“…you gave her patience, kindness and
compassion when she needed it most…it
enabled us as a family to concentrate on
loving and comforting her” Patient Survey 2013
Quality Account
2013 - 2014
Total support for patients and families
Clinical . Financial . Practical . Emotional . Spiritual
Chief Executive’s Statement
“…we are passionate
about providing the
highest quality care.”
Welcome to this year’s Quality Account which outlines
Phyllis Tuckwell Hospice’s (PTH) key quality achievements
during the year April 2013 – March 2014. This is the fourth year that we have
produced such a document and we hope that this, along with previous years’
Quality Accounts, provides a concise summary of what we have been doing over the
last year to improve our services. We are always delighted to have any feedback on
the document itself, or indeed, our services more generally, so please do feel free to
get in touch.
Patients and their families remain at the heart of what we do here at PTH. We are
proud of our strong track record and high levels of patient satisfaction summarised
later in this document. Equally, however, we are not complacent and have a robust
and long established clinical governance programme which takes a critical review of
all our clinical work, seeks improvements and oversees service developments.
Over the last year we have reviewed and introduced new procedures to help clinical
managers maintain the high standards we are rightly proud of. Operationally we
have been delighted at the way in which our expanded Hospice Care at Home
service has become a key part of our clinical services. Building work has continued
apace and I am pleased to report that we now have a bright and airy large space in
the former Day Hospice area which now opens all sorts of possibilities for creative
uses going forward.
My thanks must go to not only our staff and volunteers who work tirelessly to
provide high quality services but also to our faithful and committed supporters who
enable us to raise the necessary funds to provide our services free of charge to
patients and their families.
I can confirm that I am responsible for overseeing the preparation of this report and
its contents. To the best of my knowledge, the information reported in this Quality
Account is accurate and a fair representation of the quality of healthcare services
provided by our hospice.
Thank you for your interest in the work of Phyllis Tuckwell Hospice.
Sarah Brocklebank
Chief Executive
June 2014
2
Contents
Page
Section 1
Improvements - Present and Future
4
Quality Improvements 2013-2014
4
Improvement 1: Review of clinical incidents policy and procedure
Improvement 2: Expansion and development of the Hospice Care at Home Service
Improvement 3: Day Hospice refurbishment
4
5
6
Areas that we have identified for improvement 2014 – 2015
Improvement 1: The continued development of e - learning training
Improvement 2: Incorporation of Hospice Home Support into PTH
Improvement 3: The strengthening of the Bereavement Service and pilot of the
VOICES survey
6
7
7
8
Section 2
9
Statutory Information
Review of services
Participation in clinical audits
Data quality
Research
Quality improvement and innovation goals agreed with our commissioners
9
9
9
10
10
Section 3
11
Quality Overview
The National Council for Palliative Care; Minimum Data Set
Community
Hospice Care at Home
Day Hospice
Out-Patients
Bereavement Service
Quality Markers
Clinical audits 2013 – 2014
National audits (Help the Hospices)
Phyllis Tuckwell Audits and Evaluations
What patients and families say about the services they receive /Patient Survey
The Hospice Care at Home Carer Survey
Feedback from the unannounced provider visit
What our regulators say about Phyllis Tuckwell Hospice
External Comments
The Board of Trustees’ commitment to quality
11
12
13
14
15
15
16
17
17
18
19
20
21
22
23
24
3
Section 1
Improvements present and future
In the 2012 – 2013 Quality Account
PTH reported on a number of quality
initiatives it had undertaken, with the
aim of ensuring that care is safe,
effective and provides patients and
carers with a positive experience. The
Hospice also identified three areas for
improvement for 2013 – 2014.
This Quality Account reports on what
progress the Hospice has made in
these areas and identifies three more
areas for improvement for the year
2014 – 2015.
Position only
– New porch
shot
Quality Improvements 2013 – 2014
Improvement 1:
Review of clinical incidents policy and procedure
Last year we wrote a new policy and procedure to assist clinical managers with
the management of clinical incidents. By asking the question …‘is this the
outcome we expected for this patient’ we can be reassured that our care has
been appropriate for the patient. Where the outcome is not ‘as expected’ we
now review the patient’s care record and consider the care given and the
outcome.
Mostly there are very straightforward reasons why the patient’s condition
changed unexpectedly; occasionally, however, the review helps to consider the
care given and whether in a similar circumstance again we would do anything
differently.
