We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by Care Quality Commission (CQC) which looks at the overall quality of the service.

This was an announced inspection. Forty eight hours’ notice was given to the provider. This was because the hospice at home service is a community based service and we wanted to ensure the relevant staff were available to talk with us during our inspection.

Mary Ann Evans hospice provides a day care service for people with life limiting conditions, a hospice at home service for people moving towards the end of their lives, and a service to alleviate the symptoms for people with lymphoedema, a condition which can occur after cancer surgery or radiation therapy.

At the time of our inspection a registered manager was employed at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People who used the hospice and their relatives told us they were happy with the services provided by the hospice. They felt the staff understood their needs and they felt safe.

People’s wishes and preferences were taken into account and recorded in care plans. Risk management procedures were in place to ensure people’s health risks were identified and plans were in place to manage those risks.

Staff demonstrated a good understanding of the needs of people with life limiting illness. They had received good training and support to meet people’s needs.

The organisation worked well with other health and social care providers to ensure people’s needs were met.

There were appropriate policies and procedures in place to support people should they ever have a need to complain or raise concerns. When concerns had been raised, they had been dealt with effectively.

There were systems in place to assess and monitor the quality of support provided for people.

During our inspection we spoke with six people who were using the hospice. We also spoke with the registered manager, the staff nurse who is the clinical lead for the hospice, the facilities manager, a support worker, and two ‘hospice at home’ support workers.

The people we spoke with had given their consent to care and treatment based on the information they received. One person said, “They explained everything.”

We saw that people’s care plans were personalised and detailed. They included information about people’s own priorities and preferences in respect of their care and treatment. People told us they enjoyed visiting the day hospice. One person commented, “I can be myself here. Staff know how I feel.”

We were told that the staff and volunteers were very supportive and nothing was too much trouble. One person explained: “I can’t praise the staff here enough. They can’t do enough for you.”

Staff we spoke with told us about their high level of job satisfaction. They said they felt well supported by the management team. They described the range of training available to them which enabled them to develop their knowledge of caring for people with a life limiting illness.

We looked at cleanliness and infection control. The hospice was very clean and had good systems in place to minimise the spread of infection.

There was a very relaxed atmosphere throughout our visit and staff and volunteers went about their duties in a happy and cheerful manner.

There were six people using the hospice day service on the day of our inspection. We spoke with two people, the registered manager, a staff nurse and two care workers.

People told us that they were consulted about every aspect of their care. We saw that people were supported by a multidisciplinary team of health and social care professionals to ensure they had care tailored to meet their individual needs. Records showed extensive consultation and planning to ensure people's care was appropriate. One person told us "I look forward to coming here every week, they’re a great team of people."

People told us there were lots of things to do and that they enjoyed all the activities and craft sessions available to them. One person commented, “There is always something going on.”

We saw quality assurance systems in place which measured people’s satisfaction with the service provided in the home. The service consulted with people to improve the care they offered. Audits of health and safety checks, risk assessments, care planning and other areas associated with the quality of care were in place. One person told us “There is nothing too much trouble, they think about what is best for you.”

The staff we spoke with told us they were happy working at the hospice and felt well supported by the management team. We were told that training opportunities were frequent and planned to ensure staff had sufficient knowledge to meet people’s needs.