Q
St Helena Hospice
Quality Account 2013 - 2014
“People told us that care and treatment options were explained in
detail and that they were fully involved in setting and reviewing
their goals. They said that this helped them to feel more in control.”
“It was evident that staff, at all levels of the organisation, were
committed to improving the quality of the hospice services.”
A statement from the Care Quality Commission inspection report September 2013
Registered Charity Number 280919
ST HELENA HOSPICE
QUALITY ACCOUNT 2014-15
Contents Page
SECTIONSPAGE
Part 1
Introductory Statement by the Chief Executive Mark Jarman – Howe
3
Statement from the Board of Trustees 4
Part 2
Priorities for improvement
5
Future Priorities for improvement 2014 - 2015
5
Priorities for Improvement from 2013 – 2014
9
Mandatory statement of assurance from the Board of Trustees
14
Part 3 Review of quality performance
Quality Initiatives
20
What people say about our organisation?
31
Statement from North East Essex Clinical Commissioning Group
31
Statement from Healthwatch Essex
32
Statement from the St Helena Hospice Service User Group
33
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Part One: Introductory Statement by the
Chief Executive Mark Jarman-Howe
St Helena Hospice aims to be the lead provider for palliative
and end of life care within North East Essex and the Colne Valley.
Established for nearly 30 years it is a positive and dynamic
organisation determined to make a difference to the quality of
care received by patients and their families, and to ensure year
on year that the extent of unmet need is steadily eroded.
The Hospice has a range of professional teams and services including a large
Hospice Nurse Specialist team, Hospice at Home service, a 15-bedded
inpatient unit, and two day centres – one in Colchester, co-located with the
inpatient unit, and one at our Tendring Centre in Clacton. We also have a large
complementary therapy team, a growing rehabilitation team, vibrant chaplaincy
team and excellent bereavement services. We also provide a transition service for
young adults in partnership with The J’s Hospice.
In 2013/14 we implemented the 24/7 SinglePoint telephone advice, referral
and coordination centre service for patients, their families and professionals. This
includes hosting the My Care Choices electronic end of life register for the locality.
We also extended our bereavement service and are pleased that this is now
available to everyone who requires such support in our locality regardless of
their age or reason. We continually explore ways to extend the scope and
responsiveness and quality of our services, and work closely with other providers
and service users.
We provide an education centre, linked with a local university, which has one
of the best specialist libraries in the country, and supports our varied education
programme. We highly value innovation and research and continue to develop our
own in-house practice development methodology known as the HEARD model
(Hospice Education And Research and Development).
Safety and quality are at the heart of our commitment to excellence in all the
services we provide and we welcome the opportunity to share our progress and
priorities in this report.
For further information about St Helena Hospice, including Strategic Plans, recent
CQC Inspection Reports and Patient Survey Reports please see our website at
www.sthelenahospice.org.uk
Mark Jarman-Howe
Chief Executive
St Helena Hospice
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Statement from the Trustees
The Board of Trustees is committed to ensuring the quality and sustainability of
the care provided to patients, whether delivered within the hospice environment
or in the community. To this extent the Board is organised into sub-committees,
representing all the main hospice activities, which meet regularly with staff and
management to review current services and future developments. These
sub-committees report directly to the Board.
A corporate governance sub-committee, also reporting direct to the Board,
monitors overall compliance with current practices, policies, and procedures and
has responsibility for risk management, especially those risks which may impact
patient care.
Trustees continue to show an appetite for investing in strategic developments
and, in this respect, fully support the new SinglePoint initiative. They are pleased
to see that evidence proves it is already valued by patients and carers as well as
helping to reduce avoidable hospital admissions and, indeed, has become central
to the hospice services. Trustees also commend the Chief Executive and the senior
management team on establishing an excellent relationship with the local Clinical
Commissioning Group which we believe will result in more inclusive, integrated
and consistent quality care for palliative and end of life patients.
The Board is confident that the care and treatment provided by St Helena Hospice
is of a high quality, is cost effective and can be sustained in the foreseeable future
and they fully endorse this Quality Account.
Peter Vergo
Chair of the Board of Trustees
“
I want you and your colleagues to know that the care we received from Hospice
at Home was of the highest standard, the best I have ever experienced, and
without fault. Everyone, including the phone call handlers, were very kind, sensitive,
knowledgeable, and professional. You all have such a holistic, person centred
”
approach, and very good listening skills. Also, it seemed that you were never rushed.
From patient and family feedback 2014
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Part 2: Priorities for Improvement
Introduction
St Helena Hospice Strategic Plan covers the three years between 2014/15 to 2016/17
Our Strategic Objectives for the next three years are:
1 We will meet the specialist palliative care needs of all patients, and their families, at any stage of
their illness regardless of diagnosis
2 We will meet all palliative and end of life care needs of patients identified as being in the last 12
months of life and support their families
3 We will promote open attitudes in our community toward death and dying, and provide
bereavement support to all that need it.
How we will achieve this
• The care we provide will be individualised and unique
• We will continuously improve our services to ensure that they deliver quality, flexibility and cost
effectiveness
• We will work and act in a way that makes a positive contribution to our local community
The quality issues in this Quality Account are related to the provision of direct clinical care services
and those support services that are related to patient and family care. It does not relate to other
functions at St Helena Hospice such as income and marketing and administration.
Future Planning and Priorities for Improvement 2014 – 2015
These priorities for improvement have been developed through consultation with those who
provide services and representatives from the service user group.
The priorities that have been selected directly impact on the three domains of quality
• Patient safety
• Clinical effectiveness
• Patient experience
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Future Improvement Priority 1
Expansion of the St Helena Hospice Bereavement Service.
Quality Domains: Clinical Effectiveness / Patient Experience
People who experience bereavement need to have their loss recognised and acknowledged by
professionals. We have a responsibility to ensure that information and practical and emotional
support is available to people who are bereaved. The manner in which professionals and volunteers
respond to those who are bereaved can have a long term impact on how they grieve, their health
and their memories of the individual who has died. (Reference “When a person dies”: Guidance
for Professionals on developing Bereavement Services. National End of Care Programme. www.
endoflifecareforadults.nhs.uk)
St Helena Hospice already supports bereaved adults and children where the patient was known to
hospice services. During 2013 the bereavement team gave support to approximately 1600 people.
In the future St Helena Hospice bereavement service will offer bereavement support to ALL newly
bereaved families and individuals, including children, who live in North East Essex
Standard
The service will be developed and extended to include all those who are bereaved in North East
Essex including those individuals and families who are not already known to the Hospice. The
extended service will increase the number of individuals who receive the offer of support
pro-actively. Previously Bereavement support was available for 45% of local deaths and the
extended service will offer support to 100%.
