The Duchess of Kent Hospice is a local service run by the Sue Ryder charity. The in-patient facility covers a catchment area in Berkshire West which includes Reading, Wokingham and Newbury and is located in Reading. The hospice service provides specialist palliative care, advice and clinical support for adults with life limiting illness and their families. 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 15 beds ‘In-Patient Unit’, or in their ‘Hospice day service’ that welcomes up to 14 people per day, and in people’s own homes through their community service. The service provides specialist advice and input, symptom control and liaison with healthcare professionals. Services are free to people and the Duchess of Kent Hospice is dependent on donations and fund-raising by dedicated staff and volunteers in the community.

The services provided include counselling and bereavement support, family support, clinical psychology, chaplaincy, an out-patient clinic, occupational therapy, physiotherapy, dietetics, befriending, complementary therapies and diversional therapies and a lymphoedema service (for people who experience swellings and inflammation usually to their limbs post cancer treatments).

This inspection was carried out on 1 and 2 December 2015 by two inspectors and a pharmacist inspector who was shadowed by a new CQC pharmacist inspector. It was an unannounced inspection.

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 also managed the community services, the day hospice service on site and the two day hospices located at Newbury District hospital and Wokingham hospital.

People were kept safe by staff who were trained in the safeguarding of vulnerable adults and health and safety. They were able to fully describe their responsibilities with regard to keeping people, in their care, safe from all forms of abuse and harm. It was apparent from discussion with members of the management team that all health and safety issues were taken seriously to ensure people, staff and visitors to the service were kept as safe as possible. There were enough staff, on duty, to ensure people received safe care. People were given their medicines in the right amounts at the right times by properly trained staff. Recommendations were made in respect of fire drills and the use of as required medications in order to encourage improvement in these areas. The recruitment process was robust and the service was as sure, as possible that staff employed were suitable and safe to work with people who were cared for in the service.

People’s human and civil rights were upheld. The service had taken any necessary action to ensure they were working in a way which recognised and maintained people’s rights. The staff team understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people in their care. The Mental Capacity Act 2005 legislation provides a legal framework that sets out how to act to support people who do not have capacity to make a specific decision. DoLS provides a lawful way to deprive someone of their liberty, provided it is in their own best interests or is necessary to keep them from harm. The registered manager had made or was making the appropriate DoLS referrals to the Local Authority.

Clear information about the service, the facilities, and how to complain was provided to people and their relatives. Pe

The Duchess of Kent Hospice has recently been refurbished to improve the facilities of the inpatient ward and day therapy unit. The improvements were of a high standard and promoted people’s privacy and dignity.

People’s care plans detailed how they wanted their needs to be met and risk assessments supported the choices that they had made. People told us they felt safe, cared for and listened to by staff. They told us they had “every faith in ward staff’’ and were “very, very happy with the wonderful care’’.

Policies and procedures that were followed by staff promoted the safe administration of people’s medicines.

There were sufficient numbers of trained staff to care and support the people who used the services. Staff had received an in-depth induction and also received support to develop their skills and knowledge through continual professional development.

Health and safety measures were in place and were monitored by the provider to ensure a comfortable and safe environment.

The provider had listened to people who used the services. People told us, ‘’you are always involved and asked your views, they always listen to you’’.

We looked at commendations that the hospice had received directly or indirectly via their website. One of those read, “our memories of the oasis of care are still vivid and we know there must be many other families who share our feelings.”

We spoke with two people on the in-patient unit. They were both very positive about the care and treatment they had received. For example, one person said “this invaluable support had made a vast difference to my life and that of my family”. They both said staff had respected their privacy and dignity.

People were provided with information in relation to their treatment and care, which included information on how to make a complaint.

Staff had been given support and training to enable them to deliver care and treatment to an appropriate standard.

There was an effective system in place to regularly assess and monitor the quality of service provided.