The Care Quality Commission (CQC) has rated the quality of services provided by Prospect Hospice as Requires Improvement overall, following an inspection in June 2019.
Overall the hospice is now rated as Good for being caring. Requires Improvement for being safe, effective, responsive and well-led.
This is the third inspection of Prospect Hospice by CQC since February 2018. At the focussed inspection in February 2018 the CQC issued a warning notice requiring the hospice to improve. The provider was told to improve the management oversight systems and to ensure that staff received appropriate training, support and appraisal to carry out their roles.
The second inspection took place in August 2018 which was a focused inspection to review the providers actions in respect of the warning notice. While some improvements had been made, these were not enough to provide assurance. As a result of this conditions were imposed upon the providers registration. This included CQC receiving monthly risk and health and safety reports from the hospice.
At this inspection which took place in June 2019, inspectors found improvements although there are still areas where further improvements were required to ensure that patients receive consistently safe care.
CQC’s Head of Hospital Inspection, Mary Cridge, said:
“I am very pleased to report that since our last inspection we have found evidence that the hospice is making progress.
“Two years ago, we visited the service because of concerns relating to patient safety, the organisational culture and governance throughout the service. Since that time we have been keeping a close watch, monitoring the activity within the hospice.
“There is no doubt that improvements have been made and embedded but further work is required to ensure patient safety. The leadership team are leading to a workforce who are now becoming better engaged and whose morale is now much higher.
“We have identified areas that do require attention. We will return later to check: I will be disappointed if we find that the hospice has not continued to make further progress.”
Inspectors found that training and staff recognition of abuse and infection controls procedures had all improved since the last inspection in August 2018.
The leadership team could not provide assurance that the services they provided were based on national guidance and evidence-based practice. This included end of life care planning and the recording of the wishes of individuals within their care plans.
The management needed to continue to work on the organisation culture to encourage, openness. Some staff, did not always feel respected, supported and valued. The culture did not always encourage, openness within the organisation.
The service did not always demonstrate that they have enough nursing staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm.
The service did not always plan and provide care in a way that met the needs of local people and the communities served. Nor was the service inclusive and did not always record patients’ individual needs and preferences. Waiting times from referral to achievement of preferred place of care and death were not documented in line with good practice.
Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs. They provided emotional support to patients, families and carers to minimise their distress. They also understood patients’ personal, cultural and religious needs. Inspectors found a committed team who wanted to work well together, inclusively for the benefit of people using the service.
However, the Chief Executive was clear on the direction of travel and the organisational priorities.
The leadership team had identified ways of working to improve the position of the service. They also recognised that work is still needed to improve the culture and in ensuring the service was a good place to work.
There were new members of the leadership team and the Non-Executive Directors were taking a more pro-active role in the organisation.
A copy of the report can be found here: www.cqc.org.uk/location/1-117219570
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