Little Harbour

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

This means we looked for evidence that the service met people’s needs.

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

This service scored 82 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional at making sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People had care plans that clearly reflected their physical, mental, emotional and social needs. All children and young people had comprehensive, holistic care plans that captured their views, wishes and needs. Where children and young people were approaching the end of their lives, detailed advance care plans were in place, with a clear focus on maintaining quality of life. Families told us they were key partners in their child’s care and treatment.

The environment was designed to support person‑centred care. Although all bedrooms were mostly the same, there was 1 ensuite bedroom that allowed independence for children that preferred their own private bathroom. Individual bedding was used to personalise each room to the child’s preferences. The service had a variety of bed types according to each patients needs. Bedrooms had direct access to the outdoor grounds and were fully accessible, enabling beds to be moved outside where this supported the child’s wishes.

The service offered a range of personalised activities to support children’s wellbeing, including music therapy, access to a craft room and a variety of sensory resources such as fidget toys and rainmakers. The soft‑play area was accessible and included a hoist. Children and young people also had access to a large accessible outdoor area with games and swings including wheelchair swings to support play and enjoyment.

Staff had relevant experience and training and acted as advocates for the voice of the child. Children and young people were supported to use their preferred communication methods. Where appropriate, children used their own communication aids, including eye‑gaze technology, which was tailored to the individual child’s abilities and parameters. The service encouraged children to bring familiar communication aids from home or school.

Staff used a range of communication approaches, including personalised books, signs and Makaton, and were trained to identify and use the communication methods that worked best for each child. The service worked with a specialist who was neurodiverse to ensure staff had the skills and understanding of complex communication needs.

The service demonstrated an understanding of the specific needs of bereaved relatives and ensured these needs were appropriately supported.

We scored the service as 3. The evidence showed a good standard. 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.

The service provided respite, symptom management, and end of life care. Children and young people were offered up to two planned respite stays each year, totalling 6 nights. Stays were provided from Monday to Thursday or Thursday to Sunday.In addition to the 2 planned stays per year, the service offered short‑notice respite for families with identified needs, such as issues with care packages, increased emotional support requirements or specific clinical needs for example completing sleep studies to avoid hospital admission.

The service was established for 4 children. The service accepted emergency referrals and were responsive to need. For example, on one occasion they received a request for an emergency stay at 1pm and by 5pm the child had arrived at the hospice.

In the case of an emergency stay, to support families in crisis and to help prevent cancellations of planned stays, the service requested additional staff. However, if this was not possible, occasionally planned stays were cancelled but these would always be rebooked.

Families could book planned stays using an online booking system or by contacting the service directly to discuss their needs. The service worked flexibly and collaboratively with the link nurse at the local hospital to support continuity of care.

All children were allocated a contact team who maintained regular communication between stays, using either phone or email depending on family preference.

Weekly CCN meetings occasionally highlighted families who were struggling in the community. When this occurred, the hospice used the opportunity to reach out and, where possible, offer additional support such as extra stays or day visits.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service took steps to ensure information was accessible to children, young people and their families. Translation services were available, and the service worked with interpreters when required. Families could communicate face to face or use a telephone language interpretation service. Letters and written information could be translated, and translation support was used when booking stays to ensure care pathways were understood.

The service had been reviewing its patient‑facing information to improve accessibility. Easy‑read versions of key documents were available, for example the complaints policy and an easy read version of the complaints procedure was available.

The service supported effective communication. Children and families were encouraged to bring any communication aids they used. Staff liaised with schools to understand existing communication methods, such as picture exchange communication systems and bespoke communication tools. Communication needs were considered as part of the care planning process.

Information sharing was managed safely. The service had a Caldicott Guardian whose role was to ensure the ethical, legal, and secure use of personal health and social care information within the organisation. Families could contact the service at any time for advice and support.

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. They always involved people in decisions about their care and told them what had changed as a result.

Families knew how to raise concerns or make a complaint. When concerns were raised, families received feedback. The service routinely contacted families to seek feedback about their experiences. There was a QR code displayed around the house with a link to give feedback and feedback was requested after each stay. There were paper copies available for families that preferred to give feedback this way. Feedback was shared with staff and discussed at team meetings. Where improvements were identified, action was taken.

There had only been one formal complaint in the 6 months before our inspection. However, staff and managers responded promptly and sensitively to any negative feedback received. Families and children were involved in reviewing concerns and identifying improvements.

The service listened to feedback and made changes as a result. Families had fed back that the admission process for checking medicines, patient history and care plans on arrival was time‑consuming. In response, the service reviewed its practice and provided opportunities for families to complete as much of the history review process as possible before the stay. This reduced delays on arrival and improved the experience for families.

The catering team responded to family feedback by creating weekly, personalised menus based on each family’s preferences and dietary needs, resulting in a more tailored experience.

Families described being actively involved in care planning and risk assessment and told us they felt confident raising concerns and giving feedback.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

The service generally met all waiting‑time targets for routine and urgent referrals in 2025/26. All urgent referrals received a response within 48 hours and most were accepted on the same day. For routine referrals any delays were due to incomplete information or forms such as medical information.

Once accepted, the service gathered information from other professionals involved in the child’s care, with consent. This reduced duplication and supported coordinated care planning. Families were offered a visit before their first stay, allowing staff to understand needs, address concerns and agree care at the family’s pace. Online booking and proactive communication supported access.

Care plans were completed before admission and reviewed shortly before and on arrival to reflect any changes. Decisions about accepting referrals were made through a central group, and families were allocated a care team as close to home as possible to support continuity.

The hospice environment supported access for all families, including lift access and facilities adapted for children. Cultural and religious needs were considered, including support for faith‑specific practices following death.

Families told us they were generally able to access the service when needed.Phone line support was available 24 hours a day, 7 days a week from the care team with senior nurses on call if anything needed escalating.

We scored the service as 3. The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff promoted a culture where children, young people and families felt able to share their views and influence their care. Staff had received training in equality, diversity, inclusion, human rights and cultural competency.

Local multifaith services had delivered additional training to raise awareness of cultural needs within the local population. This supported the team to build relationships with community organisations and helped identify and address areas of unmet cultural need.

The service worked proactively to remove barriers to access and maintained strong links with community providers across the wide geographical area, including rural and coastal communities where specialist support can be harder to reach. Staff took part in weekly community multidisciplinary meetings to help identify clinical concerns and family‑support needs early. This ensured timely intervention and reduced inequities in care. Families’ experiences directly shaped service improvements, for example accessibility had been improved through the development of easy read resources such as the complaints procedure.

The service had connections with cultural and community groups to promote awareness and ensure underrepresented families could access support. They provided holistic assistance including help with welfare, finances, sibling support, agency referrals, and access to essential resources such as food banks.

Systems ensured families received consistent support, tailored to their individual circumstances. This helped reduce inequalities and supported equitable experiences and outcomes across the service.

We scored the service as 3. The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff supported children, young people and families to make decisions about current and future care. Personalised care plans were developed with families and reflected the child’s needs, wishes and feelings. Staff used the child and young person’s advance care plan to support planning at all stages.

Professionals involved in a child’s care were included in planning, particularly where needs were complex. This helped ensure care and treatment were coordinated and aligned with families’ preferences.

Planning for the move into adult services typically began at around 14, giving ample time to explore future needs, prepare for changes and introduce families to adult‑service providers. Transition was viewed as a phased and collaborative process rather than a single point of transfer.

A dedicated transition lead, supported by transition champions within each team, coordinated this work. They collaborated closely with acute‑sector transition leads and partner organisations to ensure that risks were managed effectively and that young people received safe, consistent support through a multidisciplinary approach.