St Wilfrid’s Hospice is a charity which provides specialist end of life care and support to adults living within the local area. It provides a 14 bedded In-patient beds unit, a day hospice services and a community service. A range of other services are also provided including occupational therapy, physiotherapy, counselling and spiritual care.

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 were cared for by staff who knew how to recognise the signs of possible abuse. Staff were able to identify a range of types of abuse including physical, emotional and neglect.

Systems were in place to identify risks and protect people from harm. Where someone was identified as being at risk, actions were identified on how to reduce the risk and referrals were made to health professionals as required. Risk assessments were centred on the needs of people and were reviewed daily by nursing staff. When people’s risk had changed the assessments were updated to reflect these changes.

People being cared for at the hospice were protected against the risks associated with medicines because the provider had appropriate arrangements in place for the proper and safe management of medicines.

The registered manager compiled a report on accidents and incidents and these were reviewed by the chief executive and reported to the provider's governance team. There was an audit of accidents and incidents which identified trends and patterns, all clinical incidents were reviewed by the registered manager and following investigation an action plan was agreed.

There were sufficient numbers of staff with the required skills and experience on duty to keep people safe and meet their needs. We reviewed the staff rota that confirmed this. Staff told us they felt there were enough staff on duty. People’s needs were responded to in a timely way.

Staff had undertaken appropriate training to ensure they had the skills and competencies to meet people’s needs effectively. Staff received regular supervision and an annual appraisal to ensure that any issues with staff practice or areas for development could be identified and responded to.

People’s rights were upheld as the principles of the Mental Capacity Act and the Deprivation of Liberty Safeguards (DoLS) had been adhered to. The registered manager told us that at the time of our inspection no-one was subject to DoLS.

People spoke positively of the food and told us their food likes and dislikes were taken into consideration including their preference on portion size. For people who needed a pureed diet the chef created “moulded meals”. This involved moulding pureed food into the shape of recognisable food. This improved the experience of meal times for people.

There was always a doctor on call including at weekend and overnight. People told us that the community nursing team had regular contact with other professionals involved in their care. This ensured that people received the support and advice they needed and changes to people’s health was monitored and responded to promptly.

People and their relatives spoke overwhelmingly positively about the caring approach of staff. An example of what people told us was “the care you get is exceptional”. People valued their relationships with the staff team and felt they often “went the extra mile”.

Staff were highly motivated to offer care that was kind and compassionate. They placed a high value on building relationships with people and there were examples of how they supported people in a way that ensured they felt understood and valued.

Staff had an in-depth appreciation of people’s individual needs around privacy and dignity. Staff

We spoke with one day patient who said that they were very well supported by the hospice staff. They said, “I am treated with 100% respect, dignity and the care is extremely good. I couldn’t fault it. Yes, they are able to cater for all my needs”. They went on to say, “While I’m here my symptoms are well managed. You see they have the time to answer all my questions which my own doctor has not time to answer. I feel it’s nice to be here”.

Another person said, “The staff are exceedingly good. I admire them all and they always have time for you. Quite honestly I can’t fault the place for the care and the kind way they treat you. It’s better than I would ever have imagined”.

One person told us about the Hospice at Home service. They said that they did not require it, but that it was a comfort to know that it was available. “I would recommend this hospice to anyone who asks”.

We spoke with one person who said that they had received a foot massage that morning, “Which makes me feel good”. The foot massages were provided by volunteers. Other volunteers were holding a quiz for the patients in the Day Hospice. The person we were speaking with explained that they felt safe and said, “That’s the one good thing, they treat me so well, better than when I am living in my home”.

We spoke with a relative who summed up all the feedback we received from staff and patients by saying, “We have total confidence in St Wilfrid’s; it’s such a caring place”.

We looked at documents and patient records and observed the care being provided to people. We saw very good care with real attention to detail and respect for peoples’ wishes. Everyone we spoke with told us that, “Nothing was too much trouble”.

All the staff we spoke with were very happy in their work, describing the joy and privilege of having the time, resources and support to care for people properly.

The hospice staff worked closely with other providers involved in end of life care locally. They are beginning to widen their community links and are now working to improve end of life care for traditionally hard to reach groups.

Patients and relatives we spoke with told us that the staff were ‘absolutely marvellous’ and that the hospice should be a ‘template for care’. We were not able to speak to patients or staff from the day care facility which was closed during our visit. However, we saw that the same policies, governance arrangements and training apply throughout the hospice.

People we spoke with told us that communication was good amongst staff and patients, and between the inpatient and hospice at home service. Patients said they felt well cared for. We saw that people were treated with respect and involved and supported in decisions about their care and treatment. We saw that individual needs had been assessed with patients and recorded in their care plans.

Patients were protected from abuse and staff respected their human rights. The hospice had made suitable arrangements to ensure that people are safeguarded from the risk of abuse, including policies and guidance and training for all staff. All staff we spoke with described their safeguarding responsibilities and what may constitute abuse.

Patients at the hospice are cared for by staff with the right knowledge, qualifications and skills to support people. Staff told us that they ‘felt lucky to work here’ and enjoyed being able to give people the care they want.

The hospice had systems in place to monitor the quality of the service and could show how patient, relative, and staff feedback has informed and developed practice.

Everybody that we spoke to told us what a lovely place St Wilfrid’s hospice was. They said that the care was excellent and that the staff were ‘very special people’. We were told about the ‘wonderful volunteers’ who gave their time to improve the lives of people staying at St Wilfrid’s. People said that the volunteers “popped in and did the important little things, which they would not want to trouble the nurses with”.

We asked about any improvements that could be made and people told us they could not think of anything.