Bluebell Wood Children's Hospice offers care and support to children and young people with life-shortening, life-threatening conditions. Children and their families receive support through regular care in their own homes, planned periods of respite care at the hospice, end of life care and counselling and bereavement support.

The hospice has an eight bed unit. All bedrooms are equipped with medical equipment, including hoists and piped oxygen; all have their own en-suite. Bedrooms also have a sofa bed or an extra bed can be accommodated, so parents have the option to sleep in their child’s room. Alternately family members who stay with their child at Bluebell Wood can have their own double bedroom, as well as use of a family lounge and kitchen.

Bluebell Wood covers a large geographical area, supporting children, young people and families across South Yorkshire, North Nottinghamshire, North Derbyshire and North West Lincolnshire.

Bluebell Wood support children and young people up to the age of 25 and provide a wide range of support services for all family members.

The hospice have a transitions team which work closely with all who are approaching young adulthood to ensure the right support is in place in a variety of ways.

Bluebell Wood are currently supporting around 250 families, both in their own homes and at the hospice.

Bluebell Wood has two end of life suites where children who have died can stay until their funeral. Both have family accommodation to enable families to stay if they wish.

The hospice sits in extensive grounds with a variety of garden areas with accessible playground and specialist play equipment. There is also the ‘Dragonfly Garden’ which is a reflective and memorial space for bereaved families.

Bluebell Wood has a registered manager. 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.

Day-to-day operation of the hospice is delegated by the Board of Trustees to the Chief Executive Officer (CEO). The CEO discharges responsibilities through the Hospice Leadership Team.

Our last inspection at Bluebell Wood took place in August 2014. The hospice was found to be meeting the requirements of the regulations we inspected at that time.

This inspection took place on 30 August 2016 and 1 September 2016. The inspection on 30 August 2015 was unannounced. This meant staff at Bluebell Wood did not know we were coming. On 30 August 2016 five beds in the hospice were occupied and one child was being supported in day care.

We saw the children and young people we met were happy and very relaxed in the company of staff. Parents told us they were very happy that staff kept their child safe.

Staff were trained in how to protect children and young people from the risk of abuse and harm. They knew how to recognise signs of abuse and how to raise an alert if they had any concerns.

Staff were recruited safely to ensure that children and young people were cared for by suitable staff. There were enough staff on duty that had the specialist skills needed to make sure children and young people’s needs could be met safely. Staffing levels were increased to respond to children and young people’s rapidly changing needs.

The service had appropriate arrangements in place to manage medicines so children and young people were protected from the risks associated with medicines. Staff had received training and support to manage children and young people’s medicines. We identified some shortfalls in the record keeping, storage of medicines and staff training although there was no indication children or young people had been placed at risk.

Staff were well informed about the risks to children and young people and we saw staff were trained in ma

The provider had an effective system to regularly assess and monitor the quality of service that people receive.

The Director of Care told us "good governance allows for good care." They also told us that a standing agenda item at meetings was the outcomes included within the Care Quality Commission's (CQC) guidance about compliance. This showed that the hospice had an awareness of quality systems needed to ensure that standards were met.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

People experienced care, treatment and support that met their needs and protected their rights. Feedback from people included "all staff involved have been fantastic.", "the staff were brilliant and very supportive." and "overall we are very pleased with the care."

People’s health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.

People who use the service, staff and visitors were protected against the risks of unsafe or unsuitable premises. The provider carried out regular checks of the premises to ensure that they remained in good condition and fit for purpose.

There were enough qualified, skilled and experienced staff to meet people’s needs.

The provider did not have an effective system to regularly assess and monitor the quality of service that people receive. The provider did not have an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately.

We didn’t speak with as many people as we would have liked during our visit, because of the individual circumstances of the children who were there when we visited. However we spoke with the parents of two children and with one of the children who was spending time there. We also observed the way care staff interacted with the children and with their families.

We were told “It’s a very good place.” I know the staff and the set up here now. They give the right care.” They added “They (the staff) sometimes have to make judgements about which treatment to provide. They call me sometimes to ask what I would do. I like that they do that. I have to trust them. And I do.”

Another parent told us “There’s enough staff. They definitely know what they’re doing.” Their child added “They’re all nice.” Their parent continued “We never want for anything. X loves coming in (to the hospice).” This person spoke positively about the meals provided and the flexibility of care, according to what their child wanted.

We observed care staff supporting parents and their children in a kind and sensitive manner. There was a lot of general banter and laughter. The discussions overheard between care workers and family groups suggested that partnership working was valued and promoted.

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 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This was an unannounced inspection. The last inspection of this service was carried out in December 2013 and the requirements of the regulations we inspected were met.

Bluebell Wood Children’s Hospice offers care and support to children and young adults with complex needs and a shortened life expectancy, both in their own homes and at the hospice. The hospice also offers respite care to family carers. There were eight inpatient beds.

A registered manager was in post. 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 service was safe since the staff were trained and had a good understanding of how they should protect and safeguard children and young adults from abuse and avoidable harm. However staff members we spoke with did not have much understanding of Mental Health Act 2005 (MCA) We were informed by the practice educator that they were in the process of organising training for all staff on MCA and the code of practice.

The hospice has been open for six years and we found out there had been several changes to the management including to the registered manager during this short time which had resulted in the present manager being the fourth in the six years and she came into post in December 2013. Staff members told us that the present registered manager listened to them and only made changes if they were needed.

Young people who spoke with us were confident that staff at the hospice were reliable and knowledgeable and supported their needs. They said they could discuss with staff, personal and confidential issues without being afraid. One young person told us how staff took steps “at one time” when they came into respite to protect them and maintained their safety.

The records relating to children and young people were not always up to date and signed and dated by relatives and staff. This has been identified through their internal audits and progress was noted at the inspection.

There was a drive by the practice educator to promote staff learning and development. She had identified the needs and was making arrangements to ensure staff received appropriate training so that they were competent and confident to do their jobs. Staff said they were well supported by the care team manager and the registered manager.

The registered manager with the help of the family liaison manager, the Chaplin and the activities co-ordinator encouraged the young people and the relatives of children to be ‘aspirational’ in their desires and wishes to make improvements to the centre. Parents were happy with the way the centre functioned and they said it was really difficult to think of ‘aspirational’ suggestions.