This inspection took place on 5 and 6 October 2016 and was announced. We provided 48 hours’ notice of our visit to ensure the registered manager would be available to facilitate our inspection. The service was last inspected on 8 October 2013 and was found to be meeting all the regulations we reviewed at that time.

Wigan and Leigh Hospice is a registered charity, situated in the Hindley area of Wigan. The hospice was founded in 1982. It is an adult hospice for people aged 18 or over and delivers specialist palliative care to people who have a life threatening illness from any disease and who are thought to be in the last year of their lives. The hospice is a purpose built unit and provides ground level accommodation for up to 14 in patients. Facilities included: 14-bed inpatient unit in 14 separate rooms; a patient and visitor lounge; an overnight room for families; a multi-faith room; three complementary therapy rooms; two counselling rooms; outpatient clinics; free of charge car parking; meeting rooms for hire.

Exceptional management and leadership was demonstrated at Wigan and Leigh hospice. Our discussions throughout the inspection demonstrated that there was an open culture which empowered people to plan and be involved in the high quality care provided at this service. This meant that people continuously had a say in how they wanted their care to be delivered. The strong and positive management approach resulted in people receiving a tailored inclusive service which focused on them receiving individualised care.

There was a hospice in your home service provided by a team of nurses, healthcare assistants and volunteers. The team offered one-to-one time with patients and gives practical as well as emotional support alongside hands-on nursing care, including daytime visits and occasional overnight stays. By providing additional support in this way the team enabled more people to stay in their own homes as they come towards the end of their lives.

There was also a team of clinical nurse specialists employed by and based at the hospice who provided support in person or via the telephone advice line.

Medical and Nurse Specialist outpatient clinics were held in the Hospice’s Woodview Centre. They offered specialist assessment or review for patients with complex or rapidly changing symptoms who needed specialist assessment.

There were five hospice doctors of whom four were very experienced in hospice care. In addition there were two registrars on the on-call rota with one doing a half day a week of daytime clinical work at the hospice as well as some teaching. The medical director was part of the leadership team and a member of three hospice governance committees. There were three consultants working at the hospice.

Wigan and Leigh hospice is registered with the Care Quality Commission (CQC) to provide care for up to 14 people on the inpatient unit. At the time of our inspection there were 12 people being cared for and approximately 250 people receiving care and support in the community. Of these 250 people, the manager told us that provision of personal care was limited and they provided more emotional and practical support.

All the people we spoke with during the inspection told us they felt safe when they received care and treatment from hospice staff. There were appropriate policies and procedures in place with regards to safeguarding and whistleblowing. This told staff how they would be supported if they reported poor practice or other issues of concern.

We looked at the way medicines were prescribed and managed at the hospice and found that medicines were managed safely. There were clear, detailed policies and procedures covering the different aspects of medicines management.

There was an accountable officer who submitted reports to the controlled drugs local intelligence network (LIN) and attended LIN meetings. Controlled drugs were handled safely and nurses checked stocks weekly. The accountable officer audi

We spoke with patients and they said "everything is discussed with you and explained in a way you can understand" " it is very good they really listen to you." " staff talk to us all the time about our care" "I know I have a care plan but don't want to see it as the nurses explain everything very well" " the doctors take the time to discuss everything with you so you don't need to see any notes." and "this place is second to none, it is nothing like I imagined it is better than a five star hotel."

We spoke with catering staff who said that menus were used as a guide but that each patient was asked what they would like before each mealtime. One patient spoken with said " I didn't like the soup they had so someone went to the shop for a tin of soup just for me, thats just what they do, no fuss just good caring staff."

Other comments from patients were " Staff are marvellous, from the top, cleaners, nurses, doctors and volunteers, even the office staff will sit with you if you need someone there, thats what I call team work" "you get treated just like royalty here, If I was the queen I couldn't have been treated any better by everyone" and "staff are just wonderful they all have so much time for you and my family have been supported as well as me."

We spoke with two people who were attending the hospice day centre and two people who were staying at the hospice. They were able to tell us about what it was like to stay at the hospice and use their day centre facility. They also told us how the staff provided the care and support they needed. People we spoke with made the following positive comments.

Day Hospice –

“The staff are all fantastic.”

“I didn’t want to come here initially but I love it now. It gives my family a break.”

“I feel safe here and they treat me lovely.”

“The food is lovely here.”

“I am having my hair done today. It makes me feel so much better.”

In patients –

“The staff can’t do enough.”

“The staff are very special people.”

“The staff are lovely.”

“The staff are brilliant.”

“We get a choice of meals daily.”

“They always come immediately when I press the buzzer. Sometimes two of them.”

“I feel so safe here.”

“If you want a mark from me it’s a 100%, from the cleaners to the Dr’s.”

We also spoke with two visitors and a relative regarding the care and support provided. Their comments were also very positive and included:

“We know she is very safe here.”

“The staff are brilliant.”

“It is not a depressing place.”

“We can stay overnight if we wish to.”

“We are always made welcome.”

“We have peace of mind.”

“The staff phone us if there are any changes in her condition. They explain everything to us”

“My friend has access to all medical services and she enjoys the social contacts here.”

We spoke with twelve staff, which included: nurses, carers and managers. Their comments included:

“The support is excellent.”

“It all works well here. It’s fantastic.”

“I love my job.”

“The training is very good.”

“We work very closely with other agencies and other health care professionals all the time to ensure we have all the information we need.”

“We get a lot of information and are kept up to date daily.”

“We have regular meetings to keep us up to date.”

“We have access to an independent person for clinical supervision.”