Hospice in the Weald

Updated 30 July 2016

We carried out this inspection under Section 60 of the Health and Social care Act 2008 as part of our regulatory functions. This focused inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and provide a rating for the service under the Care Act 2014.

We undertook a focused inspection of the Hospice in The Weald on 11 July 2016. This inspection was completed to check that improvements to meet legal requirements planned by the provider after our comprehensive inspection on 12 and 13 October 2015 had been made. We inspected the service’s systems in respect of medicines, against one of the five questions we ask about services: ‘is the service safe’. This is because the service was not meeting some of the legal requirements in relation to that question.

The inspection was carried out by one inspector.

Before our inspection we reviewed the information we held about the hospice and the provider’s action plan, which set out the action they would take to meet legal requirements.

At the visit we looked at the service’s policies and updates in regard to medicines, medicines administration records (MARs) and monitoring checks that were carried out in all aspects of medicines. We checked that each shortfall that had been identified at our previous inspection had been remedied and that improved monitoring systems were effective. We spoke with the chief executive, the registered manager, the matron for the Inpatient Unit and Therapies, and a consultant in palliative medicine.

Updated 30 July 2016

We carried out an unannounced comprehensive inspection of this service on 12 and 13 October 2015, at which a breach of legal requirements was found. Although we identified shortfalls in respect of medicines, people had not experienced any negative outcomes as a result and some remedial action was taken on the day of our inspection. However we found that some aspects of monitoring processes with regard to medicines needed to be consistently embedded to ensure that improvements were sustained over time.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook a focused inspection on 11 July 2016 to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to medicines as part of the question ‘Is the service safe?’ You can read the report from our last comprehensive inspection on our website at www.cqc.org.uk.

Hospice in the Weald is a local charity covering a catchment area in West Kent and East Sussex that provide palliative and end of life care, advice and clinical support for adults with life limiting illness and their families and carers. They deliver physical, emotional and holistic care through teams of nurses, doctors, counsellors, chaplains and other professionals including therapists. The service cares for people in three types of settings: at the hospice in a 15 beds ‘In-Patient Unit’ plus up to two people in the day procedures room, or in their ‘Hospice day service’ that welcomes approximately 120 persons per week, and in people’s own homes through their Hospice in the Home service that supports approximately 700 people. The service provides specialist advice and input, symptom control and liaison with healthcare professionals. This includes a training centre and offering advice and support to staff in nursing and residential care settings in the community, receiving up to 130 palliative care referrals per month. Services are free to people and the Hospice in the Weald is largely dependent on donations and fund-raising by volunteers in the community.

The services provided include counselling and bereavement support; an outpatient clinic; occupational and creative therapy, physiotherapy, chaplaincy and volunteer services that include approximately a thousand volunteers.

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 was also the Nursing Director for the service. They oversaw the running of the service and were supported by a leadership team that included a chief executive officer (the provider) and five directors.

At our focused inspection on 11 July 2016, we found that the provider had followed their action plan. New monitoring processes with regard to medicines had been consistently embedded in practice since October 2015 and legal requirements were met.