Using the clearly defined framework in the policy and procedure, senior clinical
managers have had more confidence in undertaking a review followed by a more
thorough investigation if required.
The framework has been used to good effect twice in the past year. Results are
discussed at the Clinical Governance Board Sub Committee and also with the
clinical teams. The procedure provides a link to the internet and an online ‘root
cause analysis’ (RCA) training module that supports our framework.
4
Quality Improvements 2013 – 2014
Improvement 2:
Expansion and development of the Hospice Care at Home Service
The Hospice Care at Home (HCAH) service continues to successfully provide care
and support for patients and their families in their homes.
The HCAH team is now managed by a newly appointed Clinical Nurse Specialist
Team Leader, with the skills, flexibility and leadership qualities, to both drive the
service forward and assess patient’s symptoms in more depth if required.
The workforce has doubled in size over the last year, providing a mix of specialist
assessment, symptom management, service coordination, hands on specialised
nursing and ongoing skilled care round the clock including some night care. This
has enabled us to widen the access and provision of good quality care and we now
take referrals from patients not known to the hospice.
We continue to develop links and work with other provider partners to reduce
unscheduled admissions to hospital and enable patients to be at home for end of
life care if they wish.
Results of the HCAH service carers’ survey and the number of patients achieving
their preferred place of care are reported later in this document.
5
Quality Improvements 2013 – 2014
Improvement 3:
Day Hospice Refurbishment - PTH has been awarded a grant from the
Department of Health to support this project.
Last year’s Quality Account identified the need to create a more flexible space to
accommodate activities such as workshops, Day Hospice sessions, therapy and
support groups and outpatient clinics.
We are pleased to report that the building work has now been completed. A new
extension has created a larger, more multifunctional, space, which now allows
room for a separate dining area. Sliding doors, stretching the breath of the
building, allow better access to the garden and flood the area with light. The
kitchen facilities have been upgraded and a new décor and furnishings provide a
homely, welcoming atmosphere. The space is now much more adaptable and will
be able to accommodate many different functions and sessions with ease. The
new facility has been very well received by patients with lots of positive
comments:
“It a really
exciting
space”
“It’s so modern
and not at all as
expected”
“It’s beautiful
and restful”
Areas That We Have Identified for Improvement 2014 – 2015
PTH is committed to the delivery of high quality care. Listening to patient, carer
and staff feedback and continuously evaluating our work against national best
practice all help us to identify areas where we would like to see service
development and improvement. Three of these are detailed in the following
section.
6
Improvement 1:
The continued development of e-learning training
PTH is committed to creating an environment that encourages and supports training
and development for all staff and believes a flexible approach which also provides
easy access to training records data is key to achieving this.
‘Training Tracker’, recently adopted by PTH, is an “all-in-one” e-learning system. Its
aim is to deploy mandatory training to staff, enhancing their knowledge, expertise
and skills and to ensure that PTH meets mandatory requirements and complies with
legislation. It is not designed to replace all face-to-face learning – more as an
additional tool. Staff will have an individual login and be able to undertake training
at a time and place that is convenient to them. The system will facilitate the
production of reports, allowing monitoring and also providing evidence to
regulators and commissioners.
Improvement 2:
Incorporation of Hospice Home Support into PTH
Clinical expertise provided by our clinical nurse specialist
team and the recent expansion of Hospice Care at Home
is enabling patients to receive care where they want – in
their own homes.
In an exciting new development ‘Hospice Home Support’,
an organisation already closely affiliated with PTH, is to
be incorporated within the PTH structure. The service
will operate under the umbrella of PTH community
services and will continue to provide volunteer support
and assistance to patients suffering from terminal or
long-term illness, helping patients to stay in their own
home, sometimes for much longer than would otherwise
be possible.
Patients will continue to be referred
to the service by local GPs, district
nurses, Macmillan nurses and
hospitals. The incorporation of HHS
into PTH community services will
strengthen existing cooperation and
communication, resulting in a more
streamlined, efficient service,
responsive to patient and family
needs.
