This inspection took place on 21 April 2016 and was announced. At our last inspection on 12 November 2013 the service met all the regulations we inspected. St Catherine’s Day Hospice-Whitby provides free day hospice care to adults with a life limiting condition or a diagnosis of cancer that live in the Whitby area of North Yorkshire. The service operates on Thursdays between 9am and 3pm and there were three people using the service on the day we inspected.

The registered provider operates three services and we inspect all three services. Although the services are registered with the Care Quality Commission separately we found that there were areas that were common to all three services. For example, training programmes, staff meetings and one set of policies and procedures across all three services. For this reason some of the evidence we viewed was relevant to all three services. Our individual findings for St Catherine's Day Hospice -Whitby, St Catherine's Day Hospice- Ryedale and St Catherine's Hospice- Scarborough are discussed in individual reports.

St Catherine's Day Hospice- Whitby is run in an adapted bungalow in a residential area of Whitby. There was a large garden, patios and summer house for people to use. People who used the service had access to consultants and medical care, nursing care, physiotherapy, occupational therapy, social workers and spiritual support to meet their needs.

There was a registered manager employed for this service who also managed the main site, a hospice at home service and another day hospice. 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 was very experienced after being employed by the hospice for many years. The day to day running of this service was managed by a nursing sister employed by St Catherine’s Hospice Trust.

Staff followed risk assessments and guidance in risk management plans when providing care and support for people in order to maintain their safety.

Staff were able to describe what it meant to safeguard people and told us how they would report any suspected abuse. There were policies and procedures in place for staff to follow.

Staff recruitment processes were followed with the appropriate checks being carried out. There were sufficient staff on duty to meet people’s needs and the service had a team of volunteers who provided additional support. The hospice had a bank of staff who they could contact if they needed additional staff. All staff received supervision individually or as a group and annual appraisals were undertaken. New staff and volunteers received a thorough induction and regular training to ensure they had the knowledge and skills to deliver high quality care.

The environment was maintained by the hospice maintenance team. There were servicing agreements in place for mains services. The premises were clean and tidy with appropriate adaptations in place for people who used the service.

People brought their own medicines with them to the service and there were systems in place to ensure they were stored and administered safely.

Staff worked within the principles of the Mental Capacity Act where appropriate. People had choices about their care and their consent was sought by staff.

People were supported to receive a nutritious diet at the service. There was a choice of menu on the day we inspected and drinks and snacks were freely available.

When people needed specialist healthcare support the day hospice made referrals to specialist services such as occupational therapy or the dietician. People and their families could access advice and support through a helpline twenty four hours a day which linked directly to the hospice.

People to

We visited St Catherine’s day hospice and carried out a scheduled inspection. We found that patients were happy with the support they received. One patient who used the service told us “Overall I am very happy with the support”. Another patient who used the service told us “The help and the facilities are brilliant. I look forward to coming”.

We found that staff ensured that patients had given their consent before any treatment or care was carried out and this was recorded in files. We observed that the day hospice was extremely clean and hygienic and staff followed robust infection control procedures.

We looked at staff files and recruitment, selection and induction procedures and found these to be robust and followed appropriately. The hospice had comprehensive quality assurance procedures in place and responded appropriately to feedback from patients.

During our inspection we spoke with two people who were receiving day care at the hospice. We also spoke with two staff nurses, one of whom was the clinical lead for the hospice, an occupational therapist and a volunteer worker.

People told us that they were consulted about every aspect of their care and that they felt supported by a network of professionals who operated in their best interests. One person told us "We spend time talking about how I feel and what support will be best for me." 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 supported extensive consultation and planning to ensure people's care was appropriate.

People were protected by the safeguarding policies and procedures of the service. Staff had training in how to protect people from abuse and the risk of abuse. There were sufficient skilled and qualified staff to ensure people had the support they required.

The service had a comprehensive quality assurance system. The staff 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. The service also had a complaint procedure so that people could have confidence that their concerns would be listened to and any problems addressed.