Rainbows Hospice for Children and Young People

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Leadership at Rainbows Hospice was visionary, inclusive, and deeply committed to excellence. Leaders had a clearly defined and ambitious strategy, underpinned by compassionate values and a strong focus on sustainability and person-centred care. They fostered a culture of openness, learning, and continuous improvement, with robust governance structures that ensured transparency and accountability. Staff consistently reported feeling valued, empowered, and aligned with the service’s compassionate ethos. The leadership team was visible, approachable, and deeply respected, creating an environment where innovation was embraced and diversity celebrated. Strategic priorities were shaped collaboratively with staff, families, and young people, ensuring care remained responsive and future-focused. The organisation demonstrated a clear commitment to workforce wellbeing, equity, and inclusion, with staff expressing pride in their roles and a strong sense of belonging. Rainbows Hospice exemplified a culture where excellence thrived, and both staff and families were supported to flourish.

This service scored 93 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Leaders had an ambitious and clearly defined vision underpinned by a strong set of values focused on compassion, quality, and sustainability. There was a well-developed and realistic strategy in place to deliver outstanding, person-centred care that was both high-quality and sustainable. The providers vision and values were embedded throughout the organisation, and staff at all levels were able to clearly articulate them. They understood how their work contributed to achieving the wider goals of the service.

Strategic priorities were ambitious yet achievable and included innovative workforce development, enhanced staff wellbeing, continuous improvement of the care environment, tailored pathways for children and young people, and strengthened governance across the service. Leaders showed deep insight into the needs of those who used the service and took a proactive approach to planning for the future. Strategy was planned over 5 years, regularly shared with staff, children, young people and their families to promote transparency and ensure that continuous change and improvement were shaped by those at the heart of the care.

The service led a project in December 2023 to refresh and revitalise its organisational values and behaviours. This involved engaging key stakeholders through staff surveys, focus groups, and conversations with families and other partners. Insights were gathered by interviewing senior stakeholders, reviewing organisational documents, collecting survey responses from staff, volunteers, and families, and holding multiple focus groups and interviews. Following this, the values and behaviours were developed collaboratively and launched during a full staff away day in April 2024.

Leaders said the service had clear plans in place to expand its retail and fundraising activity through the opening of more charity shops, supporting the long-term sustainability of the service. Staff consistently reported feeling highly valued, respected and supported in their roles. There was a strong, person-centred culture shared across the organisation. Relationships among staff were highly collaborative, respectful, and appreciative. It was clear that providing high-quality, compassionate care was a shared passion and priority. Staff understood and supported the organisation’s wider strategic aims and felt included in the service’s direction.

The service had developed strong relationships with the local community across the Midlands and worked in partnership with other acute services and the Integrated Care Board (ICB) to support joined-up care. Families were actively involved in shaping the service and shared their experiences at speaking events and community engagements. They supported the creative approach to care and advocacy at Rainbows, helping to raise awareness and champion the impact of hospice services. Their involvement was valued and helped ensure that care remained responsive, personal, and continuously improving.

Staff went above and beyond to deliver excellent care and improve outcomes for children and young people. Their enthusiasm, dedication, and commitment to the vision of Rainbows were clear in everything they did. The service had created a culture where continuous improvement, innovation and excellence were genuinely embedded.

Leaders and staff described how the hospice had developed significantly over the past 5 years, with a clear and confident shift towards becoming a recognised specialist in palliative care. Staff told us they were proud of the service's growth, highlighting specialist provision such as Hospice at Home, dedicated palliative care nurses working within hospitals, and a well-established therapy wing.

Volunteers felt highly valued and supported within the service. One volunteer shared they regularly received check-in emails from the volunteer team and had recently enjoyed a cup of tea with the volunteer coordinator, describing the experience as warm and inclusive. They told us they never felt left on their own or “in the way.”

