Springhill Hospice “The People’s Hospice” SPRINGHILL HOSPICE QUALITY ACCOUNT 2012 ­ 2013 Springhill Hospice (Rochdale) Broad Lane Rochdale OL16 4PZ Registered Charity No: 701798 www.springhill.org.uk Incorporated as a Company Limited by Guarantee No 2325905
1 Springhill Hospice “The People’s Hospice”
“For the period of time my aunt and I were fortunate
enough to receive care and support from the Hospice,
from her admission, throughout her care and up to her
peaceful and dignified death, the experience was
beneficial and supportive for us both.
Your support allowed me to love her, care for her and
allow her the peaceful death she wished and deserved.
‘Thank you’ seems a small gesture for all that was
given by the doctors and nurses. You have an
exceptional team at Springhill Hospice.
Thank you”
2 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 TABLE OF CONTENTS Page Statement on Quality from the Chief Executive 4 About us § Statement of Philosophy 5 Priorities for improvement 2013/14 6 Progress on priorities for improvement 2012/13 9 Statement of assurance from the Board § Review of services § Research § Participation in clinical audits § Learning from clinical incidents § Management of complaints, concerns, comments and suggestions § Goals agreed with Commissioners 11 What others say about Springhill Hospice § Statements from the Care Quality Commission § Statements from others we work with 14 Data quality 17 Quality overview 18 What Our Patients and their Families say about Springhill Hospice § Inpatient unit § Hospice at Home § Counselling § Day Hospice/Psychological and Supportive Care § Commission into the future of Hospice care – postcard campaign § Letters and cards of support from patients and families 19 Comment from the Clinical Commissioning Group Comment from Healthwatch (Rochdale) Comment from the Overview Scrutiny Committee
3 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 STATEMENT ON QUALITY FROM THE CHIEF EXECUTIVE At Springhill Hospice nothing is more important than how well patients and their families tell us we are doing our job of supporting them. We understand how many different perceptions there can be and we strive to communicate meaningfully with everybody, whatever their needs and beliefs. With this in mind, the annual audit of the quality of our work is even more important than our annual financial report. If you find this report useful, please draw it to the attention of your friends and family. If you think there are things we could be doing or communicating better or differently, please let us know so that we can reflect and improve. Thank you for taking the time to consider how the quality of our service can become even more effective. We are your Hospice. Jonathan G Parris Chief Executive
4 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 ABOUT US Springhill Hospice offers specialist palliative care services to patients with life­limiting illnesses and emotional and psychological support for their families. Hospice services include a 16­bed inpatient unit, where patients are admitted for end of life care, symptom management and respite; Hospice at Home service for patients at the end of life and the support of their families; Day Hospice where patients can access psychological, complementary and creative therapies; Lymphoedema clinic, Counselling and Bereavement services and a 24 hour specialist palliative care advice line for patients, families and healthcare professionals. STATEMENT OF PHILOSOPY As a specialist palliative care unit, Springhill Hospice:­ § Provides the highest standard of physical, psychological, emotional and spiritual care for patients and their families, friends and carers. § Encourages patients to maintain independence and control, and to make informed choices, whilst respecting privacy and dignity. § Offers advice and support from the time of referral, throughout the illness and into the bereavement period. § Offers post bereavement therapies, psychotherapy and counselling. § Offers information and education to patients, families, friends, carers and professionals, to promote a high standard of palliative care across the community. § Respects all cultural, religious and personal beliefs, placing the emphasis of care on individual need. § Audits and reviews the services it provides to ensure appropriate clinical standards are maintained and services are delivered effectively.
