Northern Case Management Bury Office

Northern Case Management is a domiciliary care agency which provides personal care to people in their own homes. The service specialises in providing case management and support to adults and children with an acquired brain and spinal cord injury.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection the service was supporting 81 people; of these 16 received a regulatory activity

People’s experience of using this service and what we found

Safe systems were in place to help keep people safe. Staff received relevant training and development to equip them in delivering the support people wanted and needed. Staff were provided with personal protective equipment to help minimise the risk of cross infection. Where people received support with their prescribed medicines, this was managed safely.

Staff were aware of their responsibilities to report any concerns and were confident these would be acted upon. Robust staff recruitment procedures were in place. Staff retention was an on-going issue with contingency plans in place to help minimise the impact on people’s support. Where areas of risk had been identified these were monitored and reviewed so that people's current and changing needs were effectively met.

Governance systems were in place to monitor and review the quality of the service. Staff understood their role and responsibilities and felt supported by the management team. Additional plans were being made to enhance the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 5 June 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service. We received concerns in relation to staffing levels and skills to support people’s individual needs. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service good based on the findings of this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Northern Case Management on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Northern case management is domiciliary care agency which specialises in case management and provides support and personal care for adults and children with an acquired brain and spinal cord injury.

People’s experience of using this service:

People were supported with a tailored package of care that was exceptionally personalised to their preferences and aspirations.

People told us they were supported consistently by staff who knew them and their care needs very well. Staff were especially kind and caring and people considered their support team to be “part of the family.”

People were highly involved in all aspects of their care. Staff supported people to choose adapted equipment and resources that were most suited to the individual’s specific needs.

Care records were remarkably detailed and specific to the person being supported. People’s choices and preferences, privacy and dignity and enhancing independence were all considered and consistently reflected and promoted within these records.

The service had an exceptionally positive approach to risk taking. People and relatives told us the team would work extraordinarily well together to find a solution to any potential barriers to enable people to reach their goals and access activities.

The service had an exceptionally positive approach to risk taking. People and relatives told us the team worked extraordinarily well together to find a solution to any potential barriers to enable people to reach their goals and access activities

Staff and management were well trained and had superb knowledge and experience to provide support tailored to the person they were supporting.

Staff told us they received all the support and information they needed to do their job. They felt listened to and valued by the management team.

There were quality assurance processes in place and the manager used information from accidents, incidents, complaints, other audits and feedback to deliver a high quality service and drive improvement.

Rating at last inspection:

At our last inspection (19 November 2016) the service had an overall rating of Good.

Why we inspected:

This was a planned inspection based on the rating of the service at the last inspection.

Follow up:

We will continue to monitor the service through information we receive and future inspections.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Head Office, Northern Case Management (NCM) is situated in a business complex close to Bury town centre. The service is registered to provide domiciliary rehabilitation and support to adults and children with acquired brain and spinal cord injury. At the time of our inspection there were five people using the service.

There was a registered manager in place at the time of the 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. The registered manager was supported by a team of professionally qualified case managers. Case managers were responsible for assessing facilitating, planning and advocating for the individual needs of people who used the service. A team of support workers was in place to provide the care each individual required, under the direction and supervision of a case manager.

We found the provider’s recruitment procedure needed to be improved in order to fully protect people who used the service from the risk of unsuitable staff. This was because additional checks had not been completed for those applicants who had previously worked with vulnerable adults or children. The registered manager told us the recruitment processes would be changed with immediate effect.

Staff were recruited to work specifically within a team supporting a particular individual. People who used the service or their relatives were involved in the recruitment process. Staff received a comprehensive induction programme when they started work at the service; this included mandatory training as well as an introduction to the values and policies of the organisation. Staff told us they were well trained and received the supervision and support they required to be able to carry out their roles effectively.

People we spoke with during the inspection provided positive feedback about the caring nature of staff. Staff told us they were committed to improving people’s quality of life and promoting the independence of the people they supported. People were involved in reviewing the care they received and identifying the goals they wished to achieve.

Staff had a good understanding of how to keep people safe and protect their rights should they be unable to consent to the care and support they required. The registered manager and case managers were aware of the action to take should care practices amount to a deprivation of liberty under the MCA.

Care records we reviewed contained risk assessments and detailed information for staff to follow in order to manage the identified risks. The safety of people’s home environment was also regularly monitored by staff.

People were supported to access health services. Staff monitored people’s nutritional needs and encouraged individuals to maintain a healthy diet.

A number of quality assurance processes were in place including the monitoring of complaints, accidents and incidents. Regular feedback was also sought from people who used the service and their families. All the staff we spoke with demonstrated a commitment to continuous service improvement. Staff also told us they felt their views were listened to and acted upon by senior managers.

We spoke with two people using the service. They were complimentary about the staff and the care and support provided. They told us, 'I have no concerns, the staff are very good and very respectful' and 'I like the staff, they are very nice and treat me well. I feel safe with them'.

We saw that systems were in place to help prevent and control infection within people's homes. The documents we looked at showed that staff were appropriately trained in infection control procedures and in basic food hygiene.

Arrangements were in place to ensure that people using the service were cared for and supported by skilled and experienced staff.

Systems were in place to monitor and review the service provided. This helps to protect people against the risks of inappropriate or unsafe care.