Archived: Woking Hospice

Woking Hospice is a charitable organisation owned by Woking Hospice Trust. It is registered for provision of palliative care to adults over 18 years of age. It offers 10 in-patient beds and a further fifteen day care places. There is a Hospice Care at Home service which provides treatment, care and support for up to 300 people at any one time. The hospice adjoins a local NHS community hospital.

There was a manager in post who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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. The registered manager also managed the community services, the day hospice service on site and the sister hospice Sam Beare Hospice.

People were kept safe by staff who were trained in the safeguarding of adults and health and safety. They were able to fully describe their responsibilities with regard to keeping people in their care safe from all forms of abuse and harm. It was apparent from discussion with members of the management team that all health and safety issues were taken seriously to ensure people, staff and visitors to the service were kept as safe as possible. There were enough staff on duty to ensure people received safe care. People were given their medicines in the right amounts at the right times by properly trained staff. The recruitment process was robust and the service was as sure as possible that staff employed were suitable and safe to work with people who were cared for in the service.

People’s human and civil rights were upheld. The service had taken all necessary action to ensure they were working in a way which recognised and maintained people’s rights. The staff team understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people in their care. The Mental Capacity Act 2005 legislation provides a legal framework that sets out how to act to support people who do not have capacity to make a specific decision. DoLS provides a lawful way to deprive someone of their liberty, provided it is in their own best interests or is necessary to keep them from harm. The registered manager and their predecessor had made the appropriate DoLS referrals to the Local Authority. Clear information about the service, the facilities, and how to complain was provided to people and their relatives. People’s privacy was respected and people were assisted in a way that respected their dignity. Staff sought and respected people’s consent or refusal before they supported them.

People’s health and well-being needs were met. Staff had built strong relationships with people and they were knowledgeable and knew how to meet people’s needs. The service respected people’s views and encouraged them to make decisions and choices. Food was nutritious and of good quality. Staff were appropriately trained to meet the needs of people in their care. Staff knew each person well and understood how people may feel when they were unwell or approaching the end of their life. Overall, the service was responsive to people’s needs and was proactive when people’s needs changed.

People’s feedback was actively sought, encouraged and acted on. People and their relatives were overwhelmingly positive about the service they received. They told us they were satisfied with the staff approach and how the care and treatment was delivered. The staff approach was kind, compassionate and pro-active.

The environment was well designed, welcoming, well maintained and suited people’s needs.

The service was well managed. Meeting people’s needs was the priority for staff and the registered manager. The management team including members of the board were described by staff as supportive. Emphasis was placed on continuous improvement of the service. Comprehensive audits were carried on all aspects of the service to ensure that policies and procedures were being adhered to. When areas for improvement were identified, action was taken to ensure the quality of the service and care. The service worked effectively in partnership with other organisations.

No concerns were found at our last inspection in December 2013.

People were cared for in a safe environment and their welfare was promoted through the maintenance of clear and detailed plans of care.

Woking Hospice worked in cooperation with other health professionals and organisations in order to provide appropriate care for the patients in their care.

People were protected from abuse through the provision of regular suitable training to staff, clear policies and the availability of suitable information through leaflets and procedural documents.

The premises were maintained in a clean and hygienic condition. This was achieved by domestic staff who were provided with training and guidance. The service maintained detailed policies and procedures related to cleanliness and infection control and carried out relevant audits to ensure their effectiveness. One patient we spoke with told us, 'The place is very, very clean. They are always cleaning and are very thorough.' Our visual inspection of the premises indicated that the cleanliness was maintained to a high standard.

The service had, available to staff, patients and visitors, a statement of purpose which had also been given to CQC.

We sampled four care files of people who used the service. Following an initial detailed assessment by a Doctor and nurse the care plans were drawn up together with the person who used the service or a relative. Each care plan had been written in a way that recognised each person as an individual with their own needs.

A relative told us: "The care here is excellent, it is as good as you can get. I am satisfied my X is getting all the care she needs".

One person who used the service said "This place is amazing, I'm so lucky. They cater not only for my needs but my family. They provide rock solid support for them".

Another person who used the service said "Some of the food is ok, some isn't, but you do get a load of choices. I can have tea anytime or snacks, or a sandwich at different times if I haven't eaten my supper. If there is nothing on the menu they ask what else you would like".

During the inspection we sampled six staff personnel files. We found them to be very well structured and maintained in a chronological order. The files demonstrated that staff had been effectively and safely recruited and employed.

Woking Hospice had effective systems in place to monitor the quality of the service provided. A number of audits were routinely undertaken.