St Margaret's Somerset Hospice - Taunton

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We rated responsive as outstanding. We assessed one quality statement on the care provision, integration and continuity. Patients and relatives told us the service met their needs and was an invaluable part of their lives. They told us they were presented with a variety of treatment options and settings, and they were able to choose what felt right for them, based on what was important to them and their families. Patients experienced smooth transitions between different services due to the hospice’s close collaboration with NHS trusts, GPs, and other health and social care providers. This ensured that care was continuous and well-coordinated. The service planned and provided care in a way that met the needs of local people and the communities served. Staff were trained to consider the diverse cultural backgrounds and traditions of patients. Care plans were culturally sensitive and respectful. There were systems to ensure effective communication both within and outside of the organisation. This ensured the right care was provided to patients holistically nearing the end of their life.

This service scored 100 (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 Person-centred Care during this assessment. The score for this quality statement is based on the previous rating for Responsive.

People felt involved in their care, and their families were kept informed and supported too when needed. One relative told us “We want every family in Somerset to have the support, care and empathy we had.” The hospice operated urgent access and rapid discharge pathways that were responsive to patients' needs and risks, ensuring timely care. Patients and families highlighted the inclusive nature of the hospice. The hospice provided access to translation services and made reasonable adjustments for people with disabilities. Staff were knowledgeable about how to access these services, ensuring that all patients, including those with protected characteristics under the Equality Act, received care which met their identified individual needs. The Sunflower suite was a self-contained annex with a kitchen, bedroom, bathroom and living area for patients and their families to use. Some families did not live locally; therefore, this annex could provide onsite accommodation, or for local families to spend time together with younger members of the family away from a clinical environment. We heard one example where a patient’s spouse was a chef and they cooked them a meal to eat together in the kitchen and dining area.

The service was available to all adults whose disease was not responsive to curative treatment. Patients were referred to the service by their GP, the acute local NHS hospitals or the district nursing teams. The service planned and provided care with consideration to meet the needs of local people and the communities served. There were close working relationships with the district nursing teams, local GPs, counselling services, psychiatry services, local NHS hospitals and national organisations. Spiritual care was an integral part of the service. There was a team lead and 4 volunteers. They offered care for staff, patients, families and the community. Spiritual care was part of the staff induction. The patient’ spiritual care plan was recorded in their records. They could offer funerals and recently arranged a wedding on the ward for a patient within 3 days. The Central Referral team managed referrals and the advice line. Calls were triaged and signposted to the appropriate clinician. The team were experienced in gaining relevant information about the diagnosis to assist the referral to the clinicians. The team also managed administrative queries for nurses, physiotherapists and social workers, and arranged transport bookings for admissions and the day centre. The bereavement team supported patients and their families before and after death. Staff said they did their very best to achieve patients’ and families’ wishes and helped them to do “what [families] did not want to think about.” Complimentary therapy was available for patients to assist with symptom control and relaxation. There were various treatments available including reflexology, massage, aromatherapy and Reiki. Therapy was tailored to individual patients’ health needs and choices. Treatment was discussed with the clinical team to ensure its appropriateness. The benefits and outcomes of these interventions was scored, and the data was audited to assess the effectiveness of therapy interventions.

Complaints were monitored by the audit committee and lessons learnt were disseminated across the organisation.

Patients were able to access the hospice services when they needed it and received the right care promptly. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were in line with national standards. There was very little waiting time from referral and all relatives we spoke to told us they had been contacted immediately after a referral was made. Patients that missed their appointment at the day centre were followed up with a telephone call. There were bed meetings every day to discuss patient admissions. This meant staff could plan ahead for the needs of patients. Patients were given a choice of food and drink to meet their individual preferences and cultural, and religious preferences. We were told about occasions when the catering team went to great lengths to ensure patients received nutritious food. The team had experimented with tastes and textures to ensure a patient was able to be nourished and be well enough to attend a family occasion, and to fulfil his dying wishes. There were plans to develop the estate and to refresh the clinical setting. An architectural team with hospice experience has been instructed to develop plans to support the needs of staff and patients, including flexible office space and the creation of a Community Cafe. Patients and their families , and staff will be involved in planning the developments.

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

We did not look at Listening to and involving people during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

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