Welcome to the In-patient Unit

Welcome to the In-patient Unit A guide for patients, their families and friends

Welcome to St Richard's Hospice Our caring teams provide free specialist, palliative care for patients living with serious, progressive illnesses. We support their families too. Each year, we care for more than 3,100 patients and loved ones in Worcestershire with compassion, commitment and professionalism.

Patients are cared for on our In-patient Unit (IPU), through the Living Well Services, or in their own homes by a specialist team and trained volunteers.

Overview of the In-patient Unit (IPU) The IPU provides 24-hour care tailored to each person’s needs. Patients and their families are cared for by a team of health professionals.

Your room has en-suite facilities and your own private patio area with views to the lake and gardens.

The rooms are designed to be as comfortable and homely as possible. There are televisions available. Virtual visiting is available if relatives and friends are unable to attend in person.

What support is available?

We specialise in holistic, palliative care. This is best described as ‘whole person’ care, aiming to achieve the best quality of life for patients and their families.

We try to respond to all of the needs a patient or family may have – whether that is pain and symptom control issues, physical problems, or problems of a spiritual, emotional, social or psychological nature.

Infection control We take infection prevention and control very seriously. If you have any concerns or questions please speak to our infection control nurses, IPU sisters, or IPU Manager.

Reasons for referral to the In-patient Unit The clinicians recently involved in your care, after discussion with you and your family, have decided you would benefit from a stay on the IPU. Patients are admitted for one or more of the following reasons: to help deal with symptoms that cannot readily be sorted out at home. These may include achieving adequate pain relief as well as other medical issues. to care for patients at the end of life, if that is their choice, and if it is not possible for them to be adequately supported and cared for in other places.

What to expect when you arrive You will be welcomed by one of the nursing team who will show you to your room.

A drink will be offered, if appropriate, and time will be allowed for you to settle in at your own pace.

In-patient Unit facilities will be explained to you.

We have a nurse call system and emergency pull cords in the rooms. These will be demonstrated to you.

Once you have settled in, one of our doctors and a nurse will talk to you and your family about your illness, and your current situation. They will aim to address any problems and anxieties you may be experiencing.

As soon as possible, there will be a discussion about your individual care plan. Please feel free to let us know if you prefer not to have family members involved in this, or any other, discussion. Equally, you have the right to choose not to take part in these discussions yourself.

We always understand and respect these sensitive decisions, but it is important family members and other carers understand their views and wishes will not override those of the patient.

Helpful items to have with you Personal toiletries, such as soap, shampoo and a flannel Toothbrush, toothpaste or denture cleaner Hairbrush or comb Nightdresses or pyjamas, slippers and a dressing gown Comfortable day clothes if you are likely to wish to dress during the day A supply of any medication that you take regularly, together with any relevant documentation. Please hand these items to one of the nurses when you are admitted to the unit.

You can bring your own electrical equipment, providing it is in good working order.

The item will need to be tested by the hospice to check it is safe before being used.

Please discuss with a member of the nursing team.

Useful information Meals during your stay The hospice provides freshly cooked and nutritious meals every day to everyone who is in our care. We try to offer plenty of variety to tempt different appetites. The doctors and nurses will discuss with you any dietary needs or preferences you may have.

Smoking Visitors are requested not to smoke inside the hospice. Patients will be assisted to their individual patio area to smoke with appropriate fire-retardant blankets in use.

St Richard's is a no-smoking environment.

Pets It may be possible to have pets brought in to see patients if they wish. Please discuss this with the IPU team in advance.

WiFi Free WiFi is available for you to use. Staff will arrange this for you on admission. Please speak to a staff member if you have trouble connecting.

The care we provide on the IPU The IPU provides specialist, palliative care that seeks to promote and maintain the best possible quality of life for you. The care takes into account the needs and wishes of you and your family.

