Quidenham Children’s Hospice is registered to provide care and treatment to children and young people, aged between 0 and 19 years, who have a life-limiting illness or condition. The hospice offers a wide range of services, which are delivered in the way that meets the needs of each young person and their family and in the place that suits the young person and their family best. This can be in their own home, in hospital or at the hospice at Quidenham.

Services are offered from diagnosis to end of life and throughout bereavement and include the young person’s extended family, such as grandparents. Receiving care from East Anglia’s Childrens Hospices (EACH) does not mean that the child’s death is imminent. Many of the children and young people who use the service live long and active lives but need additional care and support. The provider’s website states that the service is available 365 days a year.

Quidenham Children’s Hospice is housed in a converted building in the peaceful grounds of a monastery. The in-house short break service is housed in a two storey building and includes shared areas for relaxation, play and meals, single bedrooms and a kitchen. There are bathing facilities and facilities for families to stay.

The provider, EACH, runs three hospices in East Anglia. The three hospices work very closely together, sharing knowledge and expertise as well as sharing the Symptom Management Team (previously known as the True Colours team).

This comprehensive inspection took place on 8 March 2016 and was unannounced. On the day of the inspection no young people had stayed the previous night. We met three young people and their families who arrived during the afternoon for a short break.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The registered manager had been in post for 2 years.

The young people we met were very happy to be staying at the hospice. We saw from their body language and their interaction with staff that they were comfortable and relaxed with the staff. Parents were effusive in their praise of the staff and of the service they and their children received. They told us how much the care and support provided to them and their child meant to them.

There was a very strong ‘person-centred culture, which recognised and supported the holistic needs, preferences and goals of each individual child and each of their family members. Everything that happened was based on meeting those needs, preferences and goals. The service strived to give each child the best life, and if and when it came to it, the best death they could have. Staff supported families before, during and after a bereavement for as long the family needed support.

We saw that there were warm caring relationships between staff and the young people and also with their parents. There was a lot of laughter and fun. Staff were well-trained to meet the complex and specialised needs of the young people in their care. Staff treated every young person with care and compassion and with respect for their privacy, dignity and independence. A wide range of methods was used to communicate with each young person in the way that enabled the young person to make choices about their everyday lives.

Staff had extremely good, caring and respectful relationships with parents. Parents were grateful for the attention staff paid to detail and felt staff knew them and their children well.

There were systems in place to make sure that young people were kept as safe as possible. There were enough staff on duty to support each young person in the way they needed and preferred to be supported. Pre-employment checks had been carried out t

We spoke with a young person who was staying at the hospice and six parents who told us that staff consulted them and respected and acted on the decisions they made about the nursing care and support they agreed to.

Our observations showed us that staff members were responsive to the needs of the young people and that they were given the support and attention they needed. We saw that the young people had a positive experience of being included in conversations, decision making and activities.

We found that plans of care contained the information staff members needed to ensure that the health and safety of the young person was promoted and protected.

Parents told us that the young people staying at the hospice were safe, provided with the nursing care and support they needed and that the staff were, “Wonderful and kind.” They also told us that the service their child received at home was “Invaluable” and that support was offered to the whole family.

Medication was administered, recorded and stored accurately and safely.

Parents told us that good staffing levels were provided at the hospice and that if staff absence was not covered for their home support that they were offered an alternative date and time.

The records held were complete and up to date and ensured that staff members had access to information that protected people and ensured their needs were met.

We were unable to speak with the young people who were staying at the hospice because they were unable to give us their views. Our observations showed us that they looked happy and content and that staff spoke with them as they assisted them. We spoke with parents and relatives who told us that staff consulted them and respected and acted on the decisions they made about the nursing care, treatment and support they agreed to for their child.

Our observations also showed us that the young people were given the care, treatment, support and attention they needed and had a positive experience of being included in conversations, decision making and play and music therapies and activities.

Parents of the young people who used the service and relatives told us that the young people received the nursing care, treatment and therapeutic support that they needed and that staff were very kind.

The parents of young people using the hospice told us that the staffing levels at the hospice were always good. We found that each young person was provided with one to one or two to one support and that additional volunteers assisted the staff and therapists.

Parents spoken with were aware of the complaints system. Complaints were dealt with appropriately and people were able to access and use the complaints system in a format that met their needs.

We did not speak with any of the family members during a visit to the hospice as there were none present, however, the children and young people that were seen and spoken with conveyed happiness with their surroundings, the care and the staff.