7
Improvement 3:
The strengthening of the bereavement service & pilot of the VOICES survey
3.1 Strengthening of the bereavement service
The PTH bereavement service currently supports in excess of 190 clients, providing a
variety of services for both adults and children, both on a one to one basis and in
group sessions. PTH’s bereavement staff are lucky to be supported by hugely
committed and well trained bereavement volunteers and, collectively, the team
provide much needed counselling and support. In the last few year referrals have
increased significantly. In response to this increased need PTH will be running a
project designed to strengthen the service by recruiting and training additional
bereavement volunteers.
The project involves several phases; planning,
promoting, recruiting and training. Firstly there will
be discussion as to where the volunteers will be
best utilised and careful consideration as to the
attributes necessary for the role. A multimedia
publicity campaign, designed to reach a large,
diverse group of people will be followed by a
comprehensive recruitment process.
A training programme will ensure that the
volunteers are well equipped to undertake these
sensitive roles and this will be consolidated by an
ongoing support programme.
3.2 The Voices survey pilot
VOICES-SCH is a service evaluation and quality assurance tool, in the form of a
survey, for use in hospice and specialist palliative care settings. It is intended for
routine use to describe and evaluate what bereaved relatives think about the
quality of care provided to patients and families before the patient’s death, and
to themselves in bereavement.
Those who complete the survey act both as proxies for the deceased patient and
also recount their own experiences of care.
PTH is committed to the delivery of high quality care and the views of patients
and their carers are integral to the quality improvement process. PTH will be
trialling VOICES in the coming year with a view to incorporating it into our quality
assurance programme and governance structure.
8
Section 2
Statutory Information
This section includes:
Information that all providers must include in their quality account
(some of the information does not directly apply to specialist palliative care
providers).
Review of Services
During 2013 – 2014 PTH provided six services:
• In–Patient Unit
• Day Hospice
• Out-Patients
• Community
• Hospice Care at Home
• Bereavement
PTH has reviewed all the data available to them on the quality of care in all of these
services. The operational income generated by the NHS represented less than 12
per cent of the total income required to provide the services which were delivered
by PTH in the reporting period 2013/14
Registration
PTH is required to register with the Care Quality Commission, a regulatory body
that ensures that we meet our legal obligations in all aspects of care. Information
about the last inspection can be found later in this report (page 22).
Participation in clinical audits
As a provider of specialist palliative care PTH is not eligible to participate in any of
the national clinical audits or national confidential enquiries. This is because none
of the audits or enquiries related to specialist palliative care. However PTH’s quality
and audit programme facilitated many audits during 2013 -14 including a number of
‘Help the Hospices' Audit Tools.
Data Quality
For the year 2013 - 2014 PTH submitted audit data to the National Minimum Data
Set for specialist palliative care. Results are available publically from the National
Council for Palliative Care. www.ncpc.org.uk.
Some of this data and comparative national data is presented later in this report.
9
Research
Phyllis Tuckwell Hospice recognizes that research is essential to enable the specialty
to deliver high quality care founded on reliable knowledge or evidence.
In the coming year it is hoped that there will be an opportunity to collaborate with
other local palliative care units in multi-centre trials. Non-interventional trials may
take the form of questionnaires, surveys or interviews. Other trials may look at a
specific treatment interventions or a way of caring for a patient.
Quality improvement and innovation goals agreed with our commissioners
PTH’s income in 2013/14 was not conditional on achieving quality improvement and
innovation goals through the Commissioning for Quality and Innovation payment
framework.
10
Section 3
Quality Overview
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 Series
The Minimum Data Set (MDS) for Specialist Palliative Care Services is collected on a
yearly basis, with the aim of providing an accurate picture of hospice and specialist
palliative care service activity. The PTH MDS covers the period 1st April 2013 to 31st
March 2014. The available national comparative data is from the previous year.
The data below comprises of MDS data and PTH collated statistics.
In-Patient Unit
Latest available
national median
MDS figures
PTH
2013- 2014
PTH
2012- 2013
Total number of patient admissions
386
361
% Patients with a Non Cancer diagnosis
15%
16%
12%
% Occupancy
79%
75%
79%
Patients returning home
33%
30%
U/A
13
13.5
14
Phyllis Tuckwell Hospice
2012-2013
In – Patient - Unit (18 beds)
Average length of stay (days)
409
(Dependent size of unit)
U/A = Unavailable or not MDS data
The In–Patient Unit continues to operate efficiently, supporting many patients
and their families. We have seen an improvement in our bed occupancy –
demonstrating that we continue to make improvements in our admission and
discharge procedures and are liaising with other health care providers effectively
- this is particularly evident in the weekday bed occupancy rate of over 90%. The
percentage of non-cancer admissions to the In-Patient Unit remains higher than
the national median - this is in line with the Hospice’s aims to offer
comprehensive specialist palliative care to all adults with progressive, advanced
disease and a limited life expectancy.
