Rainbow Trust Offices at Church Farm

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.

At the time of this inspection 52 children were being supported under the regulated activity. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. A further 20 families were receiving support outside of the regulated activity.

People’s experience of using this service and what we found

Risks to children’s personal safety had been assessed and actions recorded to minimise these risks. Staff had undertaken safeguarding training and were aware of their responsibilities to identify and report potential abuse. Staff monitored the risks to the families they supported and updated these as required.

Staff felt there was enough time to give families the support they needed. Staff prioritised families according to the needs of the children and closed cases when support was no longer needed.

The service did not administer any medicines or offer this kind of support to people. However, during the pandemic staff collected and delivered medicines for families who had members that needed to shield due to being clinically vulnerable.

Staff had good access to personal protective equipment and protocols and risk assessments were in place to maintain the safety of those being supported and the staff. Staff were part of a regular testing programme and would test before each family visit if requested. Families told us staff had followed the infection control measures the service had put in place in order to minimise the risk during support visits.

The service promoted a positive culture. Staff were passionate about the role they had supporting families and took pride from the difference they made. Staff told us the registered manager was approachable and available and supported them well.

Quality assurance systems were in place to monitor the quality of service being delivered. Families and professionals had the opportunity to give feedback on the service which enabled them to review the service offered. Staff were able to be part of team meetings and monthly supervisions.

The staff and management had worked creatively to meet people’s needs and continue their support during the pandemic. From August they implemented digital support to reach families when visiting them in person was not possible. The service worked collaboratively with different professionals in order to maximise outcomes for people.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 24 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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.