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Inspection Summary


Overall summary & rating

Good

Updated 23 January 2020

The Donna Louise Trust is operated by The Donna Louise Trust

Donna Louise Trust provides care for children and young people as they become adults with life threatening or life limiting conditions. Services include specialist respite, palliative, end of life and bereavement care.

The service provides support to families of children and young people both within the hospice, through the provision of respite and day care, along with support in individual's own homes and the wider community. The hospice supports families across Staffordshire and Cheshire.

Donna Louise Trust provides a residential respite facility for up to eight children and young people at any one time, within individual bedrooms. At the time of our inspection there were four children and young people accessing respite care. The facilities provided by the hospice include, a multi-sensory room, computer room, soft play area, Jacuzzi, music room, separate lounges for children and young people, an art and crafts area and day care facility. Accommodation is also provided for parents and their families should they wish to stay. The grounds of the hospice incorporated a range of facilities for children to play, distinctive areas of landscaped gardens, areas of interests and relaxation. There was also a purpose-built play area, designed specifically to enable families to play together and create memories.

The service had 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.

Parents and young people we spoke with highly commended the service and staff and had confidence in the care and treatment that was provided.

The registered manager had been in post at The Donna Louise Trust since 2011

The service was registered to provide the one regulated activity of Treatment of disease, disorder or injury (TDDI) to people under the age of 25 years

We inspected this service using our comprehensive inspection methodology. We carried out the inspection on the 09 October 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 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 service understood and complied with the Mental Capacity Act 2005.

Services we rate

Our rating of this hospice stayed the same. We rated it as Good overall because:

We found Good practice in relation to the hospice:

  • The service provided mandatory training in key skills to all staff and made sure everyone completed it.

  • Staff understood how to protect children and young people from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse, and they knew how to apply it.

  • The service-controlled infection risk well. Staff kept equipment and the premises clean and used control measures to prevent the spread of infection.

  • The service had suitable premises and equipment and looked after them well.

  • Staff completed and updated risk assessments for each child or young person. The records were clear and updated regularly.

  • The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.

  • Staff kept detailed records of children and young people’s care and treatment. Records were clear, up-to-date and easily available to all staff providing care.

  • The service followed best practice when prescribing and giving medications and children and young people received the right medication at the right dose at the right time.

  • The service managed children and young people’s safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service.

  • The service provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance.

  • Staff gave children and young people enough food and drink to meet their needs and improve their health. They used special feeding and hydration techniques when necessary. The service adjusted this for children and young people’s religious, cultural and other preferences.

  • Staff assessed and monitored children and young people regularly to see if they were in pain. They supported those unable to communicate using suitable assessment tools and gave additional pain relief to ease pain.

  • Managers monitored the effectiveness of care and treatment and used the findings to improve them. They compared local results with those of other services to learn from them.

  • The service made sure staff were competent for their roles. Managers appraised staff’s work performance and held supervision meetings with them to provide support and monitor the effectiveness of the service.

  • Staff of different kinds worked together as a team to benefit patients. Doctors, nurses and other healthcare professionals supported each other to provide good care.

  • The service delivered a full inpatient service for children and young people receiving palliative, respite or end of lie care seven days a week.

  • Staff understood their roles and responsibilities under the Mental Capacity Act 2005. They knew how to support patients who lacked capacity to make decisions about their care.

  • The service planned and provided services in a way that met the needs of local people.

  • The service took account of children, young people and the families individual needs.

  • People could access the service when they needed it. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were in line with good practice.

  • The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.

  • Managers at all levels in the trust had the right skills and abilities to run a service providing high-quality sustainable care.

  • The service had a vision for what it wanted to achieve and workable plans to turn it into action developed with involvement from staff, children and young people, and key groups representing the local community.

  • Managers across the service promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.

  • The service had effective systems for identifying risks, planning to eliminate or reduce them, and coping with both the expected and unexpected.

  • The service collected, analysed, managed and used information well to support all its activities, using secure electronic systems with security safeguards.

  • The service engaged well with children, young people, staff, the public and local organisations to plan and manage appropriate services and collaborated with partner organisations effectively.

  • Staff cared for children, young people and their families with compassion. Feedback confirmed that staff treated them well and with kindness and sensitivity

  • Staff provided emotional support to children, young people and their families to minimise their distress.

  • Staff ensured that children, young people and their families were partners in decisions about their care and treatment.

Services we rate

Our rating of this service stayed the same. We rated it as good overall

  • The service had enough staff to care for children and young people and keep them safe. Staff had training in key skills, understood how to protect children and young people from abuse, and managed safety well. The service-controlled infection risk well. Staff assessed risks to children and young people, 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 cared for children and young people with compassion, empathy and respect.Feedback from parents confirmed that staff treated them and their children well and with kindness. People were truly respected and valued as individuals and empowered as partners in their care, practically, spiritually and emotionally.

