We inspected Lawrence Home Nursing Team (LHNT) on 28 September 2016. LHNT is a small charity, which was established to provide palliative, mostly overnight, nursing care to people in the last stage of their lives.

The service is registered to provide personal and nursing care to people in their own homes and they offer a free of charge, specialist support enabling people to die in their own homes. LHNT provides care around Chipping Norton and surrounding areas and works closely with the local GP surgeries. The registered manager told us the team was like ”an extension of community service provided by District Nurses’ team to ensure people received 24 hours care at home”. At the time of our visit the service cared for three people.

There was a registered manager in post at the service. 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.

Due to the nature of the care provided we were unable to directly contact the people who used the service to obtain their views. The feedback received from people’s relatives was positive. People’s relatives were complimentary about the caring approach and professional attitude of the team. They told us Lawrence Home Nursing Team enabled them to fulfil their loved ones’ wishes of remaining at home at the final stages of their illness. They also told us the team helped them to ensure people experienced a comfortable and dignified death.

People’s relatives told us people were always supported in a safe way and their wishes were respected and their dignity promoted. They also commented on positive caring relationships the service built with the people they cared for and with their families.

The service communicated well with families and other professionals to ensure people received tailored, person centred and compassionate care at the end of their lives. People’s nutritional needs were considered, assessed and recorded.

People were supported by a team of registered nurses who all had many years of experience either working as a District Nurse or at hospices. The nurses were aware what action to take to ensure that people were protected if they suspected people were at risk of abuse. The registered manager and the nurses were aware about the Mental Capacity Act and their responsibilities regarding involving people. The nurses were well supported by the registered manager and had access to further training and professional development opportunities. People’s relatives also told us the nurses displayed exceptional empathy towards the whole families and to all who mattered to people who received the service from Lawrence Home Nursing Team.

There were sufficient numbers of nurses employed to provide care to the people using the service. Records confirmed relevant checks had been carried out to ensure the safe recruitment practices were followed.

The provider had signed a partnership agreement with the Oxford Health NHS Foundation Trust which detailed cooperation between the service and the local health professionals and the provider's use of district nursing notes to ensure continuity of care for people. The registered manager ensured risks to people’s individual needs had been identified and actions had been taken to manage these.

People were mostly referred to LHNT by the local health professionals and the referral notes reflected people’s needs were known to the service before they supported people. The registered manager ensured detailed records of any support provided were kept. Each overnight shift was followed up by a robust handover to the nurse co-ordinator and to the District Nurses team to ensure people’s changing needs were met. People’s relatives commented positively on the flexibility of the se