During your stay, you will be cared for by a team which includes doctors, nurses, social workers, chaplains, occupational therapists, physiotherapists, Citizens Advice workers and others according to your needs and wishes.

We will always be open and honest with you and your family about the planning and delivery of your care. While we understand and respect the fact that some patients prefer not to ask questions, we are always happy to answer any queries you have.

If individual members of staff are unable to answer particular questions themselves, please be patient while they refer the question elsewhere to ensure the answer you get is correct and up-to-date.

We understand the pressures on patients and their families, but ask all our guests to remember that our staff are often under pressure themselves and are also entitled to be treated with courtesy, respect and patience.

Further support during your stay The Family Support Team Our staff offer a comprehensive and specialist service to patients and families including social work, support for children, group work, counselling and Citizens Advice. Please speak with a member of staff if you would like to access any of these services.

Spiritual care and chaplaincy The Spiritual Care Team looks forward to getting to know people of all faiths and philosophies. They want to make sure, with the rest of the staff, that your beliefs are understood and are built into your care at every level.

A member of the Spiritual Care Team is available to you at any time. We have a range of items to support your spiritual care. If there is something in particular that you need, please let the chaplains know.

Complementary Therapies Our therapists work closely with the medical and nursing teams and offer a number of treatments including massage, relaxation, aromatherapy, and creative therapy, such as artwork, as appropriate.

Occupational Therapy Occupational Therapists can work with you, enabling you to participate in activities which are important to you. This can include practical advice to manage symptoms, such as fatigue, and the provision of equipment for either increasing independence or to support energy conservation.

Physiotherapy Physiotherapists can work with you to achieve your goals. These may be related to mobility, maintaining function, or maintaining strength and balance. Physiotherapists can also work with you to develop strategies to help you manage complex symptoms such as breathlessness and fatigue.

Visiting the IPU Visiting hours and visitor numbers Patients can be visited each day between 12pm and 8pm.

When a person is approaching the very end of their life, we will talk with their family and loved ones about how we can support more relaxed visiting times.

We adapt the numbers of visitors to suit the wishes of each patient. And, the arrival time and duration of a visit is dependent on the patient's wishes too.

Visiting arrangements for patients transferred from the Worcestershire Royal Hospital will be discussed with the IPU Team and will be honoured at the hospice.

How to get to the IPU Visitors should come into the IPU via the main hospice Reception, which is accessed from Wildwood Drive, Worcester WR5 2QT. Please see a map on the back page of this booklet. Visitors can park in the hospice's main car park for free.

Visitors will be met in Reception and taken to their loved one's room. Please do not visit unless you have arranged a time in advance after discussions with the IPU team.

Please do not hesitate to contact the IPU on 01905 958163 with any questions.

Refreshments during your visit It is important that visitors bring the refreshments they may need during their visit.

Free tea and coffee making facilities are available on the In-patient Unit for visitors.

Visitors can buy a variety of delicious food, sweet treats, and hot and cold drinks, from the café in The Green, a beautiful social space at the heart of the hospice.

The Green is open for hot drinks from 8am, with cakes and snacks available from 10am. Hot dishes are available between 12pm and 2pm.

Sandwiches, baguettes, toasties and jacket potatoes are available from 12pm to 3.30pm. The café closes at 4pm.

Visiting and infection prevention and control Please do not visit if you have symptoms of, or have tested positive for, Covid-19.

We also ask you not to visit if you have symptoms of any other transmissible illness, such as the flu or norovirus.

On arrival at the hospice, visitors will be asked to wash their hands and use hand sanitiser.

Before you leave the patient’s room, please cleanse your hands with the alcohol gel available.

Should Covid-19 infection levels or national guidance change, visiting arrangements may be altered.

Updates to the guidance here can be found online at: www.strichards.org.uk/ourcare/planning-a-visit-to-the-ipu

Staying in touch To help families stay in touch, we encourage virtual visiting using video calls and apps. This will be discussed with patients and families on admission, and we can help provide access to equipment.

