The overall rating for Butterwick Hospice in Bishop Auckland, Durham, has dropped from requires improvement to inadequate, following an inspection by the Care Quality Commission (CQC) in February.
Butterwick Hospice, run by Butterwick Limited, provides adult hospice services including palliative and neurological day care, family support services and a home care service for palliative and end of life patients. It does not have any inpatient beds.
CQC carried out an unannounced comprehensive inspection to review how the service was performing. Following the visit, the overall rating for the service dropped from requires improvement to inadequate. Its ratings for being safe, effective, responsive and well-led also dropped from requires improvement to inadequate. Its rating for being caring remained as good.
Due to its findings, CQC has served Butterwick Limited a warning notice requiring it to make improvements and ensure patient safety.
Sarah Dronsfield, CQC’s head of hospital inspection, said:
“When we inspected Butterwick Hospice, we found staff worked well together, treated patients with kindness and compassion, and they were passionate about improving the service.
“However, we were concerned that the leadership team didn’t fully understand the issues the service faced, and they didn’t have appropriate systems and processes in place to run services which meets patients’ needs. Also, policies to ensure the safe and effective running of the service either lacked detail or were non-existent.
“Not all staff had completed the appropriate training. We found staff were giving medicine to patients in their own homes without the necessary training which could put people at risk.
“Additionally, some staff weren’t trained in how to report incidents, and there was limited evidence that the service was learning from incidents that occurred to ensure these didn’t happen again.
“Following the inspection, we told the provider it must make a number of improvements to ensure people receive safe care. We will continue to monitor the service to ensure that improvements are made, and we will return to check the improvements are fully embedded.”
CQC found the following during this inspection:
- Governance systems did not identify or monitor the quality of care provided and there was lack of oversight from senior leaders.
- Staff were not suitably trained, and they did not have appropriate policies and guidance to support them to deliver care in line with the service’s purpose.
- A failure to provide incident reporting training meant that the service could not be assured staff knew how to appropriately identify and report incidents.
- The service did not have effective systems to assess, monitor and mitigate risks relating to people’s health, safety and welfare.
- The service did not have a policy or procedure for staff to follow in situations where people’s risks had changed, or where a person had deteriorated or become seriously unwell.
- The service did not have systems and processes to safely administer, record and store medicines.
However:
- The service had enough nursing and support staff, and staff worked well together to meet the needs of patients.
- Staff demonstrated caring, compassionate interactions with patients and their families. People spoke highly of staff and the care that they received.
- The service had an open culture and staff felt confident to be able to raise and escalate concerns.
- People could access the service when they needed it and did not have to wait too long for treatment.
- The service controlled infection risk well and kept equipment and the premises visibly clean.
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