Quality Account
2013 -14
Mission Statement
Teesside Hospice Care Foundation (THCF) is committed to enhancing the
quality of life of those suffering from life limiting illness, offering specialist
palliative care and support to patients and their carers in the belief that each
person is entitled to dignity and choice within the best provision of care.
Teesside Hospice
1, Northgate Road, Linthorpe,
Middlesbrough,
TS5 5NW
1
Registered Charity Number - 512875
We observed the experiences of people who used the service and relatives visiting
the unit. We saw that staff interacted and communicated well with people and their
relatives and staff were attentive and treated patients with dignity and respect. We
saw that the atmosphere was friendly and relaxed.
We saw that people had their needs assessed and that care plans were in place. We
found there were effective processes in place to ensure safe sharing of information
with other providers. We found that people were cared for a clean and safe environment.
We saw there was a range of equipment available to support people and we found
that systems were in place to monitor the quality of the service”.
CQC Inspection Report, January 2014
“Throughout my stay I was impressed by the kindness and concern shown to me by
everyone from volunteers, doctors, nurses, etc. I was made to feel very special and
that what I thought as a person was always taken into consideration, a big thank you
to you all.
Patient comment – Inpatient Unit Satisfaction Survey 2013/14
“Absolute confidence in the knowledge that the patient was in the hands of a fully
dedicated and professional team who in spite of numerous setbacks just didn’t stop
caring or give up. Doctors and nurses were always available to listen, advise and
answer my question”
Bereaved Carer 2013/14
“I cannot find the words to express how amazing & supportive to my parents, myself
and family hospice was during a period of hideous grief and pain the staff were a
rock of kindness and allowed our parents to keep their dignity and spirits lifted. “
Bereaved Carer 2013/14
2
PART 1
Statement from Chief Executive
Teesside Hospice Care Foundation is committed to delivering the best possible
experience for patients and their families. Through the Hospice’s Consultant led
multi professional team we aim to provide the highest standard of specialist palliative
care we can achieve.
In 2013/14 the Board of Trustees reviewed board succession and have clearly
identified the skills and expertise required to continue to be a strong dynamic board
who can support the senior management team going forward. We have also welcomed four new trustees and have had a change to the chairs position.
This Quality Account will hopefully demonstrate the level of commitment we have to
deliver, review and improve the quality of the service we provide to patients and their
families that access our services. The Care Quality Commission made an unannounced inspection to the Hospice in January 2014. The report on this inspection did
not identify any areas where remedial action was required, nor were any recommendations or suggestions made.
We commenced a major refurbishment project in December 2013 which has enabled
the Hospice to improve and enhance the environment and facilities to fit the
changing needs of patients and families. The project has been part funded through
a Department of Health Capital Grant scheme and topped up from the Hospice’s
financial reserve. The project is expected to be complete at the end of April 2014.
The Board of Trustees continues to oversee the corporate governance of the
organisation, with various sub committees having trustee representation. Policy
review and new documentation is developed with the inclusion of the appropriate
management and staff.
We receive 35% funding from the NHS but rely heavily on our Trading Company
together with the very generous support of local businesses and supporters to make
up the remaining 65% of the required funding. Legacy income is not a guaranteed
source of income but is needed to ensure the Hospice has vital reserves going
forward. In April 2013 we secured a three year contract with our local Clinical
Commission Groups to provide a Community Lymphoedema Service for the Tees
wide locality. Throughout the year we have seen the number of patients attending
this service significantly increase.
I would like to thank all staff, volunteers and supporters for their dedication in
contributing to make our patients and families have the best experience of palliative
we can deliver.
To the best of my knowledge the contents of this report are true and accurate.
Maureen Thompson
Chief Executive
3
PART 2
Looking ahead: Key priorities for improvement for 2014/15
2.1 Introduction
Teesside Hospice Care Foundation (THCF) was established in 1982 as a specialist
palliative care centre to enhance the quality of life of those suffering from life limiting
illnesses. It offers Consultant led specialist palliative care and support to patients and
their carers.
Our aim is to provide the relief of complex symptoms with regard to physical, social,
psychological and spiritual aspects of patient/family care, thus enabling them to
return home or to another care environment. The majority of care to patients, families
and carers focuses upon pain and symptom control, but we also provide respite
admissions for specialist palliative care.
An annual patient survey is
undertaken and managed by THCF
Clinical Audit Group. The outcome of
the survey is shared with the Clinical
Governance Committee,
Council of Management Trustees
and summaries of the survey are
displayed as posters in each department to inform patients, their families
and other visitors to the organisation
of the outcome of the survey.
A carer support programme is established alongside the Day Care Service and
where possible patient and carer views are sought prior to specific changes or service developments.
Teesside Hospice is fully compliant with the National Minimum Standards (2002) and
has satisfied the Care Quality Commission (CQC) that standards are being met
through both self-assessment and an unplanned CQC inspection in January 2014.
The CQC inspection was extremely successful and Teesside Hospice was deemed
fully compliant. Teesside Hospice monitors the quality of care that is provided across
the organisation via its Clinical Governance Committee. The importance of providing
quality care is underlined by the membership of the committee which includes the
organisations most senior clinicians, the Director of Patient Services and
representatives from the Board.
Since writing the last quality account, significant re-configurations in the NHS have
taken place with the advent of the Clinical Commissioning Groups (CCG). The
Hospice’s catchment area is predominately Middlesbrough, Redcar and Cleveland
