You are here

Reports


Inspection carried out on 9th October 2019

During a routine inspection

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 carried out on 26 July 2016

During a routine inspection

This inspection took place on 26, 27 and 28 July 2016 and was unannounced.

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, and distinctive areas of landscaped gardens, areas of interests and relaxation.

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 staffs’ ability to keep them safe. The provider had established direct working relationships with external agencies to share information to promote the welfare and safety of children and young people. Internal meetings were held that provided a forum for potential concerns and risks to be identified. Enabling the provider to provide timely support to families.

We found improvements were needed in the assessment of risk and the plans to mitigate risk, in some areas, which included medicine management and within the care plans that detailed areas of individuals care. The provider assured us they would take action and we received information following our inspection advising that improvements had been made.

Young people who used the service and a parent we spoke with said medicine was managed safely and staff provided support where needed. Medicine was stored securely within the service and staff responsible for the administration of medicine had their competency regularly assessed.

The provider employed sufficient qualified and experienced staff, from a range of disciplines to meet the needs of children and young people. This had a positive impact on the experience of children, young people and their families. For children and young people it presented opportunities for them to take part in activities including play. Whilst for the families of children and young people, the provider recognised the impact of a child’s health on the wider family. They had recruited a strong contingent of volunteers to support the wider family, through befriending services and the support provided to siblings, through activities and social events. Staff received regular training in areas relevant to their practice. Safe recruitment practices were followed when recruiting new staff.

The provider worked in partnership with children, young people and their families by providing opportunities for all to comment and influence the care and treatment provided. This enabled staff to deliver person centred care, with staff and volunteers supporting children and young people, both within the hospice and at home. Parents valued their relationships with staff who felt the support they received had a positive impact on t

Inspection carried out on 19 November 2013

During a routine inspection

On the day of our inspection there was one person using the service. They did not wish to speak with us but we observed the care they received and spoke to a parent. We spoke with the registered manager, four care staff and three administrative staff.

A parent told us, �The quality of the service is excellent� and, �I have been made to feel welcome here. Every time I visit the nurses give me an update of what has been going on so I am up to date with everything�.

We saw that before people received any care or treatment they, or the legally appropriate person, were asked for their consent and care staff acted in accordance with their wishes. We saw that the care, treatment and support met their needs and the needs of their family because people were cared for by staff that were supported to deliver care and treatment to an appropriate standard.

We saw that people were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

We saw that the provider had an effective system in place to regularly assess and monitor the quality of the service that people received.

Inspection carried out on 11 February 2013

During a routine inspection

On the day of our inspection there were four people using the service. Due to their complex health care needs, most of the people using the service were unable to communicate verbally with us but we observed the care and support they received. We spoke with four parents of people who were using the service and five staff that supported them.

Parents told us that they had been fully involved in the decision to use the service and decisions regarding the ongoing service that their children required. One parent told us, "They explained what it would be like here before we visited but it surpassed our expectations. You get more here than they could ever say ".

Parents told us that staff had a good understanding of their children's care needs and treated them with respect. One parent told us, "As soon as I walk through the doors I feel as though a big weight has been taken off my shoulders�.

Parents told us that they felt certain that their children were kept safe at the hospice and we saw evidence that people were cared for by suitably trained and experienced staff. We observed that some care records were kept securely and that the provider had recently completed an audit of care records which had identified changes that needed to take place so that they were clearly legible.

Reports under our old system of regulation (including those from before CQC was created)