The Care Quality Commission
  • Hospice service

The Treehouse

Overall: Outstanding read more about inspection ratings

St Augustines Gardens, Ipswich, Suffolk, IP3 8NS (01473) 271334

Provided and run by:
East Anglia's Childrens Hospices

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about The Treehouse 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 The Treehouse, you can give feedback on this service.

14 January 2020

During a routine inspection

East Anglia's Children's Hospices (EACH) operates The Treehouse - a dedicated children's hospice with five beds. Facilities include an outdoor play area with woodland walks, a sensory garden, a music room, an art studio, a hydrotherapy pool, a sensory room, a faith and reflection room, a refreshment and kitchen area, and dedicated play areas.

The Treehouse provides hospice care for children and young people. We inspected all services provided by the hospice.

We inspected this service using our comprehensive inspection methodology. We carried out a short-notice announced inspection on 14 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 hospice improved. We rated it as outstanding overall.

We found areas of outstanding practice in relation to hospice care for children:

  • There was a truly holistic approach to assessing, planning and delivering care and treatment to all children and young people who used the service. The service provided care and treatment based on national guidance and evidence-based practice, and managers checked to make sure staff followed guidance. Staff protected the rights of children and young people subject to the Mental Health Act 1983.
  • Staff consistently treated children, young people, and their families with compassion and kindness. Staff respected and maintained children and young people's privacy and dignity throughout their care. There was a strong patient-centred culture, and staff were passionate about meeting the holistic needs of each child, young person and their families.
  • Staff provided emotional support to children, young people and their families to minimise their distress. Staff recognised and respected the totality of people's needs, and their personal, cultural and religious needs. Staff went the extra mile to meet people's emotional needs, and saw these as important as their physical needs.
  • Staff supported children, young people and their families to understand their condition, make decisions about their care and treatment, and become active partners in their care. Staff ensured a family-centred approach to care, and were fully committed to working with people to make this a reality. Staff encouraged and empowered the people who used the service to have a voice and realise their potential. For example, we saw the service had developed a model and approach to care planning that firmly placed the child or young person at the centre. Staff and managers proactively undertook a comprehensive and regular review of the needs of all people who used the service, through the development of the holistic needs assessment process.
  • The service planned and provided care that met the needs of local children, young people and their families. Staff worked with other healthcare providers to deliver care, including community providers and local organisations. Staff were passionate about meeting the needs of local children and young people, and were proactive in the development of flexible and tailored pathways for each service user. For example, we saw the service had developed a comprehensive transition programme with a local adult hospice to support the transition of young people from children’s and young people’s services into adult services.
  • Staff went the extra mile to understand the needs of each child and young person who used the service, as well as the needs of their families and those close to them. The service was inclusive, and staff took a proactive approach to make adjustments to allow all children and young people to access hospice services. The service coordinated care with other healthcare organisations and providers. For example, we saw the service had developed a comprehensive long-term ventilator community outreach service, staffed by experienced nurses, who provided children and young people with dedicated and specialist advice within their own home and within the hospice.
  • Leaders and staff actively and openly engaged with children, young people, families, staff, equality groups, the public and local organisations to plan and manage services. They collaborated with partner organisations to help improve services for children and young people. For example, we saw the service had developed a comprehensive network of local volunteers, which helped the organisation to meet the needs of local people, particularly with the development of their 'Help at Home' volunteer service.
  • The service had a vision and a mission statement for what it wanted to achieve, developed with all relevant stakeholders. The vision was focused on sustainability of services and aligned to local plans within the wider health economy. Leaders and staff understood and knew how to apply them and monitor progress. For example, we saw the service had formed strong and lasting working relationships with other care providers and community organisations, and had taken a leadership role in the local healthcare environment to meet the needs of the local population.

We found areas of good practice in relation to hospice care for children:

  • The design, maintenance and use of facilities, premises and equipment kept people safe. Staff received training to use them. Staff managed clinical waste well. When providing care in patients’ homes, staff took precautions and actions to protect themselves and patients.
  • The service managed patient safety incidents well. Staff recognised and reported incidents and near misses. Managers investigated incidents and shared lessons learned with the whole team and the wider service. When things went wrong, staff apologised and gave children, young people and their families honest information and suitable support. Managers ensured they implemented and monitored any actions from patient safety alerts.
  • 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 for patients’ religious, cultural and other needs.
  • Staff assessed and monitored children and young people regularly to see if they were in pain, and gave pain relief in a timely way. They supported those unable to communicate using suitable assessment tools and gave additional pain relief to ease pain.

​Heidi Smoult

Deputy Chief Inspector of Hospitals

25 and 29 June 2015

During a routine inspection

This unannounced inspection took place on 25 and 29 June 2015.