An email address is available for you to send personal messages and photographs to your loved one at St Richard’s Hospice. Please email: PatientMessages@strichards.org.uk Messages will be printed out and given to your loved one. If your loved one would like to send a reply, our IPU Team will help ensure their message is sent on to you.

Your details We ask you for information about yourself so we can give you appropriate care and treatment.

St Richard’s uses a computerised electronic medical notes system, similar to those used in GP surgeries, to record the care of all our patients.

The notes can only be accessed by specialist palliative care professionals working in Worcestershire if they need to advice on your care.

In addition, in partnership with Herefordshire and Worcestershire Shared Care Record, our health and care professionals will be able to securely view the most upto-date information about health and care services you are receiving from some other providers in the locality so we can give you better, safer care.

You can find out more about this here: www.strichards.org.uk/privacypolicy/patients-and-individuals-supported-by-st-richards These professionals can access hospice patients’ notes only through an authorised ‘Smart’ card with a security chip and PIN. Please ask staff if you have questions about our electronic medical notes system.

Please also ask to see a copy of our detailed leaflet explaining our duty of confidentiality and use of electronic records if you have further questions.

Confidentiality Our aim is that any records we have about you are accurate, secure and held in strictest confidence. We only give information to your relatives, friends and carers if you have given us permission to do so.

Access to medical records St Richard’s Hospice works within the national guidance of access to health records.

Under the Data Protection Act 1998 you have the right to ask to see information written in your health records. If you would like to see your records please talk to your doctor or health professional who will help you.

Your healthcare – decisions to make Advance Care Plan The hospice team will offer opportunities for you to discuss your preferences for future care. As each person is different there will be a unique combination of things that are important to you.

It is often helpful for your health professionals and family members to understand your preferences and concerns, so that we can support you according to your wishes.

Some people chose to record their wishes in an ‘Advance Statement’ which can be used to guide those involved in their future care.

Health services in Worcestershire have developed an ‘Advance Care Plan’ booklet which can help you develop an Advance Statement that tells us about your concerns, preferences, beliefs and values.

It can be helpful to look through this booklet with the support of a loved one or a member of our staff. Please ask us if you would like see a copy.

Advance decision to refuse treatment You may want to think about any treatment you would prefer to refuse in the future. If so, you could consider making an ‘advance decision to refuse treatment'.

We have a detailed leaflet available if you would like more information, and the medical team will be available to discuss this with you.

About resuscitation Cardiopulmonary (heart and lung) resuscitation (CPR) is the medical term used for attempts to restart your breathing or your heart. It is rare for the heart or breathing to stop unexpectedly, but the clinical team will ensure that a plan is in place to support you should the unexpected occur.

Research has shown CPR is rarely successful in restarting the heart and lungs in patients with advanced illness. If CPR is started at St Richard’s then transfer to hospital would be required in order to carry out continued advanced life support.

At St Richard’s we do not routinely carry out CPR, and focus instead on providing the best comfort, dignity and support when a person’s life comes to its natural end. All decisions are made on an individual basis, weighing up the relative benefits and burdens of CPR for each person.

National guidelines recommend we discuss decisions about CPR with you during your admission, unless these discussions might be harmful to you. You are under no obligation to discuss resuscitation if you do not wish to do so. If you prefer, the in-patient team will make the decision on your behalf, after weighing up the possible benefits and burdens of CPR in your situation. If you have any questions please talk to a member of your medical or nursing team.

The discussions and decisions that you make in relation to Advance Care Planning and CPR will be recorded on a ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) plan. This represents a summary of the discussions you have had, the choices you have made and what you and your clinicians recommend or want for your care in the future. The ReSPECT plan belongs to you. While you are in the IPU we will store it for you but it will be given back to you if you are discharged home or to another care provider.

Organ and tissue donation Some people wish to donate their organs and tissue after their death. If this is something you are interested in doing, please speak to a member of your medical team.

