Coventry Myton Hospice

Updated 21 January 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 5 October 2016 and was unannounced. The inspection team consisted of an inspector and a member of the Care Quality Commissions medicines team. A specialist advisor who is a nurse with experience of palliative and end of life care and an expert by experience with knowledge of end of life care were also part of the inspection team.

Before our inspection we asked the provider to complete a Provider Information Return (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and what improvements they plan to make. The previous registered manager had submitted the information as we requested in May 2016. We took this information into account when we made the judgements in this report. We sent out questionnaires to people who use the services, their relatives and community professionals and staff seeking their views about the hospice services. Nine questionnaires were returned to us. We took people's responses into account when we made judgements in this report.

We checked the information we held about the service and the provider including statutory notifications. Statutory notifications include information about important events which the provider is required to send us. We sought information about the quality of service from the clinical commissioning group (CCG) who purchase care and support from the provider on behalf of people who lived at the home. We also asked Healthwatch for their views. Heathwatch is an independent consumer champion who promotes the views and experiences of people who use health and social care.

We spent time with people who were inpatients and with people who attended the day hospice on the day of this inspection and saw the care and support they were offered. We spoke with four people who were inpatients and six people attending the day hospice about the care they received. We looked at sections of care records of four people to see how their care and treatment was planned and delivered. Consideration was given to how medicines were managed which meant we looked at medicine charts and administration records.

We spoke with the registered manager and a range of 12 staff across the inpatient and day hospice services. These included a deputy director of nursing, day hospice sister, ward sister, doctor, nurses, health care assistants and volunteers. We looked at a range of records related to the management and the quality of the service. These included projects, compliments and complaints, incident reporting and the latest quality assurance checks which were used to monitor and assess the quality of the service provided.

Updated 21 January 2017

This inspection took place on 5 October 2016 and was unannounced.

Coventry Myton Hospice provides care and treatment to people over the age of 18 with life limiting conditions who require specialist palliative care (palliative care is comprehensive treatment of the discomfort, symptoms and stress of serious illnesses) in their 16 bedded inpatient unit or their day service. At the time of our inspection 13 people were using the inpatient service. The day hospice is open on Mondays, Wednesdays and Fridays and six people were in attendance at the day hospice at the time of our inspection visit. Initially people attend the day hospice for one day per week over a 12 week period. The hospice services provides people with access a range of care and support which includes, children and family support, occupational therapy, physiotherapy, chaplaincy, counselling and bereavement support.

There was a registered manager in post who was also the director of nursing, care and education. 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.

The leadership team continuously looked at the local community to see how best they could respond to people’s needs. Excellent work was being done in identifying the needs of the local population by developing services to meet those needs.

The registered manager was passionate about raising the profile of the hospice and created opportunities for different ideas to meet the diverse needs of people with palliative and end of life care needs. There was a strong commitment for the hospice services to be inclusive and responsive to the needs of all people including those people who may not have traditionally used hospice services.

People and their family members, staff and the board of trustees were actively informed and involved in developing the service. Their views including complaints and compliments were used to continuously develop and influence the services people received so these remained effective, caring and raised quality where needed. People were involved in the development of the service and asked for their views.

There was a very positive atmosphere within the hospice and people were very much at the heart of the services offered. Staff had developed positive, respectful relationships with people and were kind and caring in their approach. People who attended the day hospice were very appreciative of how staff and volunteers had made their days memorable and filled with therapeutic and fun times. People's privacy and dignity was respected by staff who worked to a set of values around providing care centred on each person.

Staff were supported to develop in their roles through a positive culture and idea of teaching and sharing skills within the service as they had link roles in various subjects and in the wider community. Staff worked closely with the staff at the local hospital to educate and promote high quality palliative and end of life care.

People were supported with their nutritional needs with the assistance of the catering team who actively sought and welcomed people’s feedback. There was a shared commitment between all members of the staff team to sharing how meals remained nutritious and people enjoyed these in comfort. Staff made sure changes in people’s dietary needs could be effectively catered for and creatively met in different ways.

Staff knew each person well and understood how people may feel when they were unwell or approached the end of their life. People and their relatives were enabled to be involved in the care and staff were motivated in ensuring people were treated as individuals and had a good as life as possible. People were able to see their friends, families and pets when they wanted as there were no restrictions on when they could visit and they were made welcome by staff.

People were supported to receive end of life care in their preferred place of choice which met with their needs and wishes and to achieve a private, dignified and pain free death. People, their family members and staff were able to access the emotional, psychological, spiritual and bereavement support they needed.

Staff knew how to protect people and reduce accidents and incidents from happening by ensuring people's needs were met in a safe way. Staff knew how to recognise and report any concerns so people were kept safe from harm and abuse. Recruitment checks had been completed before new staff and volunteers were appointed to make sure they were suitable to work with people who used the hospice services. People were supported by sufficient numbers of staff with the right skills to meet their needs and reduce risks to their safety.

Staff practices around the administration and management of people's medicines reduced the risks of people not receiving their medicines as prescribed to meet their health needs. This included making sure all people's medicines to ease their pain and symptoms were consistently available to them should they choose to have these. People also had access to a range of healthcare professionals when they required specialist help.

The provider showed a strong commitment to actively listen and support people who used the hospice services and staff. Staff at all levels were involved in the quality checks where a varied range of methods were used to determine the quality and safety of people’s care and treatment to maintain improvements so people received the best possible care. The leadership team planned to share good practice and initiatives they had developed across the provider’s other two hospices.

The registered manager showed an open and responsive management style. They provided strong leadership to the staff team and encouraged them to be ambitious in continuously improving their knowledge and skills. People were at the centre of the management and staff's core values of personalised palliative and end of life care aimed to provide quality of care and life to everyone.