The inspection was carried out on 30 August 2016 and was unannounced. On the day of inspection there were seven people receiving care and treatment on the in-patient unit and the hospice was supporting approximately 200 people in the community.

Sue Ryder Manorlands provides palliative care and complementary therapy services to support people with life-limiting conditions which can involve complex physical or psychological problems. The hospice offers support to people living in Craven, Airedale, and Wharfedale as well as central, northern and western areas of Bradford. The hospice has a 16 bed in-patient unit, a day therapy unit and a team of specialist nurses who support people in the community. This inspection did not include the day therapy unit.

The last inspection was carried out in September 2013 and at that time the service was meeting all the regulations inspected.

The hospice had a registered manager in place. 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.

There were systems and processes in place to protect people from the risk of harm and people told us the service was safe. Staff had been trained and understood the different types of abuse. They knew how to recognise signs of abuse and how to report any concerns about people’s safety and welfare.

The building was clean and well maintained. Checks were carried out on the premises, equipment and installations to make sure they were safe. Risks to people’s safety and welfare were identified, assessed and managed.

Staffing levels were kept under review and there were enough staff to provide people with the care and support they needed in a timely way. The hospice employed a multi-disciplinary team of health and social care professionals. 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.

People’s medicines were managed safely and people told us they were able to have their medicines when they wanted them.

There was a comprehensive programme of staff training which showed staff were supported to develop their skills and knowledge. Staff had annual appraisals and had the opportunity to attend reflective sessions which were led by the Chaplain.. The arrangements for clinical supervision had changed recently and we found some staff were unclear about the arrangements and the provider’s expectations.

The hospice was working in accordance with the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. We found staff understood their responsibilities. There was a multi-disciplinary approach to assessing people’s capacity to understand and make decisions about their care and treatment. We found appropriate referrals had been made when people lacked capacity to consent to their care and treatment. This helped to make sure people’s rights were protected.

We found people were asked for their consent to care and treatment and their wishes were respected. This included their right to refuse interventions.

People’s nutritional status was assessed and their dietary needs and preferences were catered for. People were offered a variety of food and drinks and snacks were available outside of set meal times.

People had access to the full range of health and social professionals and complementary therapists. Everyone we spoke with told us they were extremely satisfied with the support they received. People who used the community services told us they had full access to the out of hour’s services and praised the effectiveness of the communication

We spoke with four people who used the service, four members of staff and we looked at six care plans. The people we spoke with were happy with the care they received at Manorlands Hospice. One person told us, “Staff here are superb, never had anything like this before, you are well looked after.” Another person said, “I feel valued as a person I am not just a number I am a person in my own right.” Other comments included, “Definitely staff understand how to look after me” and “Staff are marvellous, absolutely superb.”

We saw that people were encouraged to live their lives to the best of their ability, for example, one person told us they went for walks independently and accessed the local shop.

The communal areas and bedrooms were clean and free of any malodours. One person said “The rooms are always clean.” Another person told us, “Cleanliness is excellent.” Another person said, “Place is absolutely, superbly clean, they always wear aprons when cleaning and always discuss the procedures with you.”

There were effective systems in place to reduce the risk and spread of infection.

There were systems in place to ensure people were protected because accurate and appropriate records were maintained.

During the visit we observed staff supporting people and saw that staff responded promptly to any requests for assistance. Staff told us that they got lots of support. One member of staff said "We get good training and also gain experience and learn from each other."

During the visit we had the opportunity to speak with three people who used the service. They told us they had “nothing but praise” for the care, treatment and support they received. People told us they were fully involved in decisions about their care and treatment, one person described their relationship with the medical and nursing staff as a “partnership” and another said “decision making is up to me as the patient”. People told us the staff were “caring” and were always available to provide whatever help was needed. People said they had nothing to complain about but said they felt confident any concerns they had would be addressed. People told us the hospice was clean and comfortable.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

During the visit we were able to speak to one person using the service. They told us the staff were caring and supportive and said nothing is too much trouble for them. They told us they felt safe and comfortable at Manorlands and were happy with the care and support they received.