St Catherine's Hospice is a charity which provides specialist end of life care and support to adults living within the local area. It provides an 18 bed in-patient beds unit, a day hospice and a community service. A range of other services are also provided including occupational therapy, physiotherapy, counselling, spiritual care and a nursing service to help people with lymphoedema (fluid retention and tissue swelling). The service runs its day hospice and outpatient services from its main site in Crawley and from its site in Caterham. Services are free to people and St Catherine’s Hospice is largely dependent on voluntary fund-raising.

The service has a registered manager. 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 valued their relationships with the staff team and felt they often go “the extra mile” when providing care and support. There was a focus on people’s wellbeing and providing emotional support. People and their relatives spoke positively about the caring approach of staff. We were told “To be quite honest with you, the staff make the job, nothing is too much trouble, they are conscientious and have the right type of manner which makes you feel good. They’re attentive, they all take the time to introduce themselves and they make me feel good”.

Staff are highly motivated to offer care which was kind and compassionate and were creative in overcoming obstacles faced to achieve this. Bereavement services were tailored to people’s individual needs and were provided over a significant period of time. People’s spiritual needs were considered in the care that they received. Chaplaincy support was available for people and their family. Relatives were invited to a remembrance service once a year.

Staff are exceptional in enabling people to remain independent and had an in-depth appreciation of people’s individual needs. People were encouraged to set goals and to focus on their possible achievement. The registered manager spoke about their focus on promoting people’s independence and told us “It’s about being there and not taking over”.

People’s care was planned in partnership with them and their family. Staff knew people well and understood how they liked to be supported and used innovative ways of communicating with people to ensure that they were listened to. Staff also had a good understanding of how people may feel when considering their end of life care. Staff ensured that they responded to people’s feelings in an understanding and compassionate way and the services was flexible and responsive to people’s individual needs. Each care plan was person centred and unique to ensure that people felt valued and understood. People told us that staff involved them in decision about their care and listened if they preferred for things done another way. When we asked one person if they felt involved they told us “absolutely I’m involved”.

The hospice was involved in the local community and focused on building a strong positive profile in the community. We spoke with the Patient and Family Support Team who told us about their links with the local schools. They visited local schools and spoke with students about the hospice and provided advice for students that may be experiencing or have experienced the loss of a family member. A staff member spoke with us about one student that had spoken with them about the loss of their family member of the support their family received through the hospice.

There was a strong emphasis on continually striving to improve and staff also told us “Quality is at the heart of this place”. Quality assurance systems were in place to regularly review the quality of the service that was provided. The

We found patients were provided with information and were asked for their consent prior to care and treatment. Comments from staff and patients included, “I talk to patients about the options, risks and benefits and make sure there is time to ask questions”, “The policy and procedure gives guidance to staff and we document consent in notes” and “I had some medication changes and they talked these through with me, discussed side effects and the options available so I could decide.”

We found patients nutritional needs were assessed and planned. Menus provided choice and alternatives to ensure nutritional needs were met. Comments from patients included, “There are alternatives at mealtimes and they are always prepared to do something else.”

We found the service was clean and tidy and there were systems in place to prevent the spread of infections.

We found there were sufficient staff on duty to care for patients. The staff had access to clinical supervision, support, training, development opportunities and annual appraisal to ensure they had the required skills and knowledge for their roles. Comments from patients regarding the staff team included, “Their one objective is to look after us; it’s wonderful here and I really value the service” and “The nurses and doctors are absolutely super; they always have a smile."

We found the service had a complaints process and patients spoken with told us they felt able to complain if necessary.

We spoke with people staying at the hospice, people attending it's day service and people being supported by hospice staff in their own homes. Everybody we spoke to praised the kindness, patience and professionalism of the staff who provided their care. One person told us "The staff and volunteers are all so good and so caring. The nurse phones me every week to ten days to see how I am doing and to see if I have any questions. It is great and makes me feel that I am not alone." Another person told us "The staff are beyond helpful. Nobody rushes you and nobody minds what they do to help. The doctor is honest with me. If I use the bell and the nurses are with someone else they still come to tell me when they will be with me and are as good as their word. I feel very safe here."

We found a welcoming and friendly service where staff went about their work in a calm and professional way. They treated people with great respect and kindness.

Staff were given support and training to enable them to do their jobs to a high standard. We judged that, together with the doctors, volunteers and support staff, they formed a close and cohesive team which provided people with highly tailored support and care. There were effective systems in place to regularly assess and monitor the quality of the service provided.