We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This report was written during the testing phase of our new approach to regulating adult social care services. After this testing phase, inspection of consent to care and treatment, restraint, and practice under the Mental Capacity Act 2005 (MCA) was moved from the key question ‘Is the service safe?’ to ‘Is the service effective?’

The ratings for this location were awarded in October 2014. They can be directly compared with any other service we have rated since then, including in relation to consent, restraint, and the MCA under the ‘Effective’ section. Our written findings in relation to these topics, however, can be read in the ‘Is the service safe’ sections of this report.

The inspection was unannounced, which meant the provider did not know that we were coming.

At the last inspection of the service there was a breach of Regulation 15 of the Health and Social Care Act 2005 (Regulated Activities) Regulations 2010. This was judged to have a minor impact on people and the provider took measures to put the issue right.

St Helena Hospice Limited provides a range of palliative care services to patients at home, through two day centres and an inpatient unit. The service is available to anyone over the age of 16. A pre- and post-bereavement support service is also provided to family members. St Helena Hospice Limited covers North East Essex and the Colne Valley area of Mid Essex. St Helena Hospice, Tendring Centre is one of the day centres and operates five days a week.

There is a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People told us they felt safe when they used the service. One person said, “You get a lovely service and there are so many carers and volunteers you could not be safer.” There were sufficient members of staff and volunteers with the skills and understanding to provide people with the care and support they needed.

Staff were supported to develop their skills so that they could provide people who used the service with the care and support they needed. Staff said they felt well supported by colleagues and manager. People were complimentary about the way staff cared for them. One person said, “If I have any problems they want to know and do everything in their power to make it better and if they cannot, then they call the doctor.”

When they came to the hospice people received care and support that met their individual health, emotional and social needs. They said that staff did, “everything in their power” to support them or to get them specialist help.

People were treated with dignity and respect by staff and volunteers who were caring and compassionate.

Staff responded to people’s changing needs; they involved people in assessing their needs and took their views into account. Care and support was tailored to the individual’s needs at any particular time. People were supported to take part in therapies and treatments to help with their physical and emotional well-being.

There was an open culture and people were kept informed of changes that would affect the service. Staff and managers gave people opportunities to express their views and concerns and did what they were able to reduce people’s anxiety.

During our inspection we spoke with four people attending the day unit. All the people we spoke with were extremely complimentary about the services and the support they received. They also valued the support from other people attending the day centre. They told us that staff and volunteers, without exception, provided an excellent service. They felt fully involved in all decision making. They very much appreciated that staff liaised with their GP about their symptom control and medication. One person told us: “This place is marvellous. The staff are all so kind.” Another person said: “I don’t know what I would have done if hadn’t been able to come here.”

The care and treatment records demonstrated excellent communication within the hospice services and with external health and social care professionals. The hospice provided training that enabled staff to meet people’s individual needs. They had a commitment to continuous quality improvement of the services, treatment and care that they provided. Actions had been taken to address issues raised by people and their carers. There was also evidence of improved standards within the services following internal audits.

At our last inspection in October 2012 a person told us that they had problems using the doors in the day centre. Some improvements were made during our last inspection. However, a full assessment of access for people with disabilities had not been carried out within the day centre.

The three people we spoke with during our inspection of the Tendring Centre were all full of praise for the care and support they received. One person told us “The service is absolutely tremendous. If you have a personal problem staff are always there to help.” The care records demonstrated excellent communication within the hospice services and that the person receiving the support was fully involved in the decision making process

People said that they had no concerns with the service. However, one person told us that the doors were heavy to negotiate if you were in a wheelchair and they were not wide enough, which resulted in them sometimes bruising their hands. The doors were adjusted during our visit so that they could be held open when needed and would still close automatically in the event of a fire. The deputy director told us that an assessment of wheelchair access would be carried out as soon as possible.