This inspection was unannounced on 8 and 9 December 2015

Wessex Children’s Hospice Trust runs two hospices, Naomi House and Jacksplace. Naomi House is for children up to the age of 16 or 18 years old and Jacksplace is for young people and adults from the ages of 16 years to 35 years.

The hospices support babies, children, teenagers and young adults with life limiting or life threatening conditions and provide accommodation for respite (short breaks), emergency care, day care and end of life care. Both hospices have bereavement suites and provide family support services.

We last inspected Naomi House and Jacksplace in January 2014 and they met the regulations.

There is a registered manager who has been in post since 2011. 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.

Most of the children and young people we met had complex needs and were not able to tell us their experiences because of their complex ways of communicating. We observed how the staff interacted with the children, young people and their families.

Parents told us their children were safe at the hospices. Children and young people sought reassurance from staff and were relaxed with them. This indicated they felt comfortable and safe with staff. Staff knew how to recognise any signs of abuse and how they could report any allegations.

We saw children and young people received care and support in a personalised way. Children and young people had access to the specialist healthcare support from the medical and nursing teams at the hospices. Their complex medical needs were well managed and staff were trained to meet these specialist complex needs. Risks were assessed and managed and there was focus on positive risk taking so children and young people could safely try new experiences. All parents and professionals were happy with the care provided by Naomi House and Jacksplace. Staff knew children and young people well and understood their complex needs.

Staff were very caring and showed children, young people and their families kindness and compassion. Staff were very motivated and demonstrated a commitment to providing the best quality care in a compassionate way. Parents told us they and their children were cared for to a high standard and this included ongoing bereavement support for families. They spoke of excellent relationships with staff who understood their needs and preferences and who devoted time to them. Siblings and other family members such as grandparents were also cared for. Staff treated children, young people and their families with respect and dignity. Children and young people’s privacy was maintained at all times during the inspection. Sensitive planning for end of live care and post death care and support was provided to children, young people and their families. Bereaved families told us that the ongoing support and care provided had been invaluable.

There was a holistic approach to children’s and young people’s care with the physical, well-being, social and spiritual needs of each child and young person given equal importance, together with the needs of those closest to them.

Children and young people and their families received a very responsive service. Their needs were fully assessed, planned for and met. The service was creative and responsive to the changing needs of children and young people and had developed services in response to the local communities changing needs. Children, young people and families were involved in developing the service and this was based in their needs.

Children, young people and staff had fun together and there were lots of play and activities that were based on their preferences and needs. Children’s individua

Staff understood that parents were able to give consent for care for children; however there was evidence to show that older children had been involved as much as possible in the discussions about their care. One of the parents we spoke with whose child was 14 told us that: “[my child] is always there so is aware of what is being discussed”.

An assessment of care needs was made at the child or young person's first visit. Care plans were written and agreed for every aspect of care. Everybody we spoke with was very complimentary about the care they or their child received. One parent told us: “It is my saviour this place, I can just relax when [my child] is here”.

There were effective systems in place to reduce the risk and spread of infection. One of the people we spoke with said: “The rooms are cleaned from top to bottom between one person going out and another coming in”.

During our visit we spoke with five parents and a visitor. All the people we spoke with said there always appeared to be enough staff available and they could get help and support at any time. One parent said: “We had an emergency and suddenly five or six people came. It’s good to know that in an emergency they are able to respond”.

We looked at the quality assurance systems used to monitor aspects of the service. The provider had appropriate systems in place for gathering, recording and evaluating information about the quality and safety of care the service provided.

We spoke to children, young people and families that were visiting the hospice. We observed how care was being provided to help us understand the experiences of people using the service.

We observed that staff communicated appropriately with sensitivity to the children and young people using the service and supported them in ways that promoted their choice, wishes and dignity. Support provided was individual to their needs. Health issues and any risks associated with the individual's care and support were assessed and managed well, taking into account people's safety and their right to make choices.

The service had systems in place to ensure people were protected from abuse and the risk of abuse. Staff had an understanding of safeguarding issues and how to report abuse or allegations of abuse. Families told us that they had “every faith and trusted the people working at both Naomi House and jacksplace.”

We observed that there were sufficient staff with appropriate up to date clinical skills and there was access to additional medical staff when needed. We were told that people felt children and young people were looked after by staff with the right skills.

We saw that there were systems in place to monitor the quality and safety of the service that people received and to continually make improvements. We saw that people’s views were sought and that they said that the quality of care was good.

We spoke to parents and young people using the service, both during our visit and by telephone. Naomi House is designed to accommodate children, and jacksplace is a newer facility, specifically designed to meet the needs of young adults, generally people under 25 years. People told us that they really appreciated the facilities at the hospice, and the staff. They said that the quality of care was good and that they were involved in developing and discussing changes to care plans. They said they felt children and young people were looked after by staff with the right skills and that people enjoyed their visits. People valued the range of activities on offer, and the flexibility of staff to support people in what they wanted to do, at times of their choosing.