This inspection took place on 5 October 2016 and was unannounced.

Coventry Myton Hospice provides care and treatment to people over the age of 18 with life limiting conditions who require specialist palliative care (palliative care is comprehensive treatment of the discomfort, symptoms and stress of serious illnesses) in their 16 bedded inpatient unit or their day service. At the time of our inspection 13 people were using the inpatient service. The day hospice is open on Mondays, Wednesdays and Fridays and six people were in attendance at the day hospice at the time of our inspection visit. Initially people attend the day hospice for one day per week over a 12 week period. The hospice services provides people with access a range of care and support which includes, children and family support, occupational therapy, physiotherapy, chaplaincy, counselling and bereavement support.

There was a registered manager in post who was also the director of nursing, care and education. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The leadership team continuously looked at the local community to see how best they could respond to people’s needs. Excellent work was being done in identifying the needs of the local population by developing services to meet those needs.

The registered manager was passionate about raising the profile of the hospice and created opportunities for different ideas to meet the diverse needs of people with palliative and end of life care needs. There was a strong commitment for the hospice services to be inclusive and responsive to the needs of all people including those people who may not have traditionally used hospice services.

People and their family members, staff and the board of trustees were actively informed and involved in developing the service. Their views including complaints and compliments were used to continuously develop and influence the services people received so these remained effective, caring and raised quality where needed. People were involved in the development of the service and asked for their views.

There was a very positive atmosphere within the hospice and people were very much at the heart of the services offered. Staff had developed positive, respectful relationships with people and were kind and caring in their approach. People who attended the day hospice were very appreciative of how staff and volunteers had made their days memorable and filled with therapeutic and fun times. People's privacy and dignity was respected by staff who worked to a set of values around providing care centred on each person.

Staff were supported to develop in their roles through a positive culture and idea of teaching and sharing skills within the service as they had link roles in various subjects and in the wider community. Staff worked closely with the staff at the local hospital to educate and promote high quality palliative and end of life care.

People were supported with their nutritional needs with the assistance of the catering team who actively sought and welcomed people’s feedback. There was a shared commitment between all members of the staff team to sharing how meals remained nutritious and people enjoyed these in comfort. Staff made sure changes in people’s dietary needs could be effectively catered for and creatively met in different ways.

Staff knew each person well and understood how people may feel when they were unwell or approached the end of their life. People and their relatives were enabled to be involved in the care and staff were motivated in ensuring people were treated as individuals and had a good as life as possible. People were able to see their friends, families and pets when

We carried out a routine inspection at Myton Hospice, Coventry on 7 January 2014. We looked how people were involved and treated at each stage of their care. We looked at equipment used by people who used the service. We looked at the recruitment process for staff, staffing levels and training. We talked with people who used the service, their relatives and staff.

On the day of our visit to Myton Hospice-Coventry, we saw eight people were using the in-patient service. We spoke with the registered manager, ward sister and deputy-sister. We also spoke with two registered nurses and one care worker.

We spoke with two people who used the service. One person stated, “ The care is absolutely fantastic, its 1000% and the staff are like angels”.

We saw care records for three people who used the service were informative and up- to-date.

We saw equipment provided was safe for people to use and there was an inventory detailing the service history for most pieces of equipment.

We saw the service had a robust staff recruitment process in place and there was a staff training programme to support the needs of the people who used the service. We saw the need for updated specialist training for some staff had been recognised but not yet implemented.

We found that there was an effective procedure in place for recording and responding to complaints.

There was no day hospice service on the day we visited Coventry Myton Hospice so we were only able to speak with inpatients using the service. The two patients we spoke with were very complimentary of the care and treatment received.

We looked at the meals and drinks provided to patients during their stay. We were satisfied patients received a nutritious menu. Patients told us they enjoyed the food provided. We saw that the meal times were flexible and responsive to when people felt able to eat.

We looked at the care and treatment of patients using the hospice. We saw that the hospice looked after patients well, and responded quickly to any changing needs. We observed staff being warm, kind and supportive to patients in their care.

We checked medication practice. We were satisfied that medication was being administered and stored safely and securely.

We looked at whether there were enough staff to meet the needs of patients using the hospice. We determined there were good staffing levels, and staff had good skills and experience to support patients with their care and treatment.

We looked at the complaints policy and procedure. We noted this was accessible to all, and the service was pro-active in listening and acting on the views of patients and people who used it.

During the visit we spoke with two people who attend the day hospice and two people receiving in-patient care. We also spoke briefly with two visiting family members.

People attending the day hospice told us staff had time to listen to them and said attending the day hospice had really helped them with all aspects of their daily lives. One person commented on how much they enjoyed and benefitted from the various activities and therapies provided. They said, “I have had my hair washed and set and my nails done.”

People talked enthusiastically about the care and the support they received in all areas of the service. They told us that staff were helpful and supportive and spent time explaining information to them. Comments included,

"They're absolutely wonderful to me, nothing is too much trouble,”

"I am kept fully informed about all the treatments that I receive. The care and support that I receive is exceptional.”

Everybody we spoke with during our visit reported feeling safe and said the staff respected their human rights.

People told us the hospice is clean and well maintained. One person commented, “It is always like this - spotless.”

People told us there were enough staff to meet their needs and said that when they used the call bell staff answered quickly.

People also stated that it was not just the care that they received that was excellent, they also felt that the meals served were very good. One person told us how much they had enjoyed the Sunday roast dinner and said it was “as good as you would have at home.”