We carried out a review of the data available to us about Francis House Children's Hospice on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Francis House Children's Hospice, you can give feedback on this service.
Our rating of this service stayed the same. We rated it as good because:
Francis House Children’s Hospice is operated by Francis House Family Trust.
Francis House Children’s Hospice provides palliative care for children and young adults with life limiting and life-threatening conditions and support for the whole family both during the young person’s life and following their death.
They also provide care and support for children and their families within the local community.
The hospice has 14 rooms for children and young people. The service is within one building but is separated into two areas, Francis House for children and Francis Lodge for teenagers and young adults. In addition, there are flats for family members to stay.
We inspected this service using our comprehensive inspection methodology. We carried out an unannounced inspection on 22 and 23 October 2019.
To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.
Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.
Our rating of this service stayed the same. We rated it as Good overall.
The service had enough staff to care for children and young people and keep them safe. Staff had training in key skills, understood how to protect children and young people from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to children and young people, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.
Staff provided good care and treatment, gave children and young people enough to eat and drink, and used special feeding and hydration techniques when necessary. Staff assessed and monitored children and young people to see if they were in pain and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of children and young people, advised them and their families on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. The service could deliver palliative, respite and end of life services seven days a week.
Staff treated children and young people with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to children and young people, families and carers.
The service planned care to meet the needs of local people, took account of children and young people’s individual needs, and made it easy for people to give feedback. People could generally access the service when they needed it.
Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of children and young people receiving care. Managers and staff were clear about their roles and accountabilities. They had the right skills and abilities to run a service providing high quality sustainable care. The service engaged well with children, young people and the community to plan and manage services and all staff were committed to improving services continually. They strived for excellence through consultation, research and reflective practice.
Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.
Ann Ford
Deputy Chief Inspector of Hospitals (North)
Francis House Family Trust is a charitable trust registered to provide hospice services to 14 children, teenagers and young adults. The service provides children and young adults with life limiting conditions with respite accommodation and end-of-life care. They also provide care and support for children and their families within the local community. The service is within one building but is separated into two areas. Francis House provides seven single bedrooms for children and accommodation for their families. Francis Lodge has seven bedrooms for teenagers and young adults. In addition there are facilities for their friends and siblings to stay with them.
The service accepted children from birth to 16 years old at the time of referral. They then remained patients of the hospice for as long as they required services.
There was a manager registered with CQC working at the hospice. 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.
People and their relatives told us that they felt safe at the service and we saw that there were sufficient staff on duty that had been recruited safely. Where there had been issues with staff conduct these had been dealt with through the services disciplinary procedures which mirrored employment law requirements.
Staff were aware of what was meant by abuse and could tell us who they would report any incidents to. The environment and equipment was risk assessed and serviced to maintain people’s safety. There were emergency plans and disaster recovery plans in place in the event of a major event such as a fire.
Medicines were managed safely. Infection control measures were in place to prevent the spread of infection.
Staff were well trained and knowledgeable. They received good support through supervision and appraisal.
Children, young people and their families sat together with staff to eat where possible. This gave a family feel to meal times. Where children received their nutrition by other means staff were well trained. The meals were well presented and nutritious.
Staff worked within the principles of the Mental Capacity Act 2005. Where it was appropriate the service had applied for deprivation of liberty authorisations for young adults.
The environment supported the needs of children and young adults in separate units. There were toys and media available which were age appropriate. There were areas within the service for play and therapy. There were two minibuses, one adapted vehicle and two cars available for trips out and to support families when attending appointments with their children.
Positive relationships were developed at the hospice. Children, young adults and their families were involved in decision making about their care.
Care plans were person centred, contained risk assessments and management plans. These were reviewed regularly.
End of life care was supportive and took account of peoples wishes. Following a child’s death support was provided in the form of practical and spiritual support by staff.
There was a clear management structure at the service and a clear vision was held by the management team.
There was an open culture where mistakes were acknowledged and learning took place.
Continuous improvement was a theme at the service. There were links with the local community through fundraising events and families.
There was an effective quality assurance system in place at the service which used audit tools to identify areas for improvement.
People told us that they were exceptionally well cared for and stated that they were treated with dignity and respect. One person commented that "I love coming here'. Another person at Francis Lodge told us that 'It's really good - it gives me a rest from my mum and dad".
One parent told us that: "[My child] gets a lot of opportunities to do things [they] wouldn't be able to do at home". Another said in writing: "My child] gets one to one quality care.... and is the main reason I feel confident in leaving [them]. [My child's] days are busy ....and each day is different... As a family, we all LOVE Francis House, and to be honest I don't know what we would do without it".
Across the outcomes we looked at, the provider was meeting the standards expected of them including for involving people in their care and treatment, ensuring the care and welfare of the children and young people, cleanliness and infection control, ensuring sufficient staffing levels and the management of healthcare records.
Children and young people told us that they were exceptionally well cared for and stated that they were treated with dignity and respect. One person commented that "Everyone has a laugh. I like playing on the computer. There is lots of things to do'. Another person at Francis Lodge told us that 'They give me the support I need '.
We spoke with three parents or guardians during our visit. One parent told us that the hospice staff were: "Lovely, not one bad word I could say about any of them." Another said: "Everyone's amazing' and 'It's like our second home".
Across the outcomes we looked at, the people who use the service gave very positive comments.
We reviewed written feedback for both services which the provider had collected. This was all extremely positive. Most comments said that the provider could do nothing better.