Background to this inspection
Updated
11 March 2017
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.
This inspection took place on 10, 11, 12, 13 and 14 October 2016 and was announced. We gave 48 hour’s notice of the inspection due to the complexity of the service. The inspection team consisted of a lead inspector, a pharmacist inspector, a specialist professional advisor 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 service.
Before our inspection, we asked the provider to complete a Provider Information Return (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information we held about the service. We also received feedback from two external palliative care specialists, Camden Healthwatch and one commissioning officer from Islington. Healthwatch England is the consumer champion for health and social care.
During the inspection we spoke with 13 people who used the service, four relatives. We also spoke with 10 members of staff and three volunteers. This included the registered manager, facilities manager, clinical lead nurse, ward manager, supportive care services manager and head of quality improvement, who was in the hospice on one of the days of the inspection. We spent time in the inpatient and outpatient wards, observing care and support. We joined a multi-disciplinary meeting.
We looked at six people’s care records and 10 medicines records. We looked at other records relating to the management of the hospice. This included five staff recruitment records. We also looked at staff duty rosters, accident and incident reports and records relating to complaints, compliments, health and safety, maintenance, governance and quality monitoring.
Updated
11 March 2017
This inspection took place in 10, 11, 12, 13 and 14 October 2016 and was announced. When we last visited the hospice on the 26 August 2014 we found the provider was in breach of the regulation relating to the need for consent. They had sent us an action plan and had told us they would make the necessary improvements to ensure that all care records would appropriately reflect that people had consented to their care. During this inspection we noted that the provider had made suitable arrangements to obtain, and act in accordance with the consent of people in relation to their care.
Marie Curie Hospice Hampstead is one of the hospices in the Marie Curie group providing palliative and end of life care for adults only. The hospice could accommodate up to 34 people. There were 30 people using the hospice at the time of the inspection. Staff specialise in helping people with life-limiting illnesses including cancer, motor neurone disease, heart disease and renal failure. Treatments and care offered include inpatient care and rehabilitation, day therapy and outpatient appointments.
Other services offered by the hospice included complementary therapies, outpatients, physiotherapy, spiritual support and bereavement support for families, friends and carers of people using its services.
The hospice 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.
People told us that they were safe and protected from potential abuse. Risk assessments and appropriate management plans were in place where risks were identified to protect people from potential risks from receiving care. Staff were available in adequate numbers to meet people's needs. Staff had the training and support needed to ensure they were skilled and knowledgeable to meet people's needs.
People received their medicines safely and as prescribed. There were appropriate arrangement in place to ensure the safe management of medicines, although we identified a few issues that the management team told us they would address promptly. The hospice worked to ensure that people's health care needs were met by a multidisciplinary team of health professionals.
People were supported to make decisions and choices about their care. Where people were unable to make decisions about their care their human rights were protected as assessment had been carried out to make sure any decisions were in their best interests.
Care plans reflected people's needs and their preferences. Staff understood people's care needs and provided care and support in a person centred way. People had a choice of meals that met their nutritional needs and reflected their cultural or religious preferences.
People were treated with kindness and compassion. Their dignity was respected as care was delivered to meet their individual needs.
People knew how to complain and there was an accessible complaints policy to guide them through the process. People were confident that there concerns would be addressed.
People were consulted and involved in making suggestions for improving the service. The quality of the service was monitored and action was taken to improve the service when necessary.
People, relatives and staff told us that the registered manager and the management team were accessible and listened to them. People and staff were involved in the development of the service as there were ways for them to share their views, and make suggestions to improve the hospice.