Acorns Children's Hospice in Birmingham

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We looked for evidence that people were always treated with kindness, empathy and compassion. We checked that people’s privacy and dignity was respected, that they understood that they and their experience of how they were treated and supported mattered. We also looked for evidence that every effort was made to take people’s wishes into account and respect their choices, to achieve the best possible outcomes for them.

At our last assessment we rated this key question outstanding. At this assessment the rating remained outstanding. This meant people were always treated with kindness, empathy and compassion and privacy and dignity was always respected. Staff always listened to, understood and responded to the needs of people and acted to minimise their distress. Staff wellbeing was well promoted to enable them to always deliver person-centre care.

This service scored 100 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

People felt they were treated with kindness, compassion and dignity in their day-to-day care and support. We spoke with the parents of some of the children and young people using the service and were told how supportive staff had been. One parenttold us how staff ‘doted on their child’ and what ‘a massive impact they had on their life’. We also observed a number of thank you cards and notes from families of children and young people who had been cared for by the hospice, all of whom praised the staff for their kindness shown during their time at the hospice.

Staff ensured the privacy, dignity and confidentiality of the children and young people was respected and upheld at all times. We observed staff ensuring any care provided to the children was completed in the privacy of their own rooms and ensured their dignity was maintained.

People believed staff responded quickly to their needs and efficiently, especially if they were in pain, discomfort or distress. We observed staff responding to the needs of the children they were caring for in a timely manner. Staff also discussed examples of when they had needed to act quickly to ensure the children’s needs were met and were not left in distress. Pain management was an important aspect to the care staff provided, staff responded quickly if they identified children were in pain.

Young adults felt they had control over their own privacy and the amount of parental involvement in managing their care and support. All staff were strong advocates for ensuring the children and young people using the service were in control of their own care and treatment. This included maintaining their privacy and when requiring rest in their own rooms, ensuring this was respected.

There was a culture of kindness and respect between colleagues from other organisations. Staff were respectful and complimentary about the contribution of all staff, internal and external towards the care and treatment children and young people received. Staff acknowledged some children had very complex cases which required a multidisciplinary team to ensure all their needs were met.

The service treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The service took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

People’s individual needs and preferences were understood and these were reflected in their care, treatment and support. All children admitted had their likes, dislikes and preferences recorded which was either directly reported by them or their families on their behalf. On each admission or attendance, any changes in circumstances were discussed and recorded on their care plans. We observed staff playing music by a child’s favourite artist whilst we were onsite, this had a positive impact on the child’s mood and wellbeing. Staff understood the need to ensure the children and young people had their individual needs assessed so they were able to meet them whilst attending the service.

People’s personal, cultural, social and religious needs were understood and met. All staff were aware of the importance in meeting the cultural and religious needs of the children and young people, as well as their families. Staff discussed examples where they had met the cultural and religious needs of the children which had included working with other partners to ensure a child was able to travel to a mosque to meet their religious requirements after their death. In another example discussed, staff supported and joined in with families when they undertook Iftar (evening meal that marked the end of daily fasting in Ramadan). Feedback from families had been positive and thankful towards the staff who had supported them. We observed displays around the service which included information about different religious events and celebrations which the service observed and participated in.

People’s communication needs were met to enable them to engage in their care, treatment and support to maximise their experience and outcomes. Communication was an important aspect of the assessment process for the children to ensure they, where possible were able to contribute to their care and treatment plans. Staff used a number of tools to enable effective communication with children who were not able to verbalise their input. One example of a successful tool which the service had implemented was the bedroom sign. This enabled the child or young person to select what activity they wanted to complete as well as how they were feeling. This also enabled the child to indicate if they wanted to be left alone in their rooms and rest. Staff told us these had been extremely useful with some of the children who were currently under the care of the hospice to enable them to express what they wanted to do.

The service was exceptional at promoting people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

People were supported to have choice and control over their own care and to make decisions about their care, treatment and wellbeing. Staff were strong advocates for ensuring children and young people where appropriate, were included in any decision making over their care and treatment. Staff were aware this made some external partners uneasy. However, as the decisions directly impacted them, it was seen as a vitally important aspect and part of their ethos to ensure, where appropriate, the child or young person discussed their wishes. Staff discussed examples of where this had occurred, including 1 young person who had accepted their terminal prognosis and was explicit with their wishes, which staff not only observed but whole heartedly supported.