The leadership team at Rainbows Hospice provided a clear, values-driven vision underpinned by role modelled accountability and governance and a relentless commitment to high-quality, person-centred care. Every member of staff we talked with showed they lived the organisational values and beliefs without exception. Leaders were credible, inclusive, and compassionate and held the needs of the BCYP, their families, values and staff at the heart of service provision. Leaders were visible, supportive, and adaptable. Staff gave us examples of managers being approachable and always available for support. Staff consistently told us they felt proud to be part of the organisation, highlighting a deep sense of purpose and alignment with the service’s values and direction.

The senior leadership team invited all staff to join a quarterly meeting that included recognition of good work, improvement projects, and a review of how services are being delivered in line with the aims and vision.

We conducted focus groups and spoke with a wide range of staff across Rainbows, including over 60 individuals from a variety of roles. This included leaders, human resources, marketing, family bereavement support , cultural link staff, music therapists, registered nurses, healthcare assistants, directors, and housekeeping staff. Staff consistently described a culture of inclusivity and compassion, with no sense of hierarchy. Everyone we spoke with shared a clear commitment to caring for children, young people and their families. The open and respectful culture enabled all staff, regardless of role, to feel valued and empowered to contribute to the delivery of excellent care.

During assessment, we saw a newsletter shared with staff and families in May 2025. It highlighted the service’s strong commitment to culture, inclusion, and staff well-being. The newsletter reported staff involvement in various initiatives, including workplace yoga and the sharing of inspiring stories. These activities fostered a supportive environment where staff felt valued, connected, and motivated. The ongoing celebration of excellence contributed to enhanced morale, resilience, and teamwork across the service.

Leaders expressed a strong sense to do even more for the young people and families they supported. While staff were aware of financial pressures, they showed creativity and determination in finding ways to enhance and sustain the quality of the service. This reflected a culture of pride, ownership, and continuous improvement.

The service actively promoted a culture of openness, honesty, and psychological safety, where staff felt empowered to speak up without fear. A new Freedom to Speak Up policy had been embedded across the organisation, creating a supportive environment where staff could raise personal or professional concerns. Leaders ensured that learning from concerns was regularly discussed at board level, showing a strong commitment to transparency and improvement. There was a clear emphasis on listening to staff and acting on what was heard. Staff consistently told us they felt able to speak openly about difficulties and challenges, and that their views were respected and valued. They described a workplace culture where their wellbeing was prioritised and where they were encouraged to contribute ideas to improve care.

The service had access to independent, external Freedom to Speak Up Guardians (FTSUG) who provided a trusted and impartial route for raising concerns. These Guardians worked proactively and reactively across the organisation, including within community and hospice settings. Staff were aware of how to contact them and felt confident that any concerns raised through this independent channel would be taken seriously and addressed appropriately. This contributed to a culture of openness and accountability and influenced the delivery of safe, high-quality care for children, young people, and their families.

Leaders completed externally led expert training in psychological safety, ally-ship, and values, as part of a drive to embed inclusivity in the workplace. In June 2024, a staff survey recorded that 96% of staff said that they enjoy their work and 97% said they felt proud to be part of Rainbows. Staff felt well supported in their personal development and aligned with Rainbows' vision and values.

The service showed an authentic commitment to understanding and supporting families from different cultural and religious backgrounds. A Community Cultural Link Worker helped to make sure families felt listened to, respected, and properly understood. They supported good communication between families and staff, helped with translation when needed, and made sure that cultural and religious beliefs were included in care plans. The Link Worker also helped the Family Support Team learn more about different cultures so they could give better, more personalised care.

The community cultural link worker helped ensure that families felt listened to, respected, and properly understood. They supported good communication between families and staff, helped with translation when needed, and cultural Hubs provided a friendly and welcoming space for parents and carers to meet others from similar backgrounds. These sessions gave families a chance to share their stories, talk about challenges, and feel less alone. They also helped families learn about services like hospice care, short breaks, and bereavement support in ways they could understand.

