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Inspection Summary


Overall summary & rating

Outstanding

Updated 12 January 2015

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 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

Julia's House provides a respite service for 69 children and young people with life limiting or life threatening conditions. They are cared for in the hospice or in their own homes and are supported to access their local communities. Up to four children and young people can stay overnight at the hospice and up to eight children or young people can access day sessions at the hospice. Julia’s House also supports the families of the children and young people who use the service.

The inspection was announced and took place on 8 and 11 August 2014. We told the provider three days before our visit that we would be coming.

There was a registered manager at the service who had worked at the service for many years. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

Most of the children and young people we met and visited 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 in the care of Julia’s House. 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 good links and access to the specialist healthcare support they needed whilst using the service. All parents and professionals were happy with the care provided by Julia’s House. 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. One parent told us: “When my son is in hospital they offer to go and sit with him and that makes a big difference, they just offer I don’t ever have to ask”.

Throughout our inspection we saw examples of creative personalised care that helped make the service a place where children and young people felt included and consulted about how they wanted to spend their time. 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.

Any risks to children and young people’s safety and health needs were assessed and managed to minimise them.

We saw children and young people were supported to learn, play, develop and take part in and try new activities and experiences in the hospice, their homes and in the community. One parent said: “They do so much with him and so much more than we ever imagined he was able to do. They champion him it’s amazing”.

Children and young people were supported and cared for by their own specialist teams of staff. They were supported by at least one member of staff during sessions at their home or in the hospice.

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 needs.

There were safe systems in place to safely manage and administer medicines in both the hospice and in children and young people’s homes. 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 and families were involved and consulted about all aspects of the service. 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 quality of the service provided.

Inspection areas

Safe

Good

Updated 12 January 2015

The service was safe. Parents and professionals told us children and young people were safe in the care of Julia’s House.

Staff knew how to recognise and report any allegations of abuse.

Staff, relatives and professionals told us there were enough staff to keep children and young people safe. Staff were safely recruited.

There were effective infection control systems in place and staff had access to protective equipment, such as gloves and aprons. People had access to equipment that was maintained and serviced.

Effective

Good

Updated 12 January 2015

The service was effective.

Staff had effective training and support to carry out their roles. Parents and professionals felt staff were skilled and knowledgeable in meeting children and young people’s needs.

Children and young people were supported to eat and drink and had the specialist diets they needed.

The environment had been adapted and specialist equipment was provided to meet the individual needs of the children and young people.

Caring

Outstanding

Updated 12 January 2015

The service was caring. During our inspection staff were kind and compassionate and treated children, young people and their families with dignity and respect.

Parents and professionals told us Julia’s House cared for the whole family not just the child receiving the service. They told us the staff routinely offered to do more than what the service initially offered.

Staff were aware of children and young people’s preferences. Children, young people and their families were involved in decisions about the support they received and their independence was respected and promoted. Staff spent time listening and talking with children and their families. They took their time to make sure they explained things with children in ways they could understand so they could make choices.

Children, young people and their parent’s wishes in relation to end of life care were sensitively discussed and planned for at the pace of each individual.

Responsive

Outstanding

Updated 12 January 2015

The service was responsive to children, young people and their families.

Staff responded quickly and appropriately to children and young people’s needs.

Staff understood children and young people’s complex ways of communicating and responded to their verbal and non-verbal communication and gestures.

Children and young people were supported to pursue activities and interests that were important to them both in the hospice and in the community. Staff made sure they had play equipment and technology to meet each child’s needs. Each child and young person had their own play and occupation plan that was based on their skills and abilities.

There was a complaints procedure which children, young people and their families knew how to use if they needed to.

Information was shared effectively when children and young people moved between services. For example, there was a new project supporting young people making the transition to adult services.

Well-led

Good

Updated 12 January 2015

The service was well-led. Observations and feedback from children, young people, parents, staff and professionals showed us the service listened to their views and acted on these.

The management team had arrangements in place to assess and monitor that there were enough staff, with the right skills, knowledge and experience to meet the needs of people.

There were systems in place to monitor the safety and quality of the service. There was learning from accidents, incidents and complaint investigations.