This was an announced inspection which took place on the 19 June 2017.

This was the service’s first inspection since registration in May 2016.

Rainbow Trust is a national organisation providing services to children and their families across the UK. This branch in Sunderland offers services to children and families where children have life threatening or terminal conditions. The service works with families in hospitals, in their own homes and in the community. They provide care and support directly to the child or young person affected by a life threatening or terminal condition, their siblings or their parents or carers. At the time of our inspection there were five children receiving the regulated activity of personal care from the service.

The service had a registered manager in post. 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.

We found that children’s care and support was delivered safely and in a manner of their or their representatives, choosing. Children and families were supported in a way that reflected their wishes and assisted them as distinct individuals.

Staff were well trained and encouraged to look for new ways to improve their work. Staff felt valued by the registered manager and this was reflected in the way they talked about the service, the registered manager and other staff.

Staff received regular in depth supervision from the registered manager as well as additional support from a trained therapist to help them deal with the issues their roles managed. Staff were trained and supported to be leaders in their field by a specialist provider.

Children who used the service were initially assessed and then matched up with suitably trained staff to support their needs, and if people requested changes to how support was delivered these were facilitated quickly. The service worked within the principles outlined in the Common Assessment Framework (CAF) to make plans and decisions involving the child or young person and in their best interests. (The CAF is a shared assessment and planning framework for use across all children's services and all local areas in England. It aims to help the early identification of children and young people's additional needs and promote co-ordinated service provision to meet them.) We found the service involved children and young people and worked within the UN Convention on Children’s Rights.

The service had developed a family support network at the hospital wards where families spent much of their time. This offered families a chance to discuss their feelings and find mutual support.

We found every child or family member receiving support had an individualised care plan and risk assessments in place. Staff were aware of risks and worked alongside other agencies to minimise those risks.

There were high levels of contact between the staff, children and their families with staff seeking feedback and offering support as family’s needs changed over time. Children and their families were able to raise any questions or concerns with the service and were confident these would be acted upon. No one we spoke with had any issues or complaints about the service they received.

Staff worked to keep children, their siblings or their families involved in activities that mattered to them wherever possible. Relatives thought that staff were caring and supportive and sought their advice and support when working with their children or their siblings.

The registered manager was seen as an experienced leader, by staff, external professionals and people’s relatives. The registered manager was trusted and had created a strong sense of commitment to meeting families diverse needs, supporting their staff and d