The Rowans Hospice
Quality Account
2012 – 2013
Our Vision is that within our community of Portsmouth and South East Hampshire all
those affected by life-limiting disease have access to the excellent specialist and
supportive care provided by the Hospice, thus ensuring their quality of life is optimised
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PART 1
STATEMENT FROM RUTH WHITE,
CHIEF EXECUTIVE OF THE ROWANS HOSPICE
It gives me great pleasure to present the Quality
Account for The Rowans Hospice, Registered Charity No.
299731 for the fiscal year 2012/2013. We are very
proud of the services we provide to our local community
and therefore relish this opportunity to share our work
with a wider audience and thank you for your interest.
The quality of our care is very important to us; we
therefore make every effort to ensure our services meet
the expectations of those whom we serve.
Registered with the Care Quality Commission (CQC) and
subject to annual inspection we are delighted that our
service has been recognised as achieving the highest
standards. This has been further endorsed by peer
review audit and CHKS; achieving service accreditation
for the past decade. The quality review by CHKS is not
mandatory but chosen by Trustees and the Executive to demonstrate compliance over a range of
robust standards. Investment to support and demonstrate quality is important to us; providing
evidence to reassure all stakeholders, whether they are commissioners, donors, staff, volunteers,
other partners in care provision and most importantly the service users who trust us to support their
care needs.
Quality is at the heart of all we do and is what we continually strive to achieve and optimise within
allocated resources. Both clinical and non-clinical audits are undertaken through a systematic
process of review, with reports cascading throughout the organisation and ultimately to Trustees. A
‘showcase’ is featured annually with poster presentations demonstrating the quality of our services
and displayed in public areas throughout the Hospice. The exhibition culminates with a plenary
session where commissioners in both health and social care are invited to join staff and volunteers to
celebrate the achievements across all service domains.
Systems to continually monitor quality are critically examined and robustly reviewed should
standards come into question. Complaints and concerns are taken seriously and responded to within
set policies and recorded for review by CQC, CHKS and by Trustees.
The quality of our service is not confined to the Hospice building but reaches out into the community
with peripatetic services such as Hospice at Home, which has been piloted in the previous eighteen
months leading up to this report. Quality of care, at home, presents further challenges to ensure we
provide a timely, efficient and sensitive service. to those who invite our team into their homes. This
is both an honour and a privilege; complementing and supplementing community nursing and social
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care services to take the philosophy of hospice care outside the Hospice. Hospice philosophy
combines person-centred care across physical, social, spiritual and emotional domains with
specialised nurses who have the empathy, knowledge and skills to support families when a close
family member or friend is dying. This service has also reached many people who may not have
historically received hospice care as they had chosen to be supported at home and may have
experienced more enduring chronic health difficulties, leading to a slow decline as opposed to those
with more acute symptoms who may have been referred for specialist support from The Rowans
Hospice in-patient unit or therapeutic Day Care services.
Our high quality care is only possible thanks to our dedicated staff and from our skilled volunteer
community who reduce the cost of our service through their gift of time. We also thank and
appreciate those who give donations directly to The Rowans Hospice; to its subsidiary Trading
Company; through gifts in Wills and participation in our fundraising activities.
To the best of my knowledge, the information reported in this Quality Account is accurate and a fair
representation of the quality of health and social care services we provide.
Ruth White
Chief Executive
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PART 2
PRIORITIES FOR DEVELOPMENT AND IMPROVEMENT AND STATEMENTS OF
ASSURANCE FROM THE BOARD OF TRUSTEES
Introduction
This Quality Account considers quality issues within the provision of clinical care and relevant support
services necessary to provide this care. It does not take into account the fundraising and
administrative functions of the organisation where separate quality initiatives are employed and
evidenced through Governance.
The Rowans Hospice Business Plan outlines our Vision to develop services. Strategic objectives have
been sent for 2012 - 2014 as listed below:
1. To be a leading advocate of specialist and supportive palliative care and end of life care
2. To promote, support and deliver
excellence in specialist and
supportive palliative care and end
of life care
3. To regard its staff and volunteers
as its most valuable asset,
supporting and investing in them
as appropriate
4. To undertake sound financial management and through innovation, generate sufficient income to
ensure sustainability of its services
Our Vision, as always, is inspired by the needs of people affected by a life-limiting illness and we are
continually seeking ways in which to improve existing services to ensure they remain flexible and
able to respond to people's changing needs.
