This comprehensive inspection was announced and took place on 28 November 2017. We gave the service 48 hours' notice of the inspection because we needed to ensure the manager would be available to speak with us.

Whilst we have taken into account any wider social care and support provided to people in their homes and in the community, the Care Quality Commission (CQC) carried out this inspection only in relation to the regulated activity of ‘personal care’.

The Rainbow Family Centre is a domiciliary care service which provides personal care and support to children and young adults with learning disabilities and autism in their own homes and out in the local community. At the time of our inspection 27 people were using the service, of whom eight were receiving support with their personal care needs.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

We rated the service Requires Improvement at our previous focused inspection in June 2017. We reported improvements had been made and the service was meeting the legal requirements we checked. We indicated that we would require a longer term track record of consistent good practice before we were able to revise ratings for the service. At this inspection we found the provider had continued to make and sustain improvements to the service and rated the service Good.

The manager had submitted an application to the Care Quality Commission to become the registered manager for the service. 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.

People's needs were assessed prior to them receiving a service. This ensured that any care and support provided would meet people’s needs appropriately.

People's care and support plans were developed with them and their relatives (where appropriate). People and their family members were provided with a service user guide and asked to sign a contract of agreement before a package of care was delivered. Care plans were updated on a regular basis or when there was a change to their care needs.

People were treated with kindness and compassion and staff established caring relationships with the people they were supporting.

Staff were knowledgeable about the requirements of the Mental Capacity Act (MCA) 2005 legislation and sought people's consent before providing any care and support. Staff ensured people's privacy and dignity was protected and promoted.

Staff completed safeguarding training to enable them to recognise the signs and symptoms of abuse. Safeguarding training was refreshed on a regular basis in line with the provider’s policies and procedures.

There were risk management plans in place to protect and promote people's safety. Staff understood how to protect people from harm and were confident that any concerns would be reported and investigated by the manager.

Where staff supported people with their medicines this was done in accordance with best practice guidelines. If required, staff supported people to access healthcare services and other organisations.

People were supported to access the food and drink of their choice where this formed part of the agreed care and support plan.

There were safe recruitment practices in place and these were being followed to ensure staff employed were suitable for their roles. Staffing numbers were sufficient to keep people safe and double up care was in place for people who required this.

Staff received an induction when they first commenced working at the service. Staff were supported by the manager and had regular one to one supervisi

We carried out an unannounced comprehensive inspection of this service on 7 and 8 September 2016 at which breaches of the legal requirements were found. This was because the provider had not ensured staff received appropriate training, supervision and support to carry out their duties effectively. We also found the registered person had not notified the CQC of safeguarding concerns in relation to a person using the service.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We undertook a focused inspection on the 6 June 2017 to check the provider had followed their action plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to these topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for 'Rainbow family Centre' on our website at www.cqc.org.uk

The Rainbow Family Centre is a domiciliary care service which provides personal care and support to children and young adults in their own homes and out in the local community. At the time of our inspection 24 people were using the service, nine of whom were receiving support with personal care needs.

The service manager had begun the application process to become the 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.

At this inspection, we found that the provider had followed their action plan which they had told us would be completed by the 2 December 2016.

Staff were supported by the management team through regular supervision sessions. An appraisal system was in place ensuring staff were provided with continual assessment and constructive feedback in regards to their performance, learning goals and achievements.

Team meetings and a feedback process ensured staff views were listened to, encouraged and acted on.

The service manager and care co-ordinator demonstrated a good understanding of their registration requirements in relation to notifying CQC of any serious concerns, incidents and/or accidents. We have received one notification since our last inspection which was investigated in line with the provider’s policies and procedures.

This inspection was carried out on 7 and 8 September 2016 by one inspector and was unannounced. At our last inspection on 9 January 2014 the service was meeting all of the regulations checked.

The Rainbow Family Centre is a domiciliary care service which provides personal care and support to children and young adults in their own homes and out in the local community.

At the time of our inspection the service was supporting 45 children and three young adults living with their families in the London area. Of these people, 23 received support with personal care.

There was a registered manager in post who was available to speak with us throughout our inspection. 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 not notified the CQC of one incident involving the police which should have been reported to us in line with the provider’s registration requirements. The registered manager has agreed that in future, all notifications will be sent us as soon as possible so that where needed, action can be taken in a timely manner.

Parents and relatives were mostly positive about the leadership of the service although two family members felt that communication between themselves and the management team could be improved.

Parents told us they were involved in the development of care plans. People’s care plans reflected their individual needs and personal wishes. However, care plans were not always being completed in full, reviewed and updated on a regular basis.

Staff were required to complete an induction prior to commencing their employment. During our visit we noted that records relating to staff induction and training was not always being maintained or updated to reflect what training staff had completed or needed to be refreshed.

Staff understood the types of harm vulnerable children and adults could be exposed to and knew how to recognise the signs of abuse. Staff told us they had completed training in safeguarding children and adults.

People’s risk assessments covered a range of issues including guidance around mobility, behaviour management, road safety and exploitation.

People’s independence and well-being was promoted. Staff supported people to attend activities and there were protocols in place to respond to any medical emergencies or significant changes in a person’s well-being.

Staff were aware of people’s specific dietary needs and preferences and offered people choices at mealtimes where this formed part of their care plan.

Parents told us that staff were kind, compassionate and enthusiastic and respected the privacy and dignity of their family members at all times.

Staff were recruited safely and were required to undergo a number of background checks prior to commencing employment. Staff were clear about the vision and values of the service.

Not all staff were involved in supporting people with their medicines, but where they were responsible for prompting people’s medicines, staff were required to complete training in medicines administration and first aid awareness.

Quality monitoring and audits were not always being carried out on a regular basis in relation to care records and care delivery and not all staff were receiving regular supervision and annual appraisals.

The provider had systems in place for recording accidents, incidents and complaints and these were investigated when necessary.

We found breaches of regulations in relation to staff supervision and notifying CQC of significant events. You can see the action we have told the provider to take at the back of the full version of the report.

We spoke to three parents of people who use the service. People we spoke with understood the care and treatment choices available to them and they were involved in making decisions about their care and treatment. All the people we spoke to said that care workers understood and supported their and their children’s choices and preferences. They stated they had regular care workers that they knew well and who they had had built good relationships with.

Care workers protected people’s privacy and dignity and treated them with respect. For example, parent said “I could not have managed without them’’ and another parent said “they have helped me a lot. They are really, really good”.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Parents told us that their children’s needs had been assessed when they first started receiving care and that these assessments had been ongoing.

People told us they were able to give views about the service and felt listened to. People said they knew how to raise concerns if there were any but they had not felt the need to do so.