11
Community
PTH
2013- 2014
Phyllis Tuckwell Hospice
PTH
2012- 2013
Latest National
Median
Community service: All clinicians and therapists (including Hospice Care at Home)
Total number of patients supported
958
865
846
% Patients with a Non Cancer diagnosis
20%
18%
15%
Face to face contact
5169
4181
N/A
Telephone contacts
13134
11,601
N/A
50%
51%
64%
% Home & Care Home deaths
The data includes patients supported in the community by our nurse specialists,
patient and family services team, therapists and Hospice Care at Home team.
The number continues to increase - realising the Hospice’s 30:30 vision of being
able to offer patients and their family’s choice about where they are supported
and cared for.
Community
Number of patients supported
1200
1000
800
733
787
818
2010
2011
865
958
600
400
200
0
2009
2012
2013
Community
Number of contacts
18303
20000
15000
15106
15782
2011
2012
13251
10607
10000
5000
0
2009
12
2010
2013
Hospice Care at Home
Phyllis Tuckwell Hospice
2013- 2014
2012- 2013
Total number of patients supported
300
233
Average number of visits per patient
5.2
4.2
Hospice Care at home Service
The Hospice’s Care at Home Service is now a well established provider of end of
life care in the community. The recent increase in the Hospice Care at Home
workforce and successful links with other provider partners has allowed us
increase both the access and provision of good quality care for patients in their
own homes. Not only has the team been able to support 30% more patients
overall and provide more visits per patient (as seen in the above figures) but the
HCAH service now receives double the number of direct referrals i.e. patients
previously unknown to PTH, thereby ensuring our service reaches a growing
number of people who previously would not have accessed our services at all.
13
Day Hospice
PTH
2013- 2014
PTH
2012- 2013
Latest
National
Median
Total number of patients supported
132
103
83
% Patients with a Non Cancer diagnosis
42%
35%
21%
Phyllis Tuckwell Hospice
Day Hospice
The Day Hospice continues to support many patients and their carers. The
flexible sessions and access to the multidisciplinary team have been very
positively received resulting in a rise in both new patients and attendances.
The Day Hospice welcomes many patient groups and has been proactively
promoting the service to patients with a non cancer diagnosis – with this
patient group now representing 42%. The extensive refurbishment of the Day
Hospice, completed in April 2014, has enabled effective utilisation of the space
and provided a comfortable and attractive environment for all those who visit.
14
Out-Patients
Phyllis Tuckwell Hospice
PTH
PTH
2013- 2014 2012- 2013
Latest national
median
Outpatient services
Number of patients supported
239
250
171
Total outpatient clinics attendances
541
529
313
Total outpatient clinics held
213
195
165
% Patients with a Non Cancer diagnosis
25%
27%
17%
The Dove Centre, developed to offer patients more choice and flexibility about
where and when they can receive care, treatment and advice, continues to run
regular weekly clinics in addition to many other individual appointments on
other days.
These appointments allow patients and carers to access therapies such as
physiotherapy and complementary therapy as well as counselling and
consultations with Medical and Specialist nursing staff. We have seen a rise in
clinic attendances as patients, particularly those with complex needs, are
accessing more services.
Bereavement Service
PTH
2013- 2014
PTH
2012- 2013
Latest
national
median
Total number of clients supported
195
268
486
% of contacts that were group sessions
23%
20%
8%
Phyllis Tuckwell Hospice
Bereavement Service
Phyllis Tuckwell has a well establish bereavement service and continues to
support many bereaved carers and family members.
In the last year there have been some changes within the bereavement team,
which is reflected in the above numbers. This, in addition to an increase in
referrals, has resulted in PTH identifying the strengthening of the service as a
specific objective for the coming year. This has been outlined earlier in this
document.
