MSP Case Management Ltd

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was a proactive and positive culture of safety based on openness and honesty. Staff felt able to raise concerns and told us these were listened to and acted on. Incidents were reviewed and learning was shared quickly across teams. Staff described feeling supported to reflect on practice and improve outcomes for people.

There were clear systems in place to report concerns and record events. Staff understood these and used them in practice. One staff member explained that issues were taken seriously and followed up, which gave them confidence to raise concerns.

Learning was shared through regular meetings, newsletters and discussions. Records showed open reflection on what worked well and where improvements were needed. Leaders encouraged staff to develop their skills and adapt practice. For example, additional training was arranged to support staff to respond to distressed behaviour in a more effective way, which improved care and outcomes for people.

Professionals told us that concerns were addressed quickly and there was a strong team approach to learning and improvement. One professional said, "I have found the quality of care to be consistently excellent with any areas of concern being addressed in a timely manner with a joint care team approach."

There were clear and well managed systems to support safe care across all parts of the service. The provider worked closely with people, relatives and professionals involved in their care to plan and review support. Information was shared in a timely way which reduced risks and helped ensure consistent care.

Continuity of care was maintained through consistent staffing and careful planning. Where staffing changes were needed, new staff were introduced in advance. This supported people to feel familiar with those providing care and reduced disruption. Relatives told us they had confidence in how care was organised and felt involved in decisions.

Transitions between services were planned and coordinated effectively. Staff worked closely with health professionals, schools and other services to ensure information was shared and support remained consistent. Care plans and risk information were updated as people’s needs changed so that all those involved had clear and current guidance.

One professional described the quality of care planning and delivery as consistently excellent, with concerns addressed promptly through a coordinated multi-disciplinary team (MDT) approach. They said, “I have found the quality of care to be consistently excellent with any areas of concern being addressed in a timely manner with a joint team MDT approach." Another professional told us, “The case managers are of a high quality and provide a thorough, professional service which is always client centred.”

People and their relatives were fully involved in decisions about care. They were given opportunities to share their views and take part in planning. This included involvement in recruitment by agreeing the questions to be used and giving views on later stages of the interview process.

There were positive examples of coordinated working to improve outcomes for people. One person moved from unsuitable accommodation into a new home designed to better meet their needs. The staff were working with the relatives and an architect to plan ongoing adaptations and introducing technology into the design to improve access, independence and wellbeing. In the meantime, temporary changes and equipment had been introduced to ensure the person could safely access and use their home.

For another person, staff worked with an assistive technology consultant to support them to transfer technology and learning from school to their home. This technology helped maximise access and control of their home environment and ensured consistent tools and strategies were used across school and home.

There was a clear focus on keeping people safe while respecting their rights and choices. The provider worked with people, relatives and professionals involved in their care to understand what safety meant for each person. Care was planned to reduce risks while supporting people to live as independently as possible.

Staff understood safeguarding and had received appropriate training for both adults and children. They were able to describe different types of abuse and how to report concerns. Staff told us they felt confident to raise issues and knew who to contact. Where people experienced distress or behaviours that could put them at risk, staff responded in a calm and supportive way to reduce harm.

Risks to people were assessed and monitored. Care plans included clear guidance to help staff manage risks safely. There were systems in place to record and report concerns. In most cases, information had been shared with relevant agencies and there was oversight from the registered manager. We identified 2 historical instances, where safeguarding concerns had not been reported. The provider had taken action to protect people at the time and had since reported these concerns and used this as a learning opportunity to improve practice.

Relatives told us they felt people were safe and well supported. One relative said, "100% safe at all times. This is due to the fabulous relationship we have with all the staff, case workers and everyone involved. Our support worker fits in and is now like a family member."

Restrictive practices were used appropriately and in line with legal requirements. Where needed, applications had been made to the Court of Protection and decisions were kept under review with all involved in the persons care being a part of any discussions.

There was a holistic approach to identifying and managing risks. Staff worked with people and their relatives to understand what mattered to them and how to support them safely. Care was planned in a way that balanced safety with independence so people could continue to do things that were important to them.

People were fully involved in decisions about their safety. Risks were explained in a way they could understand, with staff using different communication methods to support this. This included adapting how information was shared based on people's needs, which helped people to express their views and make informed choices.

Support plans were personalised and reflected people’s preferences, communication needs and goals. Staff followed these plans to provide consistent care. They worked with relatives and various professionals involved in people’s care to ensure risks were managed in line with current guidance and best practice. One relative told us how they felt about the risks of their family member choking, “Staff [are] always aware of potential risks and soft food is always available and the staff have the knowledge and skills to deliver this safely.”