5 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 PRIORITIES FOR IMPROVEMENT 2013/14 Springhill hospice is fully compliant with the Care Quality Commission (Registration) Regulations: Essential Standards of Quality and Safety and with the Health and Social Care Act, 2008. As such, the Board did not have any areas of shortfall to include in its priorities for improvement for 2013/14. Within the Hospice Strategy 2010­15 (Building on Success), the Board laid a strong emphasis on quality and development in the following 5 core elements: § § § § § Giving patients a choice – Hospice at Home initiative Improving quality and information – patient information systems Increasing income generation – diversifying income streams Developing the workforce – workforce analysis and joint working initiatives Education for all ­ improving knowledge and skills From this strategy the Board and Executive Management Team have identified several key priorities relating to the development of services with an emphasis on quality and ensuring the 3 elements of quality: patient safety, clinical effectiveness and patient/family experience. Key priorities for 2013/14 relating to quality are as follows: Future Planning Priority 1 Expansion of Hospice Bereavement Services In December 2012 we were approached by the Clinical Commissioning Group to consider the potential for widening access to our Hospice Bereavement service. Previously the Bereavement service had been limited to families, friends and carers of patients who had been known to Springhill. A pilot service was launched in February 2013 enabling Health and Social care practitioners to refer clients to our Bereavement service regardless of prior contact with the Hospice. Bereavement support is offered at a variety of levels dependent upon identified need. The service consists of counselling, one­to­one bereavement support, weekly/monthly bereavement support groups and grief workshops. The psychological and supportive care team are working hard to ensure the success of this project which will be evaluated both in terms of activity and, of course, outcomes for families. Subject to a positive evaluation we would hope to take this service forward at the end of the initial pilot year
6 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 Future Planning Priority 2 Development of a Patient/user forum – Springhill Hospice Critical Friends The Trustees, staff and volunteers of Springhill Hospice continually strive to improve the quality of services we provide to patient and families. In order to assist with our improvement processes it has been decided to develop a group to act as a ‘critical friend’, to work with us in examining our current service provision, considering issues around the provision of care for those who approach the end of life and suggesting ways to improve services. We are working closely with the CCG Communication and Engagement Lead who has offered assistance to develop the consultation group and facilitate quarterly meetings. Group membership will consist of those who have had previous experience of Hospice services and those who have no prior Hospice contact. The first meeting of Springhill Hospice Critical Friends Group will be held in June 2013. Future Planning Priority 3 “Digging Deep and Expanding Horizons” ­ Refurbishment of Patient Areas – Department of Health Improvement Grant, 2013 Springhill Hospice has been awarded a significant grant from the latest Department of Health Grant Awards Scheme. Over the next 12 months we plan to make the following improvements: § Refurbishment of the Day Hospice unit and therapy rooms § Provision of sheltered external seating areas for patients and families § Development of a ‘therapeutic’ vegetable garden § Replacement of glazing throughout the building § Improvements to our laundry provision § Improvements to a patient bathroom and ward treatment room This funding will enable us to progress our plans to improve the quality of facilities and the care environment for our patients and families. The Hospice was awarded 68% of the funding required to complete all of the improvements listed. Work is not underway to secure the additional funds required in order to meet the shortfall.
7 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 Future Planning Priority 4 Implement recommendations from recent Governance review Our local NHS partners in the Heywood Middleton and Rochdale CCG and statutory regulators are working ever more closely with local charities like Springhill Hospice. Our Trustees understand that as a charity working alongside statutory healthcare providers our Governance must be adequate and appropriate. Unlike Hospitals and Health Trusts, thirty years ago our founders were free to constitute Springhill as they saw fit at the time. For this very reason we have requested an independent review to ensure that our Governance meets current requirements. This is designed to reassure our patients and families, alongside those who commission our services that the Hospice is being managed and overseen in a safe and proportionate manner to ensure patient, staff and volunteer safety, organisational probity and independent accountability. At the time of drafting, this Governance review is underway and has yet to be considered and implemented. Next year we will be able to report any changes that will by then have been made as a result of the review. Future Planning Priority 5 Hospice at Home service – secure recurrent funding from Pilot year As Springhill Hospice at Home service approaches the end of its pilot year it is clear from activity data and stakeholder feedback that the service is evaluating well and clearly making a difference to our patients and families. In order to secure future recurrent funding we are working closely with the Clinical Commissioning Group to embed this service within the Heywood, Middleton and Rochdale CCG End of Life Strategy (Adults) 2012/13 – 2015/16. Closer to home, the ‘Friends of Springhill Hospice at Home’ fundraising group have worked tirelessly throughout our first year and continue to organise events which, in turn, will raise wide support for this much needed service.
