Christopher’s Children’s Hospice is provided by Shooting Star Chase, which is a registered charity caring for babies, children and young people with life-limiting conditions, and their families. Christopher’s Children’s Hospice provides support from babies to young people up to the age of 21, they support families from diagnosis to end of life and throughout bereavement with a range of nursing, practical, emotional and medical care. Their care service includes overnight short breaks, Hospice at Home, day care, symptom management, end-of-life care, bereavement care and a comprehensive range of therapies and support groups for the whole family.The hospice is a nurse led service and children and young people's health needs are met by a range of health professionals during their stay. This includes specialist children’s nurses, adult learning disability nurses, occupational therapists, physiotherapists, social workers and the care team. A local GP practice provides daily medical cover for the hospice to review children’s medicine and respond to any health needs. A children’s palliative care consultant oversees the symptom management and end of life care.
This inspection was carried out 28 and 29 July 2016 and was unannounced. Christopher’s Children’s Hospice is registered to provide bed based care for up to nine children at a time. At the time of our visit six children and young people were using the bed based unit and the hospice service had around 700 families registered as qualifying for the service.
There was 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.
Christopher’s Children’s Hospice is an outstanding service. It is focussed on the individual needs of the children, young people and parents who they support, at the time they need it in a way and place that best suits them and their whole family. Parents spoke overwhelmingly of the positive support, guidance and healthcare interventions their children had received. They were full of praise for the staff in terms of their kindness, compassion and knowledge about end of life matters. Parents viewed the staff as experts in their knowledge and skills when supporting children and young people with complex health needs.
Staff were playful, full of energy and maintained a high level of engagement with children, young people and their parents and parents consistently told us how much they valued the normality of the service and the effort staff made to ensure their children had the same experiences as other children.
Parents and professionals spoke of a service that was tailor-made for children and their families saying that staff went ‘the extra mile’ with empathy and compassion. Throughout the end of life care of children and young people parents were given information and kept involved to enable their children to continue to receive parent led care. Informed consent was embodied into all work that was undertaken at the hospice. The various departments within this hospice worked well together so that people had a seamless experience of moving from one department to another as the need arose.
The end of life support provided was highly personalised and tailored to meet the needs and wishes of each individual child, young person and their family with sensitivity and compassion. The hospice was supportive of family’s spirituality. They strived to offer support that recognised spirituality as that ‘which connects us to each other and includes whatever gives each person meaning, purpose, value, self -worth and hope’. Staff were sensitive to parents’ individual spiritual needs and thought of ways to meet these needs when they experienced difficult times.
Staff were motivated and keen to convey to inspectors their pride in working at the service. Staff were involved in the development of working practice, listened to, empowered with training and supported to offer excellent end of life healthcare and support.
The registered manager promoted a culture of openness and excellence. They listened to people and staff, involving them in the running and development of the service. They actively sought out their views and used feedback as an opportunity to improve and develop the service. There was a kindness and warmth about the management team that made them approachable to everyone and people knew them by their first names and told us they were visible and solved matters raised.
The provider creatively launched their new values ‘Professionalism, Respect, Integrity, Diversity and Excellence’ under the acronym PRIDE. Throughout our inspection we observed and heard from parents, young people and professionals that staff always demonstrating these values in how they behaved. Staff demonstrated a strong person centred culture. This was represented by the provider’s fingerprint logo the Friendlies, a group of lively fingerprint characters designed to ‘break down the misconception that children’s hospices are sad places’. By using multiple logos the provider had created interactive branding which allowed the community, parents, staff and children to engage with the aims and values of the service in a creative way.
Governance of the service was of a high standard that was benchmarked against similar services and communication was very good. The Board of Trustees were appropriately informed and closely scrutinised how the hospice operated ensuring the registered manager was held to account in ensuring a high quality service was delivered. There was parent representation on the board of Trustees and we found examples that showed parent representatives had real influence and involvement in a number of issues within the hospice The quality assurance systems in place showed that people were right to have the confidence in this local hospice.
The hospice worked innovatively in partnership with many local and national organisations to develop local services for their community and to inform and improve practice in the children’s hospice movement. We saw how this partnership working had enable young people to access appropriate adult services when they became too old for children’s services. The hospice had also developed close working with the neo-natal team to support families with new born babies at the end of their lives.