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Acorns Children's Hospice in Birmingham Outstanding

Inspection Summary


Overall summary & rating

Outstanding

Updated 1 October 2016

Acorns Children's Hospice in Birmingham is registered to provide care and treatment to children and young people, aged between 0 and 18 years, who have a life-limiting illness or condition. Acorns provide a range of services within its hospice; day care, short breaks for children, support into adult services, end of life care, and care after death. Specialist nursing care is provided at the 10 bed hospice. The provider; Acorns Children's Hospice Trust runs three hospices in the West Midlands. They share some staff expertise and teams, such as the hospice wide Transition Team, and Asian Liaison Officer.

This comprehensive inspection took place on 2 March 2016 and was unannounced. There were five children staying in the hospice on the day of the inspection with a further two children attending for day care.

There was a registered manager in post. 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.

Children and young people we met were happy and relaxed in the company of staff. Parents we spoke with told us they were very happy that staff kept their child safe. Staff had been trained and knew how to recognise and report any concerns about potential harm or abuse. Within the hospice appropriate safeguards were in place to chaperone visitors to keep children safe. There was regular review of accidents, incidents and concerns to promote the safety of children and young people. Arrangements were in place to promote the safety of staff working alone within the community. Staff were aware of risks specific to each child’s care, safety and medical condition and how to manage these.

Appropriate checks had been undertaken to ensure only suitable staff were recruited to work with children and young people. Staff had the specialist skills to care for children and young people’s needs. Arrangements were in place to increase staffing levels where children and young people’s needs increased and parents had access to out of hour’s support for help in emergencies.

Staff had received training and support to manage children and young people’s medicines. The arrangements in place for managing medicines were safe.

Staff were highly trained and had the specialist skills to support children and young people. There were strong links with other organisations to ensure children and young people at the end stage of their life benefitted from high quality palliative care. Staff and external professionals expressed a high level of praise for the expertise and commitment of staff. There was a strong focus on developing and supporting staff to take on specialist lead roles to ensure children and young people had the care they needed.

Staff had been trained in and understood the importance of gaining young people’s consent to their care and treatment. We saw young people had been involved in decisions that affected their care or treatment. Parents’ consent and decisions regarding their child’s care had been sought.

Children and young people had a choice of meals and staff knew what to do if there was a concern about eating or drinking enough. Staff worked with parents and community services to maintain children’s eating and drinking if their condition deteriorated.

Where children or young people needed end of life care advanced care plans were in place. Parents were provided with explanations and choices regarding their child’s care and support needs. Wishes in relation to end of life care were discussed and planned for. These reflected personal choices and preferences about how their care and treatment should be met and included the arrangements for managing symptoms or pain.

Parents and family members support needs had been considered and met. Bereavement support,

Inspection areas

Safe

Good

Updated 1 October 2016

The service was safe.

Children and young people were protected from potential harm or abuse by staff that had been trained in recognising and reporting abuse.

Risks to the safety and welfare of children and young people were identified and managed to keep them safe.

Staffing levels were planned to ensure children and young people were cared for by staff in the right numbers and with the right skills to meet their needs.

The arrangements for managing children and young people�s medicines were safe.

Effective

Outstanding

Updated 1 October 2016

The service was effective.

Staff were skilled in paediatric palliative care and had specialist lead roles with strong partnership working with other organisations. The training, development and support to all staff and volunteers enabled them to carry out their roles effectively.

Young people had been involved in decisions about their care and treatment by staff who understood the importance of gaining their consent. Parents� decisions regarding their child�s treatment and end of life care had been sought.

Children and young people were provided with a choice of meals and drinks. Staff liaised with parents and community services to maintain children�s eating and drinking.

Children and young people had access to specialist advice and support, including medicines and equipment for their care, symptom and pain management. Symptom and pain management could be planned and provided without delay at the hospice or via out of hours support.

Caring

Outstanding

Updated 1 October 2016

The service was caring.

Staff were kind and compassionate and treated children, young people and their families with dignity and respect. Parents felt staff listened to them and showed concern for the whole family�s wellbeing.

There were some excellent examples of �targeted� volunteering whereby families had additional practical and emotional support this included the use of �befrienders�.

There was an excellent awareness of children and young people�s spiritual/religious and cultural needs so that they and their families had the support they wanted

Children, young people and their parent�s wishes in relation to end of life care was discussed and planned for.

Responsive

Outstanding

Updated 1 October 2016

The service was responsive.

There was an excellent understanding of the diversity of children and their families and a variety of flexible services had been designed to respond to their needs.

Transition arrangements were well established to support young people moving into adult services.

Excellent links with antenatal services were evident to ensure families of unborn babies had early involvement with the hospice.

Children and young people had access to a wide range of activities, outings and events suited to their needs and age.

There was a positive approach to receiving and managing concerns or complaints which were used to improve the quality of the service.

Well-led

Outstanding

Updated 1 October 2016

The service was well-led.

There was a positive and inclusive culture with a range of opportunities for parents, children and young people to share their views about the quality of the service.

Management had a clear vision and strategy to increase the services on offer to children, young people and their families. They had promoted a flexible, accessible and consistent service to meet the specialist needs of children and young people.

There were strong links with specialist palliative care professionals and providers to share best practice and expertise so that children and young people had high quality palliative care.

There were robust auditing systems in place to ensure the quality of the service was constantly monitored and actions were in place to constantly drive improvement.