescription stationary management. A contract was in place to provide a clinical pharmacy service.

8 November 2023

During a routine inspection

We carried out a comprehensive inspection of this service as part of a follow up for concerns raised to Care Quality Commission.

It is the first time we have inspected the adults and children and young people elements of the hospice separately. We rated Keech Hospice Care as good because:

  • Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well and learned lessons from them.
  • Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, supported them to make decisions about their care, and had access to good information. Key services were available 7 days a week.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, and helped them understand their conditions. Staff took account of patients’ individual needs and went out of their way to make sure patients living with a life-limiting condition could make the most of their time with their families and loved ones. They provided emotional support to patients, families and carers.
  • The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. The service had a community connector to ensure the local population’s needs were understood and catered to. They went above and beyond to work with local services, improve visibility of services and speak to people in a way they could understand. People could access the service when they needed it.
  • Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

However:

Hospices for adults:

  • The service did not have regular clinical pharmacy input which meant medicines reconciliation was not always done.
  • The service did not have a system in place with the ability for leaders of the service to view the overall training completion rates for all volunteers.
  • Audits were not always repeated frequently enough to use the findings to make improvements.

Hospices for children and young people:

  • The service had staffing vacancies. In order to manage this, the service operated a flexible model of access which meant people could not always access the service when they needed it.
  • The service did not have regular pharmacy input and had room for improvement in their processes of accountability of controlled drug stationary.

29 June 2016

During a routine inspection

This inspection took place 29 and 30 June 2016 and was unannounced.

The inspection was carried out by two inspectors, a pharmacy inspector and a specialist advisor.

Keech Hospice Care is a purpose built hospice on the outskirts of Luton. The service provides 15 overnight beds, a palliative care centre and a hydrotherapy pool. The service provides nursing care to adults and children, many of who may be experiencing physical disability, life limiting conditions and or terminal illness.

There was a registered manager in post.

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.

People felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and how to report them. People had risk assessments in place to enable them to be as safe and independent as they could be.

Effective recruitment processes were in place and followed by the service which ensured staff working at the service were suitable. There were sufficient staff, with the correct skill mix, on duty to support people with their care and treatment needs.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines, including controlled medicines, was suitable for the people who used the service.

Staff received a comprehensive induction process and on-going training. They were well supported by the registered manager, Chief Executive Officer (CEO) and their line managers. Staff had access to a range of differing levels of support.

Staff had attended a variety of training to ensure they were able to provide care based on current practice when providing care and treatment for people.

Staff gained consent before supporting people or providing care and treatment. People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people, children and young people.

People were able to make choices about the food and drink they had, and staff gave support when required. Catering staff had good knowledge of the types of diets people had and catered for them effectively.

People were supported to access a variety of additional health professional when required. Some medical procedures were carried out in the Keech Palliative Care Centre, which cut down on hospital appointments for people. Alternative therapy was available including; aromatherapy, Indian head massages and reflexology as well as music and art therapy.

There was a support programme, manned 24 hours to provide a single point of contact for additional support.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service and their relatives. People and relatives, where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times. People were asked for their feedback, which was analysed, and actioned if required. A complaints procedure was in place and accessible to all. People knew how to complain.

Effective quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement if required.

3 July 2013

During a routine inspection

During our visit to Keech Hospice Care on 3 July 2013, the focus of our inspection was the children's unit. We spoke with the parents of some of the children using the service at the time of our visit. The people we spoke with told us their children received a thorough assessment of their needs and staff were very good at meeting those needs. They said they felt their children were safe and well cared for at Keech Hospice Care by professional, knowledgeable and friendly staff. In general, the people we spoke with had no complaints about the service. One person said of Keech Hospice Care: "I would tell anyone in my position that it has to be Keech." Another person said: "It's fantastic and I'd highly recommend them."

We found that each person received an assessment of their needs and these were regularly updated. The assessments were used to develop support plans of how the service would meet each person's needs. We saw that arrangements were in place to deal with foreseeable emergencies, including the provision of items for use in an emergency. We found that staff were receiving supervision, appraisal and professional development relevant to their roles and were trained in and knowledgeable about subjects such as protecting vulnerable people from abuse.

We found the service had a complaints system in place and people had their complaints responded to appropriately. Information about the complaints procedure was readily available to people who use the service.

16 May 2012

During a routine inspection

Peoples' diversity, values and human rights were respected. People who use the service told us that staff were very good at respecting their privacy. When they needed assistance with such things as dressing or bathing they found it a dignified experience. They said that staff respected their choices, preferences and decision making and they felt very involved in their care. They said they had been given lots of information about the service.

Peoples' needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People said they had been asked about their needs and staff displayed a good understanding of their needs and of them as people. They told us there were activities arranged for them at the service which were designed to assist in their care. They said their visitors were made welcome. One person we spoke with said her religious and cultural needs were very well respected by the staff.

They told us they had no concerns about their safety and wellbeing at Keech Hospice Care and that staff were very good at responding to call alarms when they needed them. They said that a member of staff could be located when needed and were always able to do what was required of them. People said that staff appeared competent, experienced, friendly and respectful.

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. The people we spoke with said they had never had the need to raise a concern, but if they did they would feel confident and comfortable in approaching the manager or senior staff. They told us they had been given questionnaires asking for their views on their care and the service and they had provided very positive feedback.

One person said of her experience at Keech Hospice Care: 'It's very pleasant here. I am comfortable and everyone is so nice and working hard to help me'. Another person summarised the view of the people we spoke with by saying: 'I am perfectly happy with the way everything is done here. I'd rather be [cared for] here than anywhere else'.