Inspected under a new rigorous framework

Acorns in Birmingham was inspected by the Care Quality Commission (CQC) in July. It is one of three Acorns hospices providing specialist palliative care for children with life limiting and life threatening conditions and vital support for their families across the West Midlands.

The hospice was last inspected in 2016 under the adult social care system, when it was also rated Outstanding. It is among the first hospices in England to be assessed using the CQC’s new framework, which measures children’s hospices against the same rigorous standards as hospitals – recognising the high level of medical, clinical and nursing care they provide.

Following the new inspection, Acorns in Birmingham was again commended for its excellence, with inspectors rating the hospice as Outstanding for how caring, responsive, effective and well-led it is.

At the time of the visit, the hospice was undergoing improvement works. As a result, the final area of ‘safe’ was rated as Good – the highest level achievable while the work was underway. The refresh project is now complete.

Inspectors described the hospice as exceptionally well-led, with a culture rooted in transparency, equity, inclusion and a deep understanding of children and families’ needs. Leaders and staff demonstrated integrity, openness and compassion, fostering an environment where staff felt ‘valued and respected’ and able to raise concerns.

Care was praised as highly-personalised and compassionate, with each service user treated as an individual, taking into account each child’s ‘needs, culture and unique backgrounds and protected characteristics’, and with support extending to the whole family. Volunteer involvement was recognised as ‘invaluable and well received by the families’.

The report highlighted the hospice’s effectiveness and responsiveness, with staff thoroughly assessing and reviewing needs, planning care together with children and families and in partnership with other healthcare providers, so ‘people only needed to tell their story once’.

Services were found to be flexible and inclusive, tailored to diverse needs, and aimed at supporting children and young people to live as fully and independently as possible, knowing their rights and providing ‘choice and control over their own care’.

Inspectors found safety to be a clear focus throughout the service, noting that ‘safety and continuity of care was a priority throughout people’s care journey’. High standards were consistently maintained and closely monitored, underpinned by a strong understanding of safeguarding and a holistic approach to managing risk. Staff were also commended for maintaining ‘a clear focus on improving people’s lives while protecting their right to live in safety’.

Inspectors also noted that the hospice had achieved a gold accreditation by UNICEF for its work embedding the principles of the UN Convention on the Rights of the Child.

What the CQC said

Following the publication of the report, Amanda Lyndon, CQC Deputy Director of Operations in Birmingham, said: “We were pleased to visit Acorns Children’s Hospice in Birmingham and find they had maintained an exceptional level of care. They put children and young people at the centre of everything they did to provide exemplary treatment and support, making a difficult time easier for the whole family.

“People told us they were delighted with the service and that lovely staff treated them with warmth and kindness. We also heard how much families appreciated staff extending support to the whole family to support them as part of their loved one’s care.

“We observed staff involving people in their assessments and considering their communication needs and personal preferences. They ensured people were involved in decisions and could make choices about their care, while regularly reviewing assessment plans to make sure people received effective care that met their needs.

“Strong leadership helped shape care, as leaders constantly developed the service by learning from feedback and making improvements. They fostered an open culture where people and staff felt comfortable raising concerns. Managers investigated incidents thoroughly and shared their findings with staff.

“Staff continuously looked for ways to monitor and measure people’s outcomes and had identified that while several tools were available nationally for people in adult hospices, fewer existed for children and young people. In response, they worked with another hospice network to identify what data they collected and how they could adapt this, which improved their insight and understanding of people’s care and outcomes.

“Acorns Children’s Hospice in Birmingham did everything possible to continually develop their services and give young people and their families the best possible experience and outcomes. Other care services should look at this report to see what they can learn.”

Opened in 1988, Acorns is Birmingham was the charity’s first hospice site – and only the second in the world. Over the past 37 years, the hospice team has provided lifeline care to thousands of children and their families across Birmingham and Warwickshire.

Acorns hospices in Walsall and Worcester, opened in 1999 and 2005 respectively, are also expected to undergo the same rigorous inspection in the coming months.

Acorns Children’s Hospice provides specialist palliative care for babies, children and young people with life limiting and life threatening conditions, and support for their families.

Children receive care at Acorns for rehabilitative respite, pain and symptom management, emergency and end-of-life care, as well as through community nursing and family support in their homes and local communities.

Acorns needs around £35,000 each day to provide its children’s hospice care across the West Midlands, with more than 70% of that amount coming from generous donations and fundraising by the local community.

Read the full report here.