Prospect Hospice rated ‘outstanding’ by Care Quality Commission (CQC)

Following a recent inspection by the Care Quality Commission (CQC) Prospect Hospice in Swindon has received an overall rating of ‘Outstanding’.

In the report summary, the CQC recognised that staff provided outstanding care to patients, ensuring they were active partners in their care and those patients felt that they were truly cared for and supported by hospice staff. It was also highlighted that the hospice achieved outstanding for being well-led and that leaders in the organisation had an inspiring shared purpose to deliver outstanding care and that staff were proud to work within the hospice team.

CQC inspectors look at a number of areas within the hospice operation and five areas are graded before these are combined to give an overall rating for the organisation. These areas are: Safe, Effective, Caring, Responsive and Well-Led. Following this inspection, the hospice received a good rating for three categories and was graded as ‘Outstanding’ for Caring and Well-Led, with an overall rating of ‘Outstanding’.

Irene Watkins, chief executive at Prospect Hospice, said: “This is a wonderful outcome but, more so, words cannot express just how pleased I am for our staff, doctors, volunteers and supporters that make hospice care in the community possible. As the end of life care specialist for our communities of Swindon and north east Wiltshire the ‘outstanding’ rating is a wonderful reflection of how we care and support our patients and those important to them.

“Everyone works incredibly hard and with great resilience and purpose to ensure that every patient we see receives a good death and that perception is different for everyone. Our approach is always to put the person and their wishes at the heart of their care and this is something the CQC highlighted.

“I’m also delighted that this report reflects how we work differently to other healthcare professionals to ensure each person receives the tailored care that is right for them. We’re all unique as individuals; our wants and needs are all very different and even change as we go through life. For those with a limited life expectancy it is about maintaining well-being and quality of life and to the point we approach death. Our staff are incredibly proud and privileged to be able to support those in our local community at this very difficult time of life personally and for their friends and family.”

Early on in the report, the CQC inspectors recognised how the hospice was proactive and innovative in the way it responded to patient need, developing new ways of working where needed. One such recent innovation was the introduction of a whole system of training, with new protocols, so that carers could safely administer prescribed pain relief via subcutaneous (just under the skin) injections for their loved ones. Carers fed back how they found this increased involvement in caring for their loved one a positive experience.

Carolyn Bell, director of patient services, explains why this is important: “When someone you love is in pain, you want to do everything you can to help them. In the past, family and carers have had to call our nurses and wait for their arrival before anything can be done. This small act enables the carer to be able to administer that pain relief themselves, when it’s needed, without the time delay and the feedback we’ve had from those who have trialled it has been incredibly positive. They’re pleased that they can do this one small thing for their loved one and there’s no waiting to ease their suffering. It also frees up our staff to attend other patients who may need more complex care.”

Another standout innovation is in how the hospice helps patients with their pain management and some recent work has involved virtual reality headsets to support mindfulness and meditation.

As part of the inspection, the CQC spent time with the hospice’s medical director, Sheila Popert, who has developed an app for use by patients as an alternative method to manage pain symptoms, tailored to the patients’ needs and interests. Some patients had been prescribed a high level of opioids to manage pain which often caused them to feel drowsy and less alert. Patients fed back that their quality of life had been improved by using the headsets and had supported relief of a variety of symptoms including respiratory distress as well as pain and, as a result, they needed to use less prescription medication.

In the report, the CQC identified that the patient’s needs and wishes led the care that was provided and support was provided according to their individual needs. Inspectors spoke to patients and family members of those who had received care and reported that relatives told them how staff gave strength and encouragement without giving false hope.

Carolyn Bell said: “Being honest with people is incredibly important. We’re always open with them about their condition and treatment as people are best placed to make the right decisions about their care when they have all the facts and it is wonderful for our staff that their outstanding work is recognised by the CQC.”

The biggest improvement was seen in the well-led section where the hospice was also graded as outstanding. The report commended the hospice for the improvements made in this area and noted that there was compassionate, inclusive and effective leadership at all levels and that patient and family experience was always taken into account.

Over the last couple of years the hospice has seen a change in leadership and the report recognised that the trustees, executive and leadership team was visible and approachable and that the voices of patients, carers, volunteers and staff were heard, listened to and acted upon. It also noted that the culture within the organisation was inclusive, supportive and cohesive and that staff felt respected and valued and they enjoyed working at the hospice, feeling it was an excellent place to work.

Irene said: “While our priority is always that of the patient and how we can do the best for them, the hospice is also a place of work for many people. We need to ensure that those who dedicate their time to supporting our patients and raising the funds to do so are supported in their roles, feel they can raise concerns or suggestions, feel listened to and that their comments are acted upon. We all want to feel valued in the workplace and it’s pleasing to see that staff feel they are recognised.”

The report also awarded the hospice ‘good’ in the other three areas of Safe, Effective and Responsive, recognising the progress in services by introducing the Single Point of Contact (SPoC) to assess patients as they were referred. It also praised the service for making adjustments in accordance with a patient’s religious, cultural or other needs noting that the hospice chef met with patients to discuss their preferences and created individualised menus from their discussions.

You can read the CQC report here