The hubs used creative and community-based activities to support emotional wellbeing and reduce isolation. Families said they felt comfortable and supported, and kept coming back, not just for the conversation, but because they knew they were not alone. The staff embraced changed and understood the importance of culture and individual needs to young people and families. We saw good practice in promoting diversity and inclusion, with translated materials available to support individuals with different language needs. In addition, visual aids and information boxes were provided for faiths such as Sikhism, Hinduism, and Christianity, helping to ensure culturally sensitive for young people.

The Head of Hospice and Community Services worked closely across both disciplines to provide joined-up, holistic oversight of care. Staff consistently expressed deep pride and gratitude in their roles, with 1 team member saying, “I love my job I feel incredibly grateful to work here.” This reflected a strong, values-led culture where staff were empowered, supported, and passionate about delivering exceptional care.

Rainbows Hospice had a suitable governance and risk oversight structure that checked the quality of care provided and helped find, manage, and mitigate organisational risk. The service operated through clear, tiered governance responsibilities. Staff took on responsibility for managing specific risks and introducing mitigation. Senior nurses reviewed risks and responded to recommendations from the Good Clinical Governance (GCG). They escalated issues when necessary. The Clinical Quality Assurance Committee (CQAC) oversaw the Clinical Risk Register, approving new risks, mitigation plans, and closures. The Board provided overall strategic oversight of clinical risk across the organisation.

The organisation was led by a chief executive officer (CEO) who reported to a board of trustees.

The board was supported by several senior managers, including the Executive Nurse Director of People who looked after the medical and care teams and the Director of Finance who managed the hospice’s money, buildings, and day-to-day operations.

Governance systems were mature and fully embedded at every level, ensuring strong oversight, transparency, and accountability. There was a clear line of sight from board to bedside, with leaders consistently using both qualitative and quantitative data to inform decisions and drive improvement. Leaders proactively checked an audit and risk dashboard. The dashboard was used alongside a detailed corporate risk register to check and mitigate risk. This approach ensured continuous oversight of all the quality and risk markers including clinical outcome data, organisational risk and even included data protection, health and safety processes and overall financial management.

Reports were shared through Clinical Governance meetings and regular briefings. The service worked collaboratively with NHS England (NHSE) to ensure training met national standards and best practice guidelines. Rainbows was highly praised in a safeguarding report from the local Safeguarding Board, which recognised the hospice for meeting excellent standards in safeguarding. This showed strong leadership and clear responsibility

Inductions were planned in advance and delivered face-to-face, including training sessions and opportunities to meet with executives. Introducing the organisation’s vision and values was a key focus, helping to ensure all staff understood their role in delivering excellent care at Rainbows.

One major achievement was increasing the diversity of decision-making panels by 75%, ensuring broader perspectives and lived experiences were reflected in planning. The service also appointed an Inclusion Specialist to guide their approach and ensure they followed best practice across all areas with more open and honest conversations, and a more inclusive, supportive environment for all.

There was a deeply rooted culture of reflection and responsiveness. Leaders acted swiftly and effectively on feedback, promoting continuous learning and fostering an environment where excellence thrived. The organisation recognised and embraced the change ahead, proactively preparing to meet the diverse and growing needs of children and young people through inclusive, sustainable and person-led approaches.

During the assessment, we reviewed a comprehensive and up-to-date suite of policies that showed the service’s ongoing commitment to quality, safety, and continuous improvement.

We saw there was a robust process in place to respect people’s data privacy and that any potential breaches were documented on the hospice’s incident reporting system for detailed review. In the period 1 June 2024 to 31 May 2025, there had been 15 potential incidents which had been reviewed promptly and none required reporting to the Data Protection regulator.

The hospice used a detailed finance dashboard to ensure financial probity was supported.

