This inspection took place on 15 and 16 November 2016 and was announced. This is the first inspection of the service since its registration in December 2014.

George Marsh Centre is the base for one of the North London Hospices community teams that are registered with the Care Quality Commission. This service offers community services to people living in the London Borough of Haringey who have life-limiting or life threatening illnesses. At the time of the inspection they were supporting approximately 150 people. The other community services operate from Finchley and Enfield, in addition to inpatient beds at Finchley.

The North London Hospice offers an integrated service for people who have life limiting or life threatening conditions. It also provides educational support and advice, a bereavement service and district nurse support. There is a single point of contact for people in the community who are then referred onto the most appropriate service.

The community team consists of 10 people which includes clinical nurse specialists (CNS), an assistant practitioner, a social worker, administrative support, and a consultant and team leader. Anyone in the community is initially able to refer themselves or other people who have a life-limiting or life threatening illness. The service offers advice and support to people and their families. They also take on a broader role of educating others involved in end of life care.

The community team works with primary healthcare professionals to manage people’s symptoms particularly around pain management. They provide an advice line over a 24 hour period, practical financial support, bereavement/counselling and support for people through their illness and death.

The service had a registered manager in post who was the Director of Clinical Services. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People were very positive about the support they received and told us staff were kind and compassionate. They told us staff listened to them, were respectful and tried to ensure they received care in line with their needs and wishes. The team works as part of Haringey partnership to offer an all-inclusive approach to people and their families.

New staff initially received an extensive induction programme and were consequently well trained. There was a focus on continuous professional development and learning. Staff told us they were well supported by their peers and managers. There were a number of forums where staff could raise issues and be supported to undertake their roles.

People received care that was personalised to their needs. They were supported to take as much control as they wanted of their lives and of their death. Care plans reflected their choices about specific needs and preferences; this included any cultural and spiritual needs. Care plans were continually revised so they were up to date and reflected the person’s current needs.

Staff knew how to safeguard people at risk. They knew what action they should take if they considered people were at risk of harm or abuse. People received their medicines as prescribed and staff knew how to manage medicines safely. Risks to people’s health and well-being were regularly assessed and action taken to minimise those risks.

The provider showed a commitment to providing high quality care and was continually striving for improvements. The trustees and managers of the service learnt from incidents and accidents. They actively sought feedback from people who used the service and their families. People felt able to raise any issues or complaints and the provider took any issues seriously. There was a rolling programme of audits so the provider could monit