AJ Case Management

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has changed to outstanding.

This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care.

This service scored 93 (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 very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people.

Feedback from people, relatives, and staff, alongside a review of care records, demonstrated a consistently positive culture across the service. This culture was embedded at all levels and clearly focused on kindness, equality, dignity, and a deep understanding of people’s individual needs and challenges. Staff spoke with genuine pride and commitment about their roles, and it was evident they were highly motivated to deliver the very best outcomes for the people they supported. This strong, values‑driven culture ensured a shared sense of purpose where people and staff could thrive.

Relatives were overwhelmingly positive about the service and consistently told us the support provided had a significant and positive impact on their family members’ lives. They described strong, respectful, and trusting relationships with staff and spoke confidently about the shared values and approach which underpinned care delivery. One relative told us staff team who supported their family member were “amazing.” They explained their family member had a mainly male staff team which worked particularly well for them. They described the staff team as a group of staff who, “Work well together and bounce off each other.” This had resulted in their family member having consistent, positive support and a strong, trusting relationship with their staff team.

Staff echoed this shared commitment and investment in people’s lives. One staff member told us, “I’ve seen [Person’s name] at their worst and have an understanding of who they were before their brain injury. We make sure they still experience things which reflect who they were. Seeing them achieve even the smallest things makes us [the staff team] so proud.” This demonstrated how the service’s values translated into meaningful, life‑affirming support for people.

The provider actively recognised and celebrated good practice. One person’s staff team were nominated by their case manager for the Staffordshire Dignity in Care Awards and were shortlisted, reflecting the high regard in which their work was held. When the staff team attended the event, they were accompanied by the person they supported, so they were included and able to participate in the celebration.

The provider had exceptionally inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They always did so with integrity, openness and honesty.

Leaders demonstrated a clear passion for the service and a strong commitment to providing high‑quality, person‑centred care. Their leadership ensured the provider’s values were consistently embedded in practice and risks were effectively identified, managed, and reviewed. The registered manager was highly knowledgeable and had a clear understanding of the service’s priorities, the needs of people, and the responsibilities of their role. The registered manager told us, “We really want to be open and transparent – that’s how we want our culture to be. That’s what we want embedded in everything we do.”

The registered manager and other leaders were well supported within their role. They had access to senior clinical expertise, including the provider’s clinical governance lead, who provided specialist advice, oversight, and training when required. The registered manager benefited from regular peer clinical supervision with other clinical leads within the company, which encouraged reflection of practices, shared learning, and professional challenge. They also attended regular peer safeguarding supervision with a safeguarding educator. They told us this kept them up to date with safeguarding guidance, gave them an opportunity to share concerns and discuss current safeguarding issues.

The registered manager actively maintained their professional competence and oversight of best practice through a wide range of learning activities, including webinars, training courses, professional revalidation, and alerts from recognised bodies. They used reputable sources such as NICE guidance, CQC updates, professional networks, and the provider’s policy system to ensure practice reflected current legislation and guidance. Relevant health and safety and equipment alerts were shared promptly with teams where applicable.

The registered manager promoted an open and inclusive leadership style. They told us they operated an open‑door approach and would always feedback to staff if they raised concerns. Staff told us they felt listened to. They spoke positively about the support and leadership provided by case managers and the registered manager, describing them as approachable, knowledgeable, and supportive. One case manager told us, “We have a very strong, collaborative team, and I feel able to approach them at any time. They are always willing to listen, offer guidance, and provide practical support whenever it’s needed.” Another staff member told us, “I have regular contact with the office staff at AJ Case Management and feel extremely valued and privileged to be part of a highly professional and supportive team. The office staff are always available and approachable, and they provide consistent support when needed.”
 

The provider was exceptional at fostering a positive culture where people knew they could speak up and their voice would be heard.

The provider had created a proactive, open, and transparent safety culture where staff felt confident and supported to raise concerns. One staff member said, “100% I would feel safe to speak up about concerns. I have never had any major concerns, but others have been and were listened to.” Leaders encouraged staff to speak up about concerns and sought their views in relation to people’s care. This was facilitated through staff supervision, staff meetings and the availability and approachability of the leaders. Staff also received regular newsletters which contained information about how they could speak up or become a Freedom to Speak Up Champion to support others. The provider also encouraged staff to speak up through engagement surveys where they could share their thoughts and opinions and remain anonymous. This enabled staff to feel part of the wider team and directly affect and improve the care people received.

The provider had a policy in place which supported staff in speaking up about unsafe care, this is also known as whistleblowing. A Freedom to Speak up Guardian was in place and the policy provided their contact details. A Freedom to Speak Up Guardian helps employees to speak up when they feel they cannot do so by other routes.
 

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Staff told us they felt respected and valued by managers throughout the service. One staff member said, “I feel safe and valued, 100%.”

