Charlton Farm

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

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 this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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 evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Children were actively involved in the assessment of their needs, with support provided to maximise their involvement. Staff gathered and recorded each child’s preferences, likes and dislikes. Where the children could not express their preferences, the family were encouraged to advocate for them.

Communication needs were included as part of each child’s holistic assessment. Staff completed comprehensive assessments that identified communication requirements to ensure care and treatment were delivered effectively.

We scored the service as 3. The evidence showed a good standard. The service 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.

Staff were up to date with best practice and national guidance. Staff discussed relevant changes in response to the Fuller Report around safeguarding the security and dignity of the deceased and the safety measures they had implemented following this.

The service used pressure relieving mattresses which reduced the need for air beds, however they had one available in case this was the preference of a child or their family.

Staff completed nutritional assessments for all children and young people who used the service. This included likes and dislikes, meal time preferences and specific dietetic plans. The service had a dining room where all children and young people and the staff caring for them ate their meals together. There were dedicated catering staff to meet individual dietary needs.

Staff were experienced, qualified and had the right skills and knowledge to meet the needs of patients and their families. They received regular clinical supervision, appraisals and one to one meetings. Records showed 94% of staff had an up to date appraisal. Staff participated in clinical audit processes and shared examples of quality improvement initiatives they were involved in. The service was accredited by the Crisis Prevention Institute (CPI) for managing challenging behaviour and de-escalation in care settings.

We scored the service as 3. The evidence showed a good standard. The service 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.

Staff attended regular multidisciplinary meetings and shared relevant information effectively at handovers and team meetings. Staff worked closely with community teams, acute services and other hospice providers to provide coordinated care to patients and share training and policies. This included working with liaison nurses to strengthen links between acute and community services in the area. There were 2 shared posts, a palliative care liaison nurse jointly funded by the local children's hospital, and post based in Somerset with the children's community team to extend the reach of the hospice in the community. There were weekly meetings with the community teams in other areas of the services catchment and regular contract meetings with the Integrated Care Boards (ICB) and the End of Life programme board for Somerset. The registered manager was the chair of the national forum where hospices come together to share best practice.

There were effective working relationships between the different teams within the organisation. This included the sibling support team, psychologist, medical team and family support.

The service started to prepare families for the transition to adult service from the age of 14. A transition working group was in place, and the service had been involved in a transition pilot with another hospice group to improve transition for young people and their families.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

We scored the service as 3. The evidence showed a good standard. The service 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.

Staff used recognised tools to identify and respond to clinical deterioration in patients as a key element of patient safety and improving patient outcomes.

There were effective approaches to monitor people’s care and treatment and their outcomes. The majority of outcome measures they collected around patient experience was qualitative. This information was captured in the feedback surveys which families and/or the patient completed about their experience.

Outcome information which had been collected by the service included whether the child’s preferred place of death had been achieved, resuscitation wishes and symptom management plans data. Results demonstrated staff were achieving positive outcomes for their patients.

The service strived to make continuous improvements to the experience and the care and treatment people received. Staff completed local audits including infection prevention and control, pain and medicines audits to drive improvement.

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.

Staff took all practical steps to enable patients to make their own decisions. Records we reviewed had clear documentation within them where consent had been sought prior to proceeding with care and treatment.

For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. When patients lacked capacity, staff made decisions in their best interests, included the family and recognised the importance of the person’s wishes, feelings, culture and history.

The service used children and young person's advance care plans (CYACPs) and this included the recommended summary plan for emergency care and treatment (ReSPECT) forms to document the wishes and decisions of the child, young person or the advocate or person responsible for them.