We carried out a review of the data available to us about Care and Case Management Services Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Care and Case Management Services Limited, you can give feedback on this service.
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.
The service coordinates services from an office base in Stokesley. However, services are provided across a wide geographical area in the North East of England. At the time of this inspection the service provided the regulated activity personal care to 27 people. The service employed 52 staff who were involved in providing the regulated activity.
The service had a registered manager, who had been registered with us since April 2009. 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 benefited from a service with strong leadership and an ethos of providing high quality, bespoke care and support. The registered manager was very well qualified and experienced, and an appropriate management structure was in place to support them. People who used the service, relatives and professionals expressed a very high level of satisfaction with the standard of care provided. All told us the service was very well led, with a clear focus on providing individualised and person centred care. Staff were passionate about providing high quality services that focused on the individual.
Quality monitoring took place and included listening and acting on feedback from people who used the service, staff and other professionals. Checks and audits took place to monitor the quality of the service’s work. People who used the service, relatives and other professionals were routinely involved in meetings, reviews and on-going work so that their feedback could be taken into account.
The service was committed to continuous learning and development and proactively embraced community involvement, keeping up to date with developments in their areas of expertise and sharing good practice. Professional networks and contracts with support organisations were in place, to help staff remain up to date with best practice and share their own professional skills and expertise with the wider community. Staff were members of the appropriate professional bodies and associations to help support their work.
People were protected by the service’s approach to safeguarding and whistle blowing. People who used the service told us that they were safe and could raise concerns if they needed to. Staff were aware of safeguarding procedures and could demonstrate how they had taken action to safeguard people when necessary. Staff also told us that the registered manager listened and acted on their feedback.
Safe arrangements were in place for staff recruitment, with people who used the service being involved in the recruitment process and decisions about which staff supported them. New work was only taken on if staff felt that they had time to do it well. Care workers were organised and deployed in a way that met people’s individual care needs, with small individual teams of staff who knew people well. People who used the service and their relatives told us that they received an individual, consistent and reliable service.
The service had health and safety related procedures, including emergency plans, in place. The office had been assessed for safety, with appropriate maintenance in place. Systems for reporting and recording accidents and incidents, including detailed reviews and actions, were in place. The care records we looked at included individual risk assessments, which had been completed to identify any risks associated with delivering the person’s care. Where people’s needs were complex relevant professionals had been involved to provide advice and training. Risks were managed positively, so that people were supported to develop confidence, skills and independence.
Safe systems were in place for assisting people with medicines, where this was part of their agreed care plan. Records and discussions with staff evidenced that that staff were trained and checks took place to ensure medicines were being given safely. Detailed information was available about people’s medicines and the support they needed, which had been reviewed regularly to ensure it was up to date. People were supported to take medicines independently wherever possible.
Staff had been provided with training and support to help them carry out their role. This included specialist training and support from relevant health care professionals where someone had complex needs. People and their relatives told us that staff were competent and knew what was expected of them. Staff told us they were well supported by the registered manager and other staff, who had clear expectations and provided regular support. We saw evidence of staff being encouraged to develop their own professional expertise and there was a strong focus on professional development. Training opportunities were also offered to people who used the service and their relatives.
This service supported people in their own homes and provided help with meal preparation, eating and drinking where this had been agreed as part of the person’s care service. If people needed support with eating and drinking this was detailed in their care plan and professional advice had been sought if people had complex nutritional needs.
People’s care records included detailed information about their health and wellbeing, so that staff were aware of information that was relevant to their care. Relevant health care professionals had been involved and people were involved in decisions about which therapists and professionals supported them.
People and their relatives told us that staff were caring, treated them well and respected their privacy. Staff were able to describe how they worked to maintain people’s privacy and dignity. We saw clear examples of people being supported to develop skills and independence.
People’s care records showed that their needs had been assessed and planned in a very detailed and person centred way. People who used the service and their relatives told us that they were involved in planning and reviewing their service and that their views were listened too. We saw clear examples where staff had supported people to take positive risks and develop their independence.
People had been provided with written information on the formal complaints process. People also told us that they were given opportunities to raise issues or concerns on an on-going basis. There had been one recent complaint, which had been responded to and resolved promptly. There were many compliments and letters of thanks.
Staff demonstrated a good understanding of issues around capacity and consent and the importance of gaining informed consent in the work that they did. This helped to ensure that people's legal rights were protected.
Thorough assessment, care planning and review systems were in place, which involved people who used the service in decisions about their support. This helped to ensure that people's care and support was planned and delivered in a safe and individual way.
Equipment was provided on the basis of assessed need, with appropriate maintenance arrangements in place. This helped to ensure that equipment was safe and suitable for the people who used it.
Thorough recruitment and induction processes were in place. This helped to ensure that the service employed safe and suitable staff, who had the skills needed to do their jobs.
Systems were in place to gather feedback from people who used the service and to monitor the quality of service people received.
We spoke with two of the agency's support workers and the business manager. Staff told us 'I've had all the training I should and you always get well supported' and 'we're listened to and can say what we think.'
Records were detailed and up to date, and people using the service confirmed their views were taken into account as to what was important to them in relation to the care provided.