How the priority was identified
In 2011 the report by the Marie Curie Delivering Choice programme for North East Essex identified
that there was inconsistency in the bereavement support services available and confirmed the need
for an equitable service for every newly bereaved family or individual connected with the deceased
in North East Essex.
This is also in line with the guidance in the Department of Health 2008 End of Life Strategy
How this will be achieved
Additional counsellors and bereavement volunteers were recruited in 2013 to enable the service
expansion to take place. These staff have undergone a thorough training and induction
programme. Studies have shown that trained volunteers are used very successfully in bereavement
counselling and this is the model that has been used successfully to date by St Helena and will
continue into the future.. (Adult Bereavement Support in Five Hospices in England.D. Field et al,
Palliative & End of Life Care Group, Sheffield University 2006 – 5.13.2. (65))
We will co-ordinate bereavement care for the whole locality of North East Essex and information
about the service has been distributed across the locality - to health and social care services
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(including the local hospitals and all GP practices), community groups and education facilities.
There will be a strong link with the bereavement suite at Colchester General Hospital and
collaborative work has already been undertaken to enhance the facilities when a family come to
view the deceased at the hospital.
Calls to the Bereavement Service will be triaged by a qualified counsellor who will assess the needs
and urgency of the care and support required.
We will provide equity of access to services for bereaved individuals and families, including children.
Measures to monitor effectiveness:
The measures we will use to develop and strengthen the Bereavement Service will include
• A questionnaire will be given to all people who have used the service when our support has
ended to gain feedback about the efficacy and quality of the service. The feedback will be
analysed and used for further improvements and refinements.
• For complex bereavements where counselling is appropriate we are currently developing a tool,
called the Bereavement Gauge to be used by the client to give them the opportunity to be part
of their own process. The tool will enable us to work alongside the client in assessing the process
during their counselling sessions and to assess their emotional wellbeing and future needs.
• Reports will go to the Board of Trustees via the Clinical Governance committee and to the CCG
via regular commissioning meetings
Future Improvement Priority 2
Providing a 7 day a week Rehabilitation Service.
Clinical Effectiveness, Patient Experience and Patient Safety
St Helena Hospice offers a rehabilitation service Monday to Friday consisting of Physiotherapists,
Occupational Therapists and Rehabilitation Assistants. There is currently no rehabilitation service
at weekends or on bank holidays. A patient with urgent needs referred to the rehabilitation team
would have to wait until the following week. This could result in a delayed discharge or an
unnecessary admission to hospital.
Other services at St Helena Hospice already offer 7 day provision, for example Hospice Nurse
Specialists, SinglePoint etc. A 7 day Rehabilitation service will enable patients to have wider access
to the multiprofessional team.
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Standard
St Helena Hospice will extend rehabilitation services in order to provide an out of hours service
during weekends and bank holidays, involving at least one qualified rehabilitation professional.
The service will be able to provide advice to the SinglePoint team, respond to any urgent request
for assessment in the community, have input to the Inpatient Unit for new admissions and provide
early intervention across all settings.
Measures
Pilot study is to be completed to look at the most effective ways of delivering a 7 day Rehabilitation
Service.
Feedback will be requested from patients/carers and professionals about the responsiveness of the
service.
Audit of response times
Future Improvement Priority 3
Community Services SinglePoint
Quality Domains: Clinical Effectiveness, Patient Experience, Patient Safety
There is still much work to be done
1 The development of a call clinical review tool pertinent to palliative and end of life care is planned
for April/May 2014. This will allow an audit of the consistency of clinical advice given.
2 Improved collaboration with all stakeholders is an ongoing priority. Engaging all providers has
proved challenging but great cooperation with the East of England ambulance service has been
invaluable. The End of Life Care team from Anglia Community Enterprise have been very
supportive of the initiative from the outset.
3 The impact of the SinglePoint service and also wider hospice services on avoidable hospital
admissions is being explored by an admission avoidance group that meets fortnightly to examine
when patients are admitted to hospital or if an intervention has prevented admission. Gaps in
service provision have been explored and immediately the lack of an Occupational Therapy
services in Colchester during the last 3 months of life became apparent. The hospice committed
resources to a new post and this will be taken up in May 2014.
4 There needs to be ongoing integration of specialist and generic palliative care services.
A specialist palliative care nurse is present in the SinglePoint office 7 days a week for complex
advice and support, as well as access 24/7 to the on call hospice doctors.
5 Gathering patient and family feedback via the patient survey will yield productive information to
inform future service direction
6 Medication and palliative care competencies have been developed for all registered nurses to
ensure consistency of practice and continuous professional development
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7 Similarly development and training in the use of PGD’s will enhance the patient experience in
making access easier to some basic comfort measures such as managing constipation promptly
through appropriate use of suppositories and enemas. Increasing the number of Non-Medical
Prescribers will be an ongoing service priority.
8 The majority of the SinglePoint RN’s have undertaken the Advanced Communication Skills Training during the past 6 months
9 A training needs analysis for the entire community team has been undertaken through the annual
staff development review.
Improvements and developments within St Helena during 2013/14 will be monitored and
progress will be reported to and via a range of methods including the following:
• The Quarterly Quality meeting
• The Clinical Governance Committee
• Reports to the Patient and Family Service Committee of the Board of Trustees
• The Corporate Governance Committee
• Patient and Service User Surveys
• The Quality Account
• The Annual Review
• The Annual General Meeting
• Reports to the North East Essex Clinical Commissioning Group
• St Helena Hospice newsletters and the intranet
• Updates posted on the St Helena website
• The HEARD Celebration Day
• Volunteers Day
Priorities for Improvement from 2012 – 2013
The aim of the Quality Account is to both look forward to priorities for quality improvement in the
forthcoming year and also to review and comment on achievements from priorities from the
previous year.
In last year’s report we set out three priorities for improvement. These priorities were chosen for
their direct impact on the quality of care that patients and families receive.
The Quality Improvements for last year 2012 – 2013 were:
Priority 1
Hospice Education And Research (and) Development (HEARD)
Quality Domains – Clinical Effectiveness and Patient Experience
Standard
To build on, develop and embed a model of practice development, research and education
throughout the organisation. This model will celebrate innovation and disseminate learning locally,
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regionally, nationally and internationally in order to improve palliative and end of life care for
patients and families. The aim is to share the model and promote excellence in palliative and end
of life care for the benefit of patients and families.
