We inspected St Cuthbert’s Hospice on 20 August 2014 and the inspection was unannounced. Our last inspection took place in July 2013 and we found the service was meeting all essential standards.

St Cuthbert’s Hospice is registered to provide accommodation and nursing care for 12 people with life limiting illnesses and also day care services for those who have remained in their homes during their illness. The hospice provides a wide range of specialist services designed to care for people’s physical, emotional and spiritual wellbeing. The hospice and day care facility provide patients with access to family support, physiotherapy and complimentary therapies. St Cuthbert’s Hospice is a registered charity.

The hospice had a Registered Manager who had been in post since October 2008. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

Relatives and people who used the service gave us positive comments about the staff such as “The staff and volunteers are just brilliant” We did not receive any negative comments from people who used the service, their relatives or health professionals involved in people’s care.

On the day of our visit we saw people looked well cared for, staff spoke with them in a calm and respectful way. We saw when staff spoke with people they took time to get to know them better and to listen to their needs.

We saw staff and volunteers working at the hospice understood the needs of people who used the service.

Care staff were appropriately trained to carry out their roles and additional training was provided if staff requested it. Volunteers who worked in the hospice were also given training appropriate to the roles they carried out.

Risks to people who used the service were appropriately assessed and managed.

St. Cuthbert’s Hospice used a ‘workforce planning modelling’ to ensure staffing levels were appropriate.

The hospice had plans in place to deal with unforeseen circumstances such as emergency admissions to hospital.

The hospice building provided an environment and facilities that were welcoming to people who used the service,

All rooms had patio doors which could be opened to allow beds to be wheeled outside if people wanted to gain some fresh air.

The hospice had a family support team which was available to provide pre and post bereavement counselling for patients as well as friends or relatives and they also provided a children’s counselling service if needed.

People who used the hospice and their family or friends were involved in the planning of care. When people were admitted to the hospice staff took time to meet people and get to know them whilst documenting a plan of care.

The hospice regularly reviewed complaints and incidents that had been recorded with an audit of all of these, including actions taken and lessons learned being published in the providers annual quality account.

The arrangements for supporting people to make decisions about their daily lives and preferences were recorded in their care plans. Each person was supported to take appropriate risks to promote as much independence as possible during their stay at the hospice.

The relationships between staff and the people who they supported in the community and those using the in-patient unit were good and personal support was provided in a way that promoted and protected their privacy and dignity. This was confirmed when we spoke with two people who used the service and four of their relative's.

There was a competent staff team who had the training, skills and experience to meet the specific conditions of the people who they supported.

Patients care records were written in a clear and easy to understand way. The assessments and care plans contained within each person’s care record detailed how staff should support each individual in the person’s preferred way. Risk assessments considered the risks to both people and staff. We found where risks were identified, they were appropriately managed.

We found staff were clearly knowledgeable about the care people required.

The day hospice provides specialist palliative care and therapeutic support to patients.One day patient said “The care here is first class and the staff are wonderful." Another day patient said "I love coming here, it is such a comfort to me and the various therapies are a great help."

“The nurses keep me fully informed of any treatments available to me, and they are always have time to explain things in detail about my illness. I am very grateful to them because they don’t rush things, and they answer my questions in a way that I understand”.

“I am kept fully informed about all aspects of the care that I receive here. The consultant and the nurse’s are excellent at keeping me informed. Everyone here, including the volunteers are fantastic, they are the most caring people in the world”.

“I come here to the day hospice one day each week, my life has improved greatly since coming here, I receive all the treatments that I need, and this means that I don’t have to attend hospital for tests and treatments. I cannot fault the care that I receive, and I am always treated with respect”.

“I don’t have a copy of any plans about my care and treatment, but I can confirm that the clinical staff involve me in all decisions about all aspects of the care that I receive. I am fully consulted and my views are always respected. I love coming here, it is my sanctuary”.

“I have a named nurse, she keeps me informed about everything. I signed a form agreeing to all the treatments that I need”. I have been coming here for several years, it is like a 5 star hotel”.

“They listen to my views, and they always explain things to me properly.

The care that I receive is first class”.

“The food is excellent, restaurant standard, it cannot be faulted”.

“The meals are first class”.

“There is always an excellent choice available. The food is superb”.

“The meals are impeccable”.

“The grounds are lovely with super views of the countryside, everywhere is spotlessly clean”.

“The facilities are brilliant, always fresh and welcoming”.

“I think the staff here are exceptional, they are very skilled and certainly know what they are doing”.

“I trust the staff, they take extremely good care of me”.