Registration
The Rowans Hospice is fully compliant with the Essential Standards of Quality and Safety as set out in
Care Quality Commission (Registration) Regulations 2009 and the Health & Social Care Act 2008
(Regulated Activities) Regulations 2010. These standards were met through self assessment in 2009.
The self assessment identified no areas of shortfall for inclusion in the future priorities for
improvement in 2013 - 2014.
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Priorities for improvement – 2013/2014
The priorities for quality improvement identified for 2013/14 are set out below:
These priorities have been identified in conjunction with staff, stakeholders and, as far as possible, by
consulting our patients and carers. The priorities selected below will impact directly on one or more
of the following areas:
Patient Safety
Patient Experience
Clinical Effectiveness
Increase in-patient bed occupancy and ward activity - Patient Safety, Patient Experience, Clinical
Effectiveness
Figures collected for the minimum dataset show stable activity over all for the last four years.
In the context of increased activity in our partner NHS services in the community and hospital we
would expect an increased demand. With bed occupancy stable and with investment into the
medical staff complement over the last two years we could cope with an increase in activity of about
10%. The availability of the Hospice at Home service to "hold" a situation at home provides more
opportunity to accept a late request for early the following day, where in the past, alternative
admission to hospital or nursing home might have been the only option. Hospice at Home may also
be reducing demand however, for example by supporting patients' rapid discharge from hospital in
cases which might otherwise have led to Hospice admission as an interim step.
The strategy for achieving an increase in activity is as follows:
From April 2013 a more detailed in-house analysis of activity including any capacity issues
Subject to their agreement, we hope that these data will be compared to activity data in our
partner services, permitting open discussion of any obstacles in the patient referral pathways
Staff numbers, particularly medical and nursing staff who complete the admission
assessments, will be maintained as a priority, to ensure daily availability (provided there are
free rooms)
Reports to the Board and to other stakeholders will focus on a synthesis of data including
qualitative analysis - bed occupancy alone can be misleading, being affected by length of stay
and ratio of death to discharge
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With these building blocks now in place, increased promotion of the service with potential
referrers will take place
The balance of referrals to the hospital specialist team (current gate-keeper) is more inclined
toward in-hospital expert symptom management and help with decision-making rather than
assessment of patients who are ready to leave hospital but need on-going inpatient care
This team describes that patients referred to them at the very end of life are in need of care
where they are and are not well enough to move to spend the very final hours in the Hospice
Efforts therefore will be focused on those who might refer at an earlier stage, giving us the
opportunity to admit patients from acute assessment units directly. A new consultant for
acute oncology has been invited to the Hospice to see at first hand the in-patient service we
can offer once necessary investigations and treatments in hospital have been concluded
In the community the emphasis is on working with the newly formed ‘virtual wards’ to
encourage consideration of ‘real ward’ assessment and care for some patients whose
subsequent care at home can be informed and optimised by such admission
We also expect that public awareness and demand for in-patient services will increase through
our new initiatives, in particular access to supportive therapeutic services for people living
with long-term conditions and increasing frailty. There is good evidence from Heath Centre
clients and Erika Lipscombe's research that gives us hope for this over the coming years.
In promotion of the service through community engagement, we continue to stress that, with a day
or two's notice we can generally admit someone for expert care in their dying, if that is in their
interests and accords with their wishes. With Hospice at Home we can often support the patient in
their ‘wait’.
Develop Therapeutic Day Care Services
Clinical Effectiveness, Patient Experience
The new pilot project, delivered within current resources,
paves the way to develop further opportunities whereby
community patients can access supportive therapies, rather
than engage with the whole Day Care programme. Total
engagement within Day Care provides significant support
for a minority of patients and offers respite for carers but it
does not appeal to everyone.
The overall strategic objective is to increase the number of
community patients accessing Therapeutic Day Care
Services each week. The development of this will be
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undertaken initially through a pilot project, working with patients and carers to gradually adapt the
model to meet the needs of a wider audience. It is envisaged that the current model of Day Care,
which offers carers a break for a whole day will continue. It is hoped with a new building, new
services such as a bathing service/clinics, can be explored and a recent announcement by the
Department of Health to offer additional funds to Hospices will provide additional facilities to
support the development of further on-going community outreach work.