Achievements to date:
1 Staff will be able to evidence their participation in practice development activities through their
annual appraisal and personal development plans which link strongly with the organisational
strategy
• Staff Development Reviews (SDRs) have been completed across the whole organisation within
a three month timescale to ensure that all employees have a timely SDR and the opportunity to
discuss practice development activities with their line manager. A training needs analysis
has been completed using information gathered from SDRs, which will inform an internal
programme of training to be developed over the coming months.
2 The presence of staff teaching on a range of subjects related to palliative and end of life care,
giving presentations and displaying posters at conferences, study days and on courses held
locally, nationally and internationally.
European Association of Palliative Care Conference 2013 held in Prague.
Two poster presentations
• Poster 1 - Improving the quality of palliative care to patients at home through a programme of
education for GPs.
• Poster 2 - Palliative care education and support across continents and cultures
NET 2013 Conference (Networking for Healthcare Education) international conference held in
Cambridge.
Two theme paper presentations :
• Paper 1 – Dealing with Monsters: Using “A Monster Calls” with palliative care nurses studying the impact of bereavement on children.
• Paper 2 – Ways to walk the labyrinth: Integrating poetry, art and experience to educate hospice practitioners in the use of labyrinths as a spiritual support.
Help the Hospices Conference 2013 held in Bournemouth. Poster presentation:
• Poster - Developing and celebrating good practice in a hospice setting: equipping a workforce
for a changing and uncertain future.
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3 St Helena teaching and clinical staff have taken part in many teaching sessions both within the
Hospice, and for other establishments in the area throughout the year. The aim of this initiative
is to share experience and promote excellence in palliative and end of life care for patients and
families in all settings.
All of these activities will have a positive impact on the quality of care and address the three domains of quality namely safety; clinical effectiveness and patient experience Examples of activities
which have taken place over the last year are:
I
II
III IV V VI Hospice Nurse Specialists, Lymphoedema service staff, Doctors and Complementary therapy team leader teaching on internal degree level modules held here at the Hospice.
Staff from all directorates are involved in the organisation wide induction days These days are
mandatory for all staff and volunteers joining St Helena
Teaching staff delivering off-site teaching for local care agencies and Nursing Homes.
Teaching and clinical staff providing study days for Consultants and Paramedics in the locality –
Consultants’ study day, Paramedics Champion’s day.
Teaching staff delivering sessions for Anglia Ruskin University at both Chelmsford and
Cambridge campuses.
Teaching and clinical staff delivering teaching sessions at the University of Essex to both
Nursing and physiotherapy students.
4 The success of innovations in practice will be evaluated using criteria agreed through a steering
group made up of professionals from within the organisation, service users and academics from
local higher education establishments
• After much consideration, the Steering Group has been dissolved. This role has been incorporated into the existing Education and Research Committee, which has representatives from
professionals within the organisation, user groups and academics from local higher education
establishments. Further to this, service user representation has been embedded within the core
HEARD group. The criteria have been revised to reflect this change, and continue to be used to
evaluate practice development.
5 Innovations and practice development will be available for staff and the public to view on the
organisational website and celebrated at an annual practice development day.
A very successful Celebration Day was held at the Hospice on 5th March 2013. Several areas of
practice development were highlighted, including:
• the X Project ( a project with local primary school children),
• Videoconferencing with Pakistan palliative staff to give them advice and support,
• Open Art Group with patients and families,
• Eco-therapies offering patients the opportunity for physical, social, emotional and spiritual
support,
• Showcasing a practical implementation document which addresses end of life care needs in
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relation to lesbian, gay, bisexual and transgender (LGBT) people. The document was developed
by the National End of Life Care Programme in partnership with the Director of Education and
Research at St Helena Hospice and The University of Nottingham.
• Audit in action: Breathlessness clinic and feedback from the service user survey.
Following the success of this day, a Celebration Day will be an annual event and the next one is
planned for the 12th June 2014.
Priority 2
Obtaining Real time feedback from service users
Quality Domain – Patient Experience
Standard
Service users will be facilitated to provide feedback about their experience in a structured way at
the time they are receiving the service.
Due to organisational changes the work on this priority is ongoing and to date the following has
been achieved:
• A survey for those who have used the bereavement service has been devised in collaboration with
the service user group
• Patients in all areas of the hospice have the opportunity to use a comment box and the results of
their feedback is analysed on a regular basis. Those who have left their contact details are advised
of the action plan following the receipt of their feedback.
• An audit of complaints received has been conducted. The auditors included 2 members of the
service user group. As a result of this audit improved information has been made available to
service users about how they can offer feedback, comments and complain.
• A tool has been devised for those receiving counselling. This will be used at each session to
determine the effect of the intervention on the person’s emotional wellbeing.
• Day service attendees have been consulted about the current service delivery model and asked
for their thoughts and ideas for the development of day services in the future. This has been done
using focus groups.
Priority 3
Safe administration of medication by the Hospice at Home Service
Quality Domain: Patient Safety, Patient Experience
Standard
Patients receiving care at home by the Hospice at Home service will be supported to take
their medication by trained and competent assistant nurses.
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During the year 2013 - 2014
•All Hospice at Home Assistant Nurses have received training and most are now competent to
administer medication to patients in their own home.
•The Clinical Managers of the Hospice at Home service worked in collaboration with a GP with
CCG responsibility for End of Life Care to develop a Medication Authorisation and Administration
Record for use in the patient’s home that is acceptable to GPs and used by the Hospice at Home
team and the Marie Curie Nursing Service.
•The initiative has been very successful, in particular for respite visits and has enabled the informal
carer/family member to leave the home for some time whilst allowing the end of life patient to
remain comfortable and symptom free.
•There has been an identifiable and real benefit for night time visits allowing the family member
to rest undisturbed by the need to get up to administer medication.
Priority 4
Providing a 24/7 single point of access for patients at end of life and with specialist palliative care needs.
Standard
St Helena Hospice will provide a 24 hour service, 7 days a week for North East Essex where
patients, family members and health and social care professionals can ring in and receive advice,
information, support and if, appropriate, signposting on any issues related to palliative and end of
life care.
St Helena Hospice will also host the combined electronic register where patients who are within the
last year of their life will be registered so that all health care professionals regardless of the service
they provide will have access to up to date information allowing them to make informed decisions
about the care of the patient.
Achievements to date:
• On 23rd September 2013 the SinglePoint service was launched to provide a 24 hour 7 days a
week single point of access for patients in the last year of life and those with specialist palliative
care needs at any stage. During the first 6 months calls to the service have grown steadily from
1997 calls at the end of October 2013 to 2533 in March 2014.
