What Healthcare Inspectorate Wales found when they came to visit
Having HIW in the building for two days is a particular kind of experience. Two senior inspectors, two clinical peer reviewers, and a patient experience reviewer.
They read care plans. They watch everyone go about their work. They sit with patients having lunch in the dining room, and they send surveys afterwards to all our team and the people we care for.
Inspections are not, on the whole, the most relaxing two days of the year. The whole thing is designed to answer one question:
Are we who we say we are?
Their report came out in April 2026, and whilst HIW definitely don’t deal in superlatives, the tone of their report is unusually warm. They found no immediate concerns and described the care here as ‘kind, dignified and person-centred’.
The full report is on HIW’s website. This quick version is worth a few minutes of your time.
What our patients told them
Speaking with the inspectors, one of our patients described the hospice like this:
“Skanda Vale Hospice has given me time to think, to organise my thoughts, and experience companionship in a way I never thought existed.”
Another said it had been a lifeline — a safe place to come, where their medical, physical and emotional needs were understood without having to explain themselves. A third described being here as “like being surrounded by a big warm hug.”
What our team said
Fifty-five team members also responded to HIW’s survey. Every one said patient dignity was always maintained. Every one said they would be happy for their own family to receive the care we offer. Every one recommended the hospice as a good place to work or volunteer.
Most of the people who care for patients here are volunteers, alongside a small paid team in roles where day-to-day continuity matters most. Our lead nurse, Kiera Jones, was named RCN Wales Nurse of the Year in 2024.
The model is unusual, and it depends on the goodwill of a remarkable group of people. To have fifty-five of them — knowing it from the inside, answering anonymously to a regulator — recommend this place as somewhere to work, or volunteer, is the kind of feedback that’s hard to come by and harder to dismiss.
Cate Langley, one of our volunteer nurses, on what the work has given her — and why the idea most people have of a hospice doesn’t quite match the reality.
Reading the report in context
HIW’s most recent annual report describes Welsh healthcare more broadly as a system under sustained pressure, with concerns raised with the regulator rising 21% year on year.
Across Wales, the picture is a difficult one. Marie Curie Cymru’s recent report found that almost one in three adults in Wales now have unmet palliative care needs — more than 10,000 people whose symptoms are not being addressed, and whose families are not getting the support they need. The need is projected to keep rising.
The kind of care described in this HIW report — slow, attentive, person-centred — is becoming harder to find in the wider system, precisely as the need for it grows. Skanda Vale Hospice was founded to provide it without compromise, and that founding intention is more relevant now, not less.
Br. Jakob, our Hospice Manager, put it like this:
“What you read in this report is not really about us. It’s about the patients and families who walk through our doors, and the team who treat every one of them as if they were family. To have that recognised so warmly, at a time when the wider healthcare system is having such a difficult conversation about pressure and safety, is a huge encouragement.”
Recommendations
The report includes seven recommendations — refinements rather than failings. They are:
- Consistently recording follow-up actions for patients identified at risk of falls or pressure damage
- Formally adopting a nationally recognised sepsis assessment tool (something we’d already identified, and which has now been rolled out)
- Continuing to develop our audit processes and close the loop on findings
- Indicating rounding frequency clearly on each patient’s record
- Consolidating onto a single patient records system
- Introducing an annual self-declaration process for DBS and professional registration changes
- Implementing a staff immunisation policy, including Hepatitis B
Each has a named lead and a delivery date. Some have already been completed; the rest will follow in the next few weeks.
HIW are a regulator, but at their best they’re also a fresh pair of eyes — looking carefully, asking useful questions, taking the work seriously enough to engage with it on its own terms. We’re grateful to them, and to everyone here whose work made the report possible.
growing, carefully
What this report tells us, more than anything, is that there is room here for more of the people of West Wales than we are currently caring for. The need is growing, and we are planning to grow with it — carefully, and on our own terms.
To do that, we need more volunteers. Particularly retired nurses and carers who would like to be part of a clinical team again, and people in our local community who could spare a few hours a week in our Newcastle Emlyn Charity Shop.
If that might be you, we would genuinely love to hear from you.
