This inspection of Oakhaven Hospice took place on 8 and 9 August, 2016. The hospice is a charitable organisation owned by Oakhaven Hospice Trust, which is a specialist palliative care service providing care to people in The New Forest and Waterside area who have been referred by a health care professional. Oakhaven Hospice provides specialist care to people, carers and families who are facing complex physical, emotional and practical difficulties arising from advanced progressive life limiting illness. This may be cancer or other diseases. The service delivers physical, emotional, spiritual and holistic care through teams of nurses, doctors, counsellors and other professionals including therapists. The service provides care for people through an inpatient unit (IPU), outpatient day service, a hospice at home service and The Coates Centre. The Coates Centre provides information and support for anyone in the local community who feel their lives have been impacted by illness.

At the time of the inspection there were eight people using the inpatient service. The day services provided offered a range of services to people diagnosed with life limiting conditions, their carers and families. The service provided specialist advice, courses, complementary therapy sessions and clinics. Oakhaven Hospice provided a counselling and bereavement service for people and their families if required.

Oakhaven 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. The registered manager at Oakhaven Hospice was also known as the Head of Clinical Services.

Staff had been trained in relation to safeguarding vulnerable people and knew how to protect people from abuse and harm to keep them safe.

Potential risks to people had been identified and managed appropriately. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow to make sure people were protected from harm.

There were effective health and safety systems to protect people from harm within the inpatient unit and Day Services. Regular audits and daily checks by nominated staff ensured that the environment and equipment used was safe and fit for purpose.

The service provided support for people in the community through a specialised equipment loan system. This system has recently been improved based on a recent audit to ensure all equipment is safety checked and decontaminated after each use.

Accidents and incidents were recorded and monitored to identify how the risks of their recurrence could be prevented.

People were supported by sufficient numbers of staff to provide care and support in accordance with the individual needs of people. People who were receiving care in the in-patient unit told us the staffing numbers were appropriate and assistance was provided promptly when requested.

Staff had undergone robust pre- employment checks as part of their recruitment, which were documented in their records. People were safe as they were cared for by staff whose suitability for their role had been assessed by the provider.

People’s medicines were managed effectively to ensure they received them safely. People and relatives told us people had their medicine when they needed it and staff were quick to respond to any needs they had. Staff involved in medicines administration had regular training and had undergone competency checks to ensure their knowledge and practice remained up to date.

People received effective care, based on best practice, from staff who had the necessary skills and knowledge to do so. Staff received effective training and supervision to f

During our inspection we spoke with the registered manager who is the head of clinical services at the hospice, the senior sister and other members of the staff team. We spoke with two people using the service and a visiting relative, as well as a visiting healthcare professional.

We found that people were involved in decisions about their care and that they were treated with dignity and respect. People using the service told us, for example: “I have talked with staff about the support I need,”

“I decline medicine sometimes, and they respect my views on this” and “This is a serene place. Everyone is very courteous, compassionate and professional”

We saw that people's individual needs were assessed and reviewed by a multidisciplinary team including health professionals, counsellors and therapists. People’s spiritual needs were supported and people were allocated named leads for their care.

The premises were clean and arrangements were in place for effective infection prevention and control. One person told us, “Staff always use gloves and aprons and wash their hands before handling medicines or creams.”

Clinical governance arrangements were in place to ensure risks were managed and care and treatment was in line with clinical guidance. Staff had access to education, training and support.

Patients said that staff respected their wishes. One patient told us, “I was asked to make decisions about the future, but it was made clear that I could change my mind”. Another patient said, “Staff help me to make decisions and give me the information I need”.

Patients told us staff provided the care and support that they needed. Comments from patients described the care as, “Excellent”, and, “Staff provided the care that I asked for”. Patients told us they had been involved in developing and reviewing their care plan and that staff provided the care detailed in their plan.

Patients were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Patients were made aware of the complaints system. During the visit we spoke with six patients, who used either the Oakhaven at home service or had been inpatients. Everyone we spoke with said they were aware of the complaints process and said they were confident that any concerns would be fully investigated.

During the visit we spoke with five people who use the service. People said they felt they were well treated by staff, in ways that maintained their dignity and respected their privacy. We were told staff were respectful of them and listened to their requests.

People said they received the care they needed in the way that they wanted it to be provided. People told us staff responded promptly when they called them and helped them to resolve any problems they had. One person said staff had a “good understanding of people and how to treat them”. Another person said “staff have the skills needed and provide excellent care”. The relative of one person who was using the service told us “they have provided excellent care, we couldn’t have asked for more”.

People said they felt safe in the hospice and said they were confident that staff would respond appropriately to any concerns they raised. One person said staff had a good understanding of safeguarding issues.