15
Quality Markers
We have chosen to measure our performance against the following metrics
Indicator
2013 - 2014
4
Complaints (all resolved satisfactorily)
42 (38 the previous year)
Patient falls
Patient safety incidents (Infection)
Total Number of patients known to have become
infected with MRSA whilst on the In-Patient - Unit
Total Number of patients known to have become
infected with C. difficile whilst on the In-Patient unit
0
(4 patients admitted with MRSA)
0
(2 patients admitted with C.difficile)
This reporting year there is no available national data available for the hospice setting
regarding safety incidences. However Help the Hospices (a charitable organisation that
supports hospices and palliative care professionals) have recently developed an inpatient safety metrics benchmarking tool. The tool will allow hospices to improve
quality by comparing their performance to identify improvements that have been
successful in other hospices.
Delivering choice about where and how people are cared for at the end of life is a
priority. Advance care planning is a process in which people can express views,
preferences and wishes about their future care including dying in a place of their
choice.
Indicator
In-Patient
2013 - 2014
Sample = All patients on the In-Patient unit for a 3 month period Oct – Dec 2013
Future care planning discussions - including wishes, beliefs and preferences
Percentage of patients and/or carer/family had been involved in
planning for the future (where known or documented)
98%
Patients that achieved their preferred place of death
Percentage of patients whose preferred place of death was achieved
(where known or documented)
Preference – Home 11% Hospice 89%
95%
Hospice Care at Home Sample = Hospice Care at home patients
(who remained under their care) - Oct – Dec 2013
Future care planning discussions - including wishes, beliefs and preferences
Percentage of patients and/or carer/family had been involved in
planning for the future (where known or documented)
100%
Patients that achieved their preferred place of death
Percentage of patients whose preferred place of death was achieved
(where known or documented)
Preference – Home 100%
16
94%
Clinical audits and evaluations 2013 – 2014
To ensure that we are continually meeting
standards and providing a consistently high
quality of service, PTH has a Quality and
Audit Programme in place.
The programme allows us to monitor the
quality of service in a systematic way,
identifying areas for audit in the coming
year. It creates a framework where we can
review this information and make
improvements where needed.
Regular Clinical Governance meetings
provide a forum to monitor quality of care
and discuss audit and quality evaluation
results. Recommendations are made and
action plans developed.
National audits (Help the Hospices)
Help the Hospices has developed a range of core audit tools which are relevant
to the particular requirements of hospices and can be used for quality
improvement and verification of standards.
There is currently a lack of national data available for benchmarking but again
this is an area that has identified as a priority for development by Help the
Hospices.
Help the Hospices audits completed
Compliance
Infection control - looked at 15 areas – including;
bathrooms, patient areas, hand washing & clinical
areas.
98%
Medicines Management
98%
17
A Sample of Clinical Audits Completed at Phyllis Tuckwell Hospice
Audit
Audit of Health Records
The PTH Health Records Policy and
Procedure sets out clear standards,
created in accordance to the relevant
legal and national requirements. The
biannual audit looks at the recording of
information on health records (both
paper and electronic), the storage of
records within PTH and the external
archiving process.
Required standard 100%
Findings, recommendations and actions to be taken
to improve compliance/practice
The results were excellent, with an overall compliance,
over the 3 sections, of 97.6%.
Information is written and recorded to a high standard
on both the electronic records system (Crosscare) and
paper notes – with a compliance of 96.5%.
The audit found that there was some use of
abbreviations outside those agreed by the abbreviations
guidelines. The results will be discussed with staff and
the guidance in place promoted.
The storage and destruction of records at PTH was
excellent and the external arrangements for archiving
sound
Hand hygiene
Hand hygiene is the single most
important means of preventing the
spread of infection. An audit looking at
all aspects of hand hygiene is carried out
annually. Topics include; staff training
and awareness, equipment (sinks, soap,
paper towels and bins etc) as well as the
actual process (when, how & quality of).
The process element of the audit is
repeated on a more regular basis to
ensure a more comprehensive sample.
Result = 96% compliance
The result of the audit confirmed that staff received
regular training updates & understood the importance of
good hand hygiene. Posters situated in key areas reaffirm
the message. Equipment was in plentiful supply and in
good order.
From observation – staff used gloves appropriately and
demonstrated good hand washing techniques.
Areas for discussion and improvement include – easier
access to hand cleansing for patients unable to access
bathroom facilities.
Required standard 100%
Evaluation of clinical nurse specialist
support in Day Hospice
This evaluation was undertaken to assess
the value of the support provided by a
Clinical Nurse Specialist (CNS) to patients
attending the Phyllis Tuckwell Day
Hospice (DH).
