This inspection took place on 31 May, 1 and 2 June 2016 and was unannounced.

Rainbows Hospice provides care for children and young people up to the age of 30, with life threatening or life limiting conditions. Services include specialist respite, palliative, end of life and bereavement care. The service provides support to families of children and young people both within the hospice and the wider community. The hospice supports families across the East Midlands.

Rainbows provides a residential respite facility for up to 14 children and young people at any one time, within designated areas of the hospice, within individual bedrooms. At the time of our inspection there were nine children and young people accessing respite care. The hospice is located on the edge of a housing estate on the outskirts of Loughborough. The facilities provided by the hospice include, a multi-sensory room, computer room, soft play room, hydrotherapy pool, music therapy room, separate lounges for children and young people, an art and crafts room and day care facility. Accommodation is also provided for parents and their families should they wish to stay. The grounds of the hospice incorporated a range of facilities for children to play, and distinctive areas of landscaped gardens for relaxation and a separate remembrance garden.

The service had 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.

The provider had employed staff to undertake specific roles, which had a positive impact on the experience of children, young people and their families. For children and young people it presented opportunities for them to take part in activities and experience everyday activities, including play, Whilst for the families of children and young people, the provider recognised the impact of a child’s health on the wider family and had created staff roles who led support groups for siblings and parents, the groups provided support through information, counselling and social events, and were well received by those who participated.

The inclusive approach of the provider, in response to feedback from parents had established the ‘transitions project’ and group, facilitated by a member of staff who had considered as part of its work the impact of the Mental Capacity Act 2005, (MCA) and its implications for young people who used the service as they transitioned to adulthood. The transition co-ordinator worked with young people and their parents, providing support as they transferred to adult services.

The provider worked in partnership with children, young people and their families by providing opportunities for everyone to comment and influence the care and treatment provided. This enabled staff to deliver person centred care, with staff supporting children and young people throughout the day, providing all aspects of their care and treatment along with play and the taking part in recreational activities. Parents valued their relationships with staff who felt that the support they received had a positive impact on their life and that of their child’s. Staff focused on the wellbeing of children and young people, and their families and worked together to share information for the benefit of the child or young person.

There were excellent recreational facilities, for which children and young people could access, and a range of holistic therapists were available to them and their parents. There was a commitment shown by all staff with regards to the quality of life of children and young people, with staff providing support so that they could take part in activities and play. Children and young people were observed playing, with other children, which included fac

We did not speak directly with anyone using service, at the time of our inspection. Rainbows provides specialist end of life care and people using the service on the day we visited were very ill. We wished to respect their privacy at this time. However we did speak with a visiting relative who was able to tell us their experience of the service.

We asked if they felt the service respected and involved their relative in their care, they told us that staff were friendly and helpful and included their relative in planning their care. We looked at people's support plans and these showed how they involved people in the creation and up date of plans.

We looked at people's nutrition and we saw that the service had records showing what people needed to maintain their nutrition. A visitor spoken with said that the chef had spoken with them to check what sort of things their relative liked to eat.

We asked if their medication was handled safely, the visitor we spoke with said they were confident in how their relative's medication was handled. We saw that the service had a robust system in place for monitoring medications ensuring people received their medication safely.

We were told that staff were competent in their role and we saw training that confirmed they received regular training and support.

We were told that the complaints were handled well by the service, we saw records that indicated how the service dealt with any complaints it received.

We did not speak directly with anyone using or the service, or visiting, at the time of our inspection. Rainbows provides specialist end of life care and people using the service on the day we visited were very ill. We wished to respect their privacy at this time.

We did observe care taking place in communal areas and saw that staff were kind and caring with people. They provided care according to care plans and were able to explain why they provided care in a particular way.

We saw that systems were in place and followed to ensure that people were safe and protected from abuse and that there were effective systems in place to ensure suitably qualified and experienced people were recruited to work in the service.

There are robust systems in place to ensure that the quality of the service is monitored and reviewed to ensure that people using the service can be confident they are receiving the best possible care.