Archived: Quidenham Children's Hospice

Services are offered from diagnosis to end of life and throughout bereavement and include the young person’s extended family, such as grandparents. Receiving care from East Anglia’s Childrens Hospices (EACH) does not mean that the child’s death is imminent. Many of the children and young people who use the service live long and active lives but need additional care and support. The provider’s website states that the service is available 365 days a year.

Quidenham Children’s Hospice is housed in a converted building in the peaceful grounds of a monastery. The in-house short break service is housed in a two storey building and includes shared areas for relaxation, play and meals, single bedrooms and a kitchen. There are bathing facilities and facilities for families to stay.

The provider, EACH, runs three hospices in East Anglia. The three hospices work very closely together, sharing knowledge and expertise as well as sharing the Symptom Management Team (previously known as the True Colours team).

This comprehensive inspection took place on 8 March 2016 and was unannounced. On the day of the inspection no young people had stayed the previous night. We met three young people and their families who arrived during the afternoon for a short break.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The registered manager had been in post for 2 years.

The young people we met were very happy to be staying at the hospice. We saw from their body language and their interaction with staff that they were comfortable and relaxed with the staff. Parents were effusive in their praise of the staff and of the service they and their children received. They told us how much the care and support provided to them and their child meant to them.

There was a very strong ‘person-centred culture, which recognised and supported the holistic needs, preferences and goals of each individual child and each of their family members. Everything that happened was based on meeting those needs, preferences and goals. The service strived to give each child the best life, and if and when it came to it, the best death they could have. Staff supported families before, during and after a bereavement for as long the family needed support.

We saw that there were warm caring relationships between staff and the young people and also with their parents. There was a lot of laughter and fun. Staff were well-trained to meet the complex and specialised needs of the young people in their care. Staff treated every young person with care and compassion and with respect for their privacy, dignity and independence. A wide range of methods was used to communicate with each young person in the way that enabled the young person to make choices about their everyday lives.

Staff had extremely good, caring and respectful relationships with parents. Parents were grateful for the attention staff paid to detail and felt staff knew them and their children well.

There were systems in place to make sure that young people were kept as safe as possible. There were enough staff on duty to support each young person in the way they needed and preferred to be supported. Pre-employment checks had been carried out to make sure that staff and volunteers were suitable to work in this environment. Staff had been trained to recognise and report any incidents of harm and medicines were managed safely. Any potential risks to each young person had been assessed and guidance put in place so that staff knew how to minimise the risks.

Staff showed that they understood and worked within legislation relating to young people and/or their parents giving consent to their care and treatment. Staff used different methods with each young person to enable them to make choices about their everyday lives.

The CQC monitors the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS), which apply to care services. This legislation applies to young people over the age of 16 and staff working with this age group had an understanding of the principles of the MCA and DoLS. This meant that the rights of young people not able to make their own decisions about aspects of their care were protected.

Young people and their extended families were cared for by a highly motivated, dedicated and well supported staff team. A wide range of age-appropriate activities, outings and events were organised and young people were supported to pursue and develop their own interests. The service was as fully responsive as they were able to be to the needs and goals of the young people and their families. Families valued the events and therapy sessions which were arranged and which they were encouraged to attend both during their child’s life and following bereavement.

Holistic, detailed needs assessments were undertaken so that staff were fully aware of the young person’s and their family’s needs, wishes and goals. Young people and their families were fully involved in the planning and reviewing of their care. Detailed information was available to staff so that each young person received the care and support they needed in the way they preferred.

Young people’s nutritional needs were met by a catering team who worked hard to ensure that each young person and every family member had the food and drink they preferred. Young people’s healthcare needs were monitored and staff involved external professionals when required.

The service was managed very effectively by a dedicated registered manager who was extremely passionate about their work; about the young people and their families they provided a service to; and about their staff team. The whole staff team learnt from any mistakes and were constantly striving for excellence.

Everyone involved with the service was encouraged, in a number of both formal and informal ways, to give their feedback about the hospice and the service it provided. Numerous compliments had been made about the service, the management and the staff team. Parents were aware of how to raise any issues if they needed to and felt comfortable doing so. An effective system was in place to monitor and audit the quality of the service being provided. There was a homely, friendly and open culture in the hospice.

The hospice staff worked in partnership with a wide range of other services and healthcare professionals, all of whom praised the service that was provided to each young person and their family.

Our observations showed us that staff members were responsive to the needs of the young people and that they were given the support and attention they needed. We saw that the young people had a positive experience of being included in conversations, decision making and activities.

We found that plans of care contained the information staff members needed to ensure that the health and safety of the young person was promoted and protected.

Parents told us that the young people staying at the hospice were safe, provided with the nursing care and support they needed and that the staff were, 'Wonderful and kind.' They also told us that the service their child received at home was 'Invaluable' and that support was offered to the whole family.

Medication was administered, recorded and stored accurately and safely.

Parents told us that good staffing levels were provided at the hospice and that if staff absence was not covered for their home support that they were offered an alternative date and time.

The records held were complete and up to date and ensured that staff members had access to information that protected people and ensured their needs were met.

Our observations also showed us that the young people were given the care, treatment, support and attention they needed and had a positive experience of being included in conversations, decision making and play and music therapies and activities.

Parents of the young people who used the service and relatives told us that the young people received the nursing care, treatment and therapeutic support that they needed and that staff were very kind.

The parents of young people using the hospice told us that the staffing levels at the hospice were always good. We found that each young person was provided with one to one or two to one support and that additional volunteers assisted the staff and therapists.

Parents spoken with were aware of the complaints system. Complaints were dealt with appropriately and people were able to access and use the complaints system in a format that met their needs.