Amber Case Management Limited

The support each person received was unique to them and bespoke packages of care were delivered by staff, recruited and trained through the service but employed directly by the person themselves or a deputy appointed by the court of protection to manage the persons financial affairs. The professionals who managed the financial/legal affairs and care package, including care staff were referred to as guardians and came from a legal background. It is Amber Case Managements role to provide management and support to the guardians to ensure people get the care they require.

The service will assist with the assessment of need and the role of the case manager included attending litigation meetings, court proceedings and case conferences to draw up a comprehensive assessment of needs, and develop care plans based on the specific and individual needs of individuals.

People were kept safe. No one we spoke with raised any concerns regarding safety or had any concerns about the way the service was run. People were positive about their care and support.

Each person had dedicated members of staff to look after them. People who used the service choose which staff they had to support them.

People who used the service, family members and professionals we spoke with said the service was professional, caring and staff were flexible in their support.

The administration of medicines was safe. Staff audited the system to check for any errors.

There was a culture of openness at the service. People were included in meetings to ensure they had a say in their care and were aware of any changes.

Staff were trained in each persons specific needs as well as the mandatory training such as infection control or health and safety.

The service liaised with other organisations and professionals to ensure people received the care they needed.

People received a comprehensive assessment and care plans gave staff the details they needed to deliver effective care.

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

People’s experience of using this service:

People who used the service and family members all thought the service was professional, supportive and caring.

Rating at last inspection:

At the last inspection (report published 22 December 2016) the service was rated as good.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

We will continue to monitor information and intelligence we receive about the care service to ensure care remains safe and of good quality. We will return to re-inspect in line with our inspection timescales for good services, however if any information of concern is received, we may inspect sooner.

This was an announced inspection which took place on 13 and 14 October 2016. The inspection was announced to ensure that the registered manager or another responsible person would be available to assist with the inspection visit.

This was the first comprehensive inspection of the service following their registration with the CQC in November 2013.

Amber Case Management Limited is registered with the Care Quality Commission to provide personal care to people living in their own home. At the time of our inspection 23 people were using the service.

The service is registered to provide personal care to both adults and children. Amber Case Management provides specialist services and coordinated services on behalf of people who have an acquired brain injury or other complex, life changing injury such as spinal cord injury. It accepts referrals from Clinical Commissioning Groups (CCG’s) medical consultants, and solicitors acting on behalf of people where legal proceedings for compensation are taking place. . Awards are made, so that funding is available to pay for people’s care. All the people supported by this service have had their case heard at the Court of protection and have Appointed Deputies to make decisions on their behalf.

The support each person received was unique to them and bespoke packages of care were delivered by staff recruited though the service but employed directly by the person themselves or a deputy appointed by the court of protection to manage the persons financial affairs.

The service will assist with the assessment of need, and the role of the case manager included attending litigation meetings, court proceedings and case conferences to draw up a comprehensive assessment of needs, and develop care plans based on the specific and individual needs of individuals.

A registered manager was in place. 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.’

People who used the service received good quality care from competent staff, who understood how to provide safe care. The service had policies in place to protect people from abuse. Where necessary staff would advocate on behalf of people who used the service to ensure their rights were protected.

There was a high staffing ratio to ensure that people’s needs were met, and staff had opportunities to help people to manage risk and develop skills and competence, whilst ensuring their safety.

People were supported by skilled and competent staff who were recruited safely and had received training to manage their complex health and social needs. New staff completed a thorough induction including shadowing more experienced staff to get to know the individuals they would be working with, and received ongoing training to maintain their competency.

Staff received regular supervision and they told us that they found this informative and instructive. They told us that the registered manager was helpful and was available to speak to if they had any concerns. The service operated an on call system to allow staff to contact a member of the management team in case of any emergencies.

We saw that staff had undergone training in the Mental Capacity Act 2005, and were able to demonstrate a good understanding of mental capacity and consent issues.

Staff were trained in safe handling of medicines. There were clear systems in place for ordering, storing and administering people’s medicines.

People were encouraged to eat a healthy diet. Care plans paid attention to good nutrition. Where necessary, weight charts were kept to monitor weight and fluid charts monitored drinks to ensure people did not become dehydrated.

Amber case management was a caring organisation. One person who used the service told us, “we are very well supported and I am very happy with my care.” People were consulted about the way their care was delivered, and they were involved in selecting the staff who would support them.

We saw that people were supported and encouraged to make their own decisions, and staff respected the choices they made. Working in small teams meant staff could provide on-going and consistent support to individuals so they were able to get to know them well, understanding their background, culture and history.

Staff treated people with kindness, and supported them to take measured risks, respecting their right to do so. One member of staff told us, “We encourage people to make their own decisions, we might think them unwise but we are there and can step in to ensure the result is not too chaotic.”

The service respected people’s rights to privacy. Where staff rotas reflected round the clock care, staff would withdraw when it was safe to do so to allow people their personal space, remaining close by to provide support if needed.

Care records provided detailed guidance about how to offer good care based on individual needs and preferences. People were supported to maximise their independence. However, we saw one care plan which did not reflect the way the service was being delivered.

Staff were vigilant to people’s needs and used innovative techniques to assist people who used the service. Where changes in people’s needs were recognised, appropriate referrals to health care and other professionals were made to ensure an appropriate response was provided.

People were encouraged to take greater control of their lives, and the service used assistive technology to good effect. For example, they had begun to use ‘eye gaze’ technology to assist a person without speech to communicate. Although in its early stages, this demonstrated an ambition to support people to maximise their potential and become more autonomous.

The manager and service were held in high regard by all stakeholders. Overall governance was good with systems in place to monitor people who used the service as well as day today management of the service. Care records were reviewed on a monthly basis but systems for tracking and recording information were sometimes over elaborate. There had been no breaches of data protection or confidentiality.

The registered manager had adopted an inclusive management style that supported staff and increased their confidence in working with people who had complex health and social care needs. Staff felt well supported. The staff turnover was low which meant that people who used the service were supported by people who knew them well.