St Giles Hospice CQC Report 2017 St_Giles_Hospice_CQC_Report_2017 | Page 13

People and their relatives confirmed their care and treatment was regularly discussed and agreed with
them. All we spoke with said they received the information they needed to help them to understand the
hospice service, their health condition; care and treatment options. Results from the provider's recent
survey questionnaires with people about their care, showed they felt fully involved in making decisions
about their care as they wished. Many rated quality and usefulness of written and verbal information
provided as either 'good' or 'excellent.'
People told us that staff were competent when they provided their care and treatment and always
completed their agreed care. One person said "I find all of the staff to be highly skilled; they know what they
are doing." All grades of staff and volunteers we spoke with and those we surveyed told us they received the
training, support and development opportunities they needed for their role and responsibilities. This
included relevant clinical skills training and competency checks and performance apprais als. It also
included access to regular peer and individual bespoke supervision when required. This helped to ensure
individual and team reflective practice and learning. Staff who provided people's care via the provider's
hospice at home service received mainly peer supervision. Individual supervision was dependent on staff
arranging this with their line manager or a specialist supervisor, rather than routinely planned for staff. We
discussed this with management, who advised this was under review, with monitoring of staff uptake to
ensure they received regular one to one supervision.
We received many positive comments from staff about their training and support. One nurse said, "Training
and development opportunities are really good here; routinely offered, supported and encouraged." A large
onsite, well-resourced learning and development centre helped to facilitate staff learning and education. All
new staff and volunteers were required to complete a comprehensive training programme relevant to their
role before they started providing care. This included working alongside more experienced staff, of a
relevant grade where appropriate. People and relatives we surveyed believed staff had the skills and
knowledge required to provide people's care.
Staff and volunteers were supported to retain and develop their own service specific learning for their role.
This included through regular refresher training, new or further learning to degree level. All nurses and care
staff worked to a 'passport', for key training and competency relevant to their role. The passport set out
clear continual development pathway for staff to follow from appointment. This included core training,
education plans and optional studies, linked to and reviewed via staffs' individual annual reviews of their
performance and appraisals. Checks of staffs' professional registration were made when required to confirm
their status to practice. For example, to provide people's nursing or medical care.
Staff leads were established for all key areas of clinical care. For example, nutrition, infection control and
tissue viability. Staff were actively encouraged to share their learning and where relevant, teach and support
each other. The care certificate was introduced for new health care support staff and mapped across
existing staff to ensure they fulfilled the learning principles from this. The care certificate identifies a set of
care standards and introductory skills that non-regulated health and social care workers should consistently
adhere to. They aim to provide those staff with the same skills, knowledge and behaviours to support the
consistent provision of compassionate, safe and high quality care.
Peer learning and development was well promoted through a range of staff learning forums that were
regularly held. For example, journal club for review of research and practice concerned with end of life and
palliative care, staff case presentations and critical appraisal. Clinical staff were encouraged and supported
to undertake research and development to help inform, influence and improve people's care where
required. For example, in relation to nutrition and end of life care. The provider planned to introduce a
number of measures aimed to further improve and enhance people's care experience. This included a new
13 St Giles Hospice - Whittington Inspection report 24 February 2017