areas however, we are also contracted to provide a specialist community
lymphoedema service to patients from the North and South CCG areas.
4
2.2
Improvement Aspirations
Aspiration 1 - Patient Safety
Why choose it as a priority?
To reduce the number of patient falls
Why choose this priority?
A patient falling is the most common patient safety incident reported to the National
Patient Safety Agency (NPSA) from inpatient services.
Literature that examines falls in the palliative care setting suggests that fall rates are
particularly high in the inpatient palliative care population with rates of approximately
16 falls per 1000 bed days compared to rates of about 4.8 falls per 1000 bed days in
acute hospital inpatient populations. Frequently patients will have multiple risk
factors for falling and a multifactorial risk factor assessment to identify reversible
causes is important in preventing falls. In addition the tendency for the palliative care
patients’ condition to change rapidly makes assessment of falls more challenging.
Falls have been identified, as a significant problem in the elderly and frail patient
populations. Therefore as the number of older adults with cancer increases in the
future, the prevention of falls in this population will become even more critical.
How will this priority be achieved?
In 2008 a small group of people in the UK were brought together at the invitation of
Help the Hospices and with the support of the NPSA to create a falls prevention and
management toolkit.
A group of staff led by the
nominated lead person for Manual
Handling at THCF have reviewed
the process we follow regarding
falls. As a result we have introduced
an adapted version of the Help the
Hospice tool at THCF. This will
ensure that an evidence-based and
more effective process is followed
in the management and prevention
of falls in the inpatient unit and day
care setting.
Furthermore, the THCF group have now revised the Hospice Manual Handling
Policy, introduced a comprehensive care plan which identifies key fall risk factors
and included the incident report form as part of the process. Throughout this review,
the group have been conscious of the need to maximise patients’ mobility and
independence through the use of individualised care plans which promote the
patients right to independence, privacy, dignity and rehabilitation.
5
How will this priority be measured?
A clinical incident report tool is part of the toolkit. This ensures that the
circumstances of any fall are described completely and meaningfully in order to
analyse and use reports of falls to learn about contributing factors. An audit of the
care plan used in each patient that falls will be undertaken to check the individual’s
vulnerability in terms of fall risk factors to ensure all risks have been addressed.
6
Aspiration 2 – Clinical Effectiveness
To increase accessibility and awareness of the acupuncture service and its
benefits to patients in the holistic management of symptoms, within the Day
Care and Inpatient services ensuring that the delivery of acupuncture to
patients is beneficial and improves their quality of life.
Why choose this priority?
Patients presenting at Teesside Hospice have multiple physical and mental
symptoms, the management of which requires a holistic approach to benefit patients.
Acupuncture is a non-drug treatment which offers
an alternative therapy for patients without
significant side effects, used in conjunction with
conventional palliative care treatments.
Acupuncture can be used to help relieve
symptoms and side-effects of some cancer
treatments such as, the management of pain, it
has also been used in the treatment of hot
flushes, shortness of breath, nausea and
vomiting, peripheral neuropathy, fatigue, anxiety,
depression, insomnia and dry mouth syndrome
with positive results.
How will this priority be achieved?
This priority will be achieved through the introduction of educational sessions
informing medical and nursing staff of its beneficial effects and the treatment options
available with acupuncture. The use of two qualified practitioners will offer equity
across the Hospice services and increase accessibility for patients.
How will this priority be measured?
The priority will be measured through the qualified acupuncture therapists assessing
and documenting patient’s symptoms and using the MYCaW (Measure Yourself
Concerns and Wellbeing) assessment tool to review the effect on patients
symptoms and their general well-being. This will be documented within the patient’s
notes. An audit will also be undertaken to measure the effectiveness of treatments
on symptoms and well-being. Statistical analysis of patient uptake within the Day
Care and Inpatient departments will identify if the educational sessions have had an
impact on the numbers of patients being referred to the service.
7
Aspiration 3 – Patient Experience
To improve the experience of Day Care Patients by introducing a new
individualised programme of support
Why choose it as a priority?
The Commission into the Future of Hospice Care was established by Help the
Hospices in 2013 to help providers of hospice care prepare to meet the needs,
challenges and opportunities that will present themselves in the future. This report
highlights the need for hospices to review their services in order to ensure they are
still meeting the needs of the populations that they serve.
The Minimum Data Set (MDS) for Specialist Palliative Care Services is a voluntary
process whereby activity data is collected by the National Council for Palliative Care
(NCPC) on an annual basis. The aim is to provide an accurate picture of hospice and
specialist palliative care service activity. Teesside Hospice has contributed to this
process for several years.
THCF data identified the following changes from previous data:
•
•
•
•
•
A reduction in the number of referrals to the Day Care service
An increase in the average length of care
A decrease in the number of Day Care patients attending on their allocated
day
An increase in the number of patients requiring Doctor consultations
An increase in numbers of non-cancer patient referrals
At Teesside Hospice a meeting was held with the senior clinical team to consider the
implications of the report and led us to consider whether we needed to make any
changes to our Day Care service model.
How will this priority be achieved?
It was decided that the first step in the review of THCF Day Care service should be
to carry out a series of focus groups, which included patients, external professionals
and the Hospice team. This was led by the Clinical Team Leader at THCF.
The focus groups were held between November 2013 and January 2014 supported
by the Improvement Team at the James Cook University Hospital. The discussions
at the three focus groups provided valuable and rich information which was then
analysed. Key themes were identified regarding accessibility, programs of support,
