This inspection took place on the 11, 12 and 20 May 2016 and was unannounced.

Katharine House Hospice is registered to provide care and support to people in relation to symptom control, pain relief, assessment and end of life care.

Katharine House Hospice in-patient facility caters for up to 10 people, accommodated within two four bedded bays or an individual room. The hospice service provides specialist palliative care, advice and clinical support for adults with life limiting illness and their families. They deliver physical, psychological, social and spiritual care through teams of nurses, doctors, counsellors, chaplains and other professionals including therapists and social workers.

Katharine House Hospice provides a Hospice at Home Service, which provides palliative care within people’s own homes, which is provided by health care assistants.

Katharine House Hospice has a day therapy service, which provides an opportunity for people to meet and take part in a range of activities. The day therapy service in additions provides facilities for counselling and bereavement support, chaplaincy services, occupational therapy physiotherapy and complementary therapies.

Katharine House Hospice had 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.

People told us that they felt safe at the service and that they had confidence in the staff. The service was committed to promoting people’s safety across all levels of staff within the organisation and included advising the Board of Trustees of safeguarding concerns and ensuring staff at all levels, including volunteers and administration staff received training on protecting people from potential abuse or avoidable harm.

Risks to people were assessed and where potential risks had been identified these were minimised in consultation with the person. The provider promoted people and their relatives’ safety by providing leaflets and opportunities to take part in groups where information could be shared to reduce risk, for example in falls prevention.

The provider had robust systems to monitor risk which was facilitated by staff within the service with specific roles, such as infection control and tissue viability that undertook audits and reported the outcome to the Board of Trustees, where recommendations were considered and acted upon. The provider had a system to ensure that the premises of the hospice and its equipment were maintained to ensure peoples safety and any issues identified acted upon in a timely manner.

People’s medication needs were discussed by health professionals to manage and support people’s symptoms and pain management. And information in the form of a leaflet was provided to people, which included information when medicines were not being used for their usual indications. Medicines were regularly reviewed and audited to ensure they met people’s needs. A community pharmacist and pharmacy technician provided a medicines supply service and medicines advice to staff or people using the service, to ensure people received their medicines in a safe and timely manner.

People and their relatives were confident in the knowledge and skills of the staff that provided their care and support. Staff told us that they had access to training which enabled them to understand the needs of people and provide effective care and support. Staff said that they received planned and proactive support that enabled them to deal with the difficulties and challenges in providing care to people and their relatives with life limiting conditions and who required end of life care.

There were effective systems in place for all those involved in people’s support and care to sh

We inspected Katharine House Hospice on 12 November 2013 as part of our scheduled inspection plan. The visit was unannounced; this meant that the provider did not know we were visiting.

We met and spoke with the registered manager, staff in the day service and in-patient unit, volunteer workers, people who used the service and visitors.

People who used the service told us that the staff were 'brilliant', the food was excellent and the service was very good. Relatives told us that they felt well supported and fully involved with the care and treatment provided to their family member.

During the inspection we looked at two care plans. We saw clear evidence of consent being gained and the care and support needs of people were fully documented.

We saw systems were in place to ensure the safety of people who used the service. The premises were warm, well decorated, and comfortably furnished.

We discussed how the Hospice recruited staff and we found the five staff files we looked at were in order. Checks had been made to ensure suitable people were employed.

We saw that the Hospice had an effective system for dealing with complaints, concerns and adverse events.

We carried out this visit as part of our schedule of planned inspections. The visit was unannounced which meant the provider and the staff did not know we were coming.

People who used the service told us they were fully involved with discussing and agreeing their care and support needs.

We saw that each person who used the service had a plan of care that was reviewed at regular intervals. People told us they could have sight of their care plan upon request and at any time.

Staff told us they had the required knowledge and skills to provide the level of care that people needed. Systems were in place to protect people who used the service from harm, abuse and neglect. People who used the service told us they had no concerns or complaints. One person told us, “There is nothing to complain about, I have never witnessed anything that concerns me, all staff are very kind and caring”.

We saw the service had a robust system in place for assessing and monitoring the quality of the service.

We looked at five key outcomes to establish whether people were involved and participated in the service they received; whether care was provided appropriately; whether the service could adequately ensure people’s safety; whether there were enough qualified, skilled and experienced staff to meet people’s needs and whether there was a system for ensuring ongoing quality assurance within the service.

Katharine House Hospice was compliant in these five outcome areas.

There was evidence that people had been involved in the setting of assessed care plans, confirmed with a relatives comment: "When mum was being assessed we were asked a lot of questions regarding her needs, and we asked a few about the hospice. At a difficult time it was managed with sensitivity, and proved to be a pleasant and very helpful discussion, very informative and helpful”.

During the course of the inspection comments were received from several people using the service, and people visiting at the time. We asked for their comments on the quality of the service and care given. There was a clear appreciation of the openness and opportunity to contribute, one person visiting stated that “I have always found that I can speak to staff at any time, their patience and understanding is so appreciated".

Overall people were satisfied with the care and treatment they were receiving in the hospice; they told us that they were treated with respect and that visitors were made to feel welcome. Those written comments we saw presented a wealth of appreciation for a high standard of care and enhancement of the person’s quality of life.

We met with several people during the day who told us that the quality of the food was generally very good, and the results of a survey which showed a positive appreciation of the catering service. People remarked that they find the environment to be clean and tidy, each indicating their approval of a good standard of cleanliness throughout Katharine House Hospice.

Comments we have received from people using the service, visitors and staff members identified a confident and open relationship, based on mutual trust and respect: "Every member of staff at Katharine House have been wonderful, my main nurse always listen to me, and try to meet my needs", "They have a lot of very good staff, who are always looking after my needs"

We spoke with a number of people using the service and visitors, which demonstrated a readiness for people to express their views as to the quality of their care. The majority of comments were positive, mainly concerning the friendliness of the staff and the high standards of care. Some comments we received: "Katharine House Hospice do a wonderful job and I can only thank them for their care and patience in dealing with my husband", and "Keep doing an excellent and dignified job".