St Giles Hospice CQC Report 2017 St_Giles_Hospice_CQC_Report_2017 | Page 18

said, "It's brilliant; they can transfer all the care to our home; we couldn't ask for better. Another relative told
us, "We have talked as a family and my wife wants to try and live at home; the community team are looking
how this can be set up for us."
Active discharge planning from the inpatient unit, helped to support people's end of life care. This
supported people who chose to go home, or to go home after a period of rehabilitation and symptom
control; to be discharged in a considered, timely manner. People, relatives and staff said this was done in a
way, which enabled people to receive the care and support they needed after their discharge home. For
example, medicines and equipment needs, environmental adjustments and financial considerations were
explored with people. One of the hospice community nurse specialists told us as a trained prescriber for
specified medicines; this could enable people's quick access to the medicines for their symptom
management when required. Anticipatory medicines were subject to people's assessed needs and could be
administered out of hours by the district nurse if required, to help prevent the person being unnecessarily
admitted to hospital. Anticipatory medicines can be provided in advance, which are to be given when a
person's condition worsens; to help alleviate their discomfort or distress. This helped to ensure people
received the right care at the right time. .
The provider's arrangements helped to ensure that people were engaged, supported and informed in a way
they understood and was helpful to them. One person receiving care on the inpatient unit was unable to
move because of their health condition. They were provided with an environmental control device to assist
their independence. This is a form of electronic assistive technology, which enables people with significant
disabilities to independently access equipment in their environment, such as home or hospital. For
example, to enable them to open bedroom curtains or switch room lights on themselves. People and their
families were informed about the hospice service and matters relating to death, dying, bereavement and
loss through a range of service literature and information. Key service information could be provided in
alternative formats to suit people's needs. For example, language, type or picture format.
Comprehensive arrangements via dedicated staff helped to inform and support the local and wider
community through direct engagement with them. For example, by providing education and bereavement
support to local schools, colleges, employers and community groups. The provider also worked in
partnership with external care agencies such as CRUSE and Age UK to set up 'drop in' centres providing
advice and support in relation to dying matters. This showed the provider took a key role in the local
community to build links, services and support networks.
Service strategy and improvement planning sought and took account of local and national health
population demands for end of life and palliative care. Review and development of the hospice community
services was a key objective for 2016-17; to consider how the service could be shaped to be as flexible,
efficient and effective as possible. For example, to support the increasing number of people who wish, to die
at home. As part of this review, the provider was conducting a survey with local GPs to help better
understand and determine their expectations and perceptions of the service. Recent service initiatives
included a pilot project underway on the in-patient unit - for two continuing health care funded beds for
people life limiting illness nearing the end of their life; but without complex specialist palliative care needs.
People and their relatives knew how to raise any comments, concerns or make a complaint about the
service if they needed to. All knew how to contact the service out of normal office working hours if they
needed to. People we spoke with told us they had not found any cause for complaint, but felt any concerns
they may have would be listened to and acted on. The provider told us they had received 11 complaints
during the previous 12 months. For example, improvements to discharge planning and co-ordination and
equipment used for people's care. Records showed how these were investigated and responded to. They
18 St Giles Hospice - Whittington Inspection report 24 February 2017