Overgate Hospice

Updated 24 November 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was carried out on 20 September 2016 and was unannounced.

Before the visit we reviewed the information we held about the service, this included notifications of significant changes or events. We contacted Healthwatch and the local Clinical Commissioning Groups (CCGs) to ask for their views of the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

The provider completed a provider information return (PIR) prior to the inspection. This is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make. We used information from the PIR to help inform our judgements.

The inspection was carried out by two adult social care inspectors, a pharmacy inspector, a specialist advisor in palliative care and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service, in this case palliative care services.

During the inspection we spoke with five people who used the service and seven relatives. We looked at three people’s care records and seven people’s medication records. We listened to the handover when the staff for the afternoon shift came on duty and observed the meal service at lunch time. We looked around the communal areas, some bedrooms and the gardens. We looked at other records related to the day to day running of the service such as staff files, training records, maintenance records, meeting notes, survey results and audits.

We spoke with various staff including the registered manager, the chief executive, the clinical service manager, the human resources manager, the ward sister, the ward clerk, two doctors, three nurses, the chef, two social workers and the facilities manager.

Updated 24 November 2016

The inspection was carried out on 20 September 2016 and was unannounced. This meant the provider and staff did not know we would be visiting. At the time of the inspection there were seven people receiving care and treatment on the in-patient unit.

Overgate Hospice provides specialist palliative care for adults in the Calderdale area. The hospice supports people with cancer and life limiting, progressive illnesses and helps people with symptom control as well as providing end of life care.

The hospice provides in-patient accommodation for up to 12 people and day hospice services. The day hospice services did not form part of this inspection.

The service had a registered manager. 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.

Everyone told us they felt the hospice was a safe place where care and treatment was delivered by kind, compassionate and competent staff. There were systems in place to make sure people were protected from harm and staff knew how to report any concerns about people’s safety and welfare.

The hospice employed a range of medical and nursing staff and health and social care professionals such as social workers. There were enough staff to ensure people received the right care and treatment in a timely way. The hospice did not employ an occupational therapist but worked closely with the community based team of occupational therapists to make sure people got the support they needed. Everyone told us staff were quick to respond to their changing needs.

New staff did not start work until all the required checks had been completed satisfactorily. This helped to protect people from the risks of being cared for by staff unsuitable to work with vulnerable people.

We found risks to people’s health, safety and welfare were well managed. People’s care records included information about individual risks and how these were managed.

The hospice was clean and well maintained and equipped to meet people’s needs. Checks were carried out on equipment and installations which helped to ensure the premises were safe for people to use. There were clear systems and processes in place to deal with emergencies, both medical and non-medical emergencies.

Incidents and accidents were recorded and reviewed and whenever possible action was taken to reduce the risk of recurrence.

People’s medicines were handled safely. However, some of the storage arrangements needed to be reviewed to make sure they were secure enough.

People told us the staff were well trained and knew how to meet their specialist needs. Staff received training on safe working practices and were supported to develop their knowledge and skills. Staff received support to cope with the emotional challenges of their work.

Management and staff demonstrated a good understanding of their responsibilities in relation to The Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. This helped to make sure people’s rights were protected and promoted.

People were offered a choice of food which took account of their ethnic, cultural and dietary needs and preferences. Nutritional assessments were carried out and people received support from dieticians and speech and language therapists where necessary.

People received support to maintain their wellbeing from a multi-disciplinary team and they spoke very highly about the nursing and medical staff. They told us how staff had helped to allay their fears and make their lives more comfortable.

Without exception people told us the staff were extremely caring and kind. They told us they were always involved in decisions about care and treatment and staff always asked for their consent before providing support.

The hospice had a calm and relaxed atmosphere. We observed people who used the service, relatives and staff were comfortable in each other’s company. We saw staff were kind and patient when supporting people.

People’s privacy and dignity was always respected despite the limitations of the shared four bed rooms. The management team had identified this as an area for improvement.

Staff knew about people’s individual needs and preferences and spoke about people and their relatives with warmth and compassion. Relatives and carers were offered support when their family members were receiving care and treatment and post bereavement. People were supported to meet their spiritual needs and were offered the opportunity to attend memorial services.

Everyone told us the service was responsive to their needs and we found care and treatment was delivered in a person centred way. However, this was not always reflected in people’s care plans.

People were supported to share their views of the service and there was a complaints procedure in place.

There were systems and process in place to monitor and assess the safety and quality of the services provided. We found the management team was open and enthusiastic and constantly looking at ways to improve the service.

The service worked in partnership with other health and social care providers to improve the standards of end of life care across Calderdale.