People were supported to maintain relationships and networks that were important to them. Staff told us they had access to many networks within the surrounding area to signpost families to enhance or maintain any relationships or seek support. Staffspoke about the ongoing support and links with the Asian Mother’s Support Group, parent carer champions, and access to LGBTQ+ groups as some of the important groups who ensure the children and families were supported. The service had also introduced children ambassadors (a young person who had experience of using the service) who was important to the ongoing support to others who used the service.

People had access to their friends and family whilst using the service. Staff told us the service was focussed on providing holistic care to both the child and their family. Care for the family was an integral part of the care the hospice staff provided. Staff discussed examples where families had joined the child whilst at the service, especially within the family room where children can join them in the last days of their life or within the cold room where a child or young person may reside until their funeral. These were private spaces and had access to private outdoor spaces where extended families could gather. In addition to this, extended families were welcomed to the group activities which children and young people attended the service for.

People had access to activities and the local community to promote and support their independence, health and wellbeing. Staff told us they provided a range of activities for the children and young people, as well as any siblings and their families at the service as well as trips organised away from the service. Staff expressed how much the children enjoyed the trips out of the service and how much this boosted their wellbeing.

The service was exceptional in how they listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Staff were alert to people’s needs and took time to observe, communicate and engage people in discussions about their immediate needs. Staff completed comprehensive records about the children and young people which enabled them to recognise situations where they needed to act to prevent any discomfort, concern or distress. In addition to being alert to the needs of the children, staff discussed an example where they identified a situation involving the family of a child who used the service being in need and acted quickly to meet their needs by inviting them to stay in the family room at the service. Feedback in relation to this was extremely positive around how quickly the service had acted and considered the needs of all the family at a time of need.

Staff acted quickly to recognise when people needed urgent help or support and used appropriate tools and technology to assist. Staff discussed an example where they had acted quickly to reduce the distress of a child and used distractiontechniques to maintain their safety. This included using knowledge about their likes and preferences to help with the distraction.

Patients and their families were able to provide feedback about the service and their treatment and staff supported them to do this. We observed a ‘you said, we did’ board at the entrance to the service which displayed some actions already taken as a result of feedback provided. The provider had also sent a survey out to families who had consented to being contacted to request feedback. The survey included children and families who had used any of the 3 locations and results were not separated for the location. However, the survey identified families were largely happy with the experience they had at the hospice but also gave them the opportunity to identify any areas which could be strengthened. Suggestions provided included support for parents re-entering the workplace following on from a bereavement and additional help with adaptations and occupational health.

Staff discussed many examples of how they had listened to the needs, wishes and views of the families of the children they cared for and how they had acted to minimise their distress. One example was related to the request from a family for the staff who had created a Makaton choir to sing at the child’s funeral. Staff explained the family had been so thankful for them being able to engage with their child through Makaton whilst they were admitted, this had seemed a fitting tribute to the child. Staff were very honoured to have been asked to do this and were now looking to use the Makaton choir at other events for those who used the service, for example during their Memorial Day. Other examples discussed were related to the service where staff helped families to make lasting memories of their child.

The service always cared about and promoted the wellbeing of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care.

People received safe, effective and person-centred care by staff who had their wellbeing needs prioritised by the service. The registered manager was committed to ensuring staff wellbeing and the support they were given was a high priority. They had ensured staff had been provided with many outlets for receiving support if required. This included a wellbeing practitioner who had been working with staff, peer support sessions and the introduction of 14 mental health first aiders across the 3 locations. The service also provided staff with an employee assist and counselling service which staff could access for both work and personal concerns.

People’s experience of the service was driven by a culture that normalises good wellbeing inclusivity, active listening and open conversations. Staff told us there had been many changes in how the workforce were managed at the beginning of the year which had caused some challenges in morale and wellbeing amongst the staff.

However, the new manager had completed some away days with staff, held opportunities for “fierce conversations” to be had, held myth busting sessions in relation to the changes required and regular meetings with the executives where staff could ask questions either ahead or during the session. Staff told us during these sessions, staff had engaged well and raised some challenging topics, however the leaders listened and responded positively. This had enabled staff to move past the challenges at the beginning of the year and were now in a position where they reported morale was good and they enjoyed working in the service under a leadership who they believed respected them.