This inspection took place on 30 November 2016 and was announced. Rainbow Trust Children's Charity 6 is a domiciliary care service and provides personal care for children, young people and their families living in their own homes. The children were living with a terminal illness and life threatened health conditions. At the time of the inspection there were 60 people and their families using the service.

The service met all the regulations we inspected on 19 June and 28 June 2013. This service was operating at a different location at that time.

The service has a registered manager. 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.

Staff demonstrated clear insight to people’s needs and supported families in a holistic way. Assessments were completed so that progress was charted in a way which people and their families could understand. Assessments took place with people and their relatives to ensure personal histories were correctly recorded and used to develop a plan of care. Care was delivered placing the person at the centre and incorporated the needs of their family. Reviews of care occurred frequently and care and support delivered demonstrated flexibility that allowed families to benefit.

People were protected from the risks of harm and abuse. The registered provider had safeguarding processes in place to support staff to keep people safe from the risk of abuse. Staff understood what abuse was and felt confident in discussing safeguarding concerns with the registered manager. The registered manager knew how to report safeguarding concerns with the local authority for their investigation. Staff had processes in place to report their concerns about the service. The whistle-blowing policy provided staff guidance to escalate concerns about the quality of care people received.

Risks to people’s health and well being were identified and managed. Staff delivered care and support that enabled people to take risks while they remained safe. Identified risks were recorded in people’s care records with a risk management plan in place that aimed to reduce the likelihood of those risks.

The registered manager ensured there were enough staff available to support people’s needs. The staff rota detailed each person who required care and the name of the member of staff supporting them. There were systems in place to ensure there were sufficient staff available so people were cared for safely.

The registered provider had processes in place to ensure the safe recruitment of suitable staff. Staff had completed the registered provider’s job application process and had pre-employment checks completed to assess their suitability to support people.

The registered manager supported staff through training, supervision and appraisal. Staff attended regular training which helped them to develop their skills and knowledge to help them support people effectively. During supervision staff were able to gain advice and support from their line manager. Supervision meetings recorded actions taken and were discussed at the next supervision to make sure they were resolved. Staff had a yearly appraisal, which helped them focus and share with their manager their professional and developmental needs.

People’s relatives managed their medicines so staff did not need to do this for people. People’s medicines were managed in a safe way. There were effective systems in place that ordered, stored, delivered and disposed of medicines appropriately. The service had processes in place to ensure people’s medicines were managed safely should the need arise.

The registered manager and staff had an awareness of the principles of the Mental Capacity Act 2005 (MCA) and Deprivation o