Willowbrook Hospice

​Willowbrook Hospice is operated by Willowbrook Hospice. The hospice accepts palliative adult patients aged 17 years and above from across the St Helens and Knowsley areas for complex symptom control and pain management, and end of life care. It has 12 inpatient beds across two wards, Oak Suite and Willow Suite.

The hospice offers 66 day therapy places and 20 medical outpatient clinic appointments per week in its dedicated wellbeing services unit, the Cedarwood Centre.

The hospice operates specialist palliative care telephone advice line 24 hours a day, seven days a week. A bereavement support service ‘Willowbrook Connections’ provides anticipatory bereavement support to patients and families.

We last inspected this hospice in August 2016 and the report was published in September 2016. We previously rated the hospice as good.

We carried out this short-announced inspection on 11 December 2019 and 19 December 2019.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Services we rate

Our rating of this hospice improved. We rated it as outstanding overall.

• The hospice truly respected and valued patients, families and carers as individuals who were empowered as active partners in their care, practically and emotionally, by an exceptional and distinctive service. Staff were highly motivated to treat their patients with compassion and kindness, respected their privacy and dignity, always took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The hospice’s services were planned and tailored to meet the complex needs of individual people, and the local population, in partnership with the wider health economy. The hospice’s services were delivered flexibly, by a responsive and passionate multidisciplinary team, providing choice and continuity of care for patients, their families and carers. The hospice planned and worked to improve awareness and access to palliative care for hard to reach communities. The service made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
• The hospice had enough staff to care for patients and keep them safe. Most staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They mostly managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

We found areas of outstanding practice:

• The hospice is involved in a working partnership with the Pain and Anaesthetic Service. We were given information about a patient who had benefited from this service, where the anaesthetic team from the acute hospital had attended the hospice to administer an anaesthetic to ease discomfort while dressings were changed, and a more appropriate mattress was put in place.
• The hospice had also recently linked with two other hospices in the locality to hold collaborative medicines management group meetings. The aim of this is to share learning and good practice within the group.
• The hospice had achieved the European certificate in holistic dementia care.

We found areas of practice that require improvement:

• Safeguarding vulnerable children level two training rates were low across nursing, medical and allied health professional staff groups.
• Basic life support training completion rates for healthcare assistants was low at 64%.
• The fluid used to dilute medicines for the syringe pumps was not always specified by the prescriber and the time frame for administration was not specified as part of the prescription.
• Documentation of who had recorded the increase in dosages of medicines in the syringe pump was unclear on the medication chart, although a contemporaneous record had been made in the electronic clinical notes.

Following this inspection, we told the hospice that it should make some improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Ann Ford

Deputy Chief Inspector of Hospitals (North)