St Giles Hospice CQC Report 2017 St_Giles_Hospice_CQC_Report_2017 | Page 21

ensure critical care review, reflection and learning; to check how we communicate and promote this in a
non-threatening way; it's about staff ownership, not blame." We found the provider had recently formalised
their procedure for post incident 'critical care reviews.' This was to ensure staffs' formal support and
reflection when required and share any wider emerging learning themes from this with all staff where
relevant. This meant that the hospice board and managers knew about and took responsibility for things
that happened in the service, to safeguard people from harm.
The service worked in partnership with key organisations, including the local authority, safeguarding teams,
and clinical commissioning groups, to support care provision, service development and joined-up care.
Links were established with the local general hospitals, universities, and relevant national organisations to
support and inform palliative and end of life care; staff training and development. The provider also worked
closely and consulted with external community professionals, who told us that hospice management strove
to continuously improve the quality and people's care and support.
Senior leadership was visible, strong and supportive. The registered manager understood their
responsibilities for people's care and their related legal obligations concerned with their registration. All staff
we spoke with described a caring and dynamic organisation that continuously sought to improve people's
experience of their care and treatment. The hospice is an organisation member of Hospice UK and the
National Council for Palliative Care, which enabled cross sector support, sharing of good practice and
service development initiatives. For example, measures were being introduced to review the quality and
efficiency of end of life care from a national government initiative seeking to improve this.
The provider had either made or planned a number of service improvements, influenced by feedback from
people, stakeholders and national initiatives concerned with end of life and palliative care. This included a
review of community services against service demand; to continue to enable people who preferred to
remain at home at the end of their lives. Comparative figures showed the provider had enabled more people
to do so than the average percentage expected by national and local authorities during the period 2015-16.
The provider's arrangements for staff moving and handling training and their safeguarding policy were
under review to ensure they continued to match growing service demand and changes in national guidance.
The provider was also seeking to review the quality and efficiency of their end of life care via a new national
collaborative measure of assessment; known as the Outcome Assessment and Complexity Collaborative
(OACC). This showed the provider consistently sought to develop and improve their service when required.
Senior staff were well supported to engage in relevant roles outside the service, to support and inform
people's care. This included research development work and through membership of lead groups or
councils concerned with end of life and palliative care. For example, the deputy chief executive officer was
chair of a regional executive clinical leads group for hospice and palliative care. The director of clinical
services was a member of the National Nurse Consultants in Palliative Care Group and also held
membership at commissioning and local hospital steering groups concerned with end of life and palliative
care. Other staff held positions of chair or memberships at a range of national or regional recognised groups
concerned with people's care and treatment. For example, bereavement or lymphoedema care and
treatment. This helped ensure nationally recognised practice was followed concerned with people's end of
life and palliative care.
We looked at the provider's records relating to their forward strategy and business plan due to be formalised
in the Autumn of 2016. This showed key service opportunities, challenges and operational considerations
were taken into account, which reflected known directives and challenges for delivering specialist palliative
and end of life care. For example, meeting the diverse, changing care needs and related population health
demands. It included focus on people living with dementia who may require hospice care and workforce
21 St Giles Hospice - Whittington Inspection report 24 February 2017