8 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 PROGRESS ON PRIORITIES FOR IMPROVEMENT 2012/13 The following areas were identified as Key Priorities for 2012/13: Key Priority 1 Development of a Hospice at Home service In June 2012 Springhill Hospice launched the Springhill Hospice at Home service. The service provides flexible and responsive palliative nursing care to patients at the end of life who have indicated that they would like to spend their last days in their own home. The service is designed to work alongside, and in addition to, current services provided by the District Nursing team, Home Care providers and the Macmillan Specialist Palliative care team. The main aim of the service is to provide patients and families with the appropriate level of additional care required to ensure the patient and family have the support they need to remain in their own homes and to prevent any unnecessary admission to hospital. The Hospice at home team consists of experienced Hospice nurses who provide the service from 8:00am to 10:00pm, delivering nursing care and providing emotional and psychological support, and Hospice trained night sitters will support patients during the hours of 10:00pm to 8:00am. Evaluation of the service thus far indicates positive outcomes for both patients and families. Key Priority 2 Further development of Hospice workforce As a key element within the Springhill Hospice Strategy 2010­2015, ‘Building on Success’, the education of our workforce is perceived as a priority area by the Board and Executive Management team. Through our staff appraisal process and service development plans key areas for education and development are identified and addressed. Throughout 2012/13 our clinical team have continued to develop knowledge and skills and a number of staff have undertaken clinical programmes of learning such as the Core Themes in Palliative Care. Individual clinicians are currently undertaking the Diploma in Palliative Medicine, Assistant Practitioner training (Foundation level degree) and MSc in Palliative Care. Other staff have completed NVQ level training and all Hospice staff completed ‘Safeguarding’ training and ‘Sage & Thyme’ communication skills training in 2012. We will continue to consider education and development as a key priority area for the future of Springhill Hospice to ensure we further develop and maintain the skills and knowledge base of the Hospice team.
9 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 Key Priority 3 Restructure of Hospice Psychological and Supportive Care services In 2011 we identified the need to restructure our psychological and supportive care services. All supportive services provided for patient and families here at Springhill are designed to address the individual needs of patients encompassing a holistic approach to care. However, with the exception of the Counselling service, these individual services were not necessarily being delivered in a structured way. It was felt services such as counselling, complementary therapy, creative therapy, spiritual support and hair and beauty therapy should be more integrated into the patient’s planned programme of care. Throughout 2012 the psychological and supportive care team have developed their psychological, complementary and creative therapy services to work in a more structured and co­ordinated way with the patient always at the centre of care. Psychological assessments of patients are now made alongside the nursing assessments in order for the patient’s individual needs to be explored and a personal programme of therapies and activities designed specifically for that individual. Evaluation and feedback from patients is extremely positive.
10 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 STATEMENT OF ASSURANCE FROM THE BOARD The following are a series of statements that all providers must include in their Quality Account. Many of these statements are not directly applicable to specialist palliative care providers. REVIEW OF SERVICES During 2012/13 Springhill Hospice has provided the following NHS services: Inpatient services Day Hospice services Outpatient services Psychological & Supportive Care services Hospice at Home service Lymphoedema service Bereavement service Lymphoedema service 24 hour Advice line service Springhill Hospice has reviewed all the data available on the quality of care in all of these services. The income generated by a variety of contracts and agreements with the NHS represents approximately 32% of the total income generated to enable the provision of these services by Springhill Hospice. The remaining funds were generated through fundraising and the Hospice’s own subsidiary companies working with the local community. RESEARCH Springhill Hospice has participated in the following research studies in 2012/13: 1. Manchester University: NIHR RfPB study, ‘Development and Evaluation of an Intervention to Assist Lay Carers to Provide Physical Care to Family Members with Cancer at End­of­Life’ ( REC ref 11/H1014/3) 2. Lancaster University & Institute for volunteering research: Volunteer Management in Palliative care study, 2012 PARTICIPATION IN CLINICAL AUDITS During 2012/13 there were no national clinical audits or national confidential enquiries covering NHS services relating to palliative care. Springhill Hospice only provides palliative care services. During 2012/13 Springhill Hospice undertook a number of clinical audits. Audit tools are developed to measure compliance with Hospice policy and Standard Operational Procedures, which in turn reflect our commitment to ensure compliance with the Care Quality Commission Essential Standards of Quality and Safety.