• The My Care Choices register (End of Life Care Register) is hosted by the SinglePoint service and
the patient numbers populating the register is increasing monthly.
• Since September we have received hundreds of letters and emails commending the initiative : ‘The SinglePoint service was so good in that we could always get help or advice, the staff would
contact other agencies for us such as GP or district Nurses and they could get things done
quickly!’ ‘It was an immense relief to his family that they had only SinglePoint’s number to call
for advice. Prior to that they had been gathering phone numbers for all the different
teams - immense sigh of relief from them… this was palpable’ (doctor)
The service is still evolving and the priorities for the SinglePoint service for the forthcoming year can
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Mandatory Statements relating to quality of NHS services provided
The following are statements that all providers are required to include in their Quality Account.
Many of these statements are not directly applicable to Hospice services and this will be explained
where applicable.
Review of services
During 2013 - 2014 St Helena Hospice provided the following services:
• Inpatient – 15 beds
• Day Services - at Colchester and Clacton-on-Sea – 93 places per week
• Community services – including Hospice Nurse Specialists. Hospice at Home
• Also working in the community are Rehabilitation (Occupational therapy, Physiotherapy) Family
Support, Social Work, Chaplaincy, Complementary Therapy and Medical staff
• Bereavement services to both adults and children
• Chaplaincy
• Counselling
• Education and training
• Family and Carer Support
• Lymphoedema Service
•Outpatients
•Rapid Response to symptom or care problems within the last 3 months of life for people in the
community.
•SinglePoint – advice, support and information 24 hour hours a day
•Therapies – art and music
•Transition service - for people between the ages of 16 and 40 living with a life-limiting illness
Funding of Services
St Helena Hospice is an independent charity which provides all services free of charge. The income
generated from the NHS in 2013/14 represents approximately 34 % of the total income. The
remaining income to fund our services came from voluntary charitable donations, legacies, Hospice
shops. Hospice lottery, corporate and community fundraising.
Clinical audits
During 2013 -2014 no national clinical audits or national confidential enquiries covered NHS
services that St Helena provides.
During that period St Helena Hospice participated in no national clinical audits and no national
confidential enquiries of the national clinical audits and national confidential enquiries as it was not
eligible to participate in any.
The national clinical audits and national confidential enquiries that St Helena Hospice was eligible
to participate in during 2013/14 was as follows: NONE
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The national clinical audits and national confidential enquiries that St Helena Hospice participated
in during 2013/14 are as follows: NONE
The national clinical audits and national confidential enquiries that St Helena Hospice participated
in, and for which data collection was completed during 2013/14 are listed below alongside the
number of cases submitted to each audit or enquiry as a percentage of the number of registered
cases required by the terms of that audit or enquiry. NONE
What does this mean?
As a provider of palliative and end of life care St Helena Hospice was not eligible to participate in
any national audits or national confidential enquiries during 2013/14. This is because none of them
related to palliative and end of life care.
Local audits
St Helena has established a Quality and Audit Committee to oversee and monitor an annual
programme of quality and audit activities. The programme includes a wide range of activities across
all clinical disciplines and services. The audit tools used are both national where they exist and
locally developed tools strongly referenced to national or local quality standards. The audit process
ensures that where necessary a local action plan is agreed. The Quality and Audit Committee
receive reports on audits undertaken and monitor the action plans. Re-audits are part of the activity
programme to check that improvements have taken place and the audit activity directly results in
improvements to patient and family care. The process ensures that all services are involved in quality
improvement and assurance.
Local clinical audits are conducted by health and social care professionals and teams evaluating
aspects of care that they themselves have selected as being important to them and their team. An
example of this is the audit of the breathlessness clinic which was conducted by a physiotherapist
and a registered nurse.
Examples of other audits undertaken during 2013 – 2014 include:
•Documentation of CPR status
•Complaints Management
•Controlled Drugs
•Infection Control
•Cleaning
•Call handling for the SinglePoint service
•Discharge letters to GPs
•On - going community support from the Hospice Nurse Specialist Team
•Letters on the death of a patient
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Participation in clinical research
The number of patients receiving NHS services provided by St Helena Hospice in 2013 - 2014
that were recruited during that period to participate in research approved by a research ethics
committee was NONE. There were no appropriate national, ethically approved research studies in
palliative and end of life care in which we could participate during this period.
Use of the CQUIN payment framework
St Helena Hospice income in 2013/14 was not conditional on achieving quality improvement and
innovation goals through the Commissioning for Quality and Innovation payment framework
because St Helena Hospice does not use any of the NHS National Standard Contracts.
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What others say about St Helena Hospice:
Statements from the Care Quality Commission (CQC)
St Helena Hospice is required to register with the Care Quality Commission. and is registered to
provide the following regulated activities:
•Personal Care
•Treatment of disease, disorder or injury
St Helena Hospice is required to meet the Essential Standards of Quality and Safety. The Essential
Standards are described in the Health and Social Care Act 2008 (Regulated Activities) Regulations
2010 and the Care Quality Commission (Registration) Regulations 2009 and the CQC regulate
against these standards. During 2013/14 the Care Quality Commission has visited St Helena
Hospice and carried out two routine inspections. In September 2013 the CQC inspected the
Colchester site (which incorporates the Joan Tompkins Day Centre and the Inpatient Unit) and in
November 2013 the Tendring Centre in Clacton-on-Sea.
Judgements by the CQC are made as follows:
ü
û
û
Met this standard - This means that the standard was being met in the the
provider was compliant with the regulation. if we find that standards were met,
we take no regulatory action but we may make comments that may be useful to
the provider and to the public about minor improvements that could be made.
Action needed - This means that the standard was not being met in the the
provider was non-compliant with the regulation. We may have set a compliance
action requiring the provider to produce a report setting out how and by when
changes will be made to make sure they comply wth the standard. We
monitor the implementation of actions plans in these reports, and if necessary,
take further action. We may have identified a breach of a regulation which is
more serious, and we will make sure action is taken. We will report on this
when it is complete.
Action needed - If the breach of the regulation was more serious, or there
have been several or continual breaches, we have a range of actions we take
using the criminal and/or civil procedures in the Health and Social Care Act
2008 and relevant regulations. These enforcement powers include issuing a
warning notice; restricting or suspending the services a provider can offer, or
the number of people it can care for; issuing fines and formal cautions; in
extreme cases, cancelling a provider or managers registration or prosecuting
a manager or provider. These enforcement powers are set out in law and
mean that we can take swift, targeted action where services are failing people.
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For the Colchester site the following aspects were inspected:
1 Care and welfare of people who use service - St Helena Hospice met this standard
2 Supporting workers - St Helena Hospice met this standard
ü
ü
3 Assessing and monitoring the quality of service provision - St Helena Hospice met
ü
this standard.
