Martin House

Updated 13 September 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place over two days on 15 and 22 June 2016. The first day was unannounced. The second day was made by appointment. The inspection team on day one consisted of one adult social care inspector, a specialist advisor with a background in nursing, a specialist pharmacist inspector and an expert by experience with a background in care of younger adults. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. On the second day of the inspection one adult social care inspector returned to the service to complete the inspection.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed all the information we held about the hospice, including previous inspection reports and statutory notifications. We contacted the local authority and Healthwatch. We were not made aware of any concerns by the local authority or Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We also contacted health and social care professionals who were familiar with the service.

During our visit we spoke with eight children/young adults who used the service, seven relatives, and four members of staff, four volunteers, and two team leaders, the human resource director, estates manager, the service manager and the registered manager. We spent some time looking at documents and records related to the children and younger adults care and the management of the service. We looked at three children and young adults care records and four medication records. We spoke with 10 relatives of the children and young adults in the community on the telephone after the inspection.

Updated 13 September 2016

We inspected Martin House Hospice on 15 and 22 June 2016. The first inspection day was unannounced. The second day was made by appointment. At the last inspection in January 2014 the service was meeting the regulations we looked at.

Martin House (in patient unit) provides specialist palliative care, respite and end of life care to children and younger adults. The service also supports people in the community. At the time of our inspection visit there were 10 children and younger adults who used the (in patient service).In total 366 people were receiving a service from Martin House .

The hospice had a registered manager in place. 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.

We looked at the way medicines were managed within the hospice. We found people were not always protected against the risks associated with medicines, because appropriate arrangements to manage medicines were not always in place. This was a breach of Regulation 12 (Safe care and treatment) of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Staff understood children and younger adults’ individual needs and the support they and their family members required. Staff were very passionate about their roles and placed people at the heart of their work. We saw that care was provided with the upmost kindness, respect and compassion. Children and younger adults who used the service and relatives spoke highly about the care and service received. The families of the children and younger adults said their right to privacy was fully protected. Families of the children and younger adults told us the service they received was excellent. The hospice provided very good family support, counselling and a bereavement support within and outside the hospice. The hospice had its own chapel inside the quiet grounds of Martin House.

Care was provided to an extremely high standard with an environment for everyone at Martin House that met individual needs both emotionally and spiritually.

Families spoke of the high regard which they had for the hospice and what a significant difference this had made to all the family. Families told us of the support they received from the service in and out of the community. They received extensive services, such as short breaks, music and play therapy and counselling for all the family.

Children and younger adults told us of the excellent food which was available for both people and their families. All the food was made fresh by a small team in the kitchen. The chef told us that they did not do a specific menu; this was dependant on who they had in on the day. The chef tailored this round the knowledge of the children and young adults in the Hospice. Nutritional assessments were undertaken to identify risks associated with poor nutrition and hydration.

Risks to children and younger adults’ safety were appropriately assessed, managed and reviewed. Care records contained risk assessments specific to the needs of the children and younger adults. Their individual views and preferences had been taken into account when their care or treatment plan had been developed

There were systems and processes in place to protect children and younger adults from the risk of harm. Staff told us about different types of abuse and the action they would take if abuse was suspected. Staff were able to describe how they ensured the welfare of vulnerable children and younger adults was protected through the organisation’s whistle blowing and safeguarding procedures.

Checks of the building and equipment were completed to make sure it was safe. The service had a comprehensive maintenance file which included any outstanding actions and completion dates throughout.

The registered provider had effective systems in place for responding to concerns and complaints. Children, younger adults and families were asked for their views about the service they received. The registered manager told us they used this as a continuous learning process to ensure everyone received a high quality level of care.

The service had extensive support from other healthcare professionals such as GP, nurses, psychiatrists and tissue viability nurses who supported staff and people with their individual care needs. This meant everyone’s needs where addressed.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.