Butterwick Hospice

Following this inspection. we served the provider a Warning Notice under Section 29 of the Health and Social Care Act 2008. The warning notice told the provider they were in breach of Regulation 17 and gave the provider a timescale to make improvements to achieve compliance. The principles we use when rating providers requires CQC to reflect enforcement action in our ratings. The warning notice identified concerns in the safe and well-led domain. This means that the warning notice we served has limited the rating for safe and well-led to inadequate.

Our rating of this location went down. We rated it as inadequate because:

• The service did not have effective systems to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users. • There was no clearly defined purpose of the Hospice at Home service provided at Bishop Auckland and staff were not suitably trained to deliver care in line with the purpose. • Staff did not have appropriate policies and guidance to support them to deliver care in line with the service’s purpose. There was no appropriate oversight of the service provided at Bishop Auckland to ensure staff were delivering care in line with the service’s purpose. • The service did not have an admissions policy, operational policy, service specification, standard operating procedure or similar document which would identify the remit of the service and identify whether the service was able to meet service users’ needs. • The service did not have a policy or procedure for staff to follow in situations where service users’ risks had changed, or where a service user had deteriorated or become seriously unwell. • Not all staff had completed training in the Mental Capacity Act and Deprivation of Liberty Safeguards; Loss and Bereavement; Palliative Care; Incident Reporting; or Lone working. • Governance systems did not identify or monitor the quality of care provided and there was lack of oversight from senior leaders. However:

• Staff demonstrated caring, compassionate interactions with patients and their families. • The service had an open culture and staff felt confident to be able to raise and escalate concerns. • Service users we spoke with spoke highly of staff and the care that they received. • People could access the service when they needed it and did not have to wait too long for treatment. • Patients and families using the service were very happy with the care they had received.

2 Butterwick Hospice Inspection report

Summary of findings

Our judgements about each of the main services

Service Rating Summary of each main service Hospice Inadequate ––– Butterwick Hospice is operated by Butterwick Limited. services for The hospice is purpose built; is fully accessible and has adults appropriate facilities for day care, therapies and family support. The hospice provides adult hospice services that includes palliative and neurological day care, family support services for adults, children and young people and a home care service for palliative and end of life patients. The hospice does not have inpatient beds. We inspected the service using our comprehensive inspection methodology. We carried out an unannounced inspection on 1 and 2 February 2022. During the inspection we visited the hospice’s day care service at Bishop Auckland and one patient who was receiving care at their home. Following this inspection. we served the provider a Warning Notice under Section 29 of the Health and Social Care Act 2008. The warning notice told the provider they were in breach of Regulation 17 and gave the provider a timescale to make improvements to achieve compliance. The principles we use when rating providers requires CQC to reflect enforcement action in our ratings. The warning notice identified concerns in the safe and well-led domain. This means that the warning notice we served has limited the rating for safe and well-led to inadequate. Our rating of this location went down. We rated it as inadequate because: • The service did not have effective systems to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users. • There was no clearly defined purpose of the Hospice at Home service provided at Bishop Auckland and staff were not suitably trained to deliver care in line with the purpose. • Staff did not have appropriate policies and guidance to support them to deliver care in line with the service’s purpose. There was no appropriate oversight of the service provided at Bishop Auckland to ensure staff were delivering care in line with the service’s purpose.

3 Butterwick Hospice Inspection report

Summary of findings •