Resurgence Case Management Limited

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 outstanding. This meant people were protected by a strong and distinctive approach to safeguarding, including positive risk-taking to maximise their control over their lives. People were fully involved, and the provider was open and transparent when things went wrong.

This service scored 91 (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 strong proactive and positive culture of safety, based on openness and complete honesty. Staff actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice. The registered manager had high regard for lessons learnt and instigating improvements to the service. The lack of incidents and the quality of the actions taken to mitigate risks showed that learning from events had been successful. Leaders took every possible opportunity to learn and actively questioned practices when reviewing audits and analysing information. There was clear evidence the service had improved and developed based on this process.

The provider always worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was always continuity of care, including when people moved between different services. Right from the commencement of the service, safe systems and pathways were in place to ensure people received safe and appropriate care and support which met their needs and preferences to an extremely high standard. We saw appropriate referrals had been made to healthcare professionals and staff worked in line with requirements and recommendations they suggested. This had a positive impact on people's care and support. Plans were reviewed regularly to ensure they met people's current needs. Hospital passports were in place and included detailed information about people’s care and any health complications. For example, 1 person had a condition which meant they could only have very limited amounts of protein in their diet. The passport stated that hospital staff should be aware of this condition and monitor the persons intake to prevent complications. An external professional said, “I have worked with several clients who have transitioned between case managers at Resurgence and there has always been a period of joint working, shadowing and time allowed for new professional relationships to be developed so that the clients and their parents are supported without any disruption to the support they are offered and need.” Another external professional said, “Resurgence Case Management Ltd. is highly committed to establishing and maintaining safe systems of care. They actively manage, monitor, and assure safety across their services, ensuring that individuals receive consistent and well-coordinated support. A key strength of their approach is their focus on seamless transitions, working collaboratively with other providers to ensure continuity of care when clients move between services.”

The provider worked well with people and healthcare partners to fully understand what being safe meant to them and the best way to achieve that. Staff had a clear focus 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 always shared concerns quickly and appropriately. We reviewed safeguarding adults’ and safeguarding children's policies, and both were detailed and clearly set out the policy aims, government guidance, signs to look out for, and how to respond to safeguarding concerns. People had safeguarding protocols in place which made safeguarding personalised. For example, 1 person’s protocol clearly set out potential safeguarding issues aligned with the person’s care. The protocol was provided for the benefit of the person, parents, family members, carers and anyone involved with the person’s support. People were supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way to ensure people and their families felt in control of their journey. Policies and procedures were in place to ensure decisions were made in the best interests of people and staff sought the views of the person, relatives and relevant partners involved in bespoke care packages.

The provider always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them. Detailed risk assessments were in place and staff were required to ensure that everything reasonably practicable had been done to reduce risk. Where hazards had been identified, management plans were monitored closely to ensure they were an effective tool to manage risk. Supervision sessions with staff were used as part of the monitoring process. People had a ‘red page’ document which was a one-page document that clearly listed all the risks involved in their care and support. This ensured all staff and relevant others, knew about risks involved and what action to take to mitigate them. People were supported to manage new risks involved in their progression, for example, going on holiday. One person was supported, without limitation, to be aware around risks associated with social vulnerability and staff assisted the person with positive risk taking so they could access work and social activities. People and relatives felt involved in identifying risks and hazards and were confident staff provided care and support that was exceptionally safe. One relative said, “I feel [relative] is absolutely safe. They staff take [relative] out and I feel [relative] is completely safe.”