11 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 Audit Subject Admission and management of referrals Student and work placement Clinical documentation – Medical Clinical documentation – Nursing (IPU) Professional registration Outcome Audit indicated the requirement for improvement in the documentation of ongoing contact ­ addressed Audit indicated some improvement required in records held for work placement students ­ addressed All standards fully met indicating a high level of documenting practice. Clinical Documentation – Spiritual and Pastoral Care Assessment of patient’s nutritional requirements Infection control All standards fully met indicating a high level of documentation. Food safety Maintenance of medical equipment Patient transport Management of medicines – syringe driver Management of medicines – Independent prescribing Management of medicines – ordering and receipt Management of medicines – disposal Education, training and development Preferred priorities for care Staff dress code and uniform Audit indicated some areas for improvement in relation to review of assessments and care plans ­ addressed. All standards fully met indicating full compliance with Hospice policy All standards fully met. All patients assessed on admission and nutritional requirement subject to regular review. Audit indicated the need for improvement in staff attendance at annual mandatory training ­ addressed. Audit indicated some improvement needed in the availability of training records ­ addressed All standards fully met. Annual maintenance schedule in place Audit indicated no areas of concern All standards fully met indicating a high level of compliance with policy. Audit indicated a high standard of prescribing practice. Audit indicated some improvement needed in the recording of drugs received into the hospice – addressed. All standards fully met indicating full compliance with policy. Audit indicated some improvement in the numbers of staff attending mandatory training sessions ­ addressed All audit standards fully met. Medical documentation recording all significant interactions with patient and families in relation to advance care planning and choice. Audit indicated some minor breaches of uniform policy – addressed In addition to the clinical audits listed above, the Hospice has also undertaken audits in relation to non­clinical areas relating to our support services, administration, finance and income services.
12 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 LEARNING FROM CLINICAL INCIDENTS Springhill Hospice encourages an open approach to reporting all incidents, both clinical and non­clinical. All incidents are reported, investigated and managed immediately and incident reports subsequently collated and reported through the Hospice Risk Management sub committee and Governance Committee. All incidents are categorised according to the incident area and level of risk. Where the incident involves a patient fall, this will then be subject to a risk assessment and appropriate action taken. Any significant injury will be reported appropriately to the Care Quality Commission as a statutory notification and reported to the Health and Safety Executive (RIDDOR) as appropriate. All incidents relating to controlled drugs will be reported by the Hospice Accountable officer for Controlled Drugs (AO) to the Accountable Officer of the PCT via the Local Intelligence Network. Reported incidents are often the catalyst for change, both in clinical practice and in policy. The following incidents were reported in 2012/13: Category Clinical incidents A1 A2 A3 Falls/injuries B1 B2 Indicator Directly affects patient either by action or omission Potential to affect patient No potential to affect patient 16 6 0 Significant injury ­ patient Minor injury 1 36 Patient Staff Volunteer B3 21 (falls 17) 12 3 No injury sustained Patient Staff Volunteer Visitor Other incidents C1 C2 C3 Drug incidents D1 D2 D3 D4 Pressure ulcers P1 P2 No of incidents 38 33 (falls 28) 1 3 1 Direct affect to individual/organisation ie theft, damage Potential to affect individual/organisation No potential risk identified 8 9 3 Directly affects patient either by action or omission Potential to affect patient No potential risk to patient but deviation from policy Accidental spillages 14 14 4 8 Hospice acquired pressure ulcer Community/hospital acquired pressure ulcer identified on admission Total number of reported incidents 0 5 162
13 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 MANAGEMENT OF COMPLAINTS, CONCERNS, COMMENTS AND SUGGESTIONS Springhill Hospice encourages feedback in a variety of ways from patients, families, staff, volunteers and visitors. Comments/suggestions boxes are available in the reception area, inpatient unit and Day Hospice unit. Comments and suggestions are reported through the Operational Management team meetings. Feedback from patients and families are also encouraged through a variety of satisfaction surveys and questionnaires, reported through the Clinical Standards sub committee and Governance Committee. Complaints are managed through policy and an annual audit of the complaints procedure is undertaken. All complaints received are taken extremely seriously, thoroughly investigated and a response to the complainant made in writing. Even in cases where the complaint has not been upheld we strongly believe that we can always learn from the experiences of others where their perception of Hospice services is less than satisfactory. The Hospice received the following complaints in 2012/13: Total number of complaints received Total number of