This inspection took place on 3 April 2018 and 25 June 2018 and was announced. Rainbow Trust Children's Charity 7 is a domiciliary care service which provides personal care for children, young people and their families living in their own homes. The children were living with a life limiting or terminal health condition. At the time of the inspection there were 110 people and their families using the service, of which two children were receiving care in line with the regulated activity of ‘personal care’. The domiciliary care service also offered parent and sibling support and to support and commemorate children who had passed away.

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.

Our key findings across all the areas we inspected were as follows:

• Suitable arrangements were in place to keep people safe. Policies and procedures were followed by staff to safeguard people and staff understood these measures. Risks to people were identified and managed to prevent people from receiving unsafe care and support. The service was appropriately staffed to meet the needs of the people using the service. Recruitment procedures were followed to ensure the right staff were employed. Arrangements were in place for learning and making improvements when things go wrong.

• Staff had a thorough induction to carry out their role and responsibilities effectively. Staff had the right competencies and skills to meet people’s needs and received regular training opportunities. Suitable arrangements were in place for staff to receive regular formal supervision. People’s nutritional and hydration needs were met. People received appropriate healthcare support as and when needed. The service worked together with other organisations to ensure people received coordinated care and support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

• People were treated with care, kindness, dignity and respect. People received a good level of care and support that met their needs and preferences. Staff had a good knowledge and understanding of people’s specific care and support needs and how they wished to be cared for and supported.

• Support plans were in place to reflect how people would like to receive their care and support, and covered all aspects of a person's individual circumstances. Information about how to make a complaint was available and people’s representatives told us they were confident to raise issues or concerns. Families received appropriate bereavement support.

• Suitable arrangements were in place to assess and monitor the quality of the service provided. There was a positive culture within the service that was person-centred, open and inclusive. People received a good quality service that was flexible and responsive to their needs.