Bury Hospice is a charity which provides a range of hospice services for adults with a life-limiting illness. The hospice is purpose built and provides accommodation on the In Patient Unit for up to 12 people. The hospice also has a Day Hospice and Hospice at Home service. In addition the hospice offers a 24 hour telephone advice line for professionals, people who use the service and their families. The hospice is close to public transport routes and is situated in a residential area of Bury, not too far from the town centre. The hospice is set in well-maintained gardens with adequate parking and clearly defined parking areas for disabled visitors.Services are free to people, with Bury Hospice receiving some NHS funding and the remaining funds are achieved through fundraising and charitable donations.
There were six people being cared for in the In Patient Unit during our inspection, 18 people being cared for in the community and 10 people attending the Day Hospice.
We inspected Bury Hospice on the 13, 15 and 19 April 2016. The first day of the inspection was unannounced. We last inspected Bury Hospice on 11 July 2013 where we found all the regulations that we looked at had been complied with.
The home had a manager registered with the Care Quality Commission (CQC) who was present during the inspection. A registered manager is a person who has registered with 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 and associated regulations about how the service is run.
We found there were four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.
There was no auditing of the quality and safety of the service to ensure people were kept safe.
We found that staff had not received regular formal supervision; necessary to enable them to feel supported and be able to discuss their progress and training needs.
An inspection of the training records showed they were incomplete. Failing to keep records to demonstrate that staff have been appropriately trained and have the necessary skills to safely care for people places people who use the service at risk of harm. There were no records to show that checks had been undertaken to show that the registered nurses who worked at the hospice had a current registration with the Nursing and Midwifery Council (NMC).
There was no business continuity plan in place to deal with emergencies that could arise and possibly affect the provision of care.
People spoke highly of the kindness and caring attitude of the staff. The expressions of care and gratitude relayed to us, demonstrated that people were cared for with the utmost compassion, kindness, dignity and respect.
We saw that people’s privacy was respected and people were assisted in a way that respected their dignity. We observed respectful, kindly and caring interactions between the staff, the people who used the service and visitors. People looked well cared for and there was enough equipment available to ensure people’s safety, comfort and independence were protected.
The care records showed people were involved in the assessment of their needs. A person’s preferred place of care at all stages of their illness and the arrangements in the event of their death were documented. The care records we looked at showed that risks to people’s health and well-being had been identified, such as poor nutrition, the risk of developing pressure ulcers and the risk of falls. We saw care plans had been put into place to help reduce or eliminate the identified risks.
People were supported at the end of their life to have a comfortable, dignified and pain-free death. The clinical staff showed they were highly skilled in pain and symptom control.
Visitors were made welcome and the staff recognised and considered the importance of caring for the needs of family members and friends.
We found the medication system was safe and we saw how the staff worked in cooperation with other healthcare professionals to ensure that people received appropriate care and treatment. The healthcare professionals we contacted told us they had no concerns about the service.
Staff were able to demonstrate their understanding of the principles of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions.
Staff sought people’s consent before they supported them. The staff we spoke with had an in depth knowledge of the care and support the people who used the service required.
We found that suitable arrangements were in place to help safeguard people from abuse. Staff knew what to do if an allegation of abuse was made to them or if they suspected that abuse had occurred.
We found people were cared for by sufficient numbers of suitably skilled, competent and experienced staff who were safely recruited. Staff received the essential training and support necessary to enable them to do their job effectively and care for people safely.
All areas of the hospice were secure, well maintained and accessible for people with limited mobility. In addition good infection control procedures were in place; making it a safe environment for people to live and work in.
We saw that food stocks were good and people were provided with a choice of suitable and nutritious food and drink to ensure their health care needs were met. People who were at risk of malnutrition and poor hydration had their food and fluid intake monitored to help ensure their well- being.
Suitable arrangements were in place for reporting and responding to any complaints or concerns.