Integrated 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 newly registered service. This key question has been rated requires improvement. This meant some aspects of the service were not always safe and there was an increased risk that people could be harmed. The service was in breach of legal regulation in relation to safe recruitment.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. People and their relatives could raise concerns with staff and felt listened to. Staff told us they escalated safety concerns which were suitably investigated by the registered manager. The registered manager had a system in place to learn lessons. For example, extra measures were put in place to ensure staff administered medicines as prescribed following an incident where a person missed a medicine.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. Assessments had been completed by case managers to ascertain people’s needs before services were provided. The assessments formed the basis of care plans which were available to visiting professionals to enable a smooth transition between services. Healthcare professionals told us staff effectively shared information to support the person’s ongoing care and treatment.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. At the time of our inspection there were no people using the service under a court of protection order however the registered manager and staff had received training and understood their responsibilities should a person require one. Staff knew who to report safeguarding concerns to both internally and externally.

The provider worked with people to understand and manage risks by thinking holistically. Staff knew people and their needs well. This enabled them to provide care that met people’s needs. Staff had assessed people for risks relating to their health, safety and welfare. Risk assessments were regularly reviewed and updated when their care needs changed.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Staff assessed people’s environments for risks and took action to ensure people and staff remained safe. Staff knew who to contact if they felt people would benefit from additional equipment to aid with their mobility, such as hoists.

The provider did not always make sure staff had the right qualifications, skills and experience. They did not demonstrate they had robustly checked staff employment history and references as required by the regulations. Additionally, health declarations had not been completed for 4 staff members. This meant the provider had not taken all reasonable steps to ensure any reasonable adjustments were made to enable staff to carry out their role if required. The registered manager told us, “Our case managers are self-employed, I didn’t realise we needed to follow the same recruitment process as we do for our support workers.” The registered manager told us they planned to improve their recruitment processes. Case managers told us they completed mandatory training however, the provider did not have records in place to oversee and monitor their training was kept this up to date. A lack of robust systems to ensure staff training was up to date meant people were at risk of being supported by staff who were not aware of the latest best practice guidance. Training records showed no staff had completed learning disability and autistic people training which has been a legal requirement since 2022. Support workers completed and full induction and received regular training. One staff said, “The training we get is extensive. We also get bespoke training specifically for our client.” Following our inspection the provider sent us a training matrix to demonstrate how they now oversaw mandatory training for case managers. We were unable to assess the effectiveness and sustainability of this.Staff told us they received regular supervisions and felt supported by their line managers.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Support staff had received up to date training in order to prevent and control the spread of infection and followed guidelines for infection control to keep people safe and healthy.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Staff were trained in the safe management of medicines, and their competency was checked regularly by a senior member of staff. Case managers oversaw support workers to ensure they safely administered medicines in accordance with the prescribers directions. However, we were not provided with assurances case managers had the qualifications and competencies to do this as the provider had not followed safe recruitment practices and did not keep records to ensure case managers training was kept up to date. Families were supported to be involved in the medicines regime and risk assessments around that were clear and shared with staff to ensure delivery was safe and understood.