IT Systems
Patient Safety, Clinical Effectiveness
This remains a significant challenge as each patient is likely to come into contact with four providers
during their illness (including their general practice service). As The Rowans Hospice works with two
community Trusts, even if GP notes and social services databases are disregarded there are four
clinical databases in use for relevant patient records.
The Rowans Hospice strives to ensure that all appropriate clinical staff is able to access and read the
appropriate IT systems to ensure that information concerning patients is transferred across all
providers. Southern Health NHS Foundation Trust has offered assistance and resources for Hospice
at Home nurses, which is gratefully received.
Within the second quarter of the 2013/14 year, palliative care services will have access to read and
edit the electronic palliative care register for sharing essential advance planning information.
The Hospice aspires to an integrated software system across all providers and to look at developing a
complete electronic patient record. It is anticipated that this will not be possible unless there is a
desire and acknowledgement as a priority by our partners and in any case not until reorganisation
across health and social care has been completed.
Development of Bereavement and
Psychology Services
Patient/Client Experience, Clinical
Effectiveness
The Rowans Hospice is committed to
developing these services by employing a
Clinical Psychologist who will work across
both Bereavement and Clinical
Psychology services. The concept of cross
working will support clinical effectiveness
and the patient/client experience.
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Reablement Project
Patient Safety, Patient Experience, Clinical Effectiveness
The Rowans Hospice has been successful in securing a tender to support ‘reablement’ from
Portsmouth City Council’s Integrated Commissioning Unit. The bid is one of a number of bids that will
collectively support people to live safely in the community with an aim to avoid unnecessary hospital
admissions. The commissioned service will provide a community based specialist palliative care
social worker to support those who are deemed to be in the last year of life through the
development of a ‘care package’ suitable to support their needs at home. Monitoring the care
package will be undertaken by supervised and trained volunteers to ensure the care package is
suitable for need and reviewed and adapted accordingly as needs change. For the one year project
duration a social worker has been seconded from Portsmouth Adult Social Care Services. If the pilot
is shown to have a positive impact on reducing the number of patients being admitted to hospital, it
is hoped that funding would be continued beyond the year.
Building for the Future – ‘Living Well Centre’
Clinical Effectiveness, Patient Experience
The Rowans Hospice secured Department of Health funding for a new build that proposes to reach
more people who may require care and support as they approach the end of their lives. The facility
will provide a ‘social hub’ where people can attend and receive therapies and care that are
appropriate to their needs (for example, assisted bathing, complementary therapies, carers groups,
support groups, reminiscence, music therapy, arts and crafts, bereavement support etc.) The
building is anticipated to be completed by March 2014 and will also offer ‘space’ for other likeminded community groups to use the facilities.
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How will progress be monitored for Future Priority Improvements – 2013/2014?
The Rowans Hospice Board of Trustees, and more specifically, the Clinical Executive Group, will
monitor, benchmark and account on progress through a variety of methods including:
Annual Return to the Charity Commission
Annual Review and audited Report and Accounts
Business Plan
Quality Accounts, Clinical Governance Report
Annual audits and patient surveys
Annual General Meeting of the Charity
‘Reaching Out’, The Rowans Hospice Newsletter and other periodic communications
National data as collected by Help the Hospices and the National Council for Palliative Care
Research – both internal and external to The Rowans Hospice
Patient surveys for individual doctors, as required by General Medical Council Revalidation
As a designated body under Medical Revalidation legislation, the Hospice governance
structures and medical staff performance are overseen and subject to annual report by the
Responsible Officer provided by Southern Health NHS Foundation Trust
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STATEMENTS OF ASSURANCE FROM THE BOARD OF TRUSTEES
The Board of Trustees’ is fully committed to delivering high quality services to all our patients
whether in the Hospice or community setting.
The Board is involved in monitoring the health and safety of patients, the standards of care given to
patients, feedback from patients including complaints, and plans to improve services further. They
do this by receiving regular reports on all these aspects of care and discussing them at Board
meetings.
Of equal importance our Trustees visit the Hospice and other settings where services are delivered.
Some of these visits are unannounced and written reports are discussed by the Board and copies are
available on request from the Chief Executive.
During the visit Trustees speak to patients, carers, staff and volunteers. In this way, the Board has
first hand knowledge of what patients, families and carers think about the quality of services
provided, along with feedback from staff and volunteers. This year the Trustees have officially made
at least 12 separate visits to different areas of our service.
