Derian House Children's Hospice

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated effective as good. At this assessment the rating has remained good.

Good: This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

Staff worked towards giving children, their families, and communities the best possible outcomes by assuring their needs were assessed. Their care, support and treatment reflected these needs. Services worked in collaboration with children at the centre of their care and their families.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We scored the service as 3. The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Children’s eligibility for the service was assessed on referral to ensure care needs could be replicated in the hospice. Eligibility for care was based on the type of condition the child presented with. The condition had to be life limiting or life-threatening to meet the admission criteria. A care needs assessment was undertaken prior to admission to ensure staff were up to date with current care needs. This included consideration of their physical, sensory, social and communication needs. These assessments informed care plans. Care needs assessments were completed in conjunction with parents or carers.

Children, on admission, would have a set of observations taken which would be compared to their previous and baseline observations and kept on record so staff could identify changes in conditions. Staff shared key information to keep children and their families safe when handing over their care. Following review of our draft report for factual accuracy, the provider confirmed the service did not use Paediatric Early Warning Score (PEWS) which is a recognised national tool used to identify early signs of deterioration in children. The provider told us this was because the tool was not relevant to the service.

We scored the service as 3. The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The service planned children and young people’s care and treatment with them and their parents or carers. This including what was important and mattered to them. Staff did this in line with legislation and current evidence-based good practice and standards.

Children’s nutritional and hydration needs were met in line with current standards and evidence-based guidance. Children relying on tubes for feeding had feeding care plans in place. Nursing staff received training to ensure proper nutrition delivery and to minimise the risk of complications.

Staff followed appropriate care pathways, for example, pathways for use of Non-Invasive Ventilation and oxygen requirements.

We scored the service as 3.The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The care provided by the service was coordinated with care provided by external providers including doctors, specialist nurses, pharmacy services, occupational therapists and physiotherapists, to ensure children and young people had their individual needs met.

Leaders told us they had good working relationships with local commissioning organisations.

The service was one of the first children's hospices to introduce the Shared Care Record systems for those residing in the Lancashire and South Cumbria area. This provided read only access to other care provider records such as GP and community teams. Children and Young Person’s Advanced Care Planning (CYPACP) passports were in place, so individual preferences and wishes were known.

We scored the service as 3. The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The service had relevant information promoting healthy lifestyles and support available to children and young people and their families and carers. Staff assessed each child and young person’s health when admitted and provided support for any individual needs to live a healthier lifestyle. A family therapist was on hand to provide support and guidance and link in with other community services. We observed how staff worked with young people to adapt equipment to suit their needs and support them to maintain their independence.

Feedback from parents and carers was positive about the support they received. We observed equipment assessments being undertaken to promote children and young people’s independence.

We scored the service as 3. The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service sought and considered feedback from families, carers, professionals, and other stakeholders as appropriate when monitoring individual outcomes. Staff described a recent example where feedback led to a review of the referral criteria to support admissions.

Staff contacted families and carers after each inpatient stay at the unit to improve the child and young person’s next visit and changes were made as a result. For example, the length of stay was increased due to the amount of personal equipment children would bring with them.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

The service had a policy on consent which covered consent procedures for several aspects of care such as pain relief administration, therapies, and emergency admission to hospital.

Consent to care and treatment was obtained from the parents during the referral process. If a child or young person required examinations or treatment during an admission to the hospice staff would have a telephone conversation with the child or young person’s parents to obtain consent.

We saw parents' consent to care and treatment recorded in care records. We also observed staff obtaining consent from parents, children and young people.

For children and young people who are unable to communicate staff used communication cards to give information and obtain the child or young person’s consent to care or activities.