Demelza, Hospice Care for Children - SE London (known as Demelza SEL) provides services for children and young people from birth to18 years old with life limiting conditions and their families. They provide residential short breaks for children for respite care and end of life care. They provide additional support services for the family. There were six residential places for children and young people. When we visited four children were receiving care and a total of 193 children and young people were using the service.

The service was last inspected on 28 October 2013 when we found all of the regulations inspected were met.

The service 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. The provider also runs a children’s hospice in Kent (Demelza Kent) and the registered manager is registered for both services. She had an office at each of the provider’s sites and spent time at both.

Children and young people who used Demelza SEL, and their families received care that was compassionate and kind. People felt the practical and emotional help they were given had an impact on their lives, both during their child’s illness and afterwards. Care was provided with regards for children’s privacy and dignity and parents’ roles were valued.

The staff were responsive to children and families’ individual needs and they were assessed and catered for. Care planning was on going so changes in children's conditions were addressed, There were therapeutic activities which children enjoyed and were suitable for their needs. The staff took into account the needs of the whole family and support was available for siblings and grandparents as well as parents. Groups were arranged for siblings to meet others in the same position.

The care provided was safe. Staff were knowledgeable about abuse and the action to take if they suspected children were at risk of harm. Medicines were managed well and children received them as prescribed. Staff recruitment made sure staff were suitable to care for children. The building was kept safe and well maintained.

Staff were trained and supported to do their jobs well. Children and young people were supported with their nutritional needs. Demelza SEL had effective relationships with hospitals and health professionals to ensure that children and young people’s needs were met without delay. This helped to minimise children and young people’s pain, discomfort and distress.

Staff were trained in the principles of the Mental Capacity Act 2005 (MCA). People’s rights were respected and when necessary decisions were made in children and young people’s best interests.

There were good management arrangements to check and ensure the on-going quality of the service. The provider kept in touch with developments in the field of paediatric palliative care.

Parents and relatives we spoke with were very complimentary about the service their child had received. They told us they felt involved in their child’s care and that the service took into account the child’s and the family’s needs. They trusted the service to look after their child well. For example, one relative told us; “We’re happy to leave him here and there’re no issues when he comes home. We’re going through everything again: how he’s sleeping, breathing, does he want his hair washed, communications, bowel movements, even though he was here last weekend.” Another relative said; “I like the fact that my family is at the front of someone’s mind. I feel very comfortable here. We wouldn’t make him stay if he didn’t enjoy it.”

We found treatment and care was planned and delivered to meet individuals’ needs and to promote their safety and wellbeing. The service worked with other services to ensure people received coordinated treatment, care and support. There were enough staff on duty to meet people’s needs and they took steps to protect people from acquiring healthcare associated infections. Staff maintained records that were accurate and fit for purpose to support the safe and effective provision of the service.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

Parents of children using the service we spoke with were complimentary about the hospice, saying the treatment and care met their children’s needs and was of a very high standard. One person said; “The service is outstanding. Staff are approachable and easy to talk to regarding any concerns.” Parents told us their children were safe at the hospice and there were enough staff to attend their children’s needs.

We found the provider had arrangements in place for obtaining and acting in accordance with, the consent of people using the service and their parents. There were also arrangements in place to ensure people were safeguarded against the risk of abuse. Proper steps were taken to protect people against the risks of receiving care or treatment that was inappropriate or unsafe, and there was an effective complaints system. Procedures were in place to ensure staff employed by the provider were suitably qualified and experienced, and that all checks as to their suitability were carried out before they started work.

People who used the service and their relatives told us during our visit on 26 August 2011 that they felt safe and relaxed at Demelza, Hospice Care for Children - SE London. The treatment and care was very good and parents were supported well. One mother whose child had recently started using the service said, “It already feels as if I’ve known the staff for a long time. It feels like you’re at home.”