The Board is confident that the care and treatment provided by The Rowans Hospice is of a high
quality and cost effective.
Following a recent unannounced inspection by the Care Quality Commission (CQC) in March 2013 the
Board of Trustees are delighted to be reassured that The Rowans Hospice is compliant with the
quality and safety standards set by CQC.
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PART 3
REVIEW OF SERVICES
The aim of the Quality Account is Not only to set future priority improvements but also to evidence
achievements on priorities for improvement from the previous year. To ensure the needs of service
users are met, The Rowans Hospice identified areas of priority where improvements were needed to
enhance the care experience. Examples of developments and improvements that occurred in
2012/13 are outlined below:
Outreach into the community with the Hospice at Home Service
Clinical Effectiveness, Patient Experience
In November 2012, the Board of Trustees agreed to continue to fund the Hospice at Home service
into future years commencing 1st April 2013.
In May 2012 the Hospice at Home criteria was altered to not only care for patients whose preference
was to die at home, but to support crisis management; thus avoiding hospital admission and enabling
patients to be discharged from Portsmouth Hospital Trust to be in their preferred place of care.
As a result of this change of criteria 21% of patients referred were for crisis management.
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Develop the Schools’ Project in conjunction with Rowan’s Meerkat Service and Hospice Day Care
Clinical Effectiveness
The collaborative project was developed within current resources by Day Care nurses, and Rowan’s
Meerkat Service staff (who offer pre and post bereavement support for children and young people
from 0 – 18 years) and a local primary school to offer positive exposure to Year 5/6 (9 -11 years of
age) to people who are living with progressive illness and disability.
The project incorporated the opportunity for young people and those who are affected by a lifelimiting and progressive illness to talk together and include working collectively on an artistic project
to demonstrate joint learning and understanding.
The project was very successful and after evaluation it was agreed to continue for 2013/14.
Education Facilitator
Patient Safety, Clinical Effectiveness
In 2012, The Board of Trustees recognised as part of their strategic objectives to enhance education
and training within the community we serve. Therefore it was agreed to continue funding for the
Education Facilitator post which had previously been funded by the Strategic Health Authority. From
April 2012 the role has evolved, supporting generic health and social care workers employed by local
NHS Trusts, domiciliary care agencies, private care businesses and social care services to develop
their knowledge and skills thus enabling those delivering end of life care to address issues around
advance care planning, advance directives, support with implementing the Liverpool Care Pathway
and so forth. The success of this post is that NHS providers are seeking to sub-contract education
and training.
CHKS
Patient Safety, Clinical Effectiveness, Patient Experience
The Rowans Hospice continues to maintain accreditation with CHKS for a further three years
following the survey in October 2012, demonstrating the high quality of the service and its robust
Governance across clinical and operational domains of practice.
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Participation in clinical audits
As a provider of specialist palliative care, The Rowans Hospice was not eligible to participate in any of
the national clinical audits nor national confidential enquiries as none of the audits or enquiries
related to specialist palliative care.
The Rowans Hospice Quality and Audit Programme facilitated many service improvement audits
during 2012/13. The Hospice also used a number of audit tools by the umbrella organisation, ‘Help
the Hospices' of which we are a full member.
Audit tools included:
Infection Control
Accountable Officer
Management of Controlled Drugs
General Medicines and
Medical Gases
The tools are relevant to the particular requirements of hospices, allowing our performance to be
benchmarked against that of other hospices. The Rowans Hospice is a member of a regional audit
group and benchmarks the results of these audits on a regular basis. Our compliancy results have
been high, achieving above average in all the audits compared in 2012/13.
Other audits carried out included:
Consent
Patient Preferences
Use of Steroids
Use of Antibiotics
In addition to the above, the following actions have been undertaken to ensure The Rowans Hospice
continues to improve the quality of healthcare provided:
Participation in the National Cancer Peer Review Programme
CHKS Programme
Data Quality
For the year 2012/2013 The Rowans Hospice submitted audit data relating to patient activity to the
National Minimum Data Set for specialist palliative care. Results are available publicly from the
National Council for Palliative Care (NCPC), www.ncpc.org.uk. The Rowans Hospice also participated
in a pilot for new data sets. This was funded by NCPC.