Patients were asked to complete a
questionnaire and the results analysed.
18
The CNS DH role was developed to provide support to
patients and staff in the management of complex
symptoms, psychological issues and advance care
planning.
The results showed that patients were most commonly
seeking advice about medication and the management of
physical symptoms. All the participants agreed that the
CNS had made them feel at ease and felt that they were
involved in decision making. They were confident that
the plan of care agreed would be taken forward.
The results affirmed the value of the CNS role in DH and
its continuation.
What patients and families say about the services they receive
The views and experiences of patients and their families are important to the
Hospice and enable us to look at how we can learn, develop and improve the
services we provide. The hospice undertakes a series of questionnaires, surveys
and focus groups on a regular basis.
The In-Patient Satisfaction Patient Survey 2014
The PTH survey, designed for self-completion by patients, includes questions
relating to; information giving by staff; staff attitudes; involvement of patients in
care planning; privacy and courtesy; catering; cleanliness and awareness of the
process for complaints. A sample of some of the questions and the latest
responses are detailed below.
100% of patients
agreed that this
happened with 88%
stating ‘always’
100% of patients
stated that this
always happened
Whilst on the In-Patient
Unit did the staff
discuss your care &
treatment with you?
“Nothing too much
trouble, never rushed
and felt cared for all the
time”
Did you feel that you
were treated with
dignity and respect?
“I was treated as a
person, not just a body
in a bed – a special
person”
100% of patients felt
that they did receive
enough support
Did you feel you
received enough
support to help you
cope with your feelings
and emotions?
100% of patients
thought staff were up
to date and aware of
changes in their plan of
care, with 82% stating
‘always’
Did you feel that the hospice
health care professionals
were communicating with
each other e.g. were they
aware of updates and
changes to your plan of care?
100% of patients the
cleanliness was
excellent
What do you think of
the cleanliness?
(Rooms, toilets,
communal areas)
“The staff were
fantastic”
“Yes, very much so”
“I always felt I was
being cared for by a
very efficient team”
“Everyone was aware of
anything altered or a
change in treatment”
“Superb”
“It’s spotless”
19
The Hospice Care at Home Survey
Carers of patients that have received care from the Hospice Care at Home
Service are invited to complete a short survey. A sample of the questions and
respective responses are detailed below.
(Data from June 2013 – March 2014)
Did the Hospice care at Home team make you feel
more confident about keeping the person being
cared for at home if this was their wish?
A great deal
Quite a lot
Very little
0%
20%
40%
60%
80%
100%
How quickly did the service respond
to your needs?
Not at all
Very quickly
Quickly
Slowly
0%
20%
40%
60%
80%
100%
Did you feel the person being cared for had well
coordinated care from the Hospice Care at home
team, the District Nurse and the GP?
Very slowly
A great deal
The carers’ survey generated 48
responses from June to March.
Four patients recorded that they
thought the service had
responded slowly. These were
investigated. In all cases the
service had responded within 24
hours of the referral. The HC@H
team works in collaboration with
other community services and
there can often be some
misperception about when our
community partners had
requested the first home visit
from the PTH HC@H team
Quite a lot
Very little
0%
20%
40%
60%
80%
100%
Not at all
Comments
“The hospice Care at Home team was effective, sensitive, kind and extremely
helpful.”
“My daughter, I and my late wife really appreciated everything you did for us.
This made life easier for us all, and to make it happen to have my wife at home
with us. We will never forget what everyone did for us.”
“For the rest of my life I will always be so very grateful to all the staff at the
Phyllis Tuckwell Hospice for all their help & support they gave to me and my
husband. With their help and support I was able to carry out my husbands wish
to die at home, for which I thank you all so very, very, much.”
20
Feedback from the Unannounced Provider Visit
The Board of Trustees undertake annual unannounced visits to the Hospice. Two
members of the Board talk to staff, patients and carers. Patients and carers are
asked about their views and experiences. Details of some of those conversations
are detailed below the (August 2013 report):
The Board members met and chatted to two patients, both patients had been Day
Hospice attendees.
The feedback was very positive. Both remarked that the service – from top to
bottom – was excellent.
One patient said that the doctor had explained the progress of the disease very
well, and she was fully prepared.
The other patient considered he had received excellent care, he reported that he
felt well looked after and was very comfortable, “it’s a wonderful place”.
