• Hospice service

Wisdom Hospice

Overall: Good read more about inspection ratings

High Bank, Rochester, Kent, ME1 2NU (01634) 830456

Provided and run by:
Medway Community Healthcare C.I.C

Important: This service was previously managed by a different provider - see old profile

All Inspections

19 August and 23 August 2021

During a routine inspection

Our rating of this location stayed the same. We rated it as good because:

  • The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
  • Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
  • The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
  • Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with the community to plan and manage services and all staff were committed to improving services continually.

However:

  • Not all staff had completed their mandatory training.
  • Not all staff were clear on where they were required to put on PPE.
  • The service did not have a system to record the monitoring of their cold storage facilities.
  • The service did not audit patient’s preferred place of death against their actual place of death.
  • The service did not audit their use of do not attempt cardiopulmonary resuscitation orders.
  • The service needed to improve the way it collected feedback from patients.
  • The service did not complete all their routine audits.
  • The service did not have structured engagement with their patients.

13 April 2016

During a routine inspection

The inspection took place on 13 and 14 April and was unannounced. Wisdom Hospice is one of a range of services provided by Medway Community Healthcare. The hospice offers specialist palliative care, advice and clinical support for adults with life limiting illness and their families. They deliver physical, emotional and holistic care through a multi-disciplinary team of nurses, doctors, counsellors, social workers, occupational therapists, physiotherapists, spiritual leaders and a range of volunteers. The service cares for people in four types of settings: at the hospice in a 15 bedded ‘In-Patient Unit’; in the ‘Hospice day service’; in people’s own homes; and in hospital, where people received care from the hospital palliative care team, based at Medway Foundation Trust. The service was providing services for 392 people in the hospice and the community at the time of the inspection.

A registered manager was in post. 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 said that they felt at ease receiving care from the service and relatives reported that people were in safe hands. Ensuring that staff understood how to safeguard adults and children was central to the running of the service. Staff received training and regular updates throughout the year and demonstrated that they knew how to recognise and report potential abuse.

Assessments of risk were individual to people’s specific needs and identified how risks could be minimised. Environmental and health and safety checks were carried out to ensure that the environment was safe and that equipment was in good working order. There were systems in place to review accidents and incidents and make any relevant improvements.

Checks were carried out on all staff at the service, to ensure that they were fit and suitable for their role.

People said that there were enough staff available to promptly attend to their needs. The numbers of staff and volunteers available meant that staff had time to give people one to one attention.

Safe systems were in place for the ordering, storage, administration, recording and disposal of medicines.

New staff received a comprehensive induction and received effective support from a mentor. Training was provided which was necessary to their roles and included specialist training in bereavement and end of life care to make sure that they had the right knowledge and skills to meet people’s needs effectively.

People’s health, medical, nutritional and hydration needs were assessed and closely monitored. People’s needs were individually discussed and effectively communicated when the staff team changed on the in patient unit. People were supported by a multi-disciplinary team and referrals were made to other professionals to seek their advice and input when it was required.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes, hospitals and hospices are called the Deprivation of Liberty Safeguards (DoLS). The service manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The service had made applications under DoLS to ensure that people were not deprived of their liberty unlawfully.

The service provided a relaxed, comfortable and clean environment. There were a range of areas available for people and their visitors to sit and for day patients to undertake activities.

The service had received a large number of compliments concerning the kind, compassionate and caring manner of the staff team. Staff spend time listening and talking to people and people said they were treated as individuals.

The service had a holistic approach to caring for people at the end stages of life. Supporting the person and their family members was seen as a key to their well-being. Family members received support after the death of their loved one through individual or group bereavement counselling. People’s spiritual needs were met and there was a range of complimentary therapies which valued the contribution of people with a life threatening illness.

People’s individual wishes with regards to their care were recorded and the staff team advocated for people when necessary to ensure these were met. People and family members were involved in planning their care and treatment and were confident that staff explained everything to them clearly. Care plans were detailed, reviewed and updated on a daily basis.

People’s needs were thoroughly assessed before and at the time of being admitted to the service. The staff team ensured that care and support was offered in a timely way, and services were offered flexibly depending on people’s needs. People’s care plans were personalised and contained detailed information about their preferences and advanced decisions in relation to end of life care.

Peoples’ psychosocial, spiritual and therapeutic needs were catered for. The day hospice offered a creative and innovative programme of activities that ensured people were treated as active and valued members of the community. They were given opportunities to express their feelings and emotions through a variety of outlets including creative writing, art, photography and a quilting project.

The service and the charity which supported it, had built links with other hospices and the local community through offering services and fundraising events. Further improvements were planned for this area of development for the benefit of people.

People were able to make their views known and knew how to make a complaint or raise a concern. People were able to make their concerns know by immediately ‘texting’ them to the service, therefore, making it easier for them to do so. When complaints had been received, these had been investigated and forums held so that lessons were learned to improve the service.

There was an open culture, where people and their relatives were encouraged to share their experience of the service. Staff understood the ethos and values of the service and how to put these into practice. They felt valued, listened to and well supported. This resulted in a staff team who was motivated to give a high standard of care to people who used the service.

The service had a clear management structure and lines of accountability. There was a robust programme of clinical governance and audit to identify any shortfalls. When this occurred action plans were put in place with timescales to address these areas and monitored until completion. Therefore, there was a process of continuous improvement of the service.

9 December 2013

During a routine inspection

We found that consent was sought from people about all aspects of their care and treatment and where people were unable to make decisions best interests meetings were held involving relatives and the health and social care professionals.

People experienced effective and safe care which met their needs and promoted their rights. Care was person centred and delivered by a skilled multi-disciplinary team. People told us that the staff and the services offered were 'Superb, there's no other word for it'.

We found that people were supported to receive food and drink that they chose, whenever they wished. One person told us 'The food is excellent'.

We found that the risks of infection were reduced, because staff had received training in infection control and were knowledgeable about the actions they should take to reduce risks. Robust policies and procedures were also in place.

People using the service were protected from risks associated with inappropriate staff, because effective recruitment procedures were in place.

There were effective systems in place for monitoring the quality of the service. The systems were sufficiently detailed to ensure the service was fully complaint with the regulations we inspected. We found that there was strong leadership which helped continuously improve the service.

24 January 2013

During a routine inspection

We spoke with people who used the service and relatives of people. We spoke with nursing and administrative staff as well as members of the management team and the Consultant in Palliative Medicine.

People told us that communication between them and the staff was excellent. People told us they were fully involved in decision making about their care. People received personal care in a way that promoted and protected their privacy and dignity. People told us that the staff were friendly and welcoming.

There were a range of activities and complementary therapies available for people, including massage, physiotherapy, sensory treatments, as well as arts and crafts.

People and relatives we spoke with said that the care and support they or their loved one received was outstanding. One person said 'I can't praise them enough' another said 'You couldn't wish for a better place'.

People said they felt safe and well cared for at the hospice and were confident that if they were unhappy with anything their concerns would be listened to and acted upon.

Staff told us that they received the training and support they needed to carry out their roles.

The service had a broad range of quality assurance processes in place which ensured compliance and maintained standards.