This was an announced inspection which took place on 19 October 2016. The service was previously inspected in December 2013 when it was found to be meeting all the regulations we reviewed at that time.

Head Office, Northern Case Management (NCM) is situated in a business complex close to Bury town centre. The service is registered to provide domiciliary rehabilitation and support to adults and children with acquired brain and spinal cord injury. At the time of our inspection there were five people using the service.

There was a registered manager in place at the time of the inspection. 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. The registered manager was supported by a team of professionally qualified case managers. Case managers were responsible for assessing facilitating, planning and advocating for the individual needs of people who used the service. A team of support workers was in place to provide the care each individual required, under the direction and supervision of a case manager.

We found the provider’s recruitment procedure needed to be improved in order to fully protect people who used the service from the risk of unsuitable staff. This was because additional checks had not been completed for those applicants who had previously worked with vulnerable adults or children. The registered manager told us the recruitment processes would be changed with immediate effect.

Staff were recruited to work specifically within a team supporting a particular individual. People who used the service or their relatives were involved in the recruitment process. Staff received a comprehensive induction programme when they started work at the service; this included mandatory training as well as an introduction to the values and policies of the organisation. Staff told us they were well trained and received the supervision and support they required to be able to carry out their roles effectively.

People we spoke with during the inspection provided positive feedback about the caring nature of staff. Staff told us they were committed to improving people’s quality of life and promoting the independence of the people they supported. People were involved in reviewing the care they received and identifying the goals they wished to achieve.

Staff had a good understanding of how to keep people safe and protect their rights should they be unable to consent to the care and support they required. The registered manager and case managers were aware of the action to take should care practices amount to a deprivation of liberty under the MCA.

Care records we reviewed contained risk assessments and detailed information for staff to follow in order to manage the identified risks. The safety of people’s home environment was also regularly monitored by staff.

People were supported to access health services. Staff monitored people’s nutritional needs and encouraged individuals to maintain a healthy diet.

A number of quality assurance processes were in place including the monitoring of complaints, accidents and incidents. Regular feedback was also sought from people who used the service and their families. All the staff we spoke with demonstrated a commitment to continuous service improvement. Staff also told us they felt their views were listened to and acted upon by senior managers.

Care records contained detailed information to show how people were to be supported and cared for. The care records also showed that systems were in place to protect people who lacked the capacity to make decisions about their own treatment, care and support.

We spoke with two people using the service. They were complimentary about the staff and the care and support provided. They told us, “I have no concerns, the staff are very good and very respectful” and “I like the staff, they are very nice and treat me well. I feel safe with them”.

We saw that systems were in place to help prevent and control infection within people's homes. The documents we looked at showed that staff were appropriately trained in infection control procedures and in basic food hygiene.

Arrangements were in place to ensure that people using the service were cared for and supported by skilled and experienced staff.

Systems were in place to monitor and review the service provided. This helps to protect people against the risks of inappropriate or unsafe care.

The person that we spoke with told us they had confidence in the staff and they felt safe. We were also told that they were greatly involved in the planning of their care.

Some of the comments made were:

“The staff are very, very good”.

“Very considerate”.

“I am very happy with the service and the support I receive”.