The provider asked staff to complete an annual survey to obtain their feedback on working for the service. Following analysis of this survey, the registered manager completed a “You said, we will” document which identified what they would do in response to staff comments. One example was the appointment of a wellbeing champion. This was because staff said there was a lack of training and resources for well-being. The wellbeing champion created regular wellbeing resources which were shared with staff.

The provider had an equality and diversity policy which underpinned equitable treatment of staff to ensure they worked in an environment which was free from harassment or discrimination.
 

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The provider had not ensured statutory notifications for Deprivation of Liberty applications had been submitted to us. Statutory notifications ensure we are aware of important events and incidents which affect services or the people who use them. Providers have a statutory responsibility to submit these, and they provide us with crucial information to monitor the quality and safety of services. However, this had not had any impact on people.

The provider had effective governance systems in place and records demonstrated all aspects of the service was reviewed to ensure good quality and safe care was provided. The registered manager was accountable to the provider and had oversight of all quality systems. There were clear staff responsibilities to ensure audits and compliance checks were completed on time. The registered manager attended compliance meetings where incident and safeguarding recording and reporting was reviewed. Governance arrangements ensured the registered manager knew of any concerns within the service or specific staff teams. They told us they liaised with case managers to plan how to manage issues and then monitored the plan of action to ensure it was completed.

The provider had a Service Contingency Plan in place to manage major events which could impact the service’s ability to operate as usual. This included contingency plans for staff shortages, disruption to clinical access due to pandemic disease, major incidents, and emergencies. These plans were designed to support the continued safety and wellbeing of people should an event occur.

The registered manager understood their responsibilities under Duty of Candour. They told us, “It’s about being open honest and transparent and is embedded in everything we do.” They also explained how staff with professional registrations, such as nurses, were also individually accountable for their professional responsibilities in respect of Duty of Candour. A Duty of Candour Policy was in place which all staff had access to.

The provider’s policies were aligned with CQC regulations and national legislation. This helped to ensure staff practice was safe, up to date and in line with required national standards and best practice.
 

The provider clearly understood and carried out their duty to collaborate and worked in partnership, and services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement.

The provider worked alongside other health professionals and specialists, including speech and language therapists and assistive technology specialists. These professionals worked with the individual person and their staff team to support their communication needs, such as helping them to make the best use of communication aids. They also developed bespoke guidelines, trialled assistive technology and equipment and provided training. The registered manager said, “We continually strive to make our clients care bespoke and to ensure that our support workers have access to the relevant professionals in order for them to deliver the best care they can to each of our clients.” Information was shared during people’s multidisciplinary team (MDT) meetings. This was where the professionals involved in the person’s care met to review and discuss their care provision. For 1 person it was identified the music therapy sessions they had received had been highly beneficial for them. During the MDT it was agreed they would chase approval for music therapy funding for the person. This collaborative, joined-up approach to care enabled all partners involved in a person’s care to share knowledge and explore new or innovative ideas. This led to more effective support and better outcomes for people.

Staff also supported people to access and keep engaged with their local communities. People benefited from these partnerships which enhanced the quality, safety and effectiveness of their care.
 

The registered manager demonstrated a strong commitment to continuous learning and service improvement. They analysed feedback from quality audits and surveys and used this to help identify areas for improvement. They kept their own professional knowledge and professional registration up to date and had the support of the provider and wider company to help drive continuous improvement within the service.

Case managers, as practicing health professionals, bought their knowledge and expertise to the service. This helped to embed evidence-based practice and support improvement and innovation to benefit people. They maintained a network of external professionals they could contact to help improve the lives of people. Staff told us about people trialling new wheelchairs and new communication technologies.

The provider had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The provider had strong external relationships which supported improvement. Staff were supported to improve by the relationships they had with healthcare professionals. The support, guidance and bespoke training they received from healthcare professionals helped improve staff knowledge, confidence and practice to ensure better outcomes for people. One staff member told us, “I work closely with the multi-disciplinary team, share observations, implement agreed interventions, and keep the care team updated. This helps ensure [Person’s name] receives consistent support that adapts to their needs and promotes their overall wellbeing and quality of life.”

The registered manager was part of a professional meeting group which had access to NICE guidelines which were being updated and were relevant to case management. The group were able to review proposed changes, share professional insight, and influence the development of best practice recommendations. They recently had the opportunity to review guidelines for “rehabilitation for chronic neurological disorders including acquired brain injuries,” which was specifically for case management services.

The registered manager told us about current projects to help improve the service. They were reviewing recruitment procedures to help engage the right potential staff. They said, “We want to showcase what we do and how rewarding the work is.” They also were looking at how they could share good practices and learn from any poor practice from across the whole provider group.

The provider had processes in place to continually learn and encourage reflection when incidents happened within the service. The registered manager said, “We encourage staff to complete incident forms and send them. We don’t finger point; we want to learn lessons and ensure people are safe. In case management, compared to other services, there is not as much reporting because staff are working with 1 person and are highly skilled and this makes a massive difference to how they are cared for and kept safe.” Staff training and staff meetings included reflecting on incidents so there could be a focus on learning and improvement.