We welcome your thoughts We pride ourselves on the standards of care we seek to provide to patients and their families. We welcome comments or suggestions on how we could improve your experience and care during your stay even further. Please do not hesitate to speak to the nurse in charge about your thoughts. They will respond to your comments, including about any actions which may need to take place.

You are welcome to speak to the Care Director. If you prefer to put comments or concerns in writing, contact The Care Director, St Richard’s Hospice, Wildwood Drive, Worcester WR5 2QT

Getting your finances in order St Richard’s staff and volunteers are not permitted to witness the signing of legal documents. However, we can supply a list of local solicitors who can come to the hospice.

How to support St Richard’s Hospice Our services are offered completely free of charge to our patients and their families, however we do appreciate donations which go towards the cost of providing our care.

People are often surprised to discover that St Richard’s is a charity and that we rely on voluntary donations to fund the majority of our care, with the remainder funded by the NHS. There are many ways you, your family, and friends could support us. These include making a one-off or regular donation, leaving a gift in your Will, donating to our shops, becoming a volunteer, taking part in events, and much more.

If you would like to know more please ask to speak to a member of the Fundraising Team. You can also ask a member of staff for a leaflet, or visit our website www.strichards.org.uk

Do you have private health insurance?

If you have private medical insurance, St Richard’s may be able to recover some of the costs of your care. Private medical insurance providers may be able to help with: A donation per night if an individual is admitted to the hospice A donation per day if a patient is supported at home by a hospice nurse Please ask a member of staff for a detailed leaflet.

How is St Richard's regulated?

St Richard’s Hospice is regulated by the Care Quality Commission which assesses and reports on the quality and safety of services provided by the independent healthcare sector. We are inspected each year.

You can obtain a copy of the report on the Commission’s website www.cqc.org.uk

Frequently asked questions How long can I stay as an In-patient?

Many people find a relatively short period of in-patient care makes a real difference to how they feel, and enables them to return home feeling more comfortable.

There is a high demand for beds at St Richard’s. This means we cannot be a permanent alternative to care either in your own home, your care home, or nursing home.

If your symptoms are well managed, but it would be difficult for you to go back to your own home, then we will always help you, your family and friends to find other places where you can continue your care.

Will St Richard’s still provide support when I go home?

Yes. St Richard’s provides specialist nursing care in people’s own homes so we can continue to support you and your family and friends when you return home.

St Richard’s Nurse Specialists and the Hospice at Home Team offer care and support, as well as a 24 hour telephone advice line. They also work closely with GPs, district nurses and social services carers. If you would like to know more about these services, please talk to a member of the nursing team.

Aren’t hospices just for people who have a few weeks to live?

No. St Richard’s provides care to people whose illnesses are no longer curable and who have symptoms that need our specialist support. While some people using our services may only have a few weeks to live, others may have many months or even years to live.

What if I need to go to hospital while I am a St Richard’s in-patient?

If you need to go to a hospital appointment we can arrange transport, or you can make your own arrangements.

Can I give a gift to staff who have been looking after me?

We know many patients and families like to show their appreciation for staff through giving presents. However, staff are not able to accept individual gifts.

If you would like to make a donation to support the care of future patients you can find details in this guide.

How to find us The main St Richard’s Hospice reception and car park can be found at the following address: Wildwood Drive, Worcester WR5 2QT. You can contact our main Reception on 01905 763963, or call the In-patient Unit directly on 01905 958163.

More details on getting to St Richard's can be found online: www.strichards.org.uk/contact/how-to-find-us

We take the safety of our staff and volunteers very seriously and ask that you treat all those involved with your care with respect.

www.strichards.org.uk St Richard's Hospice, Wildwood Drive, Worcester, WR5 2QT 01905 763963 www.strichards.org.uk Registered Charity Number: 515668 Company Number: 01850502

October 2023