North Devon Hospice Quality Account 2020-2021

Quality Account 2020

being there for all the family

northdevonhospice.org.uk

Dear Colleagues,

Jo Dedes Director of Care

During the last year we have all weathered the same storm, albeit in different boats. From one clinician to another, I would like to take this opportunity to thank you for everything you have done and continue to do for the community we live and work in.

In my last Quality Account I said I hoped to write to you this year, telling you about how we’re using technology, extending our reach and improving access to services. I’m pleased to say we have done just that. One of our responses to the pandemic has been to make sure patients and their families had virtual access to care and support. That has meant people have been accessing counselling support through Zoom and WhatsApp, among others. We also became the first hospice in the UK to create a patients Facebook group. This continues to offer a private portal where resources, advice and tools can be shared in the comfort of a supportive environment. Our Supportive Care team invested heavily to create an area on our website called ‘One day at a time.’ Everyone can access a plethora of resources and tools from mindfulness sessions to art therapy; all of which can help to sustain people during a trying time.

Although the last year has brought challenges for all clinicians and carers, we remain committed to our patients and their families. We have identified a number of positive outcomes from the pandemic, such as virtual support and we are committed to continue offering all of these to families going forward.

We work best when we work together.Your continued support, the referrals you make and the collaborative approach we take to support the care for our patients is what makes their journeys the best they can be.

Thank you for your work and involvement with the hospice.

Best wishes, Jo Dedes, Director of Care

Where can we provide support for your patients?

Our care and support is available to anyone in North Devon facing a terminal illness such as cancer, motor neurone disease, heart and kidney failure and COPD. All our care is able to be provided to patients and their families, thanks to the generous local community who allow us to keep our services running, free of charge.

We can offer support in a number of ways: - Clinical at home support for patients via our team of Clinical Nurse Specialists - End of life care at home through our Hospice to Home team - End of life care and/or symptom management on our 7 Bedded Inpatient Unit - One to one bereavement and emotional counselling for family members - Group counselling and support for those caring for patients or who have lost someone - Complementary Therapies to help relieve pain and stress - A range of adaptable activities aimed at improving wellbeing, independence and quality of life for families - Clinical support for palliative patients based at North Devon District Hospital through our Clinical Nurse Specialists based there We understand that as healthcare professionals you are currently extremely busy, our aim is to support you with your patients in the most efficient way possible.

If you feel your patients would benefit from any of our services, please make a referral to us as early as possible using: SystmOne – directly referring via the patients electronic record Email – email our referral form to ndh.referrals@nhs.net

3

The Difference We Make Together “I thought losing my sister was the worst it could be but I was wrong.The death of my wonderful father has left an enormous void in our whole family.

The loss and grief I feel now are overwhelming, but I know it will ease.

Committing him to your exemplary care was an enormous relief to us all, including him. He had no fear of dying, only of saying goodbye to his beloved family. With your help, we were able to do that.”

Family Member

“I have been receiving bereavement counselling from a member of your team, for some time, having lost my mother and sister last year. I reallly want to thank my counsellor for the really excellent support I received.

My counsellor is so highly skilled and absolutely appropriate and spot on in her interventions within what feels like a completely safe and trusting space.Thank you so much.”

Family Member

4

“Our mother died peacefully at home...in particular we would like to give heartfelt thanks to the Hospice to Home team who looked after mum so practically, gently and kindly in her dying days.

It was her wish to die at home and she couldn’t have done that without you” Family member

“Your professionalism, sympathy and empathy towards her were second to none. Even though her illness was progressing quickly, with your support she was able to fight right till the very end but was so happy to have had the opportunity to come home and be with us which was only possible thanks to you” Family Member

Referrals:

You can make a huge difference to your patients and their families Referring your patients and their family members to us early ensures that they are able to access a whole range of care and support services, at any point throughout their journey from their very initial diagnosis. A referral to North Devon Hospice can also help to negate the volume of support relatedPage visits12to GPs. We respond all clinical referrals How totorefer to our services– usewithin website24 texthours (Monday - Friday) and supportive care ‘table’ that Leo/Naomi updated last yearreferrals within 5 working days. Please call us on 01271 344248 to discuss your needs.

Clinical Nurse Specialist Service We provide a specialist community nursing service for adult patients requiring palliative care; who have a progressive illness or are on the Gold Standards Framework Register and would benefit from symptom management, psychological assistance and holistic care with emotional or spiritual needs. The multi-disciplinary team work closely with other healthcare providers to ensure the patient is supported on an individual basis. Each patient has their own named contact within the team.

Agreement for CNS intervention must be received from the patients’ GP on all occasions. Contact our team on 01271 344248.

10

5

The Bedded Unit We provide a specialist in patient service for patients with complex problems associated with advanced progressive illnesses. This is available to patients who have complex end of life care needs and require palliative treatment for pain management or other distressing symptoms 24 hours a day.

All requests for referral to our bedded unit must be with the explicit agreement of the GP and/or relevant hospital consultant.

In urgent and out of hours cases, call the Duty Medical Officer on 01271 347214, alternatively contact the main hospice number on 01271 344248.

Hospice to Home Service

Page 13

We provide care and support for patients at or near end of a short-term intervention, to help Howlife,toasrefer to our services (contd) (asprevent above)a crisis from escalating or to avoid an acute admission. The Hospice to Home service is available to patients who are identified as being in the last 3 months of life. We work closely with Devon Cares to arrange packages of care if required.

Referrals can be made between 8.30am – 5pm, Monday to Friday by calling 01271 347246/7, or out of hours by calling 01392 822342. Referrals are accepted from all healthcare professionals.

