Ashgate Hospice

On this page

• 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

The service worked well with external partners, patients and carers when planning and delivering patient care and treatment, and planning for the future. The service completed appropriate assessments and demonstrated a person-centred approach which enabled them to respond quickly and efficiently to the patient’s needs and choices. Accurate information was given to patients in a timely manner.

Training and processes were in place which enabled the service to identify possible bias, discrimination and barriers to treatment and how to act on this to support the patient appropriately. Family members were encouraged to be involved in their care and treatment.

The clinical nurse specialist team responded to the needs of patients who were supported in their community via the virtual ward. Patients or family members contacted the service if there had been a potential deterioration in their health and wellbeing, known as an ‘SOS’ contact. When an ‘SOS’ contact was made, the service responded with additional support within a short period of time (usually a few hours). This included multiple face to face contacts throughout the day and night in the persons home, along with any additional equipment which may be required to meet the needs of the patient, and their families.

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.

Patients were seen as individuals, and their care was personal to them and well-coordinated. Staff encouraged patients to be involved in their care, so their individual needs and preferences were central to the care that was provided. One patient told us “It’s wonderful, so personal. No other words to describe it. A nice atmosphere and the staff make us feel so included. They have all got time to sit, listen, and explain things. The staff are well trained and knowledgeable”.

Through robust, and person-centred care planning staff saw the whole person, supporting and caring for them and their families as individuals. In-depth assessments were completed using a patient and carer assessment tool, which enabled the service to focus on, and address any individual support needs the patient or their families may have. For example, physical symptoms and pain, emotional wellbeing, spiritual needs, and functional ability. Families and carer needs were also assessed and supported.

We reviewed 8 care and treatment plans, they showed the patient, and their families had been involved in their development and review. The patient’s needs, and preferences were at the centre of care plans.

Patients had regular 1 2 1 time with their nurse and attended regular multidisciplinary team meetings with the wider team. This ensured the individual needs and preferences of the patient, and their families were central to care and treatment planning. These involved other service providers where appropriate.

Patients care was coordinated well, the service and partners worked well together, with the patient, and their families. They were involved in discussions and decisions around their future care, and how this would be provided if they were transferred to another care provider, this reassured them and ensured continuity.

After gaining the consent of the patient and their families, the service invited external partners in care to attend all care and treatment reviews. Assessments were completed to check the patients eligibility for the proposed service to ensure their future needs could be met.

Partners were encouraged and supported by the service to be actively involved in the care, treatment, and support of the patient, and their families. Partners worked collaboratively with them which had a positive impact on outcomes for patients, when planning discharge from the service, either to return home or to an alternative care provider to continue their treatment journey.

Systems and processes in place ensured people had access to the service, and appointments at a location and a time that suited them. Managers understood the diverse health and care needs of people and took action to meet these. They had identified that waiting times were increasing due to the demand for the service. Therefore, in 2023 the service launched a single point of access, and referral service. This enabled the service to reach more people in need of support, reduced the waiting times, and enhanced the access for people waiting for care.

Patients received accurate and up to date information from staff about their care and treatment in a way in which they understood. Patients and their families had access to information in different formats if they needed this.

The service had effective ways to provide clear and accurate information to patients and their families depending on their needs and preferences. Staff used resources available to them when delivering information, and when required referred patients to external communication services to ensure information was available about their care and treatment, and any information given was understood.

Processes ensured that information was shared in an effective way. The service provided support for patients and their families who may have communication needs. For example, interpreter services were provided when required to overcome potential language barriers, information was available in different languages, and information was also available in larger print/easy read format. Information was handled in line with the General Data Protection Regulation (GDPR) guidance. The service engages in a nationally recognised data security and protection toolkit and achieved green level by meeting the required standards.

Patients knew how to feedback on their care and were encouraged and supported to do so. Patients, and their families spoke with the nurse in charge or the ward manager if they wanted to and were supported to do this. One patient told us “My family wanted to speak to the nurse about my treatment, the nurse came quickly and listened to us, she reassured us and put our minds at rest”.

Staff encouraged patients and their families to raise any concerns or give feedback about the service. Any feedback or complaint was always acknowledged and investigated with the patient or the person raising the concern receiving an outcome as quickly as possible. The service used the learning from complaints and concerns as an opportunity for improvement.

Information was displayed around the service on how people were able to give feedback on their care or raise a complaint. There were feedback postcards available around the service called ‘it’s the little things’; these were completed by patients and their families. Digital feedback surveys were available and accessed using a QR code, there was a paper copy of the survey available to patients and their families if they preferred. The contact details of other organisations were also displayed around the service who people could contact. Information on advocacy and interpreter services was also available, and displayed to support patients or their families who may have communication needs.

The complaints process was robust and ensured that feedback or complaints were acknowledged and investigated. The outcome of the investigation was shared with the person that raised the issue within a set timeframe. Additionally, managers would share the learning from complaints and concerns with the staff to improve their clinical practice and outcomes for patients. We reviewed several concerns which had been raised, all were addressed appropriately and in a timely manner. Relevant information and outcomes were given to the person raising the concern.

Patients accessed the service usually by referral from either a GP or district nurse. Services were accessible to patients, their families or carers, and people who were facing bereavement or had been bereaved.

The service worked with external bodies to ensure that the service and its premises were accessible to all people assessed as being in need of the care and treatment provided. They worked in partnership with disability experts to make the premises more accessible, and learning disability organisations to improve the experience for patients using the service who may have a learning disability.

The service delivered care in a way that met patients’ needs, which was accessible and promoted equality. This included people with protected characteristics under the Equality Act, people who may be approaching the end of their life, and people who were in vulnerable circumstances or who had complexed needs. The service had completed a Quality Improvement project (QI) which had improved the referral process and streamlined patient access.

Patients were supported to overcome any potential barriers to care and treatment, they had access to services who supported them to communicate so their voices were heard, their needs met, and feedback on their experience captured.

The service supported patients to access communication services to ensure they were listened to and their feedback acted on. The service has built relationships with Derbyshire LGBTQ+ to make care fairer and more available to the LGBTQ+ community to ensure better outcomes for patients accessing care and treatment. The services virtual ward made it possible for patients to access care and treatment whilst remaining at home. The service had access to interpreters and advocates who were independent to the service.

The service had access to independent services who supported patients with communication needs. Quality improvement projects are undertaken to enhance the patients experience, projects are audited and monitored for outcomes. The service engages in collaborative benchmarking initiatives with nationally recognised organisations to measure standards, performance and progress across the relevant sectors. For example, National technology steering groups, hospice quality partnerships, community development, and education services.

Patients, and their families were given support with their care, needs, and decisions about their treatment, the service supported advanced care planning where appropriate. One patient told us “Makes us feel a bit frightened when it’s the end of life and what will be available. But they have helped us to prepare and made me feel so unafraid of dying”.

Staff worked closely with patients and their families regarding their plans for the future, so they had enough time to make informed decisions about their future including at the end of their life. The service supported patients with palliative and end of life care at home in partnership with their GP or hospital team, and other care providers depending on the complexity of their needs.

Processes enabled patients, and their families to be supported to make decisions about their care and treatment, sometimes in advance. Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) documentation and Recommended Summary Care and Treatment forms (ReSPECT) were completed after consultation and in line with guidance. Patients and their families’ choices were included with care, treatment, and discharge planning. The service was very responsive in enabling people to engage with their religious beliefs and/or preferences at the end of their life.