Community
CQC Recommends Improvements at Hospice
The Care Quality Commission carried out an inspection at Hospice between October 31 and November 3 last year.
While Hospice staff have a strong team working culture and show tremendous care for their patients, the CQC has found several significant failings.
The Care Quality Commission carried out an inspection at Hospice between October 31 and November 3 last year.
Fundamentally the CQC found that staff were focussed on the needs of patents, that they worked to benefit their patients’ experiences and showed compassion and kindness to them and their families.
Most notably, the CQC found that: ‘Staff were seen to show a genuinely caring approach to patients, patient and relative conversations supported this. There was a strong team working culture, including community support groups and volunteers, that provided a holistic service with patients at the heart of this.’
However, the report also found issues with several issues related with safeguarding, cleanliness and respite systems.
These included:
- Safeguarding – Not all staff had undertaken the correct level of safeguarding training as compliance figures for safeguarding children level 2 and 3 were low.
- Assessing and responding to risk – There was no sepsis awareness training or specified pathways for staff to follow. Recognised tools were not used to identify deteriorating patients. Falls risk assessments were completed for all those at risk, PEEPS were not regularly reviewed and therefore did not accurately reflect the current needs of patients. Resuscitation equipment was not stored in a way that would make it immediately accessible to staff.
- Cleanliness and infection prevention and control – Separate areas did not have specific cleaning equipment increasing risk of cross contamination.
- Medicines – Medication room temperatures were not monitored to ensure medications are stored within recommended parameters. Medical oxygen cylinders were not always secured to reduce risk of falling.
- Patient care records – Records, such as advance care plans, were not always uploaded onto the electronic system in a timely way meaning staff could not be assured they were delivering care in line with patient preferences.
- Competent staff – Staff did not receive training in the awareness of learning disabilities, autism or mental health.
- Access and flow – There was not a system in place to identify patients in hospital that required hospice care and therefore referrals were dependant on individual capacity to reach out to acute service.
- Vision and strategy- A new vision and strategy had not yet been developed as the service were awaiting the appointment of a new CEO.
- Governance – The service was using guidance that supports best practice, but this is not yet fully embedded across all areas.
- Managing risk – There is no effective accountability within the risk register for example audit
- Raising concerns- The service did not have a freedom to speak up guardian or an equivalent to which staff could raise concerns about the service.
The CQC also raised a concern to the DHSC that: ‘Respite services had reduced in size and therefore offered limited provision to support the wider system.’
Chief Executive Officer for Hospice Care Isle of Man, John Knight, said: ‘We were delighted to welcome the CQC for their week-long inspection of our End of Life Care provision. We’re pleased they have recognised the high quality of care that Hospice and our partners in Manx Care provide and the clear focus in keeping patients at the centre of that.
‘The CQC highlighted the strong team working culture that provides a holistic service and the highly developed clinical informatics and quality assurance systems within Hospice. Comments from their very positive report will be used to support Hospice’s 40th year celebration this year.’
