Bury Hospice

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We assessed 1 quality statement in the effective key question and found areas of good practice. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good. Feedback from people who use the service and those close to them reported positive outcomes. Feedback was overwhelmingly positive about the staff and care provided. Staff told us they were very proud of the positive patient feedback scores the service received. The service had recently been awarded a certificate of excellence. The service and staff delivered care according to best practice and national guidance. There was an effective and collaborative approach with other agencies to provide good outcomes for patients and their families. Data provided for August 2023 to August 2024 showed that all patients had been asked about their preferred place of death and this had been achieved for 95.18% of patients. Assessment of nutrition and hydration was completed as part of end of life care and all patients were prescribed anticipatory medicines which aided responsive management of symptoms. Staff told us that they noticed the positive changes in people who use the service and their families. They gave examples such as how the respite home visits and night sitting service helped reduce carer fatigue both physically and mentally.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

People who use the service and their families said they felt listened to and were involved in advance care planning discussions. They reported positive outcomes such as ‘feeling better’ ‘in less pain’ ‘taking less medication’ and ‘able to walk more’. The service asked patients for feedback on the care they received across the different services including the inpatient unit, outreach support, complementary therapies and bereavement support. Data provided by the service for the previous 12 months showed that patient feedback was overwhelmingly positive about the staff and care provided. Children shared the benefits of attending the bereavement support groups such as ‘meeting people with similar experiences’ ‘it was good to talk’ and ‘it made me happy’. From August 2023 to August 2024 the service collected feedback on care from 1736 contacts with patients and their families. The data showed that 86% reported improved well-being and 80% reported a positive impact as a carer. Other positive outcomes included a reduced need for urgent community services or acute care. Preferred place of death was discussed and recorded which was also noted in patient records we reviewed. People who use the service and their families spoke positively about the assisted bathing service at the hospice. This created a relaxing and dignified way to help patients maintain personal hygiene.

Staff told us they were very proud of the positive patient feedback scores the service received. The service used an independent patient experience website to collect patient feedback and had recently been awarded a certificate of excellence. The certificate was in recognition of ‘consistent outstanding care and patient reviews’. Staff told us that they noticed the positive changes in people who use the service and their families. They gave examples such as how the respite home visits and night sitting service helped reduce carer fatigue both physically and mentally. Staff shared examples of clinical improvements for patients on the inpatient unit such as improved oral intake, mobility, symptom control and reduced pain. This had a positive impact on patients discharge to their preferred place of care and in some instances, patients regained the ability to engage in social activities with friends and family.

The service and staff delivered care according to best practice and national guidance, such as from the National Institute for Health and Care Excellence (NICE). The service provided examples of how patients approaching the end of life were identified in a timely way and allowed them and their families to make decisions about their care. There was an effective and collaborative approach with other agencies to provide good outcomes for patients and their families. This included faster access to other support agencies and preferred place of care (PPC) being achieved more quickly. The service monitored data such as referrals to the service, PPC and preferred place of death (PPD). Data provided for August 2023 to August 2024 showed that all patients had been asked about their PPD and this had been achieved for 95.18% of patients. From April 2023 to March 2024 the average time from referral to admission was less than one day. From March 2024 to July 2024 the average waiting time was similar. There had been conversations with all patients about the do not attempt cardiopulmonary resuscitation (DNACPR) decision and we observed this in records we reviewed. Assessment of nutrition and hydration was completed prior to death and all patients were prescribed anticipatory medicines which aided responsive management of symptoms. The service was part of a national palliative care and oncology research study. The findings would be used to better understand the views of people with a cancer diagnosis and the terminology used to describe them.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.