Archived: Kites Corner

Kites Corner is operated by James Hopkins Nurses Limited. This is part of the James Hopkins Trust. The service provides respite care for children up to the age of six years who are severely disabled, life limited, or life threatened. The service currently is funded to support three older children who have been with the service for many years.

We inspected the service under our framework for community health services for children, young people and families using our comprehensive inspection methodology. We carried out a short-notice announced inspection on 15 and 16 July 2019.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we review services’ performance against each key question as outstanding, good, requires improvement or inadequate.

As the service was not given our usual length of time to prepare for this inspection, we have decided not to rate the service on this occasion.

Our key findings were:

• The service had not always maintained an accurate, complete and contemporaneous record in respect of each child, including a record of the care and treatment provided and any decisions taken in relation to their care and treatment. This included care plans, risk assessments and medicine administration records.

• The service did not have sufficient assurance that persons providing care or treatment for children had the qualifications, competence, skills and experience to do so safely.

• Not all staff had been provided with training, supervision and appraisal as is necessary to enable them to carry out the duties they are employed to perform. The information was not effectively recorded and monitored. This included mandatory, role-specific and safeguarding training.

• Staff had not effectively assessed the risks to the health and safety of children and done all possible to mitigate any such risks.

• There was not effective system of governance, assurance and audit to assess, monitor and improve the quality and safety of the services provided. This included a lack of governance to ensure the risks to health, safety and welfare of people who use the services were assessed, monitored and mitigated.

• The system for incident reporting and complaints management was not run in accordance with policy or good practice. Policies and procedures were not always being followed, and some were not realistic to the service being provided.

However:

• The caring provided to children and their families was outstanding in its compassion and level of support. There was an exceptional understanding of the needs of the children but also and specifically their families and carers. All the parents we met said they had complete faith and trust in the service and its staff.

• There were sufficient numbers of staff on duty to keep children safe and support families, and this was reviewed and safely managed.

• The environment and equipment were mostly clean, although some improvements were needed in some of the soft furnishings and disposal of waste.

• There was effective multidisciplinary working with other health and social care professionals and organisations to provide wider support to children and their families.

• There were no barriers to access to the service which met the needs of children and their families as individuals, although there needed to be a recognition of equality and diversity. However, the organisation needed to review its level of risk in cancelling respite care for children who might be unwell given the service was led by a nursing team.

• The premises were designed and maintained to level to provide a wonderful environment for children and their families.

• There was a strong and supportive culture among the staff.

• There was a clear vision and strategy for the service with quality of care and sustainability being priorities.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with three requirement notices. Details are at the end of the report.

Nigel Acheson

Deputy Chief Inspector of Hospitals (South and London)