Staff enabled people to access activities and experiences safely, with appropriate planning and risk assessments in place. One staff member described how risks were considered and discussed with others before supporting activities such as community outings and experiences, ensuring people could take part safely while maintaining choice and control.

Relatives told us they were involved in planning and felt confident that risks were managed safely while still supporting independence.

There were systems in place to identify and manage risks within the care environment. Staff assessed potential hazards and took action to reduce risk while supporting people to move around their environment safely. Equipment, facilities and technology were used to support safe care and promote independence.

Equipment was checked and maintained to make sure it was safe to use. Staff followed guidance and completed regular checks to confirm this. Where specialist equipment was needed, this was arranged to meet people's needs. For example, technology such as a smart track wheelchair was introduced to support safe and independent movement around a person’s environment. A smart track wheelchair runs along a specially designed track to enable the person to control their wheelchair independently moving about safely in a designated area.

Care environments were adapted to meet people’s needs. Staff worked with architects and health professionals to design more accessible accommodation, involving people to ensure the environment supported both safety and independence.

Staff understood how to keep environments safe and followed risk assessments in practice. They also shared information with relatives and professionals to ensure everyone was aware of any changes or concerns. Relatives told us they felt confident that risks were managed well and that equipment and the environment supported safe care.

There were enough staff with the right skills and experience to meet people’s needs safely. Staffing levels were based on people’s needs, with dedicated teams supporting each person. People and their relatives told us that regular staff teams helped build trust and understanding.

Staff worked well together to provide safe and coordinated care. They shared information clearly and supported each other in their roles. People and their relatives told us that regular staff helped build trust and understanding.

New staff received an induction that prepared them for their role. Ongoing support, supervision and regular training helped staff maintain their skills. Staff told us they felt supported by the management team and were able to raise concerns or ask for guidance when needed.

Staff had access to a range of training to support their roles, a number of which were created around the needs of the people. Some staff told us they would benefit from further tailored training in areas such as supporting children with complex disabilities and managing the impact of lone working. Leaders were aware of this and had begun to consider how training could be developed further.

Staff had undertaken the initial training required for the service to understand how to support autistic people and people with a learning disability. However, this training had not yet been updated to meet all the standards outlined in the Oliver McGowan Code of Practice. The provider had plans in place to ensure all staff completed the remaining required training.

Safe recruitment processes were in place. Checks were completed to ensure staff were suitable for their roles before they started work. Relatives spoke positively about staff and the care provided. One relative said, “We are currently, as a family, interviewing for extra staff and we are all involved in that including [my family member], who is enjoying the participation and process."

There were effective systems in place to assess and manage the risk of infection. Staff followed clear guidance to reduce the risk of infection and protect people, particularly those with increased health needs such as respiratory conditions. Relatives were confident in how infection risks were managed and felt that staff took appropriate steps to keep people safe.

Infection risks were identified and managed through care planning and risk assessments. Staff understood how infections could spread and took appropriate action to reduce these risks. This included sharing concerns promptly with relevant services when needed.

Staff used personal protective equipment and followed hygiene procedures in line with current guidance. Staff told us they had completed specific training and had access to the equipment required to reduce risks of infection.

There were systems in place to ensure medicines were managed safely and met people’s needs. Staff worked with people and their relatives when planning care, including when changes to medicines were needed. This helped ensure people’s preferences and capacity were considered.

Staff received training in medicines management and their competence was regularly checked. This supported them to handle and administer medicines safely. Records showed that medicines were given as prescribed and checks of these records were completed by senior staff to ensure accuracy.

Care plans included clear information about medicines to guide staff. Where medicines were prescribed to be given as required, guidance was available to help staff understand when to administer these medicines. Relatives told us they felt confident in how medicines were managed. One relative said, "[Staff] always give the medicines and log it on the app."

Regular reviews of medicines took place with prescribers to ensure they remained appropriate and in line with national guidance. The registered manager understood the principles of stopping over medication of people with a learning disability and autistic people (STOMP) and supporting treatment and appropriate medication in paediatrics (STAMP)to monitor and review any concerns about these types of medicines. STOMP and STAMP are national programmes that aim to reduce the overuse of medicines, especially medicines that affect mood or behaviour, for autistic people and people with a learning disability.

We identified that guidance for some medicines prescribed as required was not always complete. In particular, there was limited information about the recommended duration of use for laxatives and the risks associated with prolonged use. Leaders were aware of this and had taken steps to improve guidance for staff.