symptom and lifestyle management. These themes were discussed with the senior
team at the Hospice taking account of recent beneficial group work within the Day
Care setting. This involved a series of interventions to support patients coping with
symptoms such as fatigue, anxiety and breathlessness. The first pilot project will be
to introduce a new service running alongside Day Care using a ‘Workshop’ approach
for patients in a time limited programme of support from June 2014.
8
How will this priority be measured?
The pilot programme will be evaluated from the onset to determine whether it has
had an impact and has improved patient’s symptoms. Those involved will be asked
for feedback regarding whether they have found the programme beneficial. This will
inform any decision to establish this programme as a service offered in Day Care in
the future.
9
2.3
Statements of Assurance from the Board - (Formal statements required
by the Department of Health)
The following are statements under various headings that all providers of NHS
healthcare services must include in their Quality Account, even though many of the
statements are not directly applicable to Teesside Hospice.
a. Review of Services
During the reporting period 2013/14 Teesside Hospice provided the following
Specialist Palliative Care Services to the NHS:
•
•
•
•
•
Inpatient Unit – 10 beds
Day Hospice Services
Specialist Lymphoedema Services
Medical Out Patient Services
Adult and Children’s Bereavement Counselling Service
Teesside Hospice has reviewed
all the data available to us in
terms of the quality of care delivered. Activity data is provided
to the Commissioners of these
services on a quarterly basis
and is reviewed at quarterly
meetings with the Commissioner, Chief Executive (CE)
and Director of Patient Services
(DPS).
The income generated by the NHS services reviewed by this quality account
represents 35% of the total income generated from the provision of NHS services by
Teesside Hospice for 2013/14. This 35% represents only part of the funding required
to provide services at Teesside Hospice.
The remaining 65% of income is
generated through fundraising,
charity shops income, lottery
activity and investment income
and we are dependent on the
generosity of the local community
in sustaining this income. The
NHS contract means that all services delivered by Teesside Hospice are partly funded by the NHS
and partly funded from charitable
funds.
10
b. Participation in Clinical Audit
During 2013/14, there were no national clinical audits and no national confidential
enquiries covering NHS services relating to palliative care. Therefore, during that
period Teesside Hospice was not eligible to participate in any national clinical audits
and national confidential enquiries.
c. Research
The number of patients receiving NHS services provided by Teesside Hospice in
2013/14 that were recruited during that period to participate in research approved by
a research ethics committee was ZERO. There was no appropriate, national,
ethically approved research studies in palliative care in which we could participate.
d. Commissioning for Quality and Innovation (CQuIN) Payment Framework
A proportion of Teesside Hospice’s NHS income in 2013/14 was conditional on
achieving quality improvement and innovation goals agreed between Teesside
Hospice and the commissioning CCG. The improvement conditions that were agreed
were:
• NHS Safety Thermometer - collecting data and demonstrating a reduction in
the incidence of pressure ulcers, falls and urinary infection in patients with a
catheter
•
Undertaking a local patient experience survey and implementing actions resulting from the survey and including Friends and Family Test in the survey.
The two CQuIN measures represent 2.5% of the overall contract value with both being successfully achieved with full payment.
e. The Care Quality Commission
Teesside Hospice is required to register with the Care Quality Commission and its
current registration status is for the following regulated activities:
•
•
•
Treatment of disease, disorder or injury
Diagnostic and screening procedures
Transport services, triage and medical advice provided remotely
Teesside Hospice is registered with the following conditions:
•
•
•
Services are provided for people over 18 years old
The maximum of 10 patients may be accommodated overnight
Notification in writing must be provided to the Care Quality Commission at
least one month prior to providing treatment or services not detailed in the
Statement of Purpose
11
The last unannounced routine inspection of Teesside Hospice took place on 6th
January 2014. The report on this inspection did not identify any areas where
remedial action was required, nor were any recommendations or suggestions made.
Teesside Hospice has not participated in any special reviews or investigations by the
Care Quality Commission in 2013/14.
f. Data Quality
Teesside Hospice did not submit records during 2013/14 to the Secondary Users
service for inclusion in the Hospital Episode Statistics which are included in the latest
published data.
What this means: Teesside Hospice is not eligible to participate in the scheme.
g. Information Governance Toolkit attainment levels
Teesside Hospice did not participate in the Information Governance Toolkit. However,
the Hospice has its own Information Governance Policy / Records Management Policy
and Information Sharing Agreement with the James Cook University Hospital.
h. Clinical Coding Error Rate
Teesside Hospice was not subject to the ‘Payment by Results’ clinical coding audit by
the Audit Commission during 2013/14.
12
Part 3
Review of Quality Performance
The quality improvements outlined in our first Quality Account (2012/13) have all
been satisfactorily achieved, however, in all areas continuous improvement is
planned. The Board of Trustees has been in full support of the improvement areas
over the past year and has received regular reports on progress. Services users
have been consulted with where appropriate.
3.1 Improvement Priority 1 (Patient Safety)
To improve the standard of prescribing and administration of medicines to
ensure patient safety in medicines management
The safe and effective management of medicines is fundamental to the quality of
care provided to patients at Teesside Hospice and an important aspect of complex
symptom management. The recommendations of the audit of medicines prescribing
practice have been achieved and put into practice. These included ensuring that all
medical and nursing staff were aware of the results of the audit; amending the
Medicines Management Policy to include the additional agreed exceptions to the
generic prescribing list and using accepted abbreviations when prescribing
medications. This is currently being re-audited.
The annual Controlled Drugs (CD) audit was undertaken in November 2013 by the