For the Clacton-on-Sea site
1 Care and welfare of people who use services – St Helena Hospice met this standard
2 Safety and suitability of premises – Action required. Please see below*
3 Supporting workers – St Helena Hospice met this standard
4 Assessing and monitoring the quality of service provision
- St Helena Hospice met this standard
ü
ü
ü
*Safety and Suitability of premises – action required
This related to the width of a door in the Tendring day centre. There had been a comment from
one patient who uses a wheelchair that two doors were too narrow to allow them to wheel
themselves through the doorway independently.
Immediately the report was received an on-site inspection and risk assessment was undertaken
to ensure St Helena Hospice is complying with the Disability Discrimination Act.
On balance it was agreed that the risk of injury to patients was extremely low as staff are
available at all times. A report to the Care Quality Commission was submitted within the
required timeframe and no response has been received.
The CQC has not taken enforcement action against St Helena Hospice during 2013/14 nor has
St Helena been required to participate in any special reviews or investigations by the CQC in
this period.
St Helena Hospice did not submit records during 2013 – 2014 to the Secondary Uses service for
inclusion in the Hospital Episode Statistics which are included in the latest published data.
St Helena Hospice uses SystmOne the electronic patient information system and there is a
systematic process used to collect and monitor data as follows:
•The Clinical Governance Committee through the records management committee receive any
incident reports related to data quality
•A Data Quality Manager is in post and in addition an IT Training and Reporting Administrator has
been appointed to enable data quality and reporting to be further improved. The new post holder
will train staff in data input.
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•Data reports are scrutinised by the Patient and Family Services Committee of the Board of
Trustees on a quarterly basis.
•Quarterly meetings take place between St Helena Hospice and North Essex CCG to monitor data
quality
Information Governance Toolkit attainment levels
St Helena Hospice Information Governance Assessment Report score overall score for 2013 - 2014
was 67% and was graded Satisfactory
Clinical coding error rate
St Helena Hospice was not subject to the Payment by Results clinical coding audit during
2013- 2014 by the Audit Commission.
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Part 3 Review of quality performance
Detailed below is data about services provided by St Helena Hospice and a review of quality
performance during the year April 2013 – March 2014.
Referrals
Referrals to St Helena Hospice totalled 2172 for the period of this Quality Account
Inpatient Services
There were 310 admissions to the inpatient unit during the year.
Admissions take place 7 days a week.
The average length of stay was 19.5 days over the 12 month period.
There is clear evidence that since the introduction of the Care
Co-ordinator role there has been a reduction in length of stay. This
means that people can be back at home or their place of residence
more swiftly and can be followed up as necessary and wished by
member/s of the community team.
The average occupancy over the year for 11 months (there was no data for April 2013) was 76%
with variations during the reporting year.
Statistics on the length of wait for a bed in the inpatient unit have been kept for the last 3 months
of the year and show the average wait for a bed is 3 days.
The introduction of Care Coordinator role in the Inpatient Unit
We have introduced a new role in the Inpatient Unit, that of Care Coordinator. This development
links with all three domains of quality: patient safety, clinical effectiveness and patient experience.
Rationale
The rationale for creating this role was to further improve the quality of the patient and family’s
experience during their inpatient admission, in line with recommendations for acute hospitals from
the Francis Report into the Mid Staffordshire enquiry. Excellent communication is required within
the team and with professionals outside of the team, in order to ensure the patient’s and family’s
experience is a smooth and seamless process. The Care Coordinator role was created in order to
facilitate all aspects of the patient and family experience in the Inpatient Unit (IPU).
Definition
The Care Coordinator is an identified qualified nurse from IPU who is allocated to take on the
responsibility for the co-ordination of the provision of palliative care for the patient, their family
and friends, during their stay in IPU. This will include pre- admission assessment of patients in
conjunction with the keyworker; assessing, planning, implementation, evaluation and reassessment
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of care during IPU admission in conjunction with other staff; planning discharge arrangements and
care after discharge. The Care Coordinator takes the leading role in the co-ordination of care,
treatment, resources and activities that assists the patients in IPU toward improved quality of life
and/or adjustment to loss or change. The role of the Care Coordinator is to coordinate when to
bring in other professionals such as Occupational and Physiotherapists, Doctors, Counsellors, if
these particular skills are needed by the patient and family.
The Care Coordinators agreed that to maximise the support they provided this could be achieved
by staggering their hours to provide the service between 07.30-18.00.
Outcomes
Improved Communication
Care Coordinators are now identified as point of contact for all community and hospital based
keyworkers in relation to patients admitted or being considered for admission to IPU to provide
seamless care and prevent duplication of assessment.
Care Coordinators meet with the rehab team on a twice daily basis to up date each other on care
planning and discharge issues.
Care Coordinators liaise with nursing and medical staff to ensure plans are timely throughout
admission and relevant information is shared.
Patient and families have a point of contact throughout admission, with the Care Coordinators
making contact pre admission and also providing a follow up call 24-48 hours post discharge.
Feedback
Patient and families
Relatives have fed back that they like having a named person to speak to.
Pen Portrait of patient and family pathway since Care Coordinators in place:
A Hospice Nurse Specialist highlighted that Mr A needed a bed on the inpatient unit as an
emergency admission. The Care Coordinator was able to contact Mr A and arrange for him to
come in that afternoon. The Care Coordinator was able to facilitate this by liaising with nurses on
the ward, identifying where patients could move to a bay, in order to provide Mr A with a side
room. Admin staff ensured relevant health professionals were aware of the plan to admit.
The Care Coordinator was able to be present on Mr A’s admission with the doctor, completed the
admission paper work and highlighted Mr A’s needs to the IPU staff. Mr A’s wife needed a lot of
support during the admission and throughout his stay on IPU. Mrs A informed me that it was
helpful having a named person to go to for any questions or advice. Mr A died after a couple of
days and his wife described his death as dignified and peaceful. Mrs A contacted the Care
Coordinator after a few days as she was struggling to understand why Mr A had deteriorated
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so quickly. The Care Coordinator was then able to arrange for Mrs A to come in and see them
together with one of the doctors. Mrs A highlighted how comforting it was that she was still
able to speak to someone she knew at the hospice even though Mr A was no longer here.
Staff
Inpatient staff report now having the time to provide the clinical and emotional support to patients
without having to deal with administrative tasks or the pressures of timely discharge.
The counsellors on the unit previously spent a proportion of time discharge planning which has
now stopped. They are now able to focus on providing specialist counselling support to patients
and families and able to provide wider support across the organisation through community one to
one sessions and group work.