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Research
Three research proposals have been submitted to The Rowans Hospice Ethics Executive Group (EEG)
in 2012/13, all were granted internal ethical approval as well as receiving a favourable response and
endorsement from the local NHS Research and Ethics Committee:
The Experience of Living with a Husband or Partner who has a Life-limiting Illness
An evaluation of the Well-being Group by exploring the thoughts and feelings of people with
palliative care needs in relation to their experiences of supervised, group exercise
‘Exploring Stress and Resilience in Hospice Volunteers: A Qualitative Study’
Quality Improvement and Innovation Goals Agreed with our Commissioners
The Rowans Hospice income in 2012/13 was not conditional on achieving quality improvement and
innovation goals through the Commissioning for Quality and Innovation payment framework.
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REVIEW OF QUALITY PERFORMANCE 2012/2013
This section provides:
Data and information about how many patients use our services
How we monitor the quality of care we provide
What patients and families say about us
What our regulators say about us
The National Council for Palliative Care: Minimum Data Sets – 2012/2013 – a full report can be
located at ‘mds@ncpc.org.uk’.
In-patient Unit
Completed in-patient admission episodes – 397
(395)
Of the above, 124 (31%) admitted from hospital
(32.7%)
Average length of stay for patients 11.9 days
(12.3) (wide variation according to need)
Of the 38% who were discharged, 80% returned to their home (79%)
12.8% of patients had a diagnosis other than cancer
(10.4%)
NB: (the figures in brackets are for the previous year)
Therapeutic Day Care Services
Patients and their carers are supported through Day Care and the Heath Centre. Attendance
average was 56%, which is reasonable where patients are nearing the end of their life. Patients
attending traditional Day Care for 6 hours a week utilised the service on average for a period of 3.8
months.
The Heath Centre, a therapeutic clinic for patients newly diagnosed with a life-limiting illness offers
patients and their carers the opportunity to attend for six consecutive sessions where members of
the multi-professional team support patients to consider advance care planning. Further discrete
bespoke therapies are also being considered for patients who are less well, have particular needs
and do not wish to attend the more traditional services offered within our Hospice Day Care.
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Bereavement and Rowan’s Meerkat Services
The Bereavement Service provides extensive support in a variety of ways for adults linked to The
Rowans Hospice.
The Rowan’s Meerkat Service is a district-wide service helping children and young people, between 0
and 18 years, prepare for the loss of a close or significant adult and offers continued support into
bereavement.
Hospice at Home Service
322 patients were referred to the service
56% Malignant
12% Non-malignant
10% two or more defining conditions - mixed malignant & non-malignant
71% of referrals were not known to the SPC Team/Hospice
18% of patients were referred through Portsmouth Hospitals Trust to support the Community
Teams with discharge home
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Regularly Measured Quality Markers
In addition to the limited number of suitable quality measures in the National Data Set for palliative
care, we have chosen to measure our performance against the following:
Indicator
Preferred Place of Death
2012/2013
Establishing patients' preferences is key to addressing care and needs. A preference form is
completed with the patient (and family if requested) during the admission process.
Questions relate to treatment, care options and the patients’ and families preferences,
including preferred place of death.
Achieved preferred place of death at the Hospice
90%
10% of patients indicated preferred place of death was home, however due to reasons, such
as acute changes in their medical condition, this was not possible. However, in all cases the
family indicated their satisfaction that the patient remained in the Hospice.
Resuscitation Decisions
100% compliance – records indicated forms were completed following discussions with
patients/families as appropriate.
Liverpool Care Pathway
The Liverpool Care Pathway documentation is reviewed by the Quality Manager to ensure full
compliance. It is clear that consultation had taken place with the patients and families prior
to commencing the documentation and subsequent treatment protocols.
Patient Safety
Serious patient safety accidents/incidents range from a patient reported to have had a fall,
slipped out of a chair, rolled out of bed in their sleep, collapsed as a result of their illness and
so forth. All incidents were reported and investigated and appropriate actions taken in
addition to outcomes being reported back through governance reporting structures. Risk
assessments are regularly reviewed following any reported incident. As part of the
investigation, any trends and themes are identified are analysed.
The number of serious patient safety incidents
69
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The number of slips, trips, falls including slipping from a chair
57
Systems introduced to indicate and raise awareness of patients who have fallen or have been
found on the floor during their stay would appear to be working. We achieved our 2012
target to see a reduction in the number of patient falls with the measures taken.
