The Care Quality Commission (CQC) has rated Breakthrough Case Management, a rehabilitation service in Woolacombe, Devon, outstanding overall, following an inspection in March.
Breakthrough Case Management offers specialist support and rehabilitation services for adults and children in their own homes. Bespoke care packages are provided for people who have sustained complex life changing injuries, such as an acquired brain injury, spinal injury or cerebral palsy. Care is mainly funded by legal compensation claims.
This was the first inspection of the service. At the time of the inspection, 12 people were receiving care.
Following the inspection, the service is rated outstanding overall and outstanding for being well-led and effective. It is rated good for being safe, caring and responsive.
Amanda Stride, CQC’s head of adult social care inspection, said:
“When we inspected Breakthrough Case Management, we found a service that was incredibly well-run. The two directors had worked hard to ensure the growing service retained the personal touch. They knew people well and supported staff to navigate complex family relationships and emotions to promote the best outcomes for people.
“Care was provided by highly trained staff who treated people with dignity and respect, as they helped them and their families to come to terms with life changing events. Care packages were tailored to meet each individual’s complex needs and there were many examples of how the excellent care and support had resulted in improvements in peoples' quality of life.
“Staff were matched to the people they cared for, so they had common interests, and people were encouraged, empowered and supported to make choices about how they lived their lives. For example, one person, who had previously worked in the sporting industry, was given help to set up a bespoke gym, and supported by a rehabilitation assistant with similar interests, to help them train to become a globally ranking para-cross fit champion. Another person was supported to walk again with the help of a robotic exoskeleton and the encouragement of their rehabilitation assistant and staff support team. One of the directors was there to celebrate this person’s first steps and their achievements.
“People's views were extremely valued and used to drive improvement. Relatives told us the staff were trustworthy, reliable and completely devoted to caring for their loved one, and they always treated them with the utmost dignity and respect. Staff thought about the people they cared for all the time and were always trying to come up with new ideas to engage with them and have fun. For example, one staff member bought ingredients to make edible Christmas decorations, and invited the person’s grandchildren to help make a Christmas cake for them.
“The whole team deserves to be congratulated for their commitment to provide exemplary care and support to people at a particularly challenging time in their lives. I would encourage providers of other similar services to learn from the outstanding practices this service has introduced.”
Inspectors found the following during this inspection:
- There were very robust and high-quality governance systems in place to assess and monitor the service provided, with regular detailed reports also sent to the fee payers, (commissioners and lawyers).
- Staff were very caring and compassionate and knew people extremely well, often building up close, long-term relationships sharing common ground. Recruitment of staff was bespoke to each persons' care management package and completed safely with peoples' involvement. There were sufficient staff numbers and flexibility to provide the care and support required by people to meet their needs.
- Care assessment and planning records were extremely detailed to enable close monitoring of peoples' care, progress and future planning individual to them.
- People's rights to dignity, independence and privacy were promoted and respected. People's choices were always sought, valued and used to plan their care as well as staff offering up ideas and creative ways to enhance life quality and opportunities.
- The service worked closely with other health and social care professionals and lawyers involved in people's care to ensure they received a high level of care and support. Secure online feedback was shared regularly, including videos, which enabled health partners to see how people were progressing and if treatment and exercises were effective. Staff meticulously followed specialist health professional programmes to great effect.
- Staff were provided with safeguarding training for both adults and children, and they understood how to keep people safe.
- Risks in people's daily lives were assessed and mitigated with a focus on positive risk taking. People were supported to take their medicines safely. Infection control procedures were in place.
- The values and culture of the service focused on striving to achieve the best quality of life for people. This included being pro-active and using innovation, research and accessing specialist health professionals for people's benefit. Learning was discussed in management and team meetings and cascaded to all staff individually. Incidents were assessed, and analysed, and appropriate actions put in place to reduce future risks, for example reviewing people's care needs and sharing people's intentions and desires.
- Staff researched innovative practices and pro-actively sought new therapies that could assist and promote better quality of life for people. The focus was on sharing information about what people could achieve with the right tools, such as using music therapy.
- People were supported to develop new skills and maintain existing ones by having the right support and expertise to help motivate and enable them to achieve and reach their potential. For example, to encourage sensory play staff had requested sensory equipment. This had been promptly sourced and sent to the home.
Full details of the inspection are given in the report published on our website.
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