“All the good reports we had heard about the Hospice were completely by our actual experience
of the short stay there.”
Day Care
St Helena has two day centres; one in Colchester and one in Clacton-on-Sea. Both centres offer
some days for people attending for a full or part day and some days for outpatient appointments.
At the Colchester centre the average attendance on day centre days was 66% and at the Tendring
Centre in Clacton it was 52% . Data was kept for 11 of the 12 month reporting period.
Day Services is currently being reviewed in order to maximise the potential for these facilities and
services. Service users have been part of this process. Outcomes of this review will be in next year’s
Quality Account.
“It is incredible that all staff and volunteers display such care, kindness, and efficiently at all
times to both patients and visitors. There could not have been a more peaceful place amongst
such kind people.”
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Quality of the environment
During 2013 an Estates and Facilities Manager has been appointed to St Helena. The post-holder
manages the housekeeping, maintenance and catering functions and staff within those services.
The standard of cleaning is checked on a regular basis by the housekeeper and on a formal basis via
the internal audit programme which runs on a rolling monthly basis on a quarterly cycle for each
of the three clinical sites with the aim of delivering a continuous improvement system. Tablet
computers are currently being trialled to improve the effectiveness of site audits and to allow staff
more time to focus on the report writing aspect of the audit. The estates and facilities team also
work closely with the infection control representatives to ensure that audit findings are discussed
and acted upon.
The safety of patient care is paramount and delivering a safe environment forms a core aspect of
the services provided by the estates and facilities team. There is a maintenance reporting system
in place to ensure that maintenance issues affecting patients and the delivery of services to
patients are reported in a timely manner and attended to within satisfactory protocols. The
in-house maintenance team attend all maintenance issues primarily, and if specialist service
providers are required then contact is made and call outs are booked to ensure that the issue can
be addressed as soon as possible. There is a planned preventative maintenance schedule in place to
ensure that all maintenance equipment, fabric, fixtures and fittings are maintained to a satisfactory
level and to ensure early detection of potential disrepair so that the facilities supporting the patients
can be kept in good working order and repaired with minimal impact to patients. Non urgent issues
that may affect the health and safety of patients and patient families attending the site are also
discussed at the health and safety committee meeting, which is chaired by the Health and Safety
officer and attended by Trustees as well as staff health and safety representatives.
Nutrition for patients is a core service provided by the hospice and the in-house catering team have
a 5 star food hygiene rating. The catering team are an integral part of the estate and facilities team
and work closely with the clinical team and infection controls leads, and participate in those
aspects of the cleaning audits covering food storage and preparation areas, the server and food
consumption areas.”
Community Services
Admission avoidance
One of the prime purposes of the new SinglePoint service is to improve communication and
coordination around the prevention of dying patients being unnecessarily admitted to an acute
hospital. We have set up an Admission Avoidance group, who meets regularly, to investigate any
admissions to an acute setting that could have reasonably been avoided, or any potential
admissions that were avoided directly as a result of action taken by St Helena
Hospice. The level of SinglePoint’s impact so far suggests that we could
potentially stop 260 patients being unnecessarily admitted per annum.
“
The care and compassion you all showed means
so much to me, dad, and everyone that visited mum
telephone 01206 845566 ”
your Hospice
your community services
24/7
01206
890360
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Hospice Nurse Specialists
Hospice Nurse Specialists continue to cope with high workloads and work 7 days a week. Each
day one Hospice Nurse Specialist will be based with the SinglePoint Service to offer their specialist
knowledge and advice.
642 Initial assessments and 4217 home visits were were conducted during the reporting year.
“
Your monthly home visits were looked forward to, and the helpful
advice you always gave. I’m sure you were responsible for arranging a
bed in the Hospice when deterioration came quickly just before Christmas.
”
Rehabilitation services
The rehabilitation service is staffed by Occupational Therapists, Physiotherapists and Rehabilitation
Assistants who work in Inpatient services, Day services, and in the Community.
Breathlessness management and fatigue management are offered through clinics and home visits.
For the 11 months in which data was collected there were 309 Initial assessments by
Physiotherapists and 212 by Occupational Therapists. Over the 12 months there were 205 home
visits by Physiotherapists and 246 by Occupational therapists.
Hospice @ Home
Over the past year the Hospice at Home Service provided 7416 home visits enabling those who are
ill and their family/carers to manage end of life care in the place of their choosing.
The Medical Team
The medical team works with patients and families in all settings where the Hospice provides
a service.
All team members have undergone a 360 degree appraisal during the year and two of the Hospice
Consultants have successfully received their re-validation which is now required every 5 years on an
individualised 5 year cycle.
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“Thank you so much for all the time you spent with me over the two days I was at the hospice.
It was really insightful, and cemented my passion in pursuing a career in the medical field.
There were some real characters, and the working relationships with the other staff members,
and the patients, was incredible, and truly inspiring”.
Psycho-social
The psycho-social team offers
counselling, social work, art
therapy, music therapy. and
complementary therapies.
These are offered in all
settings as appropriate to
patients and their families
including children.
Groups are also offered; they vary and are constantly being evaluated in order to meet the
changing needs of service users. Groups during 2013 – 2014 were ‘Living with Illness Programme’
– a 6 week programme for patients diagnosed with a serious and incurable illness; ‘Your Space’
bringing together individuals who are involved with a friend or relative who is living with a lifelimiting illness, ‘Family Time’ for patients and families with dependent age children and ‘Caring for
Carers’ an evening drop in for carers.
“I have been receiving counselling both pre and post death of my mother. It has been a great
help to me, it has helped me deal with my loss and accept my loss a lot better than if I had not
received it”.
Chaplaincy
The chaplaincy team work with patients and families in the inpatient, day and community settings.
They conducted 74 home visits during 2013 - 2014
Bereavement
Data for the bereavement services is being reviewed due to the service
expansion. Bereavement support is offered both in preparation for the
death of someone close as well as after the death.
A range of professionals are involved in bereavement work including
counsellors, social workers and the arts therapists.
The STARS programme (Supporting; Talking, Adjusting, Remembering, Someone Special) is a
Family Grief Support Programme and was held during the year.
“
I wouldn’t change a thing, the week- end was great,
the sessions were brill, I feel great for working through it,
Good to talk when we felt ready
”
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The lymphoedema Service
St Helena provides a service to those who have lymphoedema as a result of cancer or its treatment.
The majority of people are seen in outpatient clinics at either the Clacton or Colchester sites.
Those who attend for treatment may not be in the palliative or end of life care stage of their illness.
