Westcountry Case Management provides a specialist service and co-ordinates packages of care, support and therapy for adults and children who have a brain injury and/or physical injuries. Its services are commissioned by Deputies who have been appointed by the Court of Protection, solicitors, the NHS and clients by direct referral. The provider carries out assessments, and delivers care, support, and therapy focused on enabling people to recover from their injuries. Staff are recruited by the service but most staff are employed directly by the person themselves or the Deputy who manages their financial affairs. The provider oversees the training and performance management of case managers, team leaders and support workers. Throughout this report case managers, team leaders, and support workers are referred to as ‘staff’.

The provider coordinates the service from their office base in Bishopsteignton. However, services are delivered across a wide geographical area in the south west of England and Wales.

The service had a registered manager. 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. Following our inspection, the care manager was interviewed by CQC and confirmed as the new registered manager. The registered manager was supported by a network of case managers located throughout the service’s area of operations. Each case manager was a registered healthcare professional with a small caseload of clients specific to their area of expertise.

We visited the office on 13 December 2016. We carried out telephone calls to people and their relatives on 15 December 2016. At the time of this announced inspection 37 people were receiving personal care from the service. The service met all of our regulations at the previous inspection in January 2014.

People were happy with the staff who supported them. Comments included “My support worker is brilliant, keeps me on track, listens” and “We get on well, always laughing and joking.” People had stable staff teams who had supported them for a long time and knew them well. Staff enjoyed their role and spoke about people with compassion. People received support from staff who respected their right to make their own decisions. People’s independence was promoted and encouraged. People received support from therapists to regain skills they had lost. Care plans contained information about people’s goals. Where possible staff worked to maintain people’s previous lifestyle.

People and their relatives told us they felt safe when staff were in their home and when they received care and support. Staff knew how to recognise signs of potential abuse when supporting adults and children and understood how to report any concerns in line with the service's and the relevant local authority’s safeguarding policy. Safe staff recruitment procedures were in place. This helped reduce the risk of the provider employing a person who may be unsuitable to work in care.

People benefited from effective care because staff were trained and supported to meet their needs. Staff told us they were happy with their training. Comments included “My training is up to date” and “Training is always on the agenda.” Staff told us they felt well supported and had regular opportunities to discuss their work.

Care plans were detailed and person centred. They included information on what was important to each person, their interests, their goals, and their history. There was detailed information about the support the person needed to manage their day to day care and health needs. People told