St Giles Hospice CQC Report 2017 St_Giles_Hospice_CQC_Report_2017 | Page 17

Good
Is the service responsive?
Our findings
People consistently told us they were involved in decision making about their care, treatment and support
needs. One person said, "They talk through my care with me all the time; they wheel the computer to my
bedside to go through things with me; yes, I can say that I am fully involved." Another person's relative told
us, "We have talked as a family and my wife wants to try care at home; the hospice community team are
looking at if our home can be set up suitably." Community health care professionals told us that staff acted
on and followed any advice for people's care in a timely manner. They also said staff worked well them to
share any relevant information about people's care. For example, when people's care needs changed.
People's care records showed how their care and treatment options were discussed with them and their
related choices and preference were followed. Staff told us they had up to date information about people's
care and treatment needs, choices and following any agreed changes to this. The provider's electronic care
plan record keeping system supported this across the hospice services. People's care was discussed; agreed
and recorded with them at the place they received care. For example, the inpatient unit or at home via the
hospice at home service. This helped to ensure that people's known care and treatment decisions were
agreed with them, followed and acted on in a timely manner by staff.
One person told us about an advance decision they had made about their care and treatment. This is a
decision a person can make in the present to refuse a specific type of treatment at some time in the future.
The person told described the 'sensitive, honest and informative support' they received from medical and
nursing staff. This helped them to consider their health condition and related care and treatment options.
They said, "It helped me feel so much better; I don't have to worry so much; I know I'll get the care I want."
People's care records we looked at showed where possible, staff took time to check if people had made an
advance decision before they provided care and treatment. We found there was a delay in staff confirming
this information from one person's care record we looked at. We discussed this with management and staff,
who took the action required to address this and also to help prevent this from happening in the future. This
meant that people were protected from receiving care and treatment that did not meet with their known
wishes.
In May 2016 the provider launched their Advice and Referral Centre (ARC). We found a mix of trained call
handlers, specialist staff and supportive care volunteers provided advice and support on a range of matters,
either directly related to or concerned with palliative and end of life care, life limiting illness, sudden death,
loss or bereavement. The service was developed from an existing referral centre launched in 2014; to provide
and improve peop le's timely assessment, care and treatment referral. Advice, support or signposting to
other services was also provided for people, their families and external health professionals when required.
Whilst most admissions to the inpatient unit were planned, arrangements were established for people's
referral, medical and nursing assessments out of normal working hours when required. For example, if
people's needs changed quickly.
A relative told us how the hospice team were supporting their family member to go home for their care. They
17 St Giles Hospice - Whittington Inspection report 24 February 2017