Zoe's Place Baby Hospice

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that people and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality characteristics.

We found parents and carers were involved in decisions about their child’s care. The service mostly provided information people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it. The service was easy to access. Children received fair and equal care and treatment. Parent’s and carers were involved in planning their child’s care. However, the service was unable the number hours it was designed to deliver.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant children’s needs were met through good organisation and delivery.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure children and their parents and carers were at the centre of their care and treatment choices and they decided, in partnership, how to respond to changes in children’s needs.

The service used a care plan approach. Care plans were developed in partnership with parents, and health care professionals who worked with the children and their families. The care given to babies and children followed their care plans to mimic the care given to them at home.

The play leader had received training in developing fun and engaging play experiences that met developmental needs of children. The play leader generated monthly themes and ideas based on the seasons for the wider staff group to help them consider new ways of interacting with the children through play. When a child responded positively to play or a sensory activity staff looked for ways to expand the activity. For example, if a child was enjoying a texture staff would offer another related texture for them to explore.

Rather than organising group activities play was structed to meet the individual therapeutic, emotional, and social needs of children. Staff tailored experiences that catered to each child's unique developmental stage, interests, and specific challenges, which maximised their potential for growth and enjoyment.

Parents and carers told us they felt the care their children were given at the service was, tailored to their needs. They said staff shared information about developmental changes with them and helped support them to introduce new toys or different ways of playing that reflected the different and emerging needs of their children.

Staff were encouraged to complete an advanced communications course and a difficult conversations course to support holding conversations with parents and carers about difficult subjects. For example, conversations about advanced care planning or organ donation. This helped ensure staff used language that everyone could understand.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

When children were supported by more than one service staff work in a transparent, collaborative, flexible and open way to make sure their care was joined-up. Staff worked as part of a multidisciplinary team (MDT) that included parents and carers to ensure the care provided continuity with the care that was given at home, school, or at nursey. MDT working was well documented in children’s records and reflected in children’s care plans.

To encourage integration with families and the wider community staff arranged an average of 4 events for the siblings each year. The events included, walking with alpacas, staying overnight at a Sealife centre, and use of a gaming bus. A gaming bus features multiple gaming consoles, high-definition screens, and a wide variety of games to suit all ages. The service also hosted a Christmas party and other parties across the year for siblings, parents and carers and other family members.The parties were an opportunity for families and siblings to support and get to know each other. All the events were provided at no cost to the families.

Families of children who died were encouraged to remain involved with the service for as long as they wished. For example, there was an annual service of remembrance to remember all of the children who had died at the hospice. This provided families with continued emotional support after the death of their child and a chance to offer each other mutual support.

The hospice had a memorial garden. The centre piece of the garden was the memorial tree, a large metal architectural structure in the design of a tree. The service of remembrance was held there every December. Families of deceased children were welcome to use the garden on days of their choosing.

Following the death of their child parents were given an envelope containing details of bereavement organisations and local charities that could support them. The envelope also contained details about a metal teddy bear that could be engraved with their child’s name and hung on the memorial tree in memory of their child.

The service had developed appropriate, accurate and up-to-date information for parents and families. However, written information was only available in English.

The service provided leaflets for parents with detailed information about the service. There was also information about the service for existing and prospective parents on the organisation’s website. However, this was only available in English.

Staff could use a face to face or telephone interpretation service to support conversations for people whose first language was not English. Staff told us they would always try to book a face-to-face interpreter for care needs assessment appointments but typically used a telephone interpretation service for day-to-day conversations with parents as needed. Staff told us about a family who said they did not need an interpreter for day-to-day conversations despite English not being their first language. However, staff were not certain that the family understood some of the instructions or information they wanted to share with them, for example bringing in specific items, so they reintroduced interpretation services for all communication with the family.

The service made it easy for people to share feedback and ideas, or raise complaints about their child’s care. Staff involved parents in decisions about their children’s care and involved children when this was possible.

The service kept a log of written and verbal compliments and complaints. From December 2024 to February 2025 the service received 20 written compliments and 5 verbal compliments. There were no complaints about the service within this timeframe.

The organisation was introducing an online survey to be sent to all families at the end of each month to replace the existing paper based monthly admission and discharge survey. Staff told us responses to the current survey had dwindled so they were relaunching it in a digital format in the hope of gaining more interest from parents and carers.

Parents and carers were given a ‘parent’s guide’. This booklet contained information about how to make a complaint or give other feedback. There was a comments box that people could leave anonymous complaints in if they did not want to complain formally.

The service was not able to consistently offer families access to the care, support and treatment they needed when they needed it.

The aim of the service was to provide home from home care for children, and respite from caring for parents and carers. Respite can prevent caregiver burnout and stress by offering a much-needed break from the demanding nature of caring for a child with a life limiting condition.