clinical complaints Total number of non­clinical complaints Total number of complaints resolved within timeframe 22 4 18 22 (100%) GOALS AGREED WITH COMMISSIONERS Use of the CQUIN payment framework Springhill Hospice income in 2012/13 was not conditional on achieving quality improvement and innovation goals through the Commissioning for Quality and Innovation payment framework because Springhill hospice does not use any of the NHS National Standard Contracts, therefore not eligible to negotiate a CQUIN Scheme. WHAT OTHERS SAY ABOUT SPRINGHILL HOSPICE Statements from the CQC. Springhill Hospice is required to register with the Care Quality Commission and its current registration status is unconditional. The Care Quality Commission has not taken enforcement action against Springhill hospice during 2012/13. Springhill Hospice has not participated in any special reviews or investigations by the CQC during the reporting period. Springhill Hospice was subject to a routine inspection by the Care Quality Commission in September 2012. The following standards were inspected and found to be fully met:
14 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 1. Respecting and involving people who use services “During the visit we observed care being delivered in a way that maintained the privacy, dignity and independence of the people who use the service” 2. Care and welfare of people who use services “During the visit we observed care being delivered in a way that supported people’s care needs, welfare and safety” 3. Safeguarding people who use services from abuse “During the visit we spoke with a senior nurse and a staff nurse. They told us they had received safeguarding training and were aware of how to detect signs of abuse” 4. Staffing “The people we spoke to told us they were very happy with the staff. They told us the staff were available when they needed them” 5. Assessing and monitoring the quality of service provision “We looked at a random selection of audit records, which showed that audits of key processes, such as management of medicines, maintenance of medical and clinical equipment, clinical documentation, infection control, food safety and staff recruitment and training processes” STATEMENTS FROM OTHERS WE WORK WITH “For many years Adult Care has enjoyed an excellent partnership working with Springhill hospice, to maintain a positive experience for patients and their carers. More recently we have worked together to establish a night sitting service, to enhance the Hospice at Home service. The Hospice has been committed to providing a quality service which meets patient expectations, local priorities and KPIs in relation to end of life care, including “Preferred Place of Care”. Hospice staff are always open to sharing knowledge and expertise, whilst being flexible to patient need” Head of Integrated Services Rochdale Council Adult Care and Support Service “I would like to send my sincere gratitude to you and your team for all the support you gave to me and thank you for your patience each time I rang on behalf of my client. In our line of work we come across people who express a wish to die in their own home. For whatever reasons sometimes this seems to be overlooked. I sincerely hope your (Hospice at Home) service can grow and continue”. Independent Mental Capacity Advocacy (IMCA) service MIND (Rochdale and District)
15 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 Partnership working with Springhill Hospice The Community Macmillan and specialist Palliative Care team have a long and successful history of partnership working and recent partnership can be grouped in the following themes: The National Cancer Peer Review Programme Springhill Hospice and the Specialist Palliative Care Team work in partnership to ensure compliance with the Cancer Peer Review Process which enables the delivery of high quality patient focussed outcomes. The hospice hosts the weekly Specialist Palliative Care MDT and the hospice Medical Director is the chair of the Group. All new patients with their consent are discussed at the meeting and there is a sharing of expertise to ensure that each patient has a management plan based on their needs. There is also shared Lead Nurse and Clinical Director both working together to ensure that deadlines are met and staff feel supported around the process. The Rochdale Partnership Group and End of Life Care Champions Following carer feedback this group was established to promote a partnership approach across health and social care agencies, to review and re­design of the function of care co­ordination in End of Life care. It was agreed that the experience of patient and carers at this crucial point in their care is one that is lasting in terms of physical and emotional impact. It is recognised that the care co­ordination is fundamental to the integration of the services centred around the patient and their carers. Whilst all agencies recognise the term and function of care co­ordinator, it is not fully embedded as a distinct element of end of life care, within the Rochdale Borough. It was agreed that a named co­ordinator for all patients and carers would potentially diminish the current gaps in the care pathway, and enhance the quality of care, in accordance with national quality standards and guidance. Springhill Hospice and its staff have been actively involved supporting the work that has led to multi­agency agreed principles to care co­ordination for the borough of Rochdale. The Partnership has then supported an End of Life Care Champions Group made up of front line clinicians and which included hospice nurses. This group has led the development of an End of Life Care Coordination Pathway and they are currently delivering interactive education to staff from all the partnership organisations on the role of the care coordinator at the end of life. Hospice at Home The development of this service during the past 12months has led to it quickly becoming an intrinsic part of End of Life Care service delivery. It underpins partnership working ensuring that all services including GPs District Nurses, Hospice at Home Staff and Macmillan Nurses are working together to ensure that care is wrapped around the patient and their carer/family, and that patients are supported to die at home if that is their choice.” Lead Cancer & Palliative Care Nurse Pennine Care Foundation Trust
