Rugby Myton Hospice

Updated 5 October 2022

The Myton Hospices is a charitable organisation which aims to provide multi-professional specialist palliative care and end of life care to adults with terminal illness across Coventry and Warwickshire.

Rugby Myton Hospice provides services to people aged over 18 who are living with life threatening and life limiting conditions. The main service we inspected was the hospice at home service.

Professionals can refer patients to the hospice at home service which provides personal care to patients and families in their own homes in the last few weeks of life with the aim of supporting people where possible to die in their preferred place care. The services work in close liaison with all other community providers. The hospice at home service is to support people with palliative (Palliative care is comprehensive treatment of the discomfort, symptoms and stress of serious illnesses) and end of life care needs in their own homes. Family support is provided. The aims of the services offered include supporting people with their physical health and emotional wellbeing. The aims of the service are:

• To enable adults to remain at home regardless of diagnosis, if this is their choice
• To work closely with their key worker (usually a District Nurse) to plan the care required to provide seamless care
• To support discharge from hospital/hospice in the last few weeks/days of life, enabling preferred choice of place of care/death
• To support rapid discharge home to die from hospital for patients who are in their last days/hours of life
• To prevent unnecessary admissions to hospital/hospice in the last few weeks to days of life
• To improve the provision of psychological support and information for the carer
• To improve bereavement outcomes for carers.

The types of care provided by staff working within the hospice at home service were as follows:

• During the day experienced staff will visit and provide personal care
• Palliative Nursing Support for the whole family, providing emotional and psychological support, providing information, advice and reassurance as well as practical advice or training from the team.
• When night care is provided an experienced carer will be in the home from 10pm – 7am to provide care throughout the night.
• The Registered Nurse can monitor symptoms and liaise with the District Nurse/Palliative Care Clinical Nurse specialist/GP.

Data from the service showed that from April 2021 to March 2022, 89 patients were seen by the hospice at home service.

The day hospice is a purpose-built hospice based within the grounds of an NHS hospital. At the time of the inspection the day hospice service was being restructured and onsite services were not running but were scheduled to open in August 2022. The Myton at Home service operates out of the hospice site.

This means there was limited regulated activity being delivered from the day hospice at the time of inspection therefore we can report on the element of the service being provided at the time of the inspection. Our report is based upon our inspection of the hospice at home service, the elements of the day hospice being delivered alongside policies and procedures in place and the environment of the day hospice.

There was a registered manager in post at the time of our inspection. The Myton at Home team comprised of a small team of nurses and nursing assistants. The location also had support from over 35 volunteers.

The service is registered for the following regulated activities:

• Treatment of disease, disorder or injury

Updated 5 October 2022

Our rating of this location stayed the same. We rated it as good because:

• Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. The service made sure staff were competent for their roles.
• Staff used effective infection control measures.
• The, maintenance of equipment was in place to keep people safe. Staff had access to and completed training to use systems that managed clinical waste well.
• Staff had processes to complete and update risk assessments for each patient. Risk assessments consider patients that might be deteriorating in the last days or hours of their life.
• The service had enough nursing and support staff, with the right qualifications, skills, training and experience to keep patients safe from avoidable harm.
• The service had not had any patient safety incidents. Managers shared lessons learned with the whole team and the wider service.
• Patients could access the specialist palliative care service when they needed it. Waiting times from referral to achievement of preferred place of care and death were in line with good practice.
• Staff from the service worked with other healthcare professionals as a team to benefit patients. They supported each other to provide good care.
• Staff monitored the effectiveness of care and treatment.
• The service provided care and treatment based on national guidance and evidence-based practice.
• Staff supported patients to make informed decisions about their care and treatment.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.
• Staff supported and involved patients, families and carers to understand their condition and make decisions about their care and treatment.
• The service planned and provided care in a way that met the needs of local people and the communities served. The service took account of patients’ individual needs and preferences. Staff made reasonable adjustments to help patients access services.
• It was easy for people to give feedback and raise concerns about care received.
• Leaders had the skills and abilities to run the service. They understood and managed the priorities and issues the service faced.
• Staff felt respected, supported and valued. However, they were focused on the needs of patients receiving care.
• Leaders operated effective governance processes, throughout the service and with partner organisations.
• Leaders and teams used systems to manage performance effectively. They identified and escalated relevant risks and issues and identified actions to reduce their impact.
• The service collected reliable data and analysed it. Staff could mostly find the data they needed, in easily accessible formats, to understand performance, however improvements to service provision were not always planned. The information systems were integrated and secure. Data or notifications were consistently submitted to external organisations as required.
• Leaders and staff actively and openly engaged with patients, staff, equality groups, the public and local organisations to plan and manage services. They collaborated with partner organisations to help improve services for patients.

However:

• The service provided mandatory training in key skills to all staff but not all staff were up to date.

Updated 5 October 2022

Our rating of this location stayed the same. We rated it as good overall because:

We rated safe, effective, responsive and well-led as good.

We did not inspect the key question of caring at this inspection. The previous rating of good remains.