  • The service responded to children’s and young people’s individual needs and preferences which were central to the delivery of tailored services. There were innovative approaches to providing integrated person-centred pathways of care that involved other service providers, particularly for children and young people with multiple and complex needs. The services were flexible, provided informed choice and ensured continuity of care.

  • There was an embedded team of volunteers who helped support the service There was a separate volunteer induction and training programme.Volunteers were valued members of the service who were provided with support and who felt part of the care team.

  • Staff provided good care and treatment, gave children and young people enough to eat and drink. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of children, young people and their families, advised them on how to lead healthier lives, supported them to make decisions about their care, and ensured they had access to good information.

  • Staff treated children, young people and their families with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided good emotional support to children young people, families and care givers.

  • The service planned care to meet the needs of local people, took account of individual needs, and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.

  • 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 the children and young people receiving care. Staff were clear about their roles and accountabilities. The service engaged well with children and young people and the community to plan and manage services and all staff were committed to improving services continually.

Heidi Smoult

Deputy Chief Inspector of Hospitals (Central Region)

Inspection areas

Safe

Good

Updated 23 January 2020

Our rating of safe stayed the same. We rated it as Good because:

  • The service provided mandatory training in key skills to all staff and made sure everyone completed it.
  • Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse, and they knew how to apply it.
  • The service-controlled infection risk well. Staff kept themselves, equipment and the premises clean. They used control measures to prevent the spread of infection.
  • The service had suitable premises and equipment and looked after them well.
  • Staff completed and updated risk assessments for each child and young person. They kept clear records and asked for support when necessary.
  • The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.
  • Staff kept detailed records of children and young people’s care and treatment. Records were clear, up-to-date and easily available to all staff providing care.
  • The service managed safety incidents well. Staff recognised incidents and reported them appropriately. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave honest information and suitable support. The service followed best practice when prescribing and giving medications and patients received the right medication at the right dose at the right time.

Effective

Good

Updated 23 January 2020

Our rating of effective stayed the same. We rated it as Good because:

  • The service provided care and treatment based on national guidance and evidence-based practice.
  • Staff gave children and young people enough food and drink to meet their needs and improve their health.
  • Staff assessed and monitored children and young people regularly to see if they were in pain, and supported pain relief in a timely way.
  • Staff monitored the effectiveness of care and treatment.
  • The service made sure staff were competent for their roles.
  • All those responsible for delivering care worked together as a team to benefit children, young people and their families.
  • Staff gave children, young people and their families practical support and advice to lead healthier lives.
  • Staff supported children, young people and their families to make informed decisions about their care and treatment.

Caring

Good

Updated 23 January 2020

Our rating of caring stayed the same. We rated it as Good because:

  • Staff cared for children young people and their families with compassion. Feedback from children young people families, loved ones and care givers, without exception confirmed that staff treated them very well and with kindness and dignity There was a strong, patient-centred culture from all staff.
  • Staff were motivated and inspired to offer care for children and young people with kindness, compassion, dignity and respect through supportive relationships.
  • Staff provided emotional support to children, young people and their families to minimise their distress. Staff understood that emotional needs were as important as physical needs.
  • Staff ensured that patients and those close to them were partners in decisions about their care and treatment. All the relatives and care givers spoke highly of the care their loved one had received and reported that had felt fully involved in all aspects of care and had also had their opinions considered.

Responsive

Good

Updated 23 January 2020

Our rating of responsive improved. We rated it as Good because:

  • Services were tailored to meet the needs of individual people and delivered in a way to ensure flexibility, choice and continuity of care and they coordinated care with other services and providers.
  • The service planned and provided care 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.
  • There were innovative approaches to providing integrated person-centred pathways of care that involved other service providers, particularly for children and young people with multiple and complex needs.
  • It was easy for people to give feedback and raise concerns about care received

  • The service treated concerns and complaints seriously, investigated them and learned lessons from the results and shared these with all staff.

Well-led

Good

Updated 23 January 2020

Our rating of well-led improved.  We rated it as Good because:

  • Managers had the right skills and abilities to run a service providing high-quality sustainable care.
  • The service had a vision for what it wanted to achieve and workable plans to turn it into action developed with involvement from staff, patients, and key groups representing the local community.
  • Managers promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.
  • There was a systematic approach to continually improving the quality of its services and safeguarding high standards of care.
  • The service was committed to improving services by learning from when things went well and when they went wrong.
  • The service had effective systems for identifying risks, planning to eliminate or reduce them, and coping with both the expected and unexpected.
  • The collected, analysed, managed and used information well to support all its activities.
  • The service engaged with patients, the public and local organisations to plan and manage appropriate services and collaborated with partner organisations effectively.
Checks on specific services

Hospice services for children

Good

Updated 23 January 2020

The Donna Louise Trust provides an eight-bed inpatient unit providing short term care for complex symptom management, respite and end of life care for children and young people up to the age of 25 years

The service provides support to families of children and young people both within the hospice, in individual's own homes and in the wider community. The hospice supports families across Staffordshire and Cheshire

We rated this service as good overall. Because we rated safe, effective, caring, responsive and well led as good.