The inspection was carried out on 13 & 29 September 2016. The visit on 13 September 2016 was unannounced which meant the provider and staff did not know we would be visiting. We informed the provider we would be visiting on 29 September 2016.

The last inspection took place in January 2014 and at that time the service was compliant with the regulations inspected.

The hospice offers specialist care for people with cancer and other life-limiting illnesses and support for families. The hospice has a 16 bed in-patient unit and also provides day services. The day services did not form part of this inspection. On 13 September 2016 there were 15 people receiving care and treatment on the in-patient unit.

The service had 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.

Everyone we spoke with told us they felt the hospice was a safe place where they were cared for by caring and competent staff. There were systems in place to make sure people were safeguarded and staff knew how to recognise abuse and how to report any concerns about people’s safety and welfare.

The recruitment procedures were robust and all the required checks were completed before new staff started work. This helped to protect people from the risks of receiving care, support and treatment from staff unsuitable to work with vulnerable adults.

The hospice employed a range of medical and nursing staff and health and social care professionals such as social workers. There were enough staff to ensure people received the right care and treatment and without exception people told us staff responded promptly to their changing needs. Staffing numbers and skill mix were reviewed to ensure they remained appropriate to people’s needs.

People’s medicines were managed safely and symptom control and pain relief was available at all times during the day and night.

We found risks to people’s health, safety and welfare were well managed. People’s care records included information about individual risks and how these were managed.

The hospice was clean and well maintained and equipped to meet people’s needs. Checks were carried out on equipment and installations which helped to ensure the premises were safe for people to use. There were clear systems and processes in place to deal with emergencies, both medical and non-medical emergencies.

Incidents and accidents were recorded and reviewed and whenever possible action was taken to reduce the risk of recurrence.

People told the staff were well trained and had an air of confidence which they found reassuring. We found staff were supported to continue to develop their knowledge and skills and to deal with the emotional challenges of their work.

The management and staff showed us they had a good understanding of their responsibilities in relation to The Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. This helped to make sure people’s rights were protected and promoted. However, this was not always reflected in the records where we found mental capacity assessments and best interests’ decisions were not clearly documented.

People were offered a choice of food which took account of their ethnic, cultural and dietary needs and preferences. We found the catering staff were committed to doing whatever they could to accommodate people’s requests. Although nutritional assessments were not being carried out routinely at the time of the inspection people received support from dieticians and speech and language therapists where necessary.

People were supported to maintain their wellbeing by a multi-disciplinary team. People spoke very highly about the nursing and medical staff, they said commun

We spoke with two people and their relatives on the in-patient unit and five people in the day therapy unit. People were overwhelmingly positive about the care and treatment they received. One person who had recently started to attend the day therapy unit said “For the first time since my diagnosis I feel I have a future”. Other people said they looked forward to attending the day therapy unit.

Everyone we spoke with said they were fully involved in decisions about their care and treatment and were given as much information as they wanted. People said the staff did everything they could to cater for their individual needs and preferences. People were very complimentary about the staff describing them as “Kind, “Compassionate and Respectful”. People told us they felt safe.

One person said car parking was sometimes a problem as there were limited spaces.

We found people’s needs were assessed and care and treatment was planned and delivered to meet their needs.

We found the provider had suitable arrangements in place to make sure people were protected from abuse or the risk of abuse.

We found the environment was clean and hygienic. The building was adequately maintained and a programme of planned refurbishment was scheduled to start the week after the inspection.

We found the provider had effective systems in place to assess and monitor the quality of the service.

During the visit we had the opportunity to speak with seven patients and one relative. All told us they had “nothing but praise” for the care, treatment and support they received. They told us the service was “first class” and “you cannot surpass it, marvellous”. The patients said they were informed about and involved in decisions about their care and treatment; two patients told us the medical and nursing staff were always available to “talk”. Patients told us the staff were “caring” and were always available to provide whatever help was needed. Patients said they had nothing to complain about but said they felt confident any concerns they had would be addressed.

People who use the services we spoke to during the site visit stated that staff at Marie Curie Hospice Bradford are responsive to their care needs.

People who use the services at the hospice also stated that staff were caring and effective in managing their pain.