Haven House Children's Hospice

Updated 28 April 2020

Haven House Children’s Hospice is operated by Haven House Foundation. Haven House is a six bedded children’s hospice located in Woodford Green, Essex. The hospice was established in 2003 and provides specialist holistic support to life limited children and young people (CYP) and their families in the ethnically diverse boroughs of Waltham Forest, Redbridge, Havering, Barking and Dagenham as its core areas, as well as supporting CYP in Enfield, Haringey, Barnet, Camden, Islington, West Essex and East Hertfordshire. Haven House aimed to provide specialised support from diagnosis to death from antenatal diagnosis to post bereavement care. There were currently 387 children including siblings open to the hospice’s services and they and their families accessed provision in a variety of ways.

Haven House Children’s Hospice provides services for 0-18 year olds, both in the hospice and in the community. The hospice was originally designed as a respite and short stay centre for life limited children in the local community. However the hospice has evolved to meet families’ needs with a more responsive service offered to families both at hospice site and in the community through the Hospice at Home team. Community support was launched in 2015 in response to family requests for more choice for end of life care in the community and evolved to provide therapeutic support to children unable to leave the home. The hospice worked closely with NHS colleagues to provide 24/7 access to specialist paediatric palliative care for children known to the service. The following services were currently available:

On site services included:

• Short breaks and respite
• Specialist neonatal link nurse
• Education and training for families, professionals and staff
• Step-down care
• Crisis support
• End of life care
• Play therapy
• Transition support
• Symptom management
• Counselling
• Family Support
• Dads' group
• Music therapy
• Physiotherapy
• Therapeutic Yoga
• Teenage Cancer Group
• Buddies Sibling Support Group
• Stay and Play
• Memory Day
• Pastoral and Spiritual Support

Hospice at Home Services included:

• Respite in the home
• Play therapy
• Therapeutic yoga
• Music Therapy
• End of Life Care
• Symptom Management
• Physiotherapy
• Specialist outreach nurses

Updated 28 April 2020

Haven House Children's Hospice provides overnight respite care for up to six children and young people aged from birth to 18 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 life-threatening conditions. Additionally, they provide community and day therapeutic and nursing services in the home or at the hospice. 

Haven House offers a multi-professional approach to the health, social care and education of children who attend the service. At the time of our inspection, there were currently 387 children including siblings open to the services and they and their families accessing their provision in a variety of ways. 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), a bereavement team and an expert parent programme designed to give training and confidence to parents caring for their children. The family flat provided adjacent accommodation for parents and siblings to stay so they could be near their child or young person. The flat incorporated the Butterfly Suite as a specially adapted cold room to provide end of life and post death care. 

The 'Hospice at Home' service was registered with Care Quality Commission (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 nurses with neonatal experience to support babies with complex needs associated with their conditions. The hospice had a registered manager in post. A registered manager is a person who has registered with the 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. The charity had seven retail shops.

We inspected this service using our comprehensive inspection methodology and the inspection was announced. The inspection was 10 and 11 March 2020.

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 hospice 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.

However, we also found the following issues that the service provider needs to improve:

• During our review of patient records, we found the use of two electronic systems and paper records during the transition lacked a cohesive approach. Senior leads acknowledged it had taken longer than expected to transfer records but told us that this was because they were were creating updated care plans.

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.

Nigel Acheson

Deputy Chief Inspector of Hospitals 

Updated 28 April 2020

We rated this service as good overall because we rated safe, effective, caring, responsive and well led as good.