Accountable Officer for Controlled Drugs (Director of Patient Services) and the
Inpatient Unit Sister. This audit measures the Hospice compliance in terms of the
Misuse of Drugs Regulations (2001), The Health Act (2006) and the Controlled
Drugs (Supervision of management and Use) Regulations 2006.
Compliance in terms of adequacy
of the premises/security;
procurement of CD’s; the
examination of the stock held and
the administration of CD’s was
100%. Some errors were noted in
terms of nursing staff following
the correct procedure to correct
documentation errors and also by
the medical staff when changing
prescribed doses of CD’s.
The results of the audit have been shared with nursing and medical staff as well as
to the Clinical Audit Group and Clinical Governance Committee. An action plan has
been formulated and implemented to address the areas of non-compliance. The audit will be repeated in 2014.
13
3.2 Improvement Priority 2 (Clinical Effectiveness)
To measure the effect of the introduction of ‘Flowtron Hydroven 12 with Lymph
assist therapy’ to the lymphoedema service to ensure that it delivers care that
is beneficial to patients and improves their quality of life.
The lymphoedema service has undergone major changes in 2013-1014 prompted by
the successful application to become a qualified provider (AQP) of the community
lymphoedema service. The service specification enables the service to be accessed
by people suffering from cancer or non-cancer related lymphoedema in the North &
South CCG areas. As part of the AQP process we have also set up a domiciliary
service to visit patients at home who are unable to travel to the clinics held at
Teesside Hospice.
In the last 12 months the lymphoedema clinic caseload has more than doubled in
size and the complexity of the patient’s continues to increase. There are more
patients requiring more advanced lymphoedema treatments in particular Manual
Lymphatic Drainage Massage (MLD).
In 2012-2013 we purchased two Flowtron Hydroven 12 Lymph Assist machines.
These have significantly improved patient’s limb shape, movement, limb volumes
and subcutaneous tissues. We have completed an audit on the effectiveness of the
machine and this shows 71% of patients received an excellent explanation of the
machine, 14.2% stated very good and 14.2% adequate. In comparing the machine
to the nurse doing the whole massage 42.8% of patent’s rated it as excellent and
42.8% very good, 14% said poor. These results were the same when patients were
asked if the machine softened the subcutaneous tissues as effectively. A total of
85% of patient’s said they would recommend the treatment to someone who had
similar lymphoedema to them. The positive comments we received were “very relaxing my arm felt lighter," “Above my knee feels a lot softer” ”help keeps my limb soft”.
The only negative comment was the foot aspect of the garment did not feel strong
enough when inflated by the machine. As a result of the audit we have recently purchased a further Flowtron Hydroven 12 Lymph Assist machine to help keep up with
the demand for its use.
3.3
Improvement Priority 3 (Patient Experience)
To increase patient and carer involvement in service development and delivery
at Teesside Hospice by initiating a new Patient & Carer Forum
Teesside Hospice has held several Patient and Carer User Forums and Bereaved
Carer User Forums throughout the year. This is a new initiative for the hospice to
ensure we are giving patients and carers every opportunity to feedback to us their
thoughts, suggestions and any issues/problems they may have experienced. It also
ensures we are constantly striving to establish ways we can improve the care and
experience for patients and their families.
We have held 2 programs of user forums with patients that attend the Day Care
14
service, holding them on each day of the week. The first one was to help us create a
new patient information leaflet. We took a draft copy and patients stated what they
felt needed adding or removing. The second one was part of a larger project
addressing the question “Does the current model of Day Care meet the need?”
Several sessions were held with hospice staff, community staff and patients. This
project is ongoing and a report and action plan is due to be completed in the next
few months.
A 3rd Patient and Carer User Forum was advertised throughout the hospice to design
a Welcome Pack for patients admitted to the Inpatient Unit (IPU). This time we did
not present a draft copy but started by asking what patients would find useful in a
Welcome Pack. We incorporated all their ideas when creating the Welcome Pack.
Patients and carers also had an opportunity to discuss other issues and there were
several suggestions and issues discussed. Those that brought about changes are
stated below. The people that attended were contacted afterwards to find out how
beneficial they found the forum and unanimously, all who attended stated they felt it
enjoyable and beneficial.
A Bereaved Carer User Forum was also held towards the end of 2013. The next of
kin of all patients who die within IPU receive a Bereaved Carers Questionnaire, from
which we get a fantastic response. Those Carers who returned the questionnaire
within the last 12 months were invited to attend the User Forum. On the day, 5
Carers attended and it was an extremely productive and beneficial meeting for all
who attended including the staff. Carers were complimentary about the care their
loved ones had received but also felt comfortable to discuss areas they felt could be
improved. The forum produced some excellent suggestions but also served as a
therapeutic process, as carers found returning to the Hospice and having time to
discuss their experiences with others extremely beneficial.
Following the Forums, the
information gleaned was shared
with the senior management
team and has resulted in
several changes in practice and
the creation of additional patient
and Carer information as listed
below.
The Bereaved Carer User Forum were also asked to attend a follow-up meeting
where the changes that had occurred due to their feedback were shared and they
were also asked to comment on a new Bereavement Pack that will be given to
bereaved carers following the death of their loved one. Again, this was an excellent
meeting where carers expressed their delight and satisfaction at being able to make
changes that will improve the experience of bereaved carers in the future. The group
decided that although it had been extremely beneficial to participate in the Bereaved
Carer User Forum they were anxious that it should finish to ensure that it did not
15
become a support group and that more recently bereaved carers should be consulted for the next group. A new Bereaved Carers Forum is being planned for later in
the year.
Actions / Changes Resulting from the User Forums












