We inspected Teesside Hospice Care Foundation on 16 March 2016. The inspection was unannounced which meant that the staff and registered provider did not know we would be visiting.

Teesside Hospice Care Foundation (in patient unit) provides specialist palliative and end of life care to a maximum number of 10 people. At the time of our inspection visit there were nine people who used the service.

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 very good staffing levels which allowed staff to meet people’s care and treatment needs in a safe, timely and personalised manner. The service had recruitment procedures in place. Staff and volunteers had robust recruitment checks, which helped to make sure they were suitable to provide people’s care and support.

Risks to people’s safety were appropriately assessed, managed and reviewed. Care records contained a number of risk assessments specific to the needs of each person.

There were systems and processes in place to protect people from the risk of harm. Staff told us about different types of abuse and the action they would take if abuse was suspected. Staff were able to describe how they ensured the welfare of vulnerable people was protected through the organisation’s whistle blowing and safeguarding procedures.

The management of medicines was safe and people told us their pain was well managed.

Checks of the building and equipment were completed to make sure it was safe. A fire drill had been undertaken in March 2015; however, we could not be sure that this covered all staff and in particular night staff. We asked the registered manager to contact the fire authority to seek advice regarding fire safety. After the inspection the registered manager contacted us to inform that they had made contact with the fire authority and their advice was a minimum of one drill should be undertaken each year. The registered manager told us there was a system of staff rotation from day and night shift and all staff would be involved in a drill. In addition there had been several activations of the fire alarm in in which staff had worked closely with the fire authority. At the time of the inspection personal emergency evacuation plans (PEEPs) for people who used the service were not in place; however, there was a summary report of each person and a moving and handling assessment which together provided important information for staff and others in the event of an emergency. The management team told us that PEEPs would be completed as a matter of importance. Tests of the fire alarm were completed but there was no system to ensure call point were tested as often as each other. The management team told us they would take action to improve the fire safety concerns we raised at the inspection.

Staff had been trained and had the skills and knowledge to provide support to the people they cared for. Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards which meant they were working within the law to support people who may lack capacity to make their own decisions.

People told us the food provided was good. Nutritional assessments were undertaken to identify risks associated with poor nutrition and hydration.

Staff understood people’s individual needs and the support they and their family members required. We saw that care was provided with kindness and compassion. People who used the service and relatives spoke very highly about the care and service received. People said their right to privacy was fully protected, and told us they were always treated with dignity and gre

During the inspection we spoke with people and relatives who used the services at Teesside Hospice. One person told us, "It’s a life line coming here, the staff are fantastic. There is always something to do.” A relative we spoke with told us, “The care here is fantastic, I cannot praise the hospice staff enough, they are excellent and we are all so well supported.”

We observed the experiences of people who used the service and relatives visiting the unit. We saw that staff interacted and communicated well with people and their relatives and staff were attentive and treated patients with dignity and respect. We saw that the atmosphere was friendly and relaxed.

We saw that people had their needs assessed and that care plans were in place. We found there were effective processes in place to ensure safe sharing of information with other providers.

We found that people were cared for a clean and safe environment.

We saw there was a range of equipment available to support people and we found that systems were in place to monitor the quality of the service.

We spoke with two people who used the inpatient service. They told us they were treated well, the staff were very good and they felt safe at the hospice. One person said “They discuss everything with you, they are marvellous.” Another person told us “I am definitely treated well, I am over the moon with them”, and “They are like family to me.”

We found there was a warm and friendly atmosphere within the hospice and people were treated with dignity and respect. We observed staff interacting well with people, which had a positive impact on their wellbeing.

We found people were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. We also found people were cared for and supported by, suitably qualified, skilled and experienced staff.

We found there was an effective complaints system in place at the home.