The number of serious patient safety incidents
0
The number of patients who experienced a fracture or other serious injury
as a result of a fall
0
Infection Control
Total number of patients known to be infected with
MRSA whilst on the In-patient Unit
Total number of patients known to be infected with C.
difficile whilst on the In-patient Unit
0 actually infected
5 patients had colonisation
0
Drug-related incidents – All drug-related incidents/errors are reported and investigated,
appropriate action is taken and the incident is reported through the appropriate channels.
Examples of incidents reported included clerical errors such as missed signature when a drug
had been administered, a missed signature in the Controlled Drug Register, when witnessing
the dispensing of a controlled drug, or an oversight that a drug had not been given.
There were 39 drug-related incidents. All were investigated and corrective action taken.
There were no serious consequences from these incidents.
Quarterly drug error/incident reports are produced for the Medicines Management Group
and discussed in detail, addressing operational procedures, circumstances around the error
and determining any outcomes and recommendations as appropriate. It is evident from the
quarterly reports for 2012/13 that the changes implemented following previous reports have
resulted in the reduced number of errors/incidents reported.
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Specialist Palliative Care Audit and Service Evaluation
The Clinical Quality Strategy Group has achieved wide involvement in clinical quality assurance
activity and developed systems for prioritisation, reporting and discussion of results with the overall
aim of a higher quality of clinical and supportive care. The continued involvement of clinical
managers is vital for this.
The Clinical Quality Strategy Group (CQSG) continues to develop a Quality Impact Analysis (QIA),
which takes account of regulatory requirements, adverse incidents and complaints. The QIA is
reviewed six-monthly to ensure that levels of concern and risk reflect the most recent data. Ad hoc
projects of interest to the services are also monitored through the QIA.
Service Showcase
The CQSG Showcase has developed over the past four years as a vehicle to raise awareness across
the domains of service of all the quality improvement work that is undertaken. Posters are produced
by both clinical and non-clinical departments and displayed for one month in the Seminar Room as
well as throughout the Hospice. A Plenary Session allows emphasis on certain key initiatives and
serves as a forum for celebrating quality and success.
Education and Training – Palliative and End of Life Care
There is a full and varied programme of in-house education and training, led by a Ward Manager in
partnership with the Bereavement Lecturer/Practitioner and a Consultant in Palliative Medicine.
As detailed earlier in this report, the Education Facilitator supports the in-house training programme
in addition to the core focus on engaging with the community team and social care providers.
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WHAT OTHERS SAY ABOUT US
We listen to our patients and carers and those who access our services. We have a robust
Complaints and Concerns Policy and Procedure which is made available to all who use our service.
In 2012/13, we received 11 complaints/concerns (written/verbal) related to: 55% (6) - were not related to the Hospice and were passed to the appropriate community
team.
27% (3) - were related to care or communication and practice was reviewed
18% (2) - were related to administration and systems were reviewed
All concerns raised, have been addressed in consultation with the person who raised the concern;
reflected upon by the staff involved and practices or procedures have been reviewed as appropriate;
followed by written feedback.
Information is provided to the complainant on how to seek independent scrutiny from the
Ombudsmen should the internal investigation be deemed inadequate. For this period all complaints
and concerns were managed internally and no further action was sought.
Many letters and cards have been received from former patients and service users, praising the staff
and volunteers for the service they have received. In addition, verbal recognition is received from
relatives or families who remain in contact with the Hospice.
Satisfaction questionnaires continue to be sent out to all patients who have been discharged; Day
Care patients; and the Heath Centre patients and carers. Views are also invited from the bereaved
through an open invitation card within the bereavement information booklet. Carers continue to use
the feedback sheets available in loose leaf files within the patient area. Again, feedback received is
very positive and reflects patients’ and families’ appreciation of the services they receive.
Evaluations from service users receiving Bereavement Support are monitored and reported.
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Here are some examples
of feedback received:
“Being admitted to the
Hospice is why I am still alive
and at home. Hospice
staff/doctors diagnosed my
condition correctly and did
their utmost to have my life
pain free.”
“Made me feel like a person instead
of a patient which I really
appreciated including using my first
name.”
“Admission to hospital
would not have provided
the type of emotional care
that was needed at the
time.”
“My medication was sorted and I
went home better than when I was
admitted.”
“Gave me time to come to
terms changed
circumstances.”