A newly designed Day Care Patient Information Leaflet has been created with
the help of Day Care patients.
A Welcome Pack for IPU has been created with the help of patients carers.
A report on the review of the model of Day Care is being produced.
The Welcome Pack, Day Care Patient Information Leaflet and other
appropriate leaflets are in the process of being uploaded onto our hospice
website so anyone can access the information as needed.
Children’s activities are to be placed into our new IPU Family Room when it is
completed
Wi-Fi has been connected throughout the hospice so patients and families
can contact family and friends at all times and in all areas.
Information leaflets are being emailed to various community professionals.
A new Bereavement Pack has been created with the help of bereaved carers.
A separate sheet has been added to the Bereaved Carers Questionnaire
which gives the carer the opportunity to be placed on a Bereaved Carers
Teesside Hospice mailing list. This will benefit the carers as they will receive
information regarding ‘in memorium events’ such as our Sunflower Memory
Walk, Tree of Life or Sunflower Memory Service and will benefit the Hospice
in regard to fundraising.
A counselling card has been created which will be included in the new
Bereavement Pack that families are given following the death of their loved
one. The idea is that people may keep hold of the wallet sized card so they
have the Bereavement Counselling service contact details at hand if they
decide counselling may help at any point in their bereavement journey.
The next of kin of patients who have died at Teesside Hospice will be
contacted via telephone approximately 6 weeks following the death of their
loved ones by a member of the Multi-Disciplinary Team.
The Bereaved Carers Questionnaire has been altered slightly to give more
opportunity to request help from the Bereavement Counselling team if this is
needed.
16

