Hospice at Home

Updated 17 January 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection team consisted of 2 inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal and nursing care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 7 December 2022 and ended on 14 December 2022. We visited the location’s office on 8 December 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people who used the service and 3 relatives about their experience of the care provided. We spoke with 6 members of staff including the registered manager, Hospice at Home team leader and the quality and training coordinator.

We reviewed a range of records. This included 5 people's care records and 3 people's medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed.

We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records and policies and procedures. We also reviewed feedback we had received from 1 professional about their experience of the service.

Updated 17 January 2023

About the service

Hospice at Home is a domiciliary care agency providing palliative, end of life care and specialist care. The service supports people in their wish to be cared for at home, facilitates rapid discharge from hospital and provides a One Call response service to avoid unwanted hospital admissions. At the time of our inspection there were 30 people using the service.

CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

Where risk assessments had been completed, updated or reviewed for people on the services electronic system which the nursing staff had access to, this information had not always been transferred into people's paper based care plans. This meant information was not always in place or up to date for the health care assistants to follow.

We have made a recommendation about the management of risk assessments and care planning to ensure updated information is accessible to all staff and reflects the current needs of people.

People told us they received safe care from staff who knew them. There was a safeguarding policy in place and the registered manager, and staff knew how to identify and report concerns. The service had enough staff to meet the needs of people using the service. Staff had been safely recruited and pre-employment checks carried out. The service had a rapid response team to enable them to respond quickly to a decline in people’s health.

Staff had received an induction and training to enable them to meet people’s needs. Staff had received training in medicine administration. Supervisions, spot checks and competency assessments for staff were carried out and the majority of staff told us they felt supported by the senior team.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff had access to personal protective equipment (PPE) and there were effective infection control measures in place. People’s nutritional needs were met where required.

The registered manager and senior management team sought support and worked collaboratively with St Luke’s Hospice and other health and social care professionals when needed. The majority of people, relatives and staff we spoke to spoke positively about the leadership of the service. There were systems in place to monitor, maintain and improve the quality of the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for the service at the previous premises was outstanding, published on 20 August 2019.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hospice at Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.