The hospice kept a Board Assurance Framework (BAF) to ensure a structured means of finding and mapping mains sources of assurance and provided clear lines of accountability, governance and reporting to and from managers to the board. The hospice’s audit and risk dashboard report for April 2025 showed effective oversight of risks, internal audit reviews, health and safety updates, data protection incidents and currency of corporate policies in operation. The organisation fostered a culture of openness and continuous improvement, with clear lines of accountability. Where gaps in control or assurance were found, such as incomplete archiving of paper care records, these were acknowledged, with actions planned or underway. Risk management was embedded across the organisation and contributed directly to the delivery of safe, effective, and sustainable care.

The service showed a strong commitment to continuous improvement and reflective practice. This was clear through the development of a dedicated working group aimed at improving communication strategies, particularly for children who use non-verbal methods. A collaborative culture was seen between clinical and non-clinical staff, promoting a joined-up approach to care that considered the full range of a child or young person’s needs. Regular communication within teams and a visible leadership presence contributed to a supportive and cohesive working environment.

We reviewed both the Corporate and Clinical Risk Registers and found that the organisation had robust governance arrangements in place to find, assess, escalate, and check risks. Strategic and operational risks were clearly documented, regularly reviewed, and aligned with the service’s regulatory responsibilities and strategic goals. Oversight was embedded through structured forums including the Senior Nurse Meeting, Clinical Quality Assurance Committee (CQAC), Good Clinical Governance (GCG) meeting, and the Board of Trustees.

Leaders showed a comprehensive understanding of key organisational risks across finance, workforce, infrastructure, and information governance. For example, the risk of reduced income from NHS England (NHSE) grant funding beyond March 2026 had been identified as high and was subject to proactive mitigation, including partnership working with Integrated Care Boards (ICBs) and contingency planning. The organisation also recognised the safety risk posed by incomplete lone worker training and the absence of a fully updated policy. While lone worker devices (an alarm device in a key-fob style) had been issued, not all community staff had completed the associated e-learning, and escalation protocols required revision.

The Fire Risk Assessment had been completed and remedial works to address fire compartmentalisation and fire panel accuracy were underway, with a completion target set for February 2025. In clinical areas, the organisation had acted to mitigate the impact of staffing vacancies among Advanced Clinical Practitioners (ACPs) by prioritising end-of-life and admission-day coverage, supported by non-medical prescribers (NMPs) and access to specialist palliative care consultants.

Financial risks were checked effectively through structured reporting to the Finance, Audit and Risk (FAR) Committee and the Income Generation and Marketing (IGM) Committee. Monthly reviews included income trends, donor engagement, and reserve levels. A clear fundraising strategy was in place to diversify income streams and support long-term sustainability.

Rainbows actively worked with Integrated Care Boards (ICBs), local authorities, families, and parents to create a truly collaborative approach to each child’s care journey. During a series of community events, families and parents openly shared their experiences and insights, showing the partnership’s dedication to excellence and person-centred support. These events fostered honest conversations that strengthened relationships between all involved, ensuring care plans were personalised to meet each child’s unique needs.

Rainbows also built strong partnerships with local communities and external organisations, including healthcare providers, schools, and voluntary groups. Through these connections, they took a comprehensive approach to care, addressing the wide-ranging needs of children, young people, and their families. The collaboration enabled smooth communication, shared resources, and joint projects, all of which helped improve outcomes and deepen community ties. Additionally, Rainbows organised fundraising and marketing events to support financial sustainability, ensuring ongoing resources were available to support and develop high-quality services.

The youth and transition team created youth groups to help young people living with life-limiting conditions meet each other and build friendships. The music therapy team provided an outreach service to patients on hospital wards and in their homes. They collaborated with volunteers to find innovative alternatives to securing equipment that was usually too expensive on the open market. For example, a volunteer had produced musical equipment using a 3D printer, which the team used effectively with patients.

The music therapy team engaged with people at a community hub to reduce cultural and religious barriers to music as a tool to improve understanding and access.

Staff were well-connected nationally and presented their work and projects at conferences and networking events. They kept evidence of the benefit and impact of such work on care and service delivery.

Staff worked with the ICB to deliver learning disability care training (Oliver McGowan training) to meet new national standards .