An audit was undertaken on the sending of the yearly anniversary card and
the system for this has been altered to ensure that every bereaved carer is
sent a card on the 1st anniversary of the death of their loved one.
3.4
2013/14 Performance - What patients and families say about the services
they receive
We value the feedback we receive from patients and families as an important aspect
of how we can identify issues, resolve problems and improve the quality of the care
Teesside Hospice provides.
As part of our commitment to ensuring patients and families have a voice we give a
survey to all patients discharged from the Inpatient Unit and send a survey to the
family of patients who die in our care. A patient survey is also given to all Day Care
and Lymphoedema Service patients. The results of these surveys are collated and
shared with Trustees, staff/volunteers and patients/carers by PowerPoint or poster
presentations. The surveys are anonymous but where concerns are raised and
people identify themselves this is followed up in a timely manner to resolve the issue
and to learn from what has gone wrong.
a.
The In Patient (IPU) Survey - Summary of Results
The annual IPU Satisfaction Survey from April 2013 – March 2014 had a response
rate of 32% (39 out of 123 discharged patients).
Some of the key findings from this report are as follows:
100% patients stated they were always treated with respect

100% patients felt their privacy was always respected

100% patients were always satisfied with the response when they needed to
ask for assistance

100% patients felt supported in making decisions about their care either
always or most of the time

100% patients felt very satisfied or satisfied with their involvement in planning
their care

100% patients stated staff introduced themselves either always or most of the
time

100% patients stated staff always or most of the time explained what they
were doing prior to any procedure

100% patients felt they always or most of the time understood explanations
given to them regarding their treatment and care

100% patients stated staff always or most of the time made an effort to meet
their individual wishes
17

100% patients felt the general environment and surroundings and room furnishings / comfort were either excellent or good

100% patients rated helpfulness of volunteers and reception staff as either excellent or good.

100% patients rated standard of Nursing Care, Medical Care, Occupational
Therapy, Social Work, Chaplaincy/Spiritual Care, Dietician, Complimentary
Therapies, Hairdressing, and Catering and food service/menu choice as either
excellent or good

100% patients felt standard of emotional support was either excellent or good

100% patients felt the cleanliness of the Hospice was either excellent or good

100% patients stated their care, treatment and support needs had been fully
met

97% patients stated they would recommend this service to a member of their
family or friends

97% patients felt they were able to ask questions about their care either always or most of the time

95% patients rated the standard of the physiotherapy support either excellent
or good

92% patients rated the standard of the Counselling session support either excellent or good

91% patients felt access to food outside mealtimes was either excellent or
good

88% patients were aware of the Teesside Hospice Information Booklet.

