Julia's House

Updated 22 December 2021

Julia’s House is operated by Julia’s House Limited. The charity provides care to children and young people with life-limiting or life-shortening conditions within the Wiltshire area.

Julia’s House provides a respite service consisting of day care sessions at the hospice as well as community-based respite in the child’s own environment. There is also access to multi-disciplinary end of life care provided for children who are currently using the service. Support to bereaved families is provided up to five years following the death of a child. During the COVID-19 pandemic, the service accommodated up to two children at one time within the hospice and provided an increased service within the community. Admission criteria for the service focuses on a modified version of Together for Short Lives guidance. Care to families is provided for free. Each family receives an allocation of care hours for their child and parents can ‘spend’ these hours as they wish.

The charity also provide care at another hospice based in Dorset. The two locations work as one team and consists of nurses, carers, family support and sibling support workers. They work closely with existing community services including community nurses, the local authority and other hospice services within the area. The service had recently recruited an additional medical doctor to provide increased medical support to the service to support choices over where end of life care could be provided. The hospice had created a bedroom suite to enable children and their families to be together at the end of life.

At the time of our inspection the charity was supporting approximately 52 families. This included 10 bereaved families. The service supported families from pre-birth and the eldest service user being supported at the time of the inspection was 18 years old.

The service is registered with the CQC to provide the following regulated activities:

• Personal Care
• Treatment for Disease, Disorder and Injury

The current registered manager has been in post since 24 August 2017. The location was registered in August 2017. This was our first inspection of this location.

Updated 22 December 2021

This is the first time we have inspected this location. We rated it as outstanding because:

• The service had enough staff to care for children and young people and keep them safe. Staff had training in key skills, understood how to protect children and young people and adults from abuse, and managed safety well. The service-controlled infection risk well. Staff assessed risks to children and young people, acted on them and kept good care records. They mostly managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
• Staff provided good care and treatment, gave children and young people enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of children and young people, supported them and their families to make decisions about their care, and had access to good information.
• Staff consistently treated children, young people and their families with compassion and kindness. They always respected their privacy and dignity. Staff recognised and respected the totality of children’s needs and that of the whole family. Staff helped children and their families to understand their conditions and supported them fully to be involved in their care. There was a strong, visible child-centred culture and staff provided emotional support to patients, families and carers in every way they could. Children and their family’s social needs were highly valued by staff and embedded in their care and treatment. Families consistently and overwhelmingly told us they felt truly cared for by the service.
• The service planned care to meet the needs of local people, took account of children’s individual needs, and made it easy for people to give feedback. People could access the service when they needed it.
• Leaders had an inspiring shared purpose to deliver outstanding care. They had created, developed and used reliable information systems to monitor and consistently improve the service. Leaders consistently motivated and supported staff to develop their skills to enhance the care they provided. The vision and values of the service were central to the whole organisation and visible to staff who understood them and applied them in their work. Staff felt respected, supported and valued and told us of the supportive and caring nature of staff at all levels of the organisation. The service was passion led and clearly held the child and their family at the centre. Staff were clear about their roles and accountabilities and staff felt they were encouraged and engaged. Constructive challenge was consistently sought by leaders and they strived to improve services continually for the benefit of children and their families. The service engaged well with children, their families and the community to plan and manage services and all staff were involved and committed to improving services.

However,

• The medication policy did not contain clear guidelines on the timescales for review of medication administration charts and some children had not been weighed in line with the service’s medication policy.

Updated 22 December 2021