The patient’s wife felt the Hospice was responsive to her needs and had been
supportive. She felt that the clinical team had acknowledged his specific wishes
regarding treatment. The discussion was handled with great care.
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What our Regulators say about Phyllis Tuckwell Hospice
The Care Quality Commission (CQC) is a regulatory body that ensures that we
meet our legal obligations in all aspects of care.
They conducted an unannounced inspection in November 2013; inspecting five
of the essential standards of quality and safety:• Care and welfare of people who use services
• Cooperating with other providers
• Cleanliness and infection control
• Supporting workers
• Statement of purpose
It was a very positive visit with PTH meeting four of the standards inspected.
During their visit the CQC spent time talking to patients and their families, this is
summarised below:Patients and their family members demonstrated a high level of satisfaction with
the care provided. One relative told us "This place is wonderful. I can't imagine
anywhere better. X is really well cared for and so are we."
Family members talked about being involved in all aspects of their relatives care.
One said. "My family and I have been kept updated with any changes in X's
health. Staff are really kind and considerate and nothing is too much trouble."
We spoke with two patients and some relatives during our visit. They told us the
Hospice was very clean and hygienic. One relative said "The place is spotlessly
clean. You could eat off the floor".
In their report the CQC make reference to conversations they’d had with nurses
on the In-Patient Unit and recount staff as saying that they felt well supported by
the registered manager, providers and colleagues. Staff described attending
regular clinical supervision sessions and stated that there was an opportunity for
debrief sessions following difficult cases.
However a small number of individual appraisals were behind schedule. PTH was
aware of the issue and had been working hard to resolve it. The CQC is satisfied
with the action taken since the inspection and all appraisals have now been
completed.
The CQC confirmed that there was comprehensive staff training programme and
records supported this.
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External Comments
Clinical Commission Group - Supporting Statement
Over the course of the last year PTH has been working closely with our local
clinical commission groups. Guildford and Waverley Clinical Commissioning Group
(CCG) have been invited to comment on this 2013 -2014 Quality Account :Guildford and Waverley Clinical Commissioning Group (CCG) have reviewed
the Phyllis Tuckwell Hospital Quality Account 2013/14 and found it to be
written in accordance with the guidance set down by the Department of
Health. We also found the style of the publication very appropriate to the
patient/lay audience, and commend you for making the effort to deliver it
in this way.
Progress to Improvements 2013/14
We are impressed with the progress made from the improvements that
were agreed in last year's account, and in particular, were very interested
to read about the expansion and development of Hospice Care at Home
Service. We are of the opinion that this is instrumental in keeping patients
out of Hospital, and very much aligns with our continued commissioning
intentions.
Priorities for 2014/15
We welcome the priorities for improvement for 2014/15, and are very
excited about the incorporation of Hospice Home Support. Our CCG are
committed to ensuring patients remain in their own home where applicable
and is there or their carers' preference, and we can clearly see that this
initiative will again, align with our commissioning plans.
We are pleased to hear about your plans for the Voices Survey Pilot, as we
all agree that patient and carer experiences are imperative for the
continual and appropriate improvement in health care services. Capturing
these in a systematic, continued and organised way will significantly
contribute to the successful improvement of services in the future. We look
forward to hearing the results of this good work.
Patient Engagement
We are very pleased to read the results of your existing patient survey, and
commend you all for the excellent results.
Vicky Stobbart
Executive Nurse, Director of Quality and Safeguarding, G &W CCG.
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The Board of Trustees’ Commitment to Quality
The Board of Trustees is fully committed to the quality agenda. The Hospice has
a well established governance structure, with members of the Board having an
active role in ensuring that the Hospice provides a high quality service in
accordance with its terms of reference. As above, members of the Board
undertake an unannounced visit twice a year - gaining first hand knowledge of
what the patients and staff think about the quality of the service.
The Board is confident that the treatment and care provided by the Hospice is of
high quality and is cost effective.
Phyllis Tuckwell Hospice
Waverley Lane, Farnham
Surrey, GU9 8BL
Tel: 01252 729400
www.pth.org.uk
Phyllis Tuckwell Memorial Hospice Ltd. Limited by Guarantee.
Incorporated in England and Wales. Registered No. 1063033 Registered Charity No. 264501
Copyright ©PTH 2014
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