Archived: Sam Beare Hospice

Sam Beare Hospice is an independent registered charity for the delivery of care and treatment for people across Surrey, owned by Woking Hospice Trust. The service is provided using the 10 bedded inpatient unit, the hospice at home service and the day hospice service. Medical, nursing, therapy and palliative care clinical nurse specialists (CNS) are provided across the hospice’s inpatient unit, day unit and community services. People and their relatives may also receive support from the bereavement service, a telephone advice line and a spiritual care service. All of these services provide specialist palliative and end of life care to people with progressive and advanced disease and a limited life expectancy. The hospice was experiencing a period of change as the service prepares to move location and merge with the provider’s other hospice in the next year. The provider was sensitive to the uncertainty this might cause people and staff and a change management programme was being implemented to ease the process.

There is a registered manager 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.

There was a defined governance and management structure in place, which staff understood. This provided clear lines of responsibility and authority for decision making about the management, operation and direction of the hospice and its services. Systems were in place to support the registered manager and board of trustees to identify risk and quality concerns and drive improvement across the service. We saw examples of improvements made in relation for example, to the staff appraisal process, recruitment records and medicine management.

People were protected from harm and abuse and robust staff recruitment procedures were followed to keep people safe. There were sufficient staff to meet people’s individual needs and to respond flexibly to changes and unforeseen emergencies.

Systems were effective to manage known risks associated with people’s care and treatment needs such as falls, pressure sores, poor nutrition and hospice acquired infections.

People were supported to eat and drink sufficiently and adjustments were made to ensure people at risk of choking could eat and drink safely. Regular reviews took place of people’s symptoms and changes were made as required to ensure people’s pain would be well managed.

Staff followed and understood the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards 2009 (DoLS). These set out requirements to ensure, where appropriate, that decisions about people’s care are made in their best interests when they are unable to do this for themselves.

There was a holistic approach to people’s care with the physical, well-being, social and spiritual needs of each person given equal importance, together with the needs of those closest to them.

People and their families received a responsive service. People were treated as equal partners in determining their care and treatment plans and their rights, wishes, preferences and diverse needs were respected. The service was responsive to the changing needs of people and had developed the service in response to the local communities changing needs. Care, treatment and support were provided within the hospice environment and people’s homes in line with their assessed needs and preferences. People, their families and staff felt that they mattered and that their views were taken into account and acted on.

People and their relatives were complimentary about and satisfied with the care provided, which they described as “Excellent”. Staff treated people with care and compassion and were motivated and committed to providing people with the best possible palliative and end of life care. People were supported to receive end of life care that met with their needs and wishes and to achieve a private, dignified and pain free death. People, their families and staff were provided with the emotional and bereavement support they needed.

Staff received the training and support they needed to perform their roles and deliver good care. Managers supported staff to undertake professional development, to ensure best practice and make improvements in care when required.

Staff worked closely and in partnership with external health and social care professionals and providers and also health commissioners, educators and national organisations concerned with palliative and end of life care. This helped to ensure that people received the right care at the right time and that knowledge was appropriately shared and used to influence best practice for people’s care.

We spoke with two relatives of people who used the service. They all told us that they felt that the care their relative received was good and that 'communication was brilliant.' One relative told us that the service 'really do do an excellent job.'

Relatives told us that they felt their family member was safe. The people we spoke with confirmed this.

We looked at staff files and found that the service had training processes in place that ensured that the staff were suitably trained. However we found that although staff were aware of safeguarding procedures half of the staff had not received safeguarding training.

The service had systems in place to monitor the quality of the service which identified when things needed to be improved. This included regular satisfaction surveys, a comments & suggestions log and a service users group.