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Acorns Children's Hospice in the Black Country Good

Inspection Summary


Overall summary & rating

Good

Updated 7 October 2016

Acorns Children's Hospice in the Black Country 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 provides a range of services within its hospice; 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 or within children and young people’s own homes. 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 22 February 2016 and was unannounced. There were four children staying in the hospice on the day of the inspection with a fifth child visiting for the day.

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.

We saw the children and young people we met were happy and relaxed in the company of staff. Parents told us they were very happy that staff kept their child safe when working with them within their own home or the hospice. 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 recruited safely to ensure that children and young people were cared for by suitable staff. There were enough staff on duty who had the specialist skills needed to make sure children and young people’s needs could be met safely. Staffing levels were increased to respond to children’s and young people’s rapidly changing needs. Separate staffing arrangements were available to ensure children and young people cared for in their own home received consistent support 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. We identified some shortfalls in the administration and storage of medicines. Corrective action was taken on the day but we found the monitoring of processes needed to be improved to ensure that medicines were administered and stored safely.

We saw positive risk taking which enabled children and young people to take part in everyday play activities that were important to them. Staff were well informed about the risks to children and young people and we saw staff were trained in managing risks specific to each child’s care, safety and medical condition. Risks had been considered and planned for which included the use of the specialist equipment children and young people needed to keep them safe.

Parents and external professionals spoke highly of the specialist skills of staff which meant children and young people received the care they needed either in the hospice or their own home. Staff were highly trained and supported in their development of specialist skills and there was a strong working partnership with other organisations to support children and young people at the end stage of their life.

Young people had been involved in decisions about their care and treatment and staff had been trained in and understood the importance of gaining young people’s consent to care and treatment. Parents’ consent and decisions regarding their child’s end of life care had been sought.

There was a choice of meals for children and young people and staff knew what to do if

Inspection areas

Safe

Requires improvement

Updated 7 October 2016

The service was not always safe.

Procedures were not always followed to ensure that medicines were managed safely.

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.

Children and young people were cared for by staff in the right numbers and with the right skills to meet their needs both in the hospice and in their own homes.

Effective

Good

Updated 7 October 2016

The service was effective.

Staff were skilled in paediatric palliative care and had specialist lead roles. Partnership working ensured staff had the specialist skills to support children and young people.

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Young people had been involved in decisions about their care 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.

Symptom and pain management was planned and provided without delay at the hospice or in the child�s own home.

Caring

Outstanding

Updated 7 October 2016

The service was caring.

Staff were kind, compassionate and treated children, young people and their families with dignity and respect. The use of targeted volunteers provided a valuable befriending service as well as practical support.

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 7 October 2016

The service was responsive.

Families had a variety of flexible services 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

Good

Updated 7 October 2016

The service was well-led.

There was a positive and inclusive culture with a range of opportunities for parents, children and external professionals to feedback about the way Acorns was managed.

There was a clear vision and strategy to increase the services on offer to children, young people and their families. A flexible, accessible and consistent service was promoted.

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