Supportive Care Services We provide a range of supportive care services as well as pre and post bereavement to patients, carers and family members, including children. These services are available to all patients within the care of the hospice along with any adults and children who are affected by the patient’s diagnosis or have been bereaved as a result of the patient’s death.

Referrals can be made by GPs, consultants, social services, other hospices and other agencies. Please contact us on 01271 344248 to discuss how we could help your patients and their families.

6

13

Our Achievements Clinical Nurse Specialists Last year...

1,771 15,152 10,577

visits to patients’ homes providing vital support miles covered across North Devon to offer care to patients telephone and video calls made to patients and carers to provide support

Bedded Unit Last year...

90 21 252 5

patients cared for on our Bedded Unit patients supported to go home after a stay with us Advice Line Calls answered and support provided star average rating from ‘I Want Great Care’ based on nearly 700 reviews

7

Hospice to Home Last year...

324 2,923 215 62,042

patients supported within their own homes visits to patient homes telephone calls to patients and carers to provide vital support miles travelled to care for people in their own home

Supportive Care Last year...

537

840

43 2,974

8

referrals made to our Supportive Care team people cared for by our Supportive Care team people supported in day care groups telephone and video calls made to patients and family members offering emotional support

Education During the last year, the following education sessions were provided for our staff: - Clinical Stat Training - Volunteer Manual Handling & Boundary Training - Human Rights in End of Life Care - Practical Approaches to Symptom Relief in Palliative Care: A Non-Pharmacological Approach - Priorities of Care for the Dying Person - Pharmacological Approaches to Symptom Relief in Palliative Care - Emotional Impact of Life-Limiting Illness - Working with the Mental Capacity Act/ LPS - Oxygen Training - Syringe Driver Training - Verification of Expected Death Training (for bedded unit staff) - Holistic Care of the Dying Person - Enhanced Communication - Human Rights in End of Life Care - Opening the Spiritual Gate - Palliative Care and Symptom Management for People with End Stage Dementia - Spiritual Care at End of Life

Overview of Clinical Audits 2020/21 We monitor our efficiency and effectiveness through quality control audits and strive to maintain a standard of quality through clinical audits: -

IPU Eating & Drinking documentation audit Hand Hygiene Audits (Monthly) Medicine Management Audit (Annual) Controlled Drugs Audits (Quarterly) Quarterly Quality Assurance Report (Quarterly)

9

Statement of Quality Assurances In compliance with statutory regulations, North Devon Hospice’s Board of Trustees can confirm: 1.1 During 2020-21 North Devon Hospice provided or sub-contracted no NHS services directly. A grant was received from the Devon Clinical Commissioning Group to provide palliative and end of life care.

1.2 During 2020-21, no National Clinical Audits and no National Confidential Enquiries covered NHS services that North Devon Hospice provides.

1.3 The reports of 22 clinical audits were reviewed by North Devon Hospice in 2020-21 and North Devon Hospice will take action to continue improving the quality of healthcare provided.

1.4 The number of patients receiving NHS services provided or sub-contracted by North Devon Hospice in 2020-21 that were recruited during that period to participate in research approved by a research ethics committee was zero.

1.5 North Devon Hospice’s income in 2020-21 was not conditional on achieving quality improvement and innovation goals through the Care Quality Commission.

1.6 North Devon Hospice is required to register with the Care Quality Com mission and its current registration status is active.

We are active in the following areas: - Treatment of disease, disorder and injury - Personal care 1.7 The Care Quality Commission has not taken enforcement action against North Devon Hospice during the reporting period of 2020-21.

1.8 North Devon Hospice has not participated in any special reviews or investigations by the Care Quality Commission during the reporting period.

1.9 North Devon Hospice did not submit recordings during 2020-21 to the Secondary Users Service for inclusion in the Hospital Episode Statistics which are included in the latest publication data.

1.10 North Devon Hospice was not subject to the Payment by Results Clinical Coding Audit during 2020-21 by the Adult Commission.

10

Where we offer our services We have been providing care for 37 years with the majority being provided within people’s own homes. In addition to the care and support we offer throughout the community, we have teams based at two locations in North Devon.

Our main site is based on the outskirts of Barnstaple. Our patients and families can access a wide range of care and support services, including our 7 Bedded Inpatient Unit.

Deer Park, Barnstaple

North Devon Hospice, Deer Park, Barnstaple, North Devon EX32 0HU 01271 344248 The Long House is a purpose built outreach centre adjacent to Holsworthy Medical Centre. Patients and their families can access a range of supportive care services including group support, complementary therapies and one to one support.

The Long House, Holsworthy

North Devon Hospice, The Long House, Dobles Lane, Holsworthy, North Devon EX22 6GH 01271 344248

11 16

Thank you On behalf of every patient and family member we have been able to care for over the last year, we thank you for your continued support of North Devon Hospice.

We rely on support from our local community to continue providing the level of care we currently offer for patients and their families. We need to raise over £4.7m each year to be able to provide our care and support year on year. We can only do this thanks to regular donations, event participation, community fundraising, donations to our charity shops and gifts left to us in wills.

If you have any comments or questions about the information provided within this publication, or on our services, we would love to hear from you. Please contact Jo Dedes by post, email or telephone: Jo Dedes Director of Care, Registered Manager & Accountable Officer for Controlled Drugs jodedes@northdevonhospice.org.uk 01271 347203 We are currently rated as ‘Good’ overall by the CQC with an ‘Outstanding’ rating for our patient care

North Devon Hospice, Deer Park, Barnstaple, Devon EX32 0HU email: info@northdevonhospice.org.uk www.northdevonhospice.org.uk / 01271 344248 Registered charity number 286554.