We carried out a review of the data available to us about Hope House Children's Hospice on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Hope House Children's Hospice, you can give feedback on this service.
Hope House Children’s Hospice is operated by Hope House Children’s Hospices.
The service provides care for children and young people and their families who have life limiting conditions and may only expect to live until early adult hood (up to 25 years old). We inspected services for children and young people.
We inspected this service using our comprehensive inspection methodology. We carried out an unannounced visit on 28 January 2020 and announced on the 29 January 2020.
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 rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.
Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.
Services we rate
Our rating of this service improved. We rated it as Good overall.
The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.
Staff treated children, young people and their families with exceptional kindness and compassion and ensured their privacy and dignity were maintained at all times. Children, young people and their families and were fully empowered as active partners in their care, practically and emotionally, by an exceptional and distinctive service. Staff provided an exceptionally high level of emotional support to patients, families and carers to minimise their distress. They understood patients’ personal, cultural and religious needs. Feedback from people who use the service, those who are close to them and stakeholders was continually extremely positive about the way staff treated them. People thought that staff went the extra mile and their care and support exceeded their expectations.
The service planned and provided exceptional care with excellent facilities in a way that met the needs of local people and the communities served. It also worked with others in the wider system and local organisations to plan care. Children’s and young people’s care and support was planned proactively in partnership with them. Staff used innovative and individual ways of involving people so that they feel consulted, empowered, listened to and valued. For people in transition, specific support groups were available and in children’s hospices, links were made to antenatal services to support families where unborn babies have life-limiting conditions. Patients could immediately access the specialist palliative care service when they needed it. The service ensured children and their parents did not have to wait for end of life care and ensured they achieved their preferred place of care and death. People were actively encouraged to give their views and raise concerns or complaints. The service saw concerns and complaints as part of driving improvement. People’s feedback was valued and responses to the matters people raised were dealt with in an open, transparent and honest way. Investigations were comprehensive.
Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.
Heidi Smoult
Deputy Chief Inspector of Hospitals (Central Region)
Hope House Children’s Hospice provides specialist nursing care for children and young people with life limiting conditions within the hospice and in their own homes. The provider has a 10 bedded in-patient unit that accepts admissions for terminal care, symptom control and respite stays. At the time of our inspection six children and young people were on the unit. The hospice also supports the families of the children and young people who use the service. Specialist care and support in the community was also provided by an outreach service.
The manager was registered with us as is required by law. 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.
Staff were trained in how to protect children and young people from abuse and harm. There were sufficient staff on duty to meet children and young people’s needs in a timely manner. Recruitment processes were robust and the provider was as sure, as possible, that staff employed were suitable and safe to work with children and young people. Staff were knowledgeable about the specific risks children and young people needed to be protected from. Accidents and incidents were recorded and monitored to identify how the risks of reoccurrences could be reduced. Medicines were prescribed, recorded and administered in safe and appropriate ways. Children and young people received their medicines in a timely manner and in line with their needs.
Children, young people and their families were supported by a highly qualified and experienced staff team. The provider equipped staff with a variety of training that met the specific needs of the children and young people being cared for. Staff were supported to acquire additional training to maintain and enhance their knowledge and skills. New staff were provided with a comprehensive induction. Regular supervision and annual appraisal was available to support staff. Management and staff understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA). Staff supported children and young people to access nutrition that met their dietary needs, restrictions and appetite. Children and young people were supported to access all the support they needed in order to maintain their health and wellbeing
Children and young people’s right to privacy was fully protected and they were treated with dignity and respect. Positive relationships were developed at the hospice and staff were kind and compassionate. Children, young people and their families were involved in all aspects of decision making, from symptom and pain management to end of life care. Communication within the service was effective and children, young people and their families were fully informed of their options for care and treatment. Children and young people were involved in the planning of activities that met their individual needs and preferences. A broad range of activities were available that included creative ways to keep children and young people occupied, engaged and stimulated.
Regular multi-disciplinary meetings were undertaken to review and respond accordingly to children and young peoples’ changing needs. The provider worked closely with other professionals and agencies to develop the hospice services to meet diverse needs and improve the health and wellbeing of children, young people and parents. Clear information about the service, the facilities, and how to complain was made available to children and young people and visitors. Complaints received were fully investigated and responded to, with evidence of the provider using them as a learning opportunity in order to make improvements to the service. Peoples’ feedback was actively sought, encouraged and acted upon.
Quality assurance systems were overall effective but some elements of the care records had not been audited for some time. When the need for improvement was identified, remedial action was taken to improve the quality of the service. Staff knew the leadership structure within the hospice and were fully involved in its development. Emphasis was placed on continuous improvement of the service, including developing clinical guidelines in line with best practice. A variety of regular clinical, governance and senior management and trustee meetings took place to share, scrutinise and review the service. The hospice supported its staff lead on projects that would benefit children, young people, and their families to improve the quality of the service they provided.
Hope House Children’s Hospice provides specialist nursing care for up to 10 children and young people with life limiting conditions from Shropshire, Cheshire and north and mid Wales. The hospice also supports the families of the children and young people who use the service. There was a registered manager in post at the home. This meant that there was an allocated person who was responsible for the day to day running and management of the service.
Specialist nursing care was provided at the hospice and within children and young people’s homes. During this inspection we looked at the care provided to the children, young people and their families in the hospice environment only.
The staff understood the children and young people’s needs and we saw that care was provided with kindness and compassion. Children, young people and their families told us they were happy with the care.
Care was provided in a safe environment by staff who were appropriately trained and skilled. We saw a robust induction and training system to ensure this.
Throughout our inspection we saw examples of innovative care that promoted an inclusive culture. Children, young adults and their families were involved in care planning and were treated with dignity, privacy and respect.
The provider had employed staff to ensure care was based upon best practice and individual staff had taken on champion or link roles to ensure that best practice guidance was implemented and followed by all staff.
The registered manager consistently assessed and monitored the quality of care. We saw that action was taken to make improvements to the care children, young people and their families received.
People told us that they felt able to raise any issues with the manager or staff should they have any concerns. Staff talked of their awareness of how to keep children and young people safe from harm. Staff told us about the training that the hospice had arranged for them to attend so that they would recognise abuse and how to report it.
People told us that staff were always available when they needed help. They said that the staff were supportive, friendly and always acted professionally. One young person said, 'The staff are nice' and a parent said, 'This hospice sets the benchmark for the care of XXX. They are excellent'.
A relative spoke very highly about the service provided. They said that it was, "Excellent" and told us that they were always made welcome. They said that the services provided had made a significant difference to the families' quality of life.
Support was offered to children and their families in a variety of ways. These included sibling groups, counselling, respite care and outreach support in their own homes.
Care plans contained detailed clear guidance for staff on children's needs and how these should be met. This was done in a way that reflected each child's individuality and preferences. Relatives were fully involved in care planning and decision making.
Measures were in place to reduce the risk of healthcare acquired infections.
Systems were in place to make sure that checks were made when new staff started working at the service to make sure that they were suitable. Staff felt very well supported by the management team.
The service supplied people with information about how to raise any concerns and complaints.
Families are involved in developing individual care plans that meet their child's needs.
Support is offered to families in a variety of ways including, sibling groups, counselling, respite care and outreach support in their own homes.
Effective management systems were in place to make sure that the home is safe and well maintained. Quality assurance systems were in place to monitor the effectiveness of the service and identify any issues of concern or areas for review.
Staff told us that they feel well supported by an effective management team and are provided with all the training they need to carry out their role effectively.