This inspection took place on 29 September 2016 and was unannounced. Further phone contact was made with children and young people using the hospices services and their parents on 4 and 6 October 2016.

Hope House Children’s Hospice provides specialist nursing care for children and young people with life limiting conditions within the hospice and in their own homes. The provider has a 10 bedded in-patient unit that accepts admissions for terminal care, symptom control and respite stays. At the time of our inspection six children and young people were on the unit. The hospice also supports the families of the children and young people who use the service. Specialist care and support in the community was also provided by an outreach service.

The manager was registered with us as is required by law. 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.

Staff were trained in how to protect children and young people from abuse and harm. There were sufficient staff on duty to meet children and young people’s needs in a timely manner. Recruitment processes were robust and the provider was as sure, as possible, that staff employed were suitable and safe to work with children and young people. Staff were knowledgeable about the specific risks children and young people needed to be protected from. Accidents and incidents were recorded and monitored to identify how the risks of reoccurrences could be reduced. Medicines were prescribed, recorded and administered in safe and appropriate ways. Children and young people received their medicines in a timely manner and in line with their needs.

Children, young people and their families were supported by a highly qualified and experienced staff team. The provider equipped staff with a variety of training that met the specific needs of the children and young people being cared for. Staff were supported to acquire additional training to maintain and enhance their knowledge and skills. New staff were provided with a comprehensive induction. Regular supervision and annual appraisal was available to support staff. Management and staff understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA). Staff supported children and young people to access nutrition that met their dietary needs, restrictions and appetite. Children and young people were supported to access all the support they needed in order to maintain their health and wellbeing

Children and young people’s right to privacy was fully protected and they were treated with dignity and respect. Positive relationships were developed at the hospice and staff were kind and compassionate. Children, young people and their families were involved in all aspects of decision making, from symptom and pain management to end of life care. Communication within the service was effective and children, young people and their families were fully informed of their options for care and treatment. Children and young people were involved in the planning of activities that met their individual needs and preferences. A broad range of activities were available that included creative ways to keep children and young people occupied, engaged and stimulated.

Regular multi-disciplinary meetings were undertaken to review and respond accordingly to children and young peoples’ changing needs. The provider worked closely with other professionals and agencies to develop the hospice services to meet diverse needs and improve the health and wellbeing of children, young people and parents. Clear information about the service, the facilities, and how to complain was made available to children and young people and visitors. Complaints received were f

Hope House Children’s Hospice provides specialist nursing care for up to 10 children and young people with life limiting conditions from Shropshire, Cheshire and north and mid Wales. The hospice also supports the families of the children and young people who use the service. There was a registered manager in post at the home. This meant that there was an allocated person who was responsible for the day to day running and management of the service.

Specialist nursing care was provided at the hospice and within children and young people’s homes. During this inspection we looked at the care provided to the children, young people and their families in the hospice environment only.

The staff understood the children and young people’s needs and we saw that care was provided with kindness and compassion. Children, young people and their families told us they were happy with the care.

Care was provided in a safe environment by staff who were appropriately trained and skilled. We saw a robust induction and training system to ensure this.

Throughout our inspection we saw examples of innovative care that promoted an inclusive culture. Children, young adults and their families were involved in care planning and were treated with dignity, privacy and respect.

The provider had employed staff to ensure care was based upon best practice and individual staff had taken on champion or link roles to ensure that best practice guidance was implemented and followed by all staff.

The registered manager consistently assessed and monitored the quality of care. We saw that action was taken to make improvements to the care children, young people and their families received.

We talked with children who used the hospice and they said that they enjoyed their stays. We talked with the parents of some of those children and they said the staff always asked them how they would like their children looked after. They said staff were always mindful of their privacy and dignity and treated them with respect.

People told us that they felt able to raise any issues with the manager or staff should they have any concerns. Staff talked of their awareness of how to keep children and young people safe from harm. Staff told us about the training that the hospice had arranged for them to attend so that they would recognise abuse and how to report it.

People told us that staff were always available when they needed help. They said that the staff were supportive, friendly and always acted professionally. One young person said, “The staff are nice” and a parent said, “This hospice sets the benchmark for the care of XXX. They are excellent”.

We spoke with one person using the service and two relatives. Other children using the service on the day of our inspection were not able to talk to us. We also spoke with eight members of staff, the manager and the nominated individual.

A relative spoke very highly about the service provided. They said that it was, "Excellent" and told us that they were always made welcome. They said that the services provided had made a significant difference to the families' quality of life.

Support was offered to children and their families in a variety of ways. These included sibling groups, counselling, respite care and outreach support in their own homes.

Care plans contained detailed clear guidance for staff on children's needs and how these should be met. This was done in a way that reflected each child's individuality and preferences. Relatives were fully involved in care planning and decision making.

Measures were in place to reduce the risk of healthcare acquired infections.

Systems were in place to make sure that checks were made when new staff started working at the service to make sure that they were suitable. Staff felt very well supported by the management team.

The service supplied people with information about how to raise any concerns and complaints.

We spoke to two families of children who use Hope House and they were very satisfied with the care their children received. They spoke very highly of the service provided and the quality of care provided by the staff.

Families are involved in developing individual care plans that meet their child’s needs.

Support is offered to families in a variety of ways including, sibling groups, counselling, respite care and outreach support in their own homes.

Effective management systems were in place to make sure that the home is safe and well maintained. Quality assurance systems were in place to monitor the effectiveness of the service and identify any issues of concern or areas for review.

Staff told us that they feel well supported by an effective management team and are provided with all the training they need to carry out their role effectively.