“The staff made me feel that nothing
was too much trouble. They would
go out of their way to please
everybody.”
“Day Care is a club no-one
wants to belong to and
no-one wants to leave.”
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Carers
The Rowans Hospice continues to recognise the vital role carers play throughout the year by
providing them with a special support service. The Hospice supports a monthly Carers' Group in
addition to the annual National Carers’ Week with a variety of events including pamper and
information days.
“I have a better understanding of what my mum
is going through. It has encouraged difficult
conversations and has made me think very
differently. I was very fearful of the dying process
especially of how I would deal with it, but I feel
more educated and able to deal. I don’t feel as
helpless as I did before.”
“The care and love my mum
received during her stay
with you made us all feel
we were in heaven and you
could never do better than
that. Thank you so much.”
“As carer and visitor I always
found Rowans clean, tidy, good
atmosphere with helpful staff.
Thank you all for being there.”
“The care and compassion shown to my wife,
we found that we only had to mention a
problem or difficulty and help and advice was
readily given.”
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Statements from Care Quality Commission
Following the recent unannounced inspection on 21st March 2013, CQC produced a report on their
findings:
We saw that extensive efforts were made to ensure people received the care and support they
needed. The holistic needs of people were taken into account. We saw that records of all care
provided were maintained by all those involved..
We spoke with the relatives of two patients staying at the Hospice during the visit. They were very
positive about the care their relatives were receiving. They told us every time staff walked into the
patient’s room they would introduce themselves and explain what they were going to do. They told
us all the staff listened to the person and would only proceed with care and treatment if the person
gave consent.
People spoken to in Day Care told us staff were respectful and treated them in a dignified manner.
People who use the service, staff and visitors, were protected against the risks of unsafe or unsuitable
premises.
Overall, we found that the service was meeting essential standards.”
No remedial requirements or recommendations for change were made.
CHKS Accreditation
There is good evidence of collaborative working both at the senior team and operational levels and it
is evident that the Trustees are committed to The Rowans Hospice by the ‘walk about’ programme.
Commitment by the Chief Executive and the management team is evident and there is a good
working atmosphere at The Rowans Hospice with staff taking pride in their work and appearance.
The guidelines and protocols on the rapid and effective communication between specialties, services,
and health professionals, to provide co-ordinated individualised care and treatment.
Staff
The Rowans Hospice has a Staff Forum providing an opportunity for staff to express their views and
feedback on areas linked to ‘Improving working lives’. Staff have previously participated in an
external Staff Satisfaction Survey led by Bird-Song and will be taking this forward again for 2013/14.
In addition to this, staff are offered regular supervision in recognition of the challenging, and at times
emotive, nature of their work.
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Volunteers
Volunteers are an integral part of The Rowans Hospice and
we support the annual ‘National Volunteers Week’ and run
a Volunteers’ Day in recognition of their valued
contribution. Annual meetings and update training is
offered to volunteers as well as a comprehensive Induction
Programme, which offers the opportunity to learn about all
Hospice services and more in-depth training relating to
working alongside people who are dying and bereaved.
Commissioning Groups Statement
“PSEH CCGs are always very impressed with the high quality of service, which is provided by The
Rowans Hospice to support patients and their families. Much of the work is ‘behind the scenes’ as
highlighted by the Showcase presentation, which was a demonstration of the quality of services,
evidenced through audit and service evaluation. The Rowans Hospice also makes a big contribution
as an independent healthcare provider to the wider health economy, working in partnership with NHS
providers to deliver an integrated and seamless palliative care service, which is why we choose to
grant a financial contribution to their work. Any visit to the Hospice will demonstrate that the service
is received positively by the local community, evidenced by satisfaction questionnaires, letters of
appreciation and, of course, the financial contribution given by the public to support the charity
through donations, including the gift of skills and time from over 1000 volunteers.”
CONCLUSION
This account is by no means exhaustive, however hopefully it provides evidence on how the quality
of our service is constantly reviewed and evaluated and where needed enhancements are made.
For further information please visit www.rowanshospice.co.uk or telephone 023 92238541 asking for
the Chief Executive, Ruth White.
Registered Charity Number: 299731
Quality Account 2012/2013
Approved by: Board of Trustees
Revision No.
Date of Approval:
Dateby:
of
Revision due
Implementation:
1
June 2013
June 2014
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