Care and Case Management Services Limited

Updated 31 October 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection activity took place from 10 to 26 September 2018 and was announced. We gave the provider 48 hours' notice so that staff members and records were available for us to review. The inspection included visits to the provider’s office where we reviewed records, policies and procedures.

The inspection was carried out by one adult social care inspector.

Before the inspection we reviewed other information we held about the service and the provider. This included statutory notifications we had received from the provider. Notifications are reports about changes, event or incidents the provider is legally obliged to send to CQC within required timescales. We contacted the commissioners for the service and the local authority safeguarding team.

We also used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we met with the registered manager, the clinical lead, four case managers and two administrative staff. We also carried out telephone interviews with two senior support workers and two support workers.

Due to the nature of people’s acquired brain injury, the geographical distances people were located, and gaining people’s consent, we were only able to speak with one person using the service. We did speak with four relatives of people who used the service.

We looked at four people’s care records and records relating to the management of the service including the recruitment and personnel records of three staff.

Updated 31 October 2018

Care and Case Management Limited was inspected between 10 and 26 September 2018 and was announced. We gave the service 48 hours’ notice of the inspection as this was a small service and we wanted to ensure management and staff were available to speak with us.

Care and Case Management Services Limited is a private case management service, providing case management, personal care and support services. It is an independent company predominately commissioned by Deputies appointed by the Court of Protection or litigation solicitors. The service undertakes assessments, and provides and reviews care and therapeutic services for children and adults who, as a result of medical negligence or personal injury, have suffered brain injury, spinal injury, or other serious medical conditions.

The service coordinates services from an office base in Stokesley. However, services are provided across a wide geographical area in the north of England. At the time of the inspection, 14 people were receiving personal care support.

Care and Case Management Limited was last inspected on 16 December 2016. The overall rating for the service was good. On our last visit the well-led question was rated as outstanding. This inspection has found the service has improved it’s rating from good to outstanding.

There was a registered manager in place at the time of 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.

Staff we spoke with told us of the excellent support for their personal and professional development. There was a proactive support system in place to encourage staff to develop and deliver outstanding care.

People were supported by staff who were extremely well trained. All staff received what one member of staff referred to as an “exceptional” induction, which introduced them to what excellent care meant for each individual person. Staff received mandatory training in addition to specific training for people’s individual needs delivered by specialists in that field. The service had innovated to deliver observational training across a wide geographical area. Staff consistently expressed an enthusiastic commitment to providing excellent care. The service was proactive in seeking professional advice and in working with other specialists to give people the best possible outcomes for a fulfilled life.

The registered manager and staff were clear about their responsibilities around the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and were both innovative and dedicated in their approach to supporting people to make informed decisions about their care. People were fully supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff advocated on behalf of people to challenge decisions about people's care and also to challenge poor practice by other services ensuring people got the rights and services they were entitled to.

We heard how the staff team by their dedication, knowledge and kindness had helped people and families live meaningful and fulfilled lives following the tragedy of an acquired brain injury, often caused in highly traumatic circumstances. We heard so many stories of the practical and emotional support provided to people and their families that had helped their lives. On an individual basis, staff recognising when people were in danger of becoming overwhelmed and offering their personal time or specialist help to keep people and their family or loved ones together.

People were placed at the heart of the service by strong, caring leadership which promoted an open culture. The management team respected, supported and listened to staff to improve the quality of service. There were now a number of champions within the staff team who each took enthusiastic responsibility to improve the quality of service in their chosen area. The service acted on people's and staff views and regularly consulted with them about how to improve. The service had excellent links nationally and locally within the case management and acquired brain injury sector and was recognised as a beacon service by those in the profession. The registered manager understood the service's strengths, where improvements could be made and had plans in place to achieve these with timescales in place.

Systems were in place to assess and monitor the quality of the service and the focus was on continuous improvement. The service continued to build it's capacity by recruiting staff with specialist skills and in developing the staff team through a personal and professional development programme.

People’s safety was maintained as staff had good knowledge how to safeguard people. People were supported by staff who were trained and skilled and support was provided at the staffing levels of each individual’s assessed needs. Recruitment processes were robust and involved people who used the service and their families. Medicines were managed safely and the provider maintained a safe working environment.

People were supported to achieve their goals, through individualised person-centred care. Positive risk taking was encouraged throughout the service, balancing the potential benefits and risks and empowering people to reach their full potential through greater independence. Strong community inclusion enabled people to live fulfilled and meaningful lives, through accessing a wide variety of local activities, education and leisure opportunities.