The treatment plan is focused on an initial course of treatment including advice and support for the
person to self-manage the condition. Periodic follow up appointments are then planned to maintain the condition and to enable the person to achieve the maximum quality of life possible.Patient
and professional education is an important part of the service and an annual conference takes place
as well as teaching sessions to a range of health care professionals.
“
Excellent presentation; really practical
information and great explanation.
Feedback from a Lymphoedema Service study day during the year
”
The Transition Service
St Helena Hospice offers a Transition Service for young adults from the age of 16 to 40. The service
is currently available at our Colchester Day Centre once a week. It allows these young adults access
to social and psychological support, spiritual care and medical professionals who can monitor their
physical wellbeing.. It is a collaborative project with the J’s Hospice in Chelmsford. It is the first
therapeutic day centre in the country for young adults with life-limiting illness.
Volunteers
St Helena Hospice continues to receive a huge contribution to the quality of services from
volunteers.
During the year a large number attended a Volunteer’s Day where they were given the opportunity
to learn more about Hospice plans for the future and to contribute their own ideas and thoughts.
The day gave the opportunity to learn as well as share.
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Quality Markers that are measured and monitored
St Helena Hospice is committed to quality; it is an integral part of everything that we do.
In January 2014 we signed up to a pilot of a national hospice benchmarking tool which enables
St Helena to benchmark against hospices of a similar size and on a national basis
Data is collected on the following incidents in the inpatient unit:
•Pressure Ulcers
•Falls
•Medication errors
The pilot has now been completed and the benchmarking will begin from April 2014
In addition the following are monitored:
•Complaints and commendations
•Risk Management: health and safety, clinical incidents and accidents, patient safety
•Quality improvement: research, standard setting, audit, practice development.
•Workforce planning: appraisal, supervision, research and education, CPD
•Management of poor performance
•Caldicott/Information Governance
•Service User Group information and feedback
Reports on all of the above are given at the monthly clinical governance meeting
Complaints and Feedback about patient and family experience
8 complaints have been received during the year 2013 – 2014. All complaints received were fully
investigated, any learning identified and the necessary steps taken to put instruction and training
into place as indicated.
A complaints audit was undertaken in January 2014, two of the auditors were from the service user
group.
Feedback from service users is monitored continuously. People are encouraged to give feedback via
a variety of methods: feedback boxes placed in all areas of the Hospice including reception and the
dining room in the inpatient unit; via the website; by talking to staff; via social media. Posters to
advise people on how they can tell us about their experience and any ideas they may have are
prominently displayed throughout the organisation.
Commendations
Compliments on the quality of the services St Helena provides are received throughout the year and
for all services. These are collated and reported to the monthly Clinical Governance committee.
We also receive positive feedback from the Patient Satisfaction Survey which is conducted by the
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Service User Group and reported to the Clinical Governance Committee.
“ The members of the Hospice Service User Group wish to congratulate all members of staff,
the enormous band of volunteers and the management team on these excellent responses.”
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The North East Essex Clinical Commissioning Group said of the 2013 Patient survey results:
“Thank you for sharing this report with the CCG. Your staff are to be congratulated on providing
such good care. We will be reporting this to our Quality Committee and Board Well done”
Pressure Ulcers
During the reporting year there were a total of 13 pressure ulcers recorded. Of these 2 were grade
4 and therefore reported to the North East Essex CCG as a serious incident.
2 of these ulcers were present on admission to St Helena.
Staff conduct a risk assessment with the consent of all newly admitted patients within 24 hours of
admission and preventative measures put in place a ccordingly. There is currently a project being
undertaken to assess the preventative equipment in use and available to prevent the formation of
pressure ulcers.
Catheter Acquired Urinary Tract Infections
During 2013 – 2014 the number of people who had a catheter already in situ and were admitted
to the inpatient unit with a urinary tract infection was 17.
There were 5 people who acquired a urinary tract infection whilst in St Helena hospice.
VTE Assessments
All patients who are admitted to the inpatient unit should have a risk assessment for venous
thromboembolism performed on admission. During the reporting year a small number of patients
did not have this assessment recorded. Investigation showed that this was a recording error and the
SystmOne data templates have been changed as a result to make recording more transparent.
Falls
During 2013 – 2014 there were 58 patient falls. A pilot if intentional rounding is now taking place
which it is hoped will reduce the number of falls by pro-actively addressing the causes of falls such
as the need to use the toilet and the desire to maintain independence with diminishing mobility.
The risk assessment process for falls prevention is also being reviewed.
Medication incidents
22 medication incidents occurred. These were fully investigated and staff re-training implemented
as indicated.. There were no serious consequences to patients in any of these cases.
Audits of all the above clinical incidents are performed quarterly. We recognise that they have
the potential to cause pain and distress to patients and are making every effort to and take
responsibility to prevent where possible or to minimise the occurrence of these incidents.
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Education and Training
St Helena Hospice has an established Education and Research Centre that provides a range of
teaching and learning opportunities that are directly applicable to patient care. Subject areas and
the approach to learning are underpinned by the 6Cs of care, compassion, competence,
communication, courage and commitment and are explicit in many courses. Courses include
symptom control, psychosocial issues, family-centred care, and communication skills. A great deal
of the teaching is skills based, such as medicines management, and these are further assessed in
practice. The level of the courses available range from degree and masters level through to short
courses and conferences. Many of the staff, including all nurses, will attend the courses. The
academic year of 2012/13 saw 82 student registration for the BSc (Hons) course in Palliative Care
and a significant number of those worked at the Hospice. All classroom based teaching is offered
to a range of disciplines throughout the Hospice but is also multi-disciplinary in its focus. In
addition, a range of different disciplines external to the organisation access the learning
opportunities, therefore teaching and learning is collaborative with others from a range of
backgrounds and care settings. The classroom teaching is further supported in practice via clinical
supervision, completion of competency portfolios and an annual staff appraisal.
Service users experiences are central to many courses and some will be part of the teaching and
learning; this needs particular support but is often very powerful and provides the unique patient
and family perspectives that practitioners can use to inform practice. In this way teaching and
learning methods are frequently experiential and will include real experiences. One particular
example that builds on this is the Advanced Communication Skills Course which uses actors,
video playback and discussion about skills used and their impact on the person. Following
feedback, these skills are refined and tried again. The overarching aim is to provide practitioners
opportunity to improve their skills and then ultimately improve the patient and family experience
by ensuring safety and effectiveness in their physical and emotional care.
All teaching and learning reflects a strong evidence-base to equip all staff to deliver the highest
quality palliative and end of life care.
