Demelza, Hospice Care for Children - SE London

Updated 12 January 2017

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 19 and 21 September 2016 and was unannounced. An inspector, a pharmacy inspector and a specialist advisor carried out the inspection. The specialist advisor is a nurse with experience of working with children with life limiting conditions.

Before the inspection we reviewed the information we held about the service. This included the Provider Information Return (PIR) which the provider had completed and sent to us. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed notifications sent to us by the service. A notification is information about important events, which the service is required to send us by law.

We observed staff interaction with four children and spoke with five family members. We spoke with the registered manager and the chief executive officer. We spoke with 12 other staff, including cleaners, health care assistants, nurses, the social worker and a volunteer.

We looked at personal care, planning and support records for eight children. We looked at other records relating to the management of the service, including medicines records, recruitment records, health and safety checks and audits of the service.

We received feedback about the service from four health and social care professionals.

Updated 12 January 2017

Demelza, Hospice Care for Children - SE London (known as Demelza SEL) provides services for children and young people from birth to18 years old with life limiting conditions and their families. They provide residential short breaks for children for respite care and end of life care. They provide additional support services for the family. There were six residential places for children and young people. When we visited four children were receiving care and a total of 193 children and young people were using the service.

The service was last inspected on 28 October 2013 when we found all of the regulations inspected were met.

The service has a registered manager. 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. The provider also runs a children’s hospice in Kent (Demelza Kent) and the registered manager is registered for both services. She had an office at each of the provider’s sites and spent time at both.

Children and young people who used Demelza SEL, and their families received care that was compassionate and kind. People felt the practical and emotional help they were given had an impact on their lives, both during their child’s illness and afterwards. Care was provided with regards for children’s privacy and dignity and parents’ roles were valued.

The staff were responsive to children and families’ individual needs and they were assessed and catered for. Care planning was on going so changes in children's conditions were addressed, There were therapeutic activities which children enjoyed and were suitable for their needs. The staff took into account the needs of the whole family and support was available for siblings and grandparents as well as parents. Groups were arranged for siblings to meet others in the same position.

The care provided was safe. Staff were knowledgeable about abuse and the action to take if they suspected children were at risk of harm. Medicines were managed well and children received them as prescribed. Staff recruitment made sure staff were suitable to care for children. The building was kept safe and well maintained.

Staff were trained and supported to do their jobs well. Children and young people were supported with their nutritional needs. Demelza SEL had effective relationships with hospitals and health professionals to ensure that children and young people’s needs were met without delay. This helped to minimise children and young people’s pain, discomfort and distress.

Staff were trained in the principles of the Mental Capacity Act 2005 (MCA). People’s rights were respected and when necessary decisions were made in children and young people’s best interests.

There were good management arrangements to check and ensure the on-going quality of the service. The provider kept in touch with developments in the field of paediatric palliative care.