Little Bridge House

Updated 30 September 2016

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.

This inspection took place on 13 June 2016 and was unannounced. The inspection team consisted of an inspector, a pharmacy inspector and one specialist advisor. The specialist advisor had experience of children’s and young people’s palliative and hospice care.

We met and spoke with three children and with one parent during the inspection. The children we met had complex needs and were not able to tell us their experiences because of their complex ways of communicating. Following the inspection we telephoned three parents, two bereaved parents and one bereaved sibling. We spoke with the registered manager (head of care) and 26 staff. This included senior team leaders, the practice educator, medical and nursing staff, senior cook, care workers, the chaplain and a volunteer.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of children and young people who could not talk with us. We observed how the staff interacted with the children, and their families. We looked at how children and young people were supported during their stay. We reviewed a range of care records for six children and two young people. We also reviewed records about how the hospice was managed. This included, staffing records, audits, meeting minutes, training records and governance records.

Following the inspection we sought the views of five professionals by email and the Clinical Commissioning Group. We only received feedback from the Clinical Commissioning Group.

Updated 30 September 2016

This inspection was unannounced on 13 June 2016.

157 children, young people and their families use the services at Little Bridge House. The hospice can accommodate up to eight children or young people and there are additional facilities and suites to enable parents and siblings to stay at the hospice with the child.

The hospice supports babies, children, teenagers and young adults up to the age of 21 with life limiting or life threatening conditions and provides accommodation for respite (short breaks), and end of life care.

We last inspected Little Bridge House in December 2013 and the service met the regulations.

There was a registered manager at the service who had been in post since 2014. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The children we met during the inspection had complex needs and were not able to tell us their experiences because of their complex ways of communicating. We observed how the staff interacted with the children and their families.

Staff were caring and showed children and their families kindness and compassion. Staff were very motivated and demonstrated a commitment to providing the best quality care to children, young people and their families.

Children received care and support in a personalised way. Children and young people had good links and access to the healthcare support they needed during their stays at the hospice. All parents were happy with the care provided by Little Bridge House. Staff knew children well and understood their complex needs.

Parents told us their children were safe in the care of Little Bridge House. Children were relaxed and comfortable with staff. Staff knew how to recognise any signs of abuse and how they could report any allegations.

Any risks to children and young people’s safety and health needs were assessed and managed in order to minimise the risk.

Children and young people and their families including siblings received a responsive service. Their needs were fully assessed, planned for and met. Children, young people and families were involved in developing care plans and keeping these under review.

Children and young people were supported to play, develop and take part in activities and new experiences in the hospice.

Parents gave positive feedback about the qualities, skills and knowledge of the staff. Staff were recruited safely and received an induction, core training and specialist training so they had the skills and knowledge to meet children and young people’s needs. It is recommended that the staff’s competency for completing specific tasks is reassessed periodically. This is to make sure they are competent and have retained the right skills and knowledge.

Overall children’s and young people’s records were accurately maintained. However, we identified some minor shortfalls in records keeping and this was an area for improvement.

There were safe systems in place to manage and administer medicines. Children and young people were protected from the risks of infection by the systems and equipment in place.

We found the hospice building was well maintained. The hospice was designed and decorated to meet the specialist needs of the children and young people.

There was a children, young people and family focused culture at the service. Children, young people and families were involved and consulted about all aspects of the service. There was a clear management structure and staff, children and young people and their families felt comfortable talking to the managers. There were systems in place to monitor the safety and quality of the service provided. An improvement plan was being developed to drive continuous improvements across the service.