Hospice Isle of Man has been evaluated in the latest report by the Care Quality Commission (CQC).

 The CQC found the service to be effective, caring, responsive and well-led. However, it did not meet all of their safety standards, making 11 recommendations for improvements.

 The report highlights some of the good practices at Hospice, notably the compassion and kindness of the staff. Staff respected the privacy and dignity of patients, providing emotional support, and supported patients to make decisions about their care.

 It was also noted that the strong culture of working together meant that employees, support groups and volunteers had effective working relationships, delivering a caring and individual service to patients.

However, it was not all good news.

Safeguarding

Not all staff had undertaken the correct level of safeguarding training as compliance figures for safeguarding children level 2 and 3 were low.

Assessing and responding to risk

There was no sepsis awareness training or specified pathways for staff to follow.

Recognised tools were not used to identify deteriorating patients. Falls risk assessments were completed for all those at risk, PEEPS were not regularly reviewed and therefore did not accurately reflect the current needs of patients. Resuscitation equipment was not stored in a way that would make it immediately accessible to staff.

Cleanliness and infection prevention and control

Separate areas did not have specific cleaning equipment increasing risk of cross contamination.

Medicines

Medication room temperatures were not monitored to ensure medications are stored within recommended parameters. Medical oxygen cylinders were not always secured to reduce risk of falling.

Patient care records

Records, such as advance care plans, were not always uploaded onto the electronic system in a timely way meaning staff could not be assured they were delivering care in line with patient preferences.

Competent staff

Staff did not receive training in the awareness of learning disabilities, autism or mental health.

Access and flow

There was not a system in place to identify patients in hospital that required hospice care and therefore referrals were dependent on individual capacity to reach out to acute service.

Vision and strategy

A new vision and strategy had not yet been developed as the service were awaiting the appointment of a new chief executive.

Governance

The service was using guidance that supports best practice, but this is not yet fully embedded across all areas.

Managing risk

There is no effective accountability within the risk register for example audit

Raising concerns

The service did not have a 'freedom to speak up guardian' or an equivalent to which staff could raise concerns about the service.

The CQC has also identified areas it has now escalated to the Department of Health and Social Care. Respite services had reduced in size and therefore offered limited provision to support the wider system.In its press release, Hospice says most of the recommendations for Hospice Care were around storage of equipment and ensuring all employees had completed their training and risk assessment, management and governance courses.

 Since the assessment was carried out last year, Hospice says several of the areas for improvement have already been addressed and assurance has been provided that further development required for the remaining recommendations will enable them to be implemented during this year.

 Hospice Care chief executive John Knight said: ‘We were delighted to welcome the CQC for their week-long inspection of our End of Life Care provision. We’re pleased they have recognised the high quality of care that Hospice and our partners in Manx Care provide and the clear focus in keeping patients at the centre of that.

He added: ‘The CQC highlighted the strong team working culture that provides a holistic service and the highly developed clinical informatics and quality assurance systems within Hospice. Comments from their very positive report will be used to support Hospice’s 40th year celebration this year.’

 The Department of Health and Social Care has commissioned the CQC to undertake the baseline assessments to gain a better understanding of health and social care provision on the island. Publishing the reports is an opportunity to identify the notable areas of practice and improvements, whilst encouraging a culture of continuous progress.

 This is the latest report to be issued since the CQC baseline assessment schedule, began last year.

 For more information relating to the inspection programme or to view the all of the reports visit the DHSC, External Quality Regulation website.