16 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 DATA QUALITY In accordance with agreement with the Department of Health, Springhill Hospice submits a National Minimum Dataset (MDS) to the National Council for Palliative Care. Springhill Hospice did not submit records during 2012/13 to the Secondary Uses Service for inclusion in the Hospital Episode Statistics which are included in the latest published data. Springhill Hospice was not subject to Payment by Results clinical coding audit during 2012/13 by the Audit Commission. Springhill Hospice undertakes to ensure that information is managed appropriately with regard to confidentiality, and privacy of individuals, in line with statutory requirements. The hospice complies with all requirements made by the Care Quality Commission and other statutory bodies requiring information to contribute to national health care studies and data sets. In line with these requirements, an Information Sharing Protocol is in place with Pennine Acute NHS Trust, The Christie NHS Foundation Trust, Pennine Care NHS Foundation Trust, Heywood, Middleton and Rochdale PCT, Bury PCT, Oldham PCT and North Manchester PCT for secure information sharing. The signed documentation is held in a central file by the Director of Corporate Services. The hospice ensures that records are retained for the required statutory periods, including health records, employment records and financial records. Compliance with Statutory Requirements Care Quality Commission Core Standards C29, C31 Data Protection Act 1998 Access to Health Records Act 1990 (with regard to information held about patients who are deceased) Caldicott Committee Report (December 1997) The Hospice undertakes annual audits of documentation and information management and security to ensure data integrity. All staff are required to undertake annual training in Information Management & confidentiality.
17 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 QUALITY OVERVIEW INPATIENT UNIT Total number of admissions Total number of patients Admissions with cancer diagnosis Admissions with non­cancer diagnosis Total number of deaths in Hospice 2010/11 216 168 125 43 103 2011/12 320 247 191 56 148 2012/13 298 249 179 70 127 MEDICAL OUT­PATIENTS Total number of patients Total number of contacts 2010/11 18 30 2011/12 21 35 2012/13 29 41 DAY HOSPICE Total number of patients Patients with cancer diagnosis Patients with non­cancer diagnosis 2010/11 148 105 43 2011/12 153 114 39 2012/13 248 186 62 HOSPICE AT HOME Total number of patients/families Total number of H@H visits Total number of H@H night sits 2010/11 NA NA NA 2011/12 NA NA NA 2012/13 125 1930 382 24 HOUR SPECIALIST PALLIATIVE CARE ADVICE LINE Total number of calls received Total number of ‘follow­up’ calls made 2010/11 2011/12 2012/13 180 122 127 80 113 54 LYMPHOEDEMA SERVICE Total number of referrals to service Total number of patients Total number of interventions 2010/11 40 96 230 2011/12 37 89 210 2012/13 40 88 217 COUNSELLING/BEREAVEMENT Total number of clients Total number of interventions 2010/11 214 518 2011/12 373 808 2012/13 445 1023 COMPLEMENTARY THERAPIES Total number of patients Total number of interventions 2010/11 NA NA 2011/12 112 441 2012/13 172 942 NB: Hospice at Home data from commencement of service in June 2012
18 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 WHAT OUR PATIENTS AND THEIR FAMILIES SAY ABOUT SPRINGHILL HOSPICE Inpatient Unit The Springhill Hospice VOICES questionnaire is designed to elicit information about the care and services received by patients in the last days/weeks/months of life, from the perspective of their families. It is also about the care and support the hospice gave the patient’s family and friends. In 2012/13 182 questionnaires were sent out and 64 responses received (a response rate of 35%) The responses indicate a high level of satisfaction with all hospice services. Unfortunately, as is the case with anonymised data where a very small number of respondents had indicated some dissatisfaction with the service we were unable to look into specific cases to ascertain what had gone wrong for that particular patient or family member. Typical comments from respondents included: “The Hospice staff couldn’t have done more. When I lost my sister I also lost my best friend. You were all there for her and her family. Thank you so much” “All I can do is give a big THANK YOU for all that you did for my wife and support you gave me and my family when she passed away in your care” “The Hospice and staff were wonderful. The atmosphere was bright and positive. I can only offer praise and a big ‘Thank you’ to everyone – wonderful place – wonderful people. Thank you all so much” Hospice at Home The Springhill Hospice at Home VOICES questionnaire is designed to gather information from the families of patients cared for by our Hospice at Home service The questionnaire focuses on key areas including the level of service provided, maintaining dignity and privacy, offering emotional and psychological support of patient and family, providing advice and information, showing courtesy and respect. All responses, without exception, indicate an exceptionally high level of satisfaction with the service. Typical comments from families include: “Without their help and support we couldn’t have managed. At the time they were called in we were discussing other options as it was getting difficult to manage and we felt we were letting her down, so it made a very sad time a lot easier to bear”
