This inspection took place on the 2 and 11 August 2016.

Blythe House Hospice had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered provider, they are ‘registered persons.’ Registered persons have a legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Blythe House Hospice provides nursing, personal care and treatment, health diagnosis and screening associated with end of life and palliative care. A range of services were provided by the hospice to support people’s care and treatment. This included a ‘Living Well’ service (support to enhance people’s quality of life and coping strategies); an on-site walk in information and advice centre, pre-diagnosis and healthy lifestyle support, alternative therapies, bereavement and counselling support to adults and children and spiritual care. A hospice at home service was also launched in April 2016. This provided personal care to people in their own homes who choose to remain and receive care there at the end of their life.

People felt safe and their care, treatment and medicines were safely managed. People receiving care, relatives and staff knew how to raise or report any concerns they may have about people’s safety. The provider’s arrangements for staff recruitment and deployment helped to ensure people’s safe care and treatment, and related support for their relative.

People’s medicines were safely managed when required. Known risks to people’s individual safety from their health condition, environment or any equipment used for their care were regularly assessed and reviewed with them in consultation with relevant external health professionals when required. The provider’s arrangements for emergency planning, equipment and environmental maintenance and their remedial fire safety measures in progress helped to ensure people’s safety at the service.

People and their families were completely satisfied, highly complimentary and appreciative of their holistic care, treatment and support. People’s care was individually planned with them and consistently delivered to provide palliative care, treatment and alternative therapies that met with their needs and wishes. Staff worked in consultation with external health professionals when required for people’s care and treatment. This helped to optimise people’s health and comfort.

People and their families were informed and treated as equal partners in care. This was provided by a multi-disciplinary team of staff and volunteers who were trained and supported for their role and responsibilities. Approaches to learning, development and end of life care education helped to ensure people received care that met with nationally recognised standards concerned with palliative and end of life care.

Staff understood and followed the Mental Capacity Act 2005 (MCA) to ensure that people’s consent or appropriate authorisation was obtained for their care and treatment. People’s preferred priorities or advanced decisions made for their care and treatment were appropriately determined and accounted for.

People commended the quality and choice of meals provided at the day hospice. People were supported to eat food and drink they enjoyed, which met their health requirements and personal choices. Staff understood and followed people’s nutritional and related health requirements.

People and their families all spoke highly of their care and positive relationships held with staff. People felt staff treated them with the utmost care, respect, kindness and compassion and as equal partners in their care. Staff were highly motivated to make a positive difference to people’s care experience; they took time to understand how people’s illness affected their lives and what was important to them and their family for their care.

People’s rights, choices, confidential

During our inspection we spoke with three people who used the service, four members of staff and two volunteers

The views expressed by people were overwhelmingly positive. One person told us, "There is nothing negative. People are so kind and amazing. Coming here is the best thing to happen to me in a long time.”

Care records had been changed to include greater detail about potential risks to people and actions to be taken in an emergency. This had been outlined in the provider's action plan following our last inspection.

People told us that they were involved in planning their care and had been given information and choices about the treatments and therapies available to them. They told us that staff were always available with support and advice particularly when they felt vulnerable.

People told us that the range of activities, therapies and counselling had been invaluable to them. One person told us how valuable it had been for their partner to be involved in one of the carer’s groups and said, “We both have the help we need in a dignified and professional way”.

Procedures were in place to protect people against the risks associated with medicines.

The premises were suitable for purpose, safe and promoted people’s wellbeing.

A system for assessing and monitoring the quality of service ensured people were protected against inappropriate or unsafe care.

We spoke with two people who used the service, two visiting stakeholders, three volunteers and four members of staff.

People were happy with the service at Blythe House. One person told us, “This place is absolutely amazing. You feel swallowed up in kindness.”

People also told us that staff kept them well informed about their care and treatment. People were able to choose from various therapeutic options that available. We found that staff knew how to communicate with people in different ways, for example one staff member we spoke with used British Sign Language and also helped someone to use a communication board.

People told us how highly they valued the activities, counselling and practical advice that was available to them.

We saw that spiritual and religious support was available for people, and services were arranged for people who wanted them.

People told us that they had access to staff at all times and that forums, surveys and meetings were held regularly to give feedback about the service. One person told us that if they had any concerns, they felt confident that they would be listened to.

People told us that felt safe at Blythe House. One person told us that they were, “Completely confident that people were safe from neglect or abuse”, and we found that staff were aware of issues or incidents that may place people at risk of harm.

We found that staff and volunteers received appropriate training depending on their role.