Archived: Alexander Devine Children's Hospice Service (Headquaters)

Updated 23 February 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

The inspection took place on 28 and 29 September 2016 and was announced. The provider was given one week’s notice that we were coming to ensure senior staff were available to access the documents we required to carry out our inspection.

The inspection team included one adult social care inspector, one registered nurse specialist advisor and an Expert by Experience. An Expert by Experience is a person who has experience of using or caring for someone who uses this type of care service. This was the first inspection at this location. We reviewed the information we held about the service and notifications we received. A notification is information about events which the service is required to send us by law. We reviewed the Provider Information Return (PIR). A PIR is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make.

We spoke with eight parents of children and young people who used the service. We observed three children who received care. We spoke with the Chief Executive Officer (CEO) the registered manager, the quality and governance lead, five registered nurses, a member of the fundraising team, a member of the care team, the play specialist and the person who donated land to build the inpatient unit.

In addition, we reviewed nine care plans, minutes of meetings, recruitment files, supervision records, staff training records, policies and procedures, and audits carried out. We also had the opportunity to visit the inpatient unit which is due for completion in 2017.

Updated 23 February 2017

Alexander Devine Children’s Hospice Service was founded in 2007 and provides support across Berkshire and surrounding counties to children and young people from 0-19 years who have a life- threatening or life- limiting condition. Care is offered through hospice at home and in the community.

There was a registered manager at the service who registered with CQC on 16/07/2013.

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.

At the time of the inspection the service was supporting 86 children and families, 15 of which were suffering a recent bereavement. The bereaved families continued to receive support from the service.

Hospice staff worked in partnership with local NHS Foundation Trusts and other services across health and social care to deliver integrated care to children and their families. Staff worked within children’s community teams to provide palliative care support and advice. Care was delivered in a variety of settings including at home, in hospitals or schools, depending on the individual needs of the families.

Children and young people who used the service were safe. Staff received safeguarding training and all staff we spoke with told us they would not hesitate to report any concerns they had to the relevant authority. Safe recruitment procedures were in place to ensure only suitable staff were employed.

Staffing levels were appropriate for the service and the service ensured it did not offer over and above what they could deliver.

Staff completed a thorough induction programme to enable them to carry out their roles and responsibilities. Palliative care and end of life training for all staff ensured children, young people and their families received compassionate and caring support. Bereavement support was available where this was identified as a need.

There were safe systems in place to manage medicines in the community. Practice was supported by robust professional guidance and policy to ensure the safe management of medicines.

There was a holistic approach to children, young people and their families, with social and spiritual needs given equal importance as the physical needs. Diverse cultural requirements were met by the service and any specific requirements following the death of a child addressed.

Where a specific need was identified in terms of dietary requirements, liaison with the relevant healthcare professionals was sought.

We saw children and young people received care and support in a personalised way. Complex medical needs were managed well by staff who were trained to deliver specialised care and support. Children and young people said they felt safe with staff. Families reported staff knew their child or young person well and were reactive to their complex needs. Parents told us on-going bereavement support allowed them to adjust to their loss and helped them come to terms with their loss, enabling them to care for their other children.

Children, young people and families had their needs fully assessed, planned for and met by the service.

The service employed a play specialists who were able to work with families and children to engage with them positively, including supporting of social activities to promote the development of relationships.

There was a clear management structure, and staff said they were proud to work for the service. Staff were fully committed to the children and families they supported. Families felt comfortable talking to managers about any concerns or ideas they had for improvements. There were systems in place to ensure the continuous improvement of the quality of the service provided.