The provider was fully aware of all potential risks in the care environment and controlled them well. They made sure equipment, facilities and technology supported the delivery of safe care. Fire risk assessments were in place and included the use of candles, log burners, gas fires, portable heaters, hoarding etc. Plans were put in place to ensure risks had been identified and controls identified to reduce them. Risk assessments in place for the handling and storage of COSHH (Control of Substances Hazardous to Health) items. Where appropriate, safe and well referrals were made to the fire service to ensure people’s home and support plans were appropriate. For example, 1 person was referred for a safe and well check to ensure the evacuation plan in place was appropriate and safe. When the fire service visited, they were in support of the evacuation plan in place. Adjustments would have been made if needed to ensure safety. From the onset, leaders and staff discussed and set goals with the family to ensure the environment was safe and that all the equipment required was in place. Following a review of the property and the equipment already in place, an environmental and equipment action plan was devised to ensure any further equipment was obtained and changes to the home actioned to improve the daily experience for people. This could include proposing a wet room for ease of access. One staff member said, “To keep people safe, we maintain a safe environment, including regular maintenance, cleaning, and infection control and by eliminating hazards. We have a great working environment where everyone can have open communication and report any incidents or concerns.”

The provider made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They worked together well to provide safe care that met people’s individual needs. Carefully selected teams of exceptionally well trained and competent staff, worked in specific teams to support children, adults and their families. Staff levels were monitored through case management reviews with people and their families, as well as at multi-disciplinary meetings and support team meetings, and through staff supervisions. This process ensured any changes to the support package could be reviewed and adjusted to reflect those changes in line with the person’s wishes and the existing support staff were involved and consulted regarding any updates. The skills, competencies, qualifications, experience and knowledge required by staff was initially listed in the job description and job advert for each specific person. Through recruitment procedures, involving the people and their families in the interview process and deciding who they would like to employ helped to ensure suitable staff members were selected to meet people’s needs. One staff member said, “Resurgence creates personalised care plans which we call ‘working file,’ it is kept up to date. We, the staff, get training to enhance competence. The organisation does check the competencies of staff by conducting staff evaluations, team meetings, supervisions and medication competency assessments.” People and relatives told us they were confident staff received appropriate training. One relative said, “The carer is safe and has the knowledge needed.” Another relative said, “The package has been put together very well. The training is good. Everyone is upskilled and has refresher training. The team [Resurgence] are approachable and professional and have a lot of knowledge.”

The provider thoroughly assessed and managed the risk of infection. They always quickly detected and controlled the risk of it spreading and always shared concerns with appropriate agencies promptly. On commencement of the service a hazard risk assessment was completed for each person. This identified any specific plans and procedures required to minimise the risks of infection. This included identifying personal protective equipment (PPE) required for the staff team to complete their roles safely. Team leaders were responsible for monitoring stock levels of PPE and alerting the office-based case management admin team who ordered the required PPE to maintain sufficient stock levels. Appropriate cleaning supplies were also ordered in the same way to maintain equipment and people’s home environments in line with COSHH guidelines. Staff received training in infection prevention and control. The use of the appropriate PPE was documented within people’s specific support plans and related to any personal care routines.

The provider always made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff always involved people in planning, including when changes happened. Systems and processes were in place to ensure people received their medicines as prescribed. Staff received advanced medicine training to enable them to administer medicines by special techniques. Therapists and external medical professionals were fully involved in creating medicine support plans, risk assessments and delivering bespoke training to staff. Medication administration records (MARs) included the time medicines were administered and were specific about when each medicine should be administered. For example, 1 person’s medicine had to be administered when they woke up, prior to them getting ready and having breakfast. Another medicine was to be taken at the same time every day to make it more effective. MAR charts seen reflected these practices. People had medication management plans in place which detailed information to ensure medication was administered safely, and to ensure people received their medicines as prescribed. For example, 1 person’s plan stated medicines were to be administered via a syringe and given orally or by a measured spoon. Support workers were required to check MARs at the beginning of each shift to see what medication had been given. The MAR chart was also checked to ensure all medications were signed for by staff on the previous shift and to ensure any gaps in recording were actioned immediately. People and relatives told us they received effective support to ensure they had access to their medicines. One person said, “I get help with taking my tablets. They’re put out for me to take.” A relative said, “They [staff] are well trained with [relatives’] medication.”