We carried out an unannounced inspection of the service on 14 July 2015.

Dove Cottage Day Hospice is an independent organisation offering palliative day care to people with life limiting conditions living in north east Leicestershire, Rutland and south east Nottinghamshire. The service is situated close to the village of Stathern. All services are provided free of charge. A small team of nurses and nursing assistants are supported by over 60 volunteers. Facilities include communal lounges, a garden room with access to a landscaped garden and treatment rooms where people receive massage and complimentary therapies. Up to 20 people use the service each day.

The service was registered to provide three regulated activities. These were Treatment of disease, disorder or injury (TDDI); Diagnostic and screening procedures and Transport services, triage and medical advice provided remotely. At the time of our inspection only TDDI was provided.

The service has a registered manager. 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.

People using the service told us they felt safe because of the quality of care they received. They explained that staff and volunteers understood and were attentive to their needs. They described Dove Cottage as being warm and friendly and that it was a place they looked forward to visiting.

Staff understood their responsibilities for keeping people safe. Equipment and premises were well maintained and free of hazards that could result in people being harmed.

People were supported by sufficient numbers of skilled and experienced permanent staff and volunteers. They received their medicines when they needed them.

Staff and volunteers were highly regarded by people using the service. Our observations of how staff and volunteers supported people confirmed what people told us. Staff and volunteers communicated effectively with people using the service and each other. We saw that staff and volunteers put their training into practice. Staff and volunteers told us they felt well supported by the management team.

All of the people using the service were presumed to have mental capacity and staff understood their responsibilities under the Mental Capacity Act 2005.

People spoke in very favourable terms about the quality of meals they had. They were supported with their nutritional and health needs and preferences by staff and volunteers.

Staff and volunteers developed caring relationships with people using the service. That happened because staff and volunteers had detailed knowledge of the needs and preferences of people that the service.

People were involved in the assessments of their needs and in decisions about their care and support. People’s wishes were respected by staff who treated them with dignity. Several people we spoke with told us that staff and volunteers were like a second family.

People’s care plans were focused on their individual needs. They were supported to maintain their interests and hobbies through a variety of activities staff and volunteers provided.

People knew how to raise concerns if they had any. They emphasised to us that they had not had occasion to raise concerns or make a complaint.

People using the service, their relatives, staff and volunteers were involved in developing the service through a wide range of fund raising activities. Staff and volunteers were enthusiastic and motivated. They told us they enjoyed their roles at Dove Cottage more than any other job they’d done before.

The provider had effective arrangements for monitoring the service. These included scheduled audits and arrangements to receive feedback from people using the service and their relatives. People’s feedback was acted upon. The provider was committed to continuous improvement.

During our visit we were able to talk with six people who were using the service, one relative, five members of the staff team and three volunteers. This enabled us to gain a clear insight into the services offered at Dove Cottage and to find out what people thought of the care and support they received.

People told us that they had been given the opportunity to visit the service before deciding whether they wanted to attend on a regular basis and their consent had been obtained before any care or treatment had been given. One person told us: “I visited with my daughter, I liked it and so I kept coming.”

We were told that the staff and volunteers were very supportive and nothing was too much trouble. One person explained: “They can’t do enough for you.”

People told us that the food served at Dove Cottage was excellent and a choice was always offered. We were told: “The foods brilliant, there’s always an alternative, we are spoilt.”

There was a very relaxed atmosphere throughout our visit and staff and volunteers went about their duties in a happy and cheerful manner.

Everyone spoken with was most satisfied with the support provided at Dove Cottage. One person told us: "I find it very therapeutic, it's my day of peace and quiet." Another person explained: "It gives me something to look forward to and it gives my wife a break, I enjoy the quality time I get here."

During our visit we were able to talk with seven people who were using the service, five members of staff and two volunteers.

People told us that they had been visited before they used the service so that they could make sure it was the right place for them and they had been able to visit to see what the service offered. One person explained, “xxxxx [senior nurse] came to see me yesterday, I didn’t know what to expect, but it’s been good, I think I would like to come again.” Another person told us, “they came and assessed me; we were struggling as I’d fallen a couple of times.”

We were told that the staff were supportive and carried out their duties in a kind and patient manner. One person told us, “the staff are very helpful, nothing is too much trouble.” Another person explained, “the staff are great, we have a laugh and a joke, you couldn’t get any better.”

We were told that the food served at Dove Cottage was very good and the meal served on the day of our visit looked nutritious and appealing. One person told us, “the food’s lovely, she is a great cook.” Another person explained, “the food is very good and there is a choice which is nice. My only complaint is the puddings, they’re so nice, you have to watch your weight!”

People told us that they were very satisfied with the care and support they received. One person explained, “If you don’t want to do anything, you don’t, if you want to do something, they go out of their way to help you.” Another person told us, “I am treated very well and the important thing is they don’t rush you at all.”

Everyone spoken with told us how much they enjoyed their visits to Dove Cottage. One person explained, “the thought of coming to a hospice, it paints a picture of the end of the road, but when I came here for the first time it was nothing like that, I love it.” Another person told us, “so far it has been spot on, when you are in hospital you worry about asking for things because they are so busy, but not here, everyone is very helpful.”

Staff spoken with told us how much they enjoyed working for the service. One staff member explained, “ I absolutely love my job, I love the interaction it’s a boost and a motivation” Another staff member told us, “I feel I’m doing something to make their life a little easier and take the strain off of their carer, that has to be a good thing.”