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 s