Link staff are being identified to work on aspects of palliative and end of life care to further
improve standards and quality. Examples of this are dementia, staff from inpatient, community day
services and education have been identified and links are established with the North Essex Mental
Health Trust. Links have been established with a learning disability provider and a multiprofessional team are working to improve both access and information for this group of people.
Each Hospice Nurse Specialist has protected time to devote to practice development and learning
and some are conducting audits in their field of practice in order to improve the quality of patient
care.
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What people say about our organisation
North East Essex Clinical Commissioining Group response
to St Helena Hospice Quality Account 2013-14
North East Essex Clinical Commissioning Group (CCG) welcomes this Quality Account as a
commitment to an open and honest dialogue with the public regarding the quality of care
provided by St Helena Hospice. Assurance from the CCG is required to ensure that the
information in this Quality Account is accurate, fairly interpreted, and representative of the
range of services delivered.
Though the CCG are commenting on a draft version of this Quality Account, we are pleased
to be able to assure the accuracy of the content in general. We have fed back our comments
on accuracy in the draft report and anticipate that these changes will be made to the final
published version. The CCG is however unable to assure all data reported, as some data will
have been provided or updated prior to publication.
Your report is a well-presented and public-facing document. The introduction includes a list
of services provided by the Hospice, which could have been enhanced by a statement
summarising the provider’s view of the quality of the services provided during the reporting
period. Quality statements are contained throughout the document and a modification
of these to be included in part one would meet with the regulatory advice for quality
account reporting.
The Quality Account states that the Hospice is registered with the CQC and describes the
outcome of the two visits undertaken in 2013 and the subsequent action undertaken by the
hospice in response to the findings of the CQC.
You have reported on your achievement in the quality priorities that you set for 2013-14,
which demonstrates that improvements have been achieved across all priority areas.
The CCG would like to congratulate the Hospice on the success of setting up Single Point;
My Care Choices Register; and the Rapid Response service. These initiatives will enable
patients at the end of their life to be appropriately cared and supported in their preferred
place of care. Developing a service in collaboration with other care providers across the
health economy has been a significant achievement which will make a real improvement to
the experience of patients and their families.
Last year we recommended that you undertake local audits and share the findings of these
audits. The Quality Account provides reference to these audits and their outcomes.
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Overall the Quality Account was a clear and concise report of the good work undertaken by
the staff and volunteers at the Hospice. The document evidences this well with the use of
CQC feedback reports, patient stories and comments from family carers.
The conclusion of the NHS North East Essex CCG is that St Helena Hospice’s Quality
Account 2013-2014 provides a clear picture of your improvements and future ambitions for
improving quality and safety in your services.
The CCG looks forward to continuing its work with St Helena Hospice in the coming year,
and encourages you to continue to implement the multiple and wide-ranging efforts and
initiatives to improve the quality of its services.
Lisa Llewelyn
Director of Nursing and Clinical Quality
NHS North East Essex Clinical Commissioning Group
Statement from Healthwatch Essex for St Helena Hospice
Quality Account 2013-2014
Healthwatch Essex is an independent organisation with a vision to be a voice for the people of
Essex, helping to shape and improve local health and social care services. We recognise that Quality
Account reports are an important way for local NHS services to report on what services are working
well, as well as where there may be scope for improvements.
We welcome the opportunity to provide a critical, but constructive, perspective on the Quality
Accounts for St Helena Hospice, and we will comment where we believe we have evidence –
grounded in people’s voice and lived experience – that is relevant to the quality of services
delivered by St Helena Hospice.
In this light, it is therefore necessary to say services provided by St Helena Hospice have not
featured significantly either in our programme of research in 2013-14, or the evidence of people’s
voice and lived experience gathered through our outreach or engagement work. As Healthwatch
Essex develops these programmes in 2014-15, including some prospective work planned with
Essex’s hospices, we would expect St Helena Hospice to feature more prominently in the future.
Healthwatch Essex recognises St Helena Hospice’s efforts to engage with service users, encouraging
and enabling them to provide feedback about their experience. These methods include - a survey
for people who have used the bereavement service, the development of a tool to determine the
impact of the counselling service on wellbeing, and consulting day service users about the current
service delivery model.
The Service User Group, made up of patients and current and previous carers, is vital in ensuring
St Helena Hospice uses lived experience to inform decisions. Each year the group also carries out a
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survey on service user experience and views on topics. It is effective in that by allowing the group to
control the survey, the Hospice aims to get unbiased, honest opinions on services and where there
can be improvement.
Healthwatch Essex shares the aspiration of putting patient experience at the centre of services,
and believes that listening to the voice and lived experience of patients, service users, carers, and
the wider population, is a vital component of providing good quality care. We hope to work
collaboratively with St Helena Hospice over the coming year, to engage service users effectively
and ensure that their views are listened to and acted upon. We look forward to working together
in the production of Quality Accounts in the coming year and making sure that the voice and
experience of patients and the public form an integral part of these.
Statement from St Helena Hospice User Group
“The Service User Group, comprising carers and patients, fully supports the developments
underway to further enhance the quality of the existing, excellent services. In particular the
group wish to commend the hospice on their active support in two key areas:
• extending the bereavement support service to all bereaved people in the area as providing
equity in this service was identified by the group as a major and much needed advance;
• introducing the SinglePoint service to all palliative patients in NE Essex which the group knew
from personal experience would help to ease the stress of caring for someone with a palliative
condition.
The Group is involved in discussion with all hospice services which enables the views of patients and
carers to be embedded in subsequent decisions. The group also continues to carry out the annual
patient survey and reports the results to the hospice management and trustees.
It is acknowledged that future changes will be challenging for all concerned but the User Group
enthusiastically endorses the strategy and looks forward to contributing to its success.”
Staff told us that there was excellent communication within the organisation and that they felt
“listened to” by the senior management team. They said that there was a good learning
environment and support for professional development.
Care Quality Commission inspection report September 2013
If you wish to give feedback or to comment on this Quality Account please contact:
Mark Jarman-Howe, CEO
St Helena Hospice
Barncroft Close
Highwoods
Colchester
CO4 9JU
01206 845566
mjarmanhowe@sthelenahospice.org.uk
telephone 01206 845566 33 St Helena Hospice is a company limited by guarantee.
Registered in England and Wales Number 01511841.
Registered Charity Number 280919.
Registered Office:
Myland Hall,
Barncroft Close,
Highwoods,
Colchester, CO4 9JU.
Registered Charity Number 280919
www.facebook.com/sthelenahospice
www.twitter.com/sthelenahospice
visit www.sthelenahospice.org.uk