19 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 “If it wasn’t for the Hospice at Home service then I feel I could not have carried out my husband’s wishes of dying in his own home, where me and my husband spent our years together” “Without the support of Hospice at Home it would have been difficult to carry on in such difficult circumstances – thank you all for your kindness, professional advice and emotional support” Counselling/Bereavement As part of our ongoing evaluation of the counselling service, periodic satisfaction questionnaires are sent out to clients who been in receipt of the counselling service. The results from a review in September 2012 indicate extremely positive outcomes for those who had used the service. Typical comments include: “A much more positive attitude to things that have happened and are going to happen. I can look to the future and not be afraid” “It has totally changed my negative behaviour by introducing me to a more positive and confident outlook for the future. By embracing this, I worry much less about my condition and feel better equipped to manage my life” “More confident and comfortable with myself, knowing that all the skills I had developed from the realisation that counselling has brought about, were going to sustain me and make me feel more secure. My feelings of well­being and self worth were also enhanced. Day Hospice/Psychological and Supportive care In order to evaluate the psychological and supportive care element of our Day Hospice service, patients are asked to complete an evaluation questionnaire. In December 2012 40 questionnaires were distributed and 28 completed and returned (response rate of 70%). Patients were asked question in relation to the services provided within Day Hospice: Counselling, Creative therapy, Complementary therapy, Beauty therapy, staff and peer support. Typical responses include: “Before I came to the Hospice, I had the idea that it was a sad place, but how wrong I was. The atmosphere is wonderful and all the staff and volunteers are so kind and helpful and cheerful. I can’t put into words how coming here has helped me. ‘Thank you’ is nowhere near how I feel” “Overall coming to Day Hospice has helped me become confident again when socialising with others” “It’s nice to talk to other patients and discuss your concerns about your illness. If you are having a new treatment and other patients have had it, it’s nice to hear how they respond to it”
20 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 Commission into the Future of Hospice Care – Postcard Campaign During December 2012, Springhill Hospice took part in a postcard campaign on behalf of the Commission into the Future of Hospice Care to help them gather the views of people who use hospice care. There has been a really good response to this campaign, and the responses were overwhelmingly positive. The commission believe the results will be very helpful in ensuring that the voice of patients, family members and carers inform our recommendations about the future of hospice care. Comments from patients, family and friends relating to Springhill Hospice include: “We, as a family, have never been supported at the Acute hospitals. All the staff at Springhill could not do enough for us at such a sad and difficult time.” “The time everyone gives. They are not rushing off because they are too busy. Nothing is too much trouble. And not just for patients but family too.” Letters of Support from Families and Thank You Cards In addition to periodic surveys and questionnaires we also continue to receive many cards of thanks and support from patients and families across all services. Typical comments include: “…..Thank you from the bottom of our hearts for looking after our lovely dad. You made an absolutely awful situation so much more bearable for our whole family” “I would just like to thank you all so much for the kind and loving way you cared for my dad toward his end of life and beyond. You truly are inspirational people. With your help to uphold his dignity I know it made his passing settled and comfortable and helped me and the rest of our family cope with it. Thank you with all my heart. My Dad was a wonderful man. Smiling ‘til the end” “Our ‘thank you’ seems so small compared to all you’ve done but it comes from our hearts. May life bring you all a reflection of the kindness you’ve shown to others. Thank you once again for your care, support and thoughtfulness you gave to him and to all our family” COMMENTS Springhill Hospice Quality Account 2012/13 has been forwarded to the following bodies for comment: § Heywood, Middleton and Rochdale Clinical Commissioning Group § LINK – Healthwatch (Rochdale) § Overview and Scrutiny Committee, Rochdale Metropolitan Borough Council
21 Springhill Hospice ‘The Peoples Hospice’ QUALITY ACCOUNT 2012 ­ 2013 No comments have been received for inclusion.
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