82% patients knew how to make a complaint
•
78% patients stated they were offered verbal feedback following MDT meeting
Comments stated following the question “Please comment on anything you
were particularly happy with or unhappy with giving an example if possible, as
this will help to improve our service for patients in the future”
“You did all you could and were very helpful and caring and assisted me whilst trying
to beat my anxiety.”
“My treatment, the care & compassion shown & the professionalism of the staff
couldn't get any better.”
“Nothing unhappy with. Personal care when in private situations (bathing, dressing,
etc.) was excellent and the overall friendliness alongside professionalism made
everything a wonderful experience. Thank you to everyone involved.”
18
“Politeness of staff, volunteers, ext. Cleanliness of unit. Absolutely outstanding work
of doctors and nurses.”
“Really happy with the support I have received I feel I have had a full holistic
approach to my needs.”
“The staff and Doctors in this unit are amazing. “
“The staff and volunteers — so very good with the patient. I felt that I was personally
cared for.”
“The staff go out of their way to make you feel comfortable and help you with any
problems.”
“Throughout my stay I was impressed by the kindness and concern shown to me by
everyone from volunteers, Drs, nurses, etc. I was made to feel v special and that
what I thought as a person was always taken into consideration, a big thank you to
you all.”
“V pleased with the care rcvd from named nurse they explain everything that was
happening and in a way that I could understand they made me feel at ease and
know that I had that support helped with my stay and made me feel relaxed and
comfortable.”
“Very happy with all aspects of my stay.”
“What I found particularly helpful was the total inclusion I was given at all stages of
my care, drug regimen, amount, frequency, side effects, it was all there. Hospice is a
happy caring environment that makes coping with a terminal illness easier to bear.”
“Words fail to express the kindness, care and love shown to me and my family. I felt
very much 'at home' and appreciate every aspect of the whole staff.”
“All staff are absolutely first class.”
“All staff were very kind and helpful.”
“Do not know how you can improve such a marvellous service”.
“Everyone very pleasant and helpful. Joy to be there apart from being unwell.”
“Excellent care.”
“I think the hospice is a nice friendly place. It is very relaxing. Staff and everyone are
very good and very understanding. Nothing is any trouble for them. Me and my family
cannot thank you enough. Thank you again for your help.”
“Absolute confidence in the knowledge that the pt was in the hands of a fully
dedicated and professional team who in spite of numerous setbacks just didn’t stop
caring or give up. Drs and nurses were always available to listen, advise and
19
answer any questions. They would always make time for you.”
“Both of my daughters and myself have said it was the best thing we could have done
for her in her last couple of days. We spent 24hrs a day with her and saw how she
was treated and us by all the staff. We have spoken very highly of Teesside Hospice”
“Fantastic team, fantastic service I’m very grateful for everything.”
“I was very happy with everything that happened in the hospice.”
“In my opinion it is not possible to improve on the standards in this hospice.”
b.
The Bereaved Carers Survey- Summary of Results
From previous research, bereaved carers were found to be the most open to
providing feedback on hospice facilities and services. Therefore, a questionnaire
was devised with user involvement as a way of evaluating services and increasing
levels of user involvement in the future. Questionnaires are posted out 8 weeks
following the death of the patient – this was the advisory period given by members of
the focus group.
The annual Bereaved Carers survey from (Jan 2013 – Dec 2013) had a response
rate 66%.
Some of the key findings from this report are:
100% bereaved carers rated standard of nursing care, medical care,
Occupational Therapy, Complimentary Therapies, Hairdressing and
food service/menu choice as either excellent or good

100% bereaved carers rated helpfulness of reception staff as either
excellent or good.
100% bereaved carers felt standard of emotional support was either
excellent or good


100% bereaved carers felt the help with practical issues was either excellent or good

100% bereaved carers rated the standard of room furnishings / comfort
was either excellent or good

98% bereaved carers rated helpfulness of volunteers as either excellent or good.