The children, families and carers who used the service were not always able to receive the care and treatment they needed when they wanted it. At the time of our inspection the service was unable to accept children for an end of life admission. This was because the service did not have enough staff to open for longer than 48 hours at a time. However, staff worked with the community paediatric nursing team to offer care to children and their families in their own home to provide a sense of continuity.

Due to low staffing most children who received respite care were looked after by the service for either 1 or 2 days a month or for 1 or 2 overnight stays. Staff told us due to staffing levels they sometimes had to cancel respite care due to staff sickness. The service only had enough staff to open 2 weekends each month.

Parents told us if they could not use the respite dates they were offered due to the family’s commitments or for other reasons, they were not given alternative dates for respite care. They told us they understood the hospice was short staffed and they were, “just grateful for the respite care we are given.”

Parents told us how important the respite care was on a personal basis and for their family as a whole. For example, one parent said respite care, “Is fab, it's amazing. It's really important for my other children that they get to spend time with me”. Parents explained that apart from school or nursery the only other place they were happy for their children to spend time without their constant supervision was Zoe’s Place. “Zoe's place is the only place that [child’s name] goes to apart from home or school because I fully trust them. It's the best care. I'm really confident that she’s being properly looked after when she's there”. They went on to explain that they only felt able to, “leave the house when [child's name] is at school or at Zoe's as they don't cope going outdoors or anywhere new”.

When there were complex social needs within a family they received a higher level of support from the service. For example, some parents and carers told us if other people cancelled their child’s respite slot they were offered the opportunity to have additional respite care.

Referrals to the service could come from anyone but they were mostly received from healthcare professionals working with the family. The referral form was available on the providers website. Once a referral was received staff would contact the child’s consultant to verify if the child had a life limiting condition which was a prerequisite for receiving care from the service. The child and parents would then be invited to attend a needs assessment. Along with information requested from professionals working with the family this was a chance for staff to get to know the child and their parents so they could decide if their facility met the family’s needs. This was also an opportunity for staff to explain what a child’s respite care might look like.

Leaders and staff were alert to discrimination and inequality that could disadvantage different groups of people in accessing their service. The families referred to the service came from across the social spectrum including families from ethnic minority groups, travellers, homeless families, and families whose first language was not English. Staff worked to remove barriers to care. For example, the service was fully accessible to wheelchair users and the staff had access to British Sign Language interpreters.

Some of the families referred to the hospice had problems with transport. The hospice could not resolve these issues, but they put the families in contact with other charities might be able to offer assistance with transport.

Staff and leaders actively listened to information about families who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. However, the service did not consistently meet the needs of children who required end of life care.

Due to low staffing numbers senior leaders told us they were not able to offer a service that met the needs of the community. They were not able to offer care to children or babies in the last days of their life because they did not have the staff to keep the hospice open. The service only had enough staff to open for 24 hours a day for 2 or 3 days each week. They recognised it would not be safe to accept a child in the final days of their life and have to transfer them to another location.

In addition to this they were not able to give families as much respite care as they might need or want due to their restricted opening times. However, children and their families had good outcomes and experiences of the service when they could use it regardless of their needs, backgrounds or protected characteristics.

When staff could support a family’s urgent request for support they tried to meet this need. For example, they provided urgent overnight respite care when a carer needed urgent surgery, and they provided day care when a parent went into labour. This parent told us, “I had a great birth because I could relax knowing [child's name] was at Zoe’s Place”.

The hospice could be used by families of children that had previously not been known to the service following the death of their child. The air conditioning in the starlight bedrooms meant the temperature could be kept at 4 Celsius to preserve a body's appearance, prevent deterioration, and maintain dignity. For example, one family did not want the body of their deceased child to be taken to a funeral parlour so arranged for their child to stay in the starlight suite until the day of the funeral. The family were able to stay with the body of their loved one throughout this period.

An episode of a child’s care had been funded by a social care team when the team had been unable to find an alternative place of care. Leaders told us that having a child for a medium- or long-term placement to support their social care partners was not equitable. As this meant families requiring respite care were not able to access as much of this as they needed.

The cultural needs of families were established at the point of referral so staff could ensure these could be met prior to commencing care. For example, positioning of beds or cots.

Parents and carers were supported to plan for important life changes, so they could have enough time to make informed decisions about theirs and their child’s future.

Staff received training around end of life care, including in what good end of life care looked like, and managing difficult conversations. Staff worked in partnership with other healthcare professions to support good end of life care.

Leaders told us they rarely worked with children who had an understanding of death. However, staff supported parents and carers to express their wishes about their child’s end of life care. Decisions were clearly recorded and communicated as appropriate.

If parents and carers wanted their child to die at home staff would go out with the community paediatric palliative care team to provide support to the family. This was because staff understood they were already a familiar face for the child and the family and this could help provide continuity of care and a chance for parents to have a period of respite from caring. One member of staff told us supporting the family in this way was important because, “Home feels like the right place until it doesn’t”.