Martin House

Martin House (in patient unit) provides specialist palliative care, respite and end of life care to children and younger adults. The service also supports people in the community. At the time of our inspection visit there were 10 children and younger adults who used the (in patient service).In total 366 people were receiving a service from Martin House .

The hospice had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We looked at the way medicines were managed within the hospice. We found people were not always protected against the risks associated with medicines, because appropriate arrangements to manage medicines were not always in place. This was a breach of Regulation 12 (Safe care and treatment) of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Staff understood children and younger adults’ individual needs and the support they and their family members required. Staff were very passionate about their roles and placed people at the heart of their work. We saw that care was provided with the upmost kindness, respect and compassion. Children and younger adults who used the service and relatives spoke highly about the care and service received. The families of the children and younger adults said their right to privacy was fully protected. Families of the children and younger adults told us the service they received was excellent. The hospice provided very good family support, counselling and a bereavement support within and outside the hospice. The hospice had its own chapel inside the quiet grounds of Martin House.

Care was provided to an extremely high standard with an environment for everyone at Martin House that met individual needs both emotionally and spiritually.

Families spoke of the high regard which they had for the hospice and what a significant difference this had made to all the family. Families told us of the support they received from the service in and out of the community. They received extensive services, such as short breaks, music and play therapy and counselling for all the family.

Children and younger adults told us of the excellent food which was available for both people and their families. All the food was made fresh by a small team in the kitchen. The chef told us that they did not do a specific menu; this was dependant on who they had in on the day. The chef tailored this round the knowledge of the children and young adults in the Hospice. Nutritional assessments were undertaken to identify risks associated with poor nutrition and hydration.

Risks to children and younger adults’ safety were appropriately assessed, managed and reviewed. Care records contained risk assessments specific to the needs of the children and younger adults. Their individual views and preferences had been taken into account when their care or treatment plan had been developed

There were systems and processes in place to protect children and younger adults from the risk of harm. Staff told us about different types of abuse and the action they would take if abuse was suspected. Staff were able to describe how they ensured the welfare of vulnerable children and younger adults was protected through the organisation’s whistle blowing and safeguarding procedures.

Checks of the building and equipment were completed to make sure it was safe. The service had a comprehensive maintenance file which included any outstanding actions and completion dates throughout.

The registered provider had effective systems in place for responding to concerns and complaints. Children, younger adults and families were asked for their views about the service they received. The registered manager told us they used this as a continuous learning process to ensure everyone received a high quality level of care.

The service had extensive support from other healthcare professionals such as GP, nurses, psychiatrists and tissue viability nurses who supported staff and people with their individual care needs. This meant everyone’s needs where addressed.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We saw that staff giving personal care were considerate of the person's wishes and asked politely before giving care. People we spoke with told us they were happy with the care they received and they were looked after well. People spoke very highly of the care and support received.

One relative we spoke with told us, "It's a good service, it's difficult, it's a children's hospice, but she loves coming here, the service is excellent.'

One person said they had been treated very well and that staff were kind and respectful. Another person said they had been looked after well and staff were very professional, didn't think they could do any better.

The provider had taken steps to provide care in an environment that was suitably designed and adequately maintained.

Appropriate checks were undertaken before staff and volunteers began work. There were effective recruitment and selection processes in place.

People's personal records including medical records were accurate and fit for purpose. Peoples care records were seen to be stored securely in order to maintain privacy and confidentiality.

One person told us, 'They were very friendly and supportive, and I think it is good that there is always enough staff to spend one to one with the children.' Another person said, 'I think they do a great job and it's really good, always someone to talk to and give you support.'

People who used the service told us that there were always plenty of staff on duty and they felt able to approach staff when they wanted to. People who we spoke with told us that they felt that staff listened to them. They told us that they felt involved in decisions regarding their care and they were able to contribute to care planning meetings.

People we spoke with said they understood the care and support plans and that staff had explained things well to them. One relative said, 'It's a good place, really good, lots of support and they ring you to make sure everything is all right and there is always someone to talk to.'

Relatives said that they felt their child was safe at the hospice and that they were well care for. One member of staff said it, 'Was a cracking place, and a much needed in society, and that it was a credit to the public who funds were raised to help the children.'