The provider supported staff to network across their specialty regionally and nationally to build relationships with other providers and set up research. A research manager provided support to staff to secure funding, adhere to good ethical practice, and develop their research skills.

Training compliance across the service was above expected levels in several key areas. Staff had completed mandatory and statutory training to a high standard. Oliver McGowan training on learning disability and autism had been well embedded, with 96 percent of clinical staff and 93 percent of non-clinical staff completing Part 1, and 82 percent of clinical staff attending the Tier 2 face-to-face session. Other courses also showed strong uptake, including Adult Basic Life Support at 100 percent, Equality and Diversity at 100 percent for clinical staff and 93 percent for non-clinical staff, COSHH at 100 percent across both groups, and Preventing Radicalisation at 100 percent for clinical staff and 96 percent for non-clinical staff. This reflected a clear commitment to safe, inclusive, and well-informed care delivery. Rainbows was highly praised in the safeguarding assurance report from the local Integrated Care System (ICS), which stated, ’The submission describes excellent safeguarding arrangements and is a credit to the Rainbows Safeguarding leadership’. This showed strong leadership and clear responsibility.

The youth and transition team (YTT) collaborated with people to adapt the facilities and resources to the needs of teenagers and young adults. For example, the hospice was renovating the extensive outdoor spaces, including gardens and recreation areas. Young people had found opportunities to make the spaces more appealing to their age group, thus improving accessibility. The YTT were collaborating with the provider to incorporate feedback into the new designs. In addition, people had asked the team to help them set up a social media platform to support communication with each other when they were not in the hospice, and to promote the work of the service to their friends and others in the community. A youth worker had created a new platform and was working with the marketing and safeguarding teams to make sure it was used safely.

The music therapy team had a continuous focus on innovation to help improve the lives of patients and their loved ones. They had secured a percussion instrument designed for people to lie in as an immersive experience. The instrument was large enough for an adult and baby and provided a calming effect that reduced tremors and improved mental wellbeing.

A music therapy student had completed the hospice’s first music therapy placement in May 2025, reflecting the growing profile of the specialism. Staff worked with the student’s university to develop a risk-assessed workplan that enabled the student to complete a specific piece of work supporting a baby group and to gain experience managing a caseload.

The provider had a clear focus on sustainability and succession planning. The nurse education team were setting up a postgraduate teaching module in end-of-life care that would be offered to colleagues across the East Midlands and enable the hospice to achieve centre of excellence accreditation. The team supported students from registered professions to gain experience in the hospice. Nurses and allied health professionals completed standards of student supervision and assessment training to ensure students had structure and guidance. The service supported 3 HCAs to complete nurse associate apprenticeships, and a nurse apprentice had recently qualified as a registered nurse. Such activities reflected the provider’s focus on development and progression.

The service used innovative and creative approaches to enhance both care delivery and the overall experience for children, young people, and their families. One particularly impactful example was the work of the music therapist, who used the heartbeat of a baby to create personalised pieces of music, a research study being considered for publication due to its emotional and therapeutic value.

The service also showed innovation in its staffing model, having developed its advanced clinical practitioner (ACP) workforce to support a shift from a respite-based model to one focused on symptom control and end-of-life care.

We viewed information on sharing good practice. The Head of Governance and a Deputy Lead Nurse recorded a podcast episode on clinical audits within hospice settings. This podcast was awaiting publication via a well-recognised online platform. The podcast aimed to promote shared learning and good practice across the wider healthcare sector.

The organisation's commitment to research, education, and innovation was a defining strength. Staff were empowered to develop professionally, contribute to service improvement initiatives, and embed evidence-based practice. The appointment of a Director of Digital Transformation further showed visionary leadership, ensuring that digital solutions enhanced accessibility, personalised care, and operational excellence and recognised change to enhance this meeting needs of young people and staff.

Bedrooms were tailored to meet individual needs, using personalised colours, pictures, and toys to create comforting, child-centred spaces