98% bereaved carers stated the standard of catering either excellent or
good

98% bereaved carers rated the standard of room cleaning was either
excellent or good
20

96% bereaved carers rated the standard of the dietetic support either
excellent or good

95% bereaved carers rated the standard of the physiotherapy support
either excellent or good

92% bereaved carers rated the standard of the social work
support either excellent or good

92% bereaved carers rated the standard of the Chaplaincy / Spiritual
Care either excellent or good.
Those completing the survey were also asked “What was the best thing about Teesside
Hospice” and “Have you any thoughts that might help other patients and families using the
hospice in the future?” Numerous comments were received and a selection are detailed
below.
“Absolute confidence in the knowledge that the pt was in the hands of a fully dedicated and professional team who in spite of numerous setbacks just didn’t stop caring or give up. Drs and nurses were always available to listen, advise and answer
any questions. They would always make time for you.”
“Unconditional support, medically and emotionally. Nothing was too much trouble
for anyone. Staff listened and cared and x was made to feel very special, as were
we all.”
“There was no best thing because across the board all was excellent. Everyone is
made to feel welcome, supported and cared for. I can' t compliment Teesside
Hospice enough.”
“The fact my husband was treated as a person and not just a number, the staff listened to him and treat him with the best care and respect, the whole family and
friends felt welcome.”
“Dad loved all aspects of the ‘extras’ especially the lady who did the hand
massages — he never thought he would!”
“All in all, mum was very well looked after in her final weeks, thanks.”
“I cannot find the words to express how amazing & supportive to my parents, myself & family, hospice was during a period of hideous grief & pain the staff were a
rock of kindness and allowed our parents to keep their dignity & spirits lifted. I
genuinely mean it when I say we could not have got through the last few years
without you“
“The caring way patients get looked after and the family. All staff are lovely and
give you any help needed. It's so peaceful and unobtrusive. X last days were made
easier. Thank you.”
21
“The best thing is the calming atmosphere and the amazing angels the staff. Don't
know how we would have coped without them. My husband felt content and safe at
Teesside Hospice and for that I am eternally grateful thank you so much.”
“Every aspect of the hospice was excellent but the staff are what make it so special. The support that pt received was exceptional and the staff made the situation
easier for all family. “
“A welcome pack sometimes you don’t like to ask about things.”
“Dont be frightened the staff will go out of their way to ease the pain for you and
your loved one. God bless them all.”
“Not to think that it is a sad place. I think I/we have coped much better as a family
knowing that dad had the utmost care right up to the end. His death was peaceful
and we were given as much time with him as we wished – greatly appreciated. The
room had also been set out beautifully when we went back in to see Dad,
thankyou.”
“The mention of the hospice worried us at first but the place was very welcoming.
This needs to be highlighted to future patients that this is not only a place to come
to at the end.”
“The time that pt spent in the hospice meant that we could use her last few wks to
just be together instead of taking care of all her needs. Don’t be afraid to ask for
any needs as Teesside Hospice do all they can to accommodate.”
No negative comments were received however, several people offered helpful
suggestions that have been actioned and will enhance the experience of patients
and carers in the future. These include the development of a ‘Welcome Pack’ to
inform patients of useful information when they are admitted to the Inpatient Unit and
the introduction of a Chaplaincy ‘Calling Card’ to inform patients that a member of
the Chaplaincy team tried to visit and how to request a further appointment.
22
The Board of Trustees Statement
The Board of Trustees is fully committed to the provision of a high quality service at
Teesside Hospice.
The Hospice has a well established clinical and corporate governance structure, with
members of the Board playing an active part in ensuring that Teesside Hospice fulfils
its mission, according to its charitable intentions and in ensuring that the organisation
remains responsible and compliant in all areas of CQC registration, health and safety,
employment law and other relevant legislation.
This Quality Account was approved 10th June 2014
Signed
Professor Brian Footitt OBE, Chairman, Board of Trustees of Teesside Hospice
Care Foundation
Healthwatch Middlesbrough and South Tees Clinical Commissioning Group
were invited to comment on the Quality Account. The following comment was
received.
Healthwatch Middlesbrough response to Teesside Hospice Care Foundation
(THCF) Quality Accounts 2013/14
Healthwatch Middlesbrough can confirm that they have consulted on the Annual
Draft Quality Account 2013/14 of Teesside Hospice Care Foundation (THCF).
The Quality Account was circulated to the Healthwatch Middlesbrough Executive
Board for comments. The chair of Healthwatch Middlesbrough, board members and
staff were all offered the opportunity to comment and feedback.
Overall, Healthwatch Middlesbrough welcomes the opportunity to respond to the
Draft Quality Account and would hope it will continue to reflect the views the residents.
It is clear from the report that you value the opinions of your patients and carers
and we applaud the active way in which you involve them in helping shape future
services and improvements.
Yours Faithfully,
Paul Crawshaw-Chair Healthwatch Middlesbrough
23