The hospice services for end of life support to children, young people and their families are based both in the community and at the hospice building. The hospice is a six bedded unit, over one floor with level access throughout. This service had appropriate facilities to meet the people’s needs that used it. Ceiling track hoists were available throughout the building where personal care would be needed. There was also a suite containing family accommodation adjacent to a child’s bedroom for use by end of life care/bereavement support. There was a multi-sensory room, music therapy room, a large wooded area that was used for events and to enable the children to play outside and a hydrotherapy pool (out of use at the present time).

The newly appointed manager was awaiting the outcome of his application to become a registered manager with the commission. He has since been confirmed as registered with the CQC. 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.

People said this was a valuable resource that they had trust and confidence in to support them and their family. Everyone said staff were kind, caring and compassionate. People had confidence in the staff’s ability to respond to need. There were sufficient staff that were well trained and supported in their roles. These staff ensured children and young people were safe when using the service. Risk assessments were completed to keep people as safe as they could be and medicines were administered as prescribed.

Families were included in all aspects of assessment; planning and children were listened to with consent and choice being sought. Families described the support they received as being very child focussed and they valued the range of services, such as short breaks, bereavement support, siblings groups, specialist play, music therapy and counselling.

There was good leadership and management of the service which resulted in children’s care meeting their needs and the needs of the family. The organisations values were known by staff and embedded in practice.

13 June 2014

During a routine inspection

As part of our inspection of this service we spoke with the acting manager, three members of care staff and one parent of a child who used the service. We undertook a physical examination of all key areas of the service and examined records of staff supervision, staff training, quality assurance information provided to children and families and written and electronic records relating to the provision of care by the service. We were unable to speak to the one young person present during our visit, as they were sleeping at the time, however we did observe staff providing care and support to one young person who was attending the service on the day of our visit.

Is the service safe?

CQC monitors the operation of Deprivation of Liberty Safeguards (DoLS) which applies to hospices. We spoke with the acting manager who demonstrated their knowledge of the protocols to follow. We saw evidence that all staff had been trained in safeguarding, first aid and mental capacity. We found risk assessments with clear action plans were in place to ensure people remained safe.

We saw evidence of a robust system for health and safety in respect of hygiene and infection control.

Is the service effective?

People told us that they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they had received appropriate training. People we talked with who used the service and their relatives were satisfied with the service provided. A relative said, "The staff are wonderful here. They always sit down and go through everything with you before each visit. They have always given me the time I needed to cope with the situation."

Is the service caring ?

We saw that staff interacted positively with people who used the service and people we talked with about the service told us that staff were caring and friendly. Assessments of children and young people's care, treatment and support needs were undertaken prior to using the service. Children and young people, their families and health and social care professionals involved in their care were consulted during this process. Records confirmed people's preferences and diverse needs had been accommodated.

Is the service responsive?

The hospice provided a range of services that responded to people's needs when they had a life-limiting illness. The services included medical care, pain management, day therapy services, spiritual care, counselling, social work advice and community care. The hospice promoted a stress-free environment where people could relax and rest. A member of staff told us, "We are very aware of the need to promote a calm environment". People were encouraged to feedback on the quality of the care and services provided and their views were taken into account. The hospice maintained close links with the community. The hospice trained volunteers in the community who were active participants in some aspects of the service.

Is the service well-led?

Staff had a good understanding of the ethos of the home and quality assurance processes were in place. We found that comprehensive policies and procedures that addressed every aspect of the service were in place.

People and their relatives or representatives were consulted about how the service was run and annual survey questionnaires were collected and analysed. Staff told us they were able and encouraged to express their views and raise any concerns they may have and said they were listened to. A member of staff told us, "We can raise any concerns and make suggestions, the management have an open door policy and they listen to us". Complaints, incidents and accidents were appropriately recorded and audited. There were audit processes in place to monitor risks, safety and wellbeing. The registered manager operated a system of quality assurance and completed audits to identify how to improve the service.

22 May 2013

During a routine inspection

We spoke with one parent of a child who used the service. Positive feedback was given regarding the care and support provided by the hospice. They told us that the hospice was the only place they trusted to leave their child for care and respite. They said, "You can't ask for a better service."

We found that care records were detailed and updated regularly with the involvement of children and young people's families.

We found that the service was clean and hygienic throughout and that the service had robust systems in place for the maintenance of all equipment used.

The service had robust recruitment procedures in place and staff were well trained and supported.

The service dealt with complaints in an appropriate way and also learnt from the outcome of complaints.

7 June 2012

During a routine inspection

During our visit to the service we were not able to talk with any children and young people as they were all involved with their care programmes. We were also not able to talk with their parents, guardians or family members, as there were none available at the time of our visit. However, we did read many positive comments that had been published in newsletters and thank you cards. The general opinion was that The Treehouse Hospice provided an excellent service that fully met the children, young people and their family's needs.