Acorns Children's Hospice in the Three Counties

Updated 19 March 2020

Acorns Children’s Hospice in the Three Counties is operated by Acorns Children’s Hospice Trust which runs three children’s hospices. Acorns Children’s Hospice in the Three Counties. The hospice opened in March 2005. It is a children’s hospice located in an urban location in Worcester, Worcestershire. The hospice primarily serves the communities of Worcestershire, Herefordshire, Gloucestershire, Warwickshire and surrounding areas.

Acorns Children’s Hospice Trust provides a holistic service which meets the needs of children and young people up to 18 years old, and their families, including the bereaved. This includes short break provision; emergency and end of life care; therapeutic and psychosocial support; sibling services and family support.

Acorns Children’s Hospice of the Three Counties has supported 191 children and young people with life limiting illness in the hospice and the wider community from October 2018 to September 2019. This included 44 children from birth to three years, 107 children and young people aged four to 12 years and 40 children and young people aged 13 to 17 years old.

The hospice has 10 bedrooms, two family care suites and two family flats with lounge areas and gardens. Facilities include a hydrotherapy pool and two chapel of rest special bedrooms where children can stay after they have died. The service has a complementary therapy team and provides treatments for children, young people and their families.

The hospice care team offers holistic care to each child and young person to support their health and social needs as well as providing recreational activities. The hospice provides end of life care and support. The care team consists of paediatric palliative care nurses, health care assistants and physiotherapists. The hospice has daily visits from local GPs. The service is supported by 54 volunteers involved in a variety of tasks including housekeeping, reception, maintenance, gardening, supporting children and families at home through group work.

Other services offered include day care, planned short breaks, emergency short break care and family splash where children, young people and their families can use the hydrotherapy pool.

The hospice has had a registered manager. The current registered manager has been in post since August 2017.

The hospice had been previously inspected in April 2016.

We inspected this service using our comprehensive inspection methodology. We carried out an announced inspection on 18 December 2019 and 2 January 2020.

Updated 19 March 2020

Acorns Children’s Hospice in the Three Counties is operated by Acorns Children’s Hospice Trust which runs three children’s hospices. Acorns Children’s Hospice in the Three Counties specialises in providing holistic palliative care to children and young people from birth to 18 years living with life limiting conditions. The hospice has 10 beds. Facilities include two family care suites, two family flats with a lounge area and gardens, activity rooms, a multisensory room, indoor soft play, outdoor play area, a adolescent room and hydrotherapy pool. The hospice also has two chapel of rest special bedrooms where children can stay after they have died.

The hospice provides holistic palliative care and support at end of life care for children and young people, outreach services, family support, complementary therapy and respite care. We inspected all services provided.

We inspected this service using our comprehensive inspection methodology. We carried out a short notice announced inspection on 18 December 2019. We gave staff one day’s notice that we were coming. We also carried out an announced visit to the hospice on 2 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 service stayed the same. We rated it as Good overall.

We found areas of good practice:

• The service provided mandatory training in key skills to all staff and made sure everyone completed it.

• Staff understood how to protect patients 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 had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. Managers regularly reviewed and adjusted staffing levels and skill mix, and gave bank, agency and locum staff a full induction.

• The service provided care and treatment based on national guidance and evidence-based practice. 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 monitored the effectiveness of care and treatment. They used the findings to make improvements and achieved good outcomes for patients. The service had been accredited under relevant clinical accreditation schemes

• 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 development.

• Staff treated children, young people and their families with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.

• Staff provided emotional support to patients, families and carers to minimise their distress. They understood patients’ personal, cultural and religious needs.

• Understanding and involvement of children, young people, their families and those close to them. Staff supported and involved children, young people and their families to understand their condition and make decisions about their care and treatment. They ensured a family centred approach.

• The service was inclusive and took account of children, young people and their families' individual needs and preferences. Staff made reasonable adjustments to help patients access services. They coordinated care with other services and providers.

• Children and young people could access the service when they needed it and received the right care promptly. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were in line with national standards.

• Leaders had the skills and abilities to run the service. They understood and managed the priorities and issues the service faced. They were visible and approachable in the service for children, young people, their families and staff. They supported staff to develop their skills and take on more senior roles.

• Leaders operated effective governance processes, throughout the service and with partner organisations. Staff at all levels were clear about their roles and accountabilities and had regular opportunities to meet, discuss and learn from the performance of the service.

However, we also found the following issues that the service provider needs to improve:

• The provider should have a consultant medical director with oversight at executive level

• The provider should ensure that all staff receive regular safeguarding supervision

• Managers should ensure that all staff are aware of feedback and learning from incidents

• Managers should ensure that all staff have an annual appraisal

• The provider should ensure that all audit processes are robust and actions are identified to improve performance.

• Managers should ensure that all staff received feedback from complaints

• Managers should ensure that audit data is included in team meeting minutes

• The provider should ensure they monitor cancelled appointments and delays into the service.

Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Heidi Smoult

Deputy Chief Inspector of Hospitals

Updated 19 March 2020

Acorns Children’s Hospice in The Three Counties provides holistic palliative, respite and end of life care to children and young people from birth to 18 years living with life limiting conditions. The hospice has 10 beds.

The service provides support to children, young people and their families both within the hospice, in individuals homes and in the wider community. The hospice supports families across Worcestershire, Herefordshire, Gloucestershire, Warwickshire and surrounding areas