Rainbow Trust Children's Charity provides emotional and practical support, including personal care, to families who have a child with a life-limiting or terminal illness. This is the first inspection for this agency at this address.

This inspection took place on 31 July and 3 August 2017 and was announced.

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 saw that support plans were in place but these needed to reflect the preferences of the child as well as the parents. Initial assessments were conducted by the registered manager and at these meetings the nature of the support to be provided was discussed. For example, respite to parents to undertake other tasks, collecting siblings from school and activities. The agency offered support to children and where appropriate siblings for maintaining social networks and participate in activities. There were drop-in groups and outings organised for children and their siblings.

The parents we spoke with said their children were safe with the staff. The staff were able to tell us the procedures for safeguarding children and gave us examples on how they identified emerging risks and the action taken to ensure the safety of children

Risks were identified during initial visits and covered areas such as children at risk of choking and falls. There were other risk assessments for the environment and lone working of support staff. The level of risk was rated and action taken on how to minimise the risk.

Parents told us they had visits from regular staff who were always on time and visits were not missed. The staff said the staffing levels were appropriate. The agency operates during the week between 8:00am and 6pm.

Medicines were not administered by the staff at the service. The agency was not involved in the delivery or supporting of the children with their ongoing healthcare needs but attended meetings and liaised with other professionals.

Parents told us the staff had the skills needed to support their children. Staff were supported to perform the responsibilities of their role through one to one supervision meetings and training. New staff had an induction which ensured they felt confident to work on their own. Mandatory training was set by the provider which included safeguarding procedures, moving and handling and first aid. One to one supervision was monthly with the line manager which covered concerns, training needs and performance. Staff said team meetings were weekly and where they discussed what was not working and achievements. There was a reward scheme used to celebrate achievements.

Staff were knowledgeable about gaining consent before they undertook activities or tasks with children. They also told us children were not forced to accept care and if support was consistently refused there were discussions with parents about how to support the child. Where necessary, distraction was used to support parents with tasks that children may not accept.

Parents told us the staff were kind and their children looked forward to the visits from the agency staff. Staff told us how they developed trusting relationships with children. They said they listened to them and shared interests and consistency with regular visits. Discussions about End of Life journeys were led by the families as some preferred not to discuss these topics.

The team said they worked well together and the registered manager was approachable and reliable.

Quality assurance systems were in place which included people’s views about the service and audits.

We have made a recommendation about developing support plans that reflect the voice of children.