Marie Curie Hospice and Community Services North West and Cumbria Region

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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 assessed 2 quality statements from this key question. We have combined the score for this area with scores based on the rating from the last inspection, which was good. Our rating for this key question remains good. We found staff treated people equally and without discrimination. The provider complied with legal equality and human rights requirements. People’s individual needs and preferences were central to the delivery of tailored services. Upon referral or admission to the service, staff developed detailed person-centred holistic care plans which considered all aspects of the patient’s care including end of life. Each person’s care plan was devised in discussions with the patient about what was important to them.

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.

Care plans fully reflected the patients physical, mental, emotional, and social needs, including those related to protected characteristics under the Equality Act. We reviewed 4 patient records, all of them had personalised care plans. Upon referral or admission to the service, staff developed detailed person-centred holistic care plans which considered all aspects of the patient’s care including end of life. Each person’s care plan was devised in discussions with the patient about what was important to them. The hospice supported open visiting for relatives and carers 7 days a week; however, the service had protected mealtimes. Patients told us visitors to the hospice were always offered refreshments, such as tea, coffee, and cakes.

The care plans were regularly reviewed and updated, and referrals were made to members of the multidisciplinary team according to each patient’s needs. The hospice used a tailored individualised care and communication record to document each patient’s care at the end of life. This included any advanced care plans, or advanced decisions to refuse treatment that had been put in place by the patient.

The hospice put people’s individual needs and preferences central to the delivery of its services. The service was inclusive and responsive in its tailored care to meet the individual and complex needs of its patients. Staff made reasonable adjustments to help patients access services and coordinated care with other services and providers. We saw there was effective team working and communication between staff across all disciplines within the service. Staff worked across health care disciplines and with other agencies when required to care for patients. The hospice had suitable facilities to meet the needs of patients’ families. The hospice had separate suites that could be used for overnight accommodation by relatives. There was also a communal area which was furnished to a good standard. We reviewed the hospice complaints process and looked at 3 recent complaints. All 3 complaints had been dealt with in a timely manner and well within the hospice policy timescales.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

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.

Patients could access the specialist palliative care service in a way and at a time when they needed it. People told us they did not experience significant delays or waiting times for their care and treatment. Not all patients referred to the service were cancer related. The hospice also supported patients with other terminal and long term illnesses.

We were informed of the completion of Spiritual/Religious assessment called “HOPE” on the electronic records system, which took place for each patient. There was opportunity for patients to an opportunity to talk about how their lives had changed, challenges they were facing, questions on life and death. All patients own faith beliefs were respected, and this may have involved consulting with their own faith leaders. The wards held lists of contact details for faith leaders and had access to different faith needs and traditions. There were policies of care at and after death in place at the hospice.

The hospice only admitted and treated adult patients. The hospice provides specialist palliative care for adults living with any terminal illness. However, the hospice could accept requests to provide care for 16–18 year olds. Requests were reviewed on a case-by-case basis and a decision made at senior clinical management level, based on their ability to ensure they could provide safe care to younger patients. Patients could be referred to the service by health professionals within the local area for end-of-life care, symptom control, unplanned respite care and for psychological support. The maximum capacity for the inpatient unit was 13 beds but it was operating at 6 beds at the time of our onsite assessment. The registered manager stated the service had made the decision to reduce operational bed capacity due to ongoing challenges with staffing level numbers as a result of sickness and also difficulties in recruitment. They stated the decision was taken to ensure continued patient safety.

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.