This inspection took place on 31 August and 1 September 2016 and was announced. The service was last inspected on 11 December 2013 and at that time was meeting all the regulations we looked at.

Haven House Children's Hospice provides overnight respite care for up to five children and young people aged from birth to 19 years who may have complex needs associated with life-limiting or life-threatening conditions. They also provide some day care. Haven House will accept initial referrals from anyone in the community who knows a child with a life limiting condition or complex health conditions which are likely to shorten their life.

Haven House offers a multi-professional approach to the health, social care and education of children who attend the service. At time of our inspection, they provided respite support to approximately 100 children and their families, the majority of whom received up to 20 days of care yearly. Parents were able to negotiate with Haven House about the most suitable and convenient time for their child to receive support. This could be provided as half days, overnights and in some situations blocks of time to allow parents time to have a holiday or visit family abroad.

In addition to the respite care offered to children at Haven House, there was support for parents and siblings. This support ranged from a specialist toy loan library, complimentary therapies for adults including Reflexology and Rejuvanessence (head and facial massage designed to help relaxation), the Butterfly suite used as accommodation for children which allows parents to stay in adjacent accommodation so their can be near their children, a bereavement team and an expert parent programme designed to give training and confidence to parents caring for their children.

There were also a number of services being developed to support families. The ‘Hospice at Home’ service has recently been registered with CQC with the aim of providing families with choices when their child was nearing the end of their life and they wish them to die with them at home. Additionally, Haven House had also employed a neonatal nurse to support babies with complex needs associated with their conditions.

The service had a registered manager in post. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

Staff, volunteers and trustees all held a shared vision to provide high quality care for children and young people with life limiting conditions. In order to achieve this staff were highly trained and supported to undertake their roles.

Care that was offered to children and young people was personalised and reflected their needs. Care plans were comprehensive and constantly reviewed so they were up to date. Practical and emotional support was provided to children and their families throughout their contact with Haven House, this included after the death of a child.

Children and young people had their health care needs met by professionals within Haven House and by community health and social care professionals. There was evidence professionals worked with each other in the interests of the child. The provider met the nutritional needs of children and young people and ensured they received their medicines as prescribed. There were appropriate infection control measures in place.

Staff used a number of communication methods to seek consent from children and young people. Where this was not possible, measures were in place to make sure their rights were protected and decisions about their care and treatment made in their best interests.

Parents told us they felt their children were safe at Haven House. Staff knew what action to take if they consider any young person was at risk

Records showed that the provider gained consent from parents before providing care or treatment. We spoke with the parents of four children who used the service. They told us that they were asked for their consent at various times.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We reviewed the records for ten children who used the service. All had a care plan in place, although some had not been reviewed for over a year.

One parent who spoke with us said "They are amazing, very professional, but very warm and caring. They look after my son very well." Another said "I find them very supportive, I am very pleased he has this place to go to and they always try to help."

Records showed that food and drink met the religious or cultural needs of children who used the service. We noted in the care plans that religious preferences had been noted.

Suitable arrangements were in place to ensure that people were safeguarded against the risk of abuse. The provider had a Safeguarding policy and this recognised various types of abuse, such as emotional, physical, sexual abuse and neglect.

We reviewed the files for six members of staff and found that appropriate checks were undertaken in most files before staff began work.

We saw a copy of the complaints policy which stated complaints would be acknowledged within two days and dealt with within 28 days.

Everyone we spoke to said the quality of the care the service provided was of a high standard. Relatives were very much included in decision making for their children, whose support needs were being met despite the complex and difficult problems they suffered from. Older young people's capacity to consent needed assessment. People's emotional and spiritual needs were understood and provided for. The provider used volunteers to provide additional support and services. People were cared for safely and appeared content. Staff professional development needs were met, but they needed training around capacity and best interests of older young people. The provider had systems in place to audit and review how it provided services and had used them to make improvements. It intended to implement personal risk assessment and management plans in the near future.

All staff we spoke to said they would recommend the service to their friends. Many said they would not work in the service if they had not believed they had made a difference.

All relatives spoken to described the service in very positive terms. One relative told us how she "totally trusted people here", another how "they surpass all my requirements". Another called it "outstanding".