Butterwick House

Updated 8 December 2022

Butterwick House is operated by Butterwick Limited. The service provides hospice services for children and young people from Stockton, Middlesbrough and surrounding areas. It is registered as a charitable trust and receives funding from the NHS. The hospice has six inpatient beds for the provision of respite care. Butterwick House is registered to provide diagnostic and screening procedures and treatment of disease, disorder or injury.

We previously inspected Butterwick House in September 2021 and raised significant concerns with the provider by issuing a warning notice under Section 29 of the Health and Social Care Act 2008, relating to breaches of Regulation 12 and 17. In addition, we issued the provider with a notice of decision to impose conditions on the providers registration. In response, the provider issued an action plan outlining how the service had taken action to address the concerns outlined within the warning notice. The conditions limited the provider to admit a maximum of two service users, already known to the provider, for respite care only.

An unannounced comprehensive inspection was carried out on 1-2 February 2022. At the time of our inspection there was a registered manager in post. This inspection was undertaken to check the service had made sufficient improvements ensure compliance with the Section 29 Warning Notice and to follow up on concerns that had been raised with us. The service was rated ‘Good’ in the domains of Effective, Caring and Responsive, it was rated ‘Requires Improvement’ in Safe and Well-led’.

An unannounced comprehensive inspection was carried out on 2-3 August 2022. There was a registered manager in post. At the time of the inspection the hospice was admitting a maximum of two children each week, subject to previous conditions.

Updated 8 December 2022

Our rating of this location improved. We rated it as good because:

• Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well.
• Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and measured patient outcomes. Staff worked well together for the benefit of patients, supported them to make decisions about their care, and had access to good information.
• Staff treated patients 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 patients, families and carers.
• Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and all staff were committed to improving services continually.
• Leaders had made significant improvements since our last inspection which included oversight of clinical and service risks. Managers had good awareness of the challenges the service faced and were implementing key changes to address previously imposed restrictions.

However:

• The service did not use a recognised scoring tool to monitor patients for deterioration.

Updated 8 December 2022

Our rating of this service improved. We rated it as good because:

• 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 provided good care and treatment, gave children and young people enough to eat and drink, 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. Key services were available 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 access the service when they needed it and did not have to wait too long for treatment.
• 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. Staff were clear about their roles and accountabilities. 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.

However:

• The service did not use a recognised tool is monitor deterioration. Staff used professional judgement. Clinical observations were not always repeated in a timely manner.

We rated this service as good because it was effective, caring and responsive and well-led. Although safe requires improvement.