8 March 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection was unannounced and took place on 8 and 9 December 2015.
The inspection team was made up of an inspector and a specialist advisor. The specialist advisor had experience of children’s and young people’s palliative and hospice care.
We spoke with and met with four children in Naomi House and eight young people in Jacksplace, some of whom were attending day care. We spoke with five parents of children and a young person during the inspection and with three bereaved parents by telephone following the inspection. We spoke with the registered manager and 26 staff. This included the head of governance, head of Jacksplace and adults services, head of community services, family support team members, medical and nursing staff, care workers and play and activity workers. In addition we spoke with one of the trustees of the board.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of children and young people who could not talk with us. We observed how the staff interacted with the children, young people and their families. We looked at how children and young people were supported during their stay. We reviewed a range of care records for eight children and young people. We also reviewed records about how the hospices were managed. This included, staffing records, audits, meeting minutes, training records and governance records.
Following the inspection we spoke with five professionals who work with the hospices. They included community children’s nurses, a paediatric respiratory specialist nurse, a consultant paediatrician and a nutrition specialist nurse.
8 March 2016
This inspection was unannounced on 8 and 9 December 2015
Wessex Children’s Hospice Trust runs two hospices, Naomi House and Jacksplace. Naomi House is for children up to the age of 16 or 18 years old and Jacksplace is for young people and adults from the ages of 16 years to 35 years.
The hospices support babies, children, teenagers and young adults with life limiting or life threatening conditions and provide accommodation for respite (short breaks), emergency care, day care and end of life care. Both hospices have bereavement suites and provide family support services.
We last inspected Naomi House and Jacksplace in January 2014 and they met the regulations.
There is a registered manager who has been in post since 2011. 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.
Most of the children and young people we met had complex needs and were not able to tell us their experiences because of their complex ways of communicating. We observed how the staff interacted with the children, young people and their families.
Parents told us their children were safe at the hospices. Children and young people sought reassurance from staff and were relaxed with them. This indicated they felt comfortable and safe with staff. Staff knew how to recognise any signs of abuse and how they could report any allegations.
We saw children and young people received care and support in a personalised way. Children and young people had access to the specialist healthcare support from the medical and nursing teams at the hospices. Their complex medical needs were well managed and staff were trained to meet these specialist complex needs. Risks were assessed and managed and there was focus on positive risk taking so children and young people could safely try new experiences. All parents and professionals were happy with the care provided by Naomi House and Jacksplace. Staff knew children and young people well and understood their complex needs.
Staff were very caring and showed children, young people and their families kindness and compassion. Staff were very motivated and demonstrated a commitment to providing the best quality care in a compassionate way. Parents told us they and their children were cared for to a high standard and this included ongoing bereavement support for families. They spoke of excellent relationships with staff who understood their needs and preferences and who devoted time to them. Siblings and other family members such as grandparents were also cared for. Staff treated children, young people and their families with respect and dignity. Children and young people’s privacy was maintained at all times during the inspection. Sensitive planning for end of live care and post death care and support was provided to children, young people and their families. Bereaved families told us that the ongoing support and care provided had been invaluable.
There was a holistic approach to children’s and young people’s care with the physical, well-being, social and spiritual needs of each child and young person given equal importance, together with the needs of those closest to them.
Children and young people and their families received a very responsive service. Their needs were fully assessed, planned for and met. The service was creative and responsive to the changing needs of children and young people and had developed services in response to the local communities changing needs. Children, young people and families were involved in developing the service and this was based in their needs.
Children, young people and staff had fun together and there were lots of play and activities that were based on their preferences and needs. Children’s individual sensory needs were met by the specialist equipment available.
The head of adult services was aware of their responsibilities in regard to the Deprivation of Liberty Safeguards (DoLS). These safeguards aim to protect people living in hospices from being inappropriately deprived of their liberty. These safeguards can only be used when there is no other way of supporting a person safely.
Parents and professionals gave positive feedback about the qualities, skills and knowledge of the staff. Staff were recruited safely and received an induction, core training and specialist training so they had the skills and knowledge to meet children and young people’s complex needs.
There were safe systems in place to safely manage and administer medicines in both hospices. Children and young people were protected from the risks of infection by the systems and equipment in place.
We found the hospice and equipment was well maintained. The hospice was designed and decorated to meet the specialist needs of the children and young people.
There was a children, young people and family focused culture at the service. Children, young people, families and staff were involved and consulted about all aspects of the service. Staff were proud of the service they provided and were fully committed to the children, young people and their families. There was a clear management structure and staff, children and young people and their families felt comfortable talking to the managers about any concerns and ideas for improvements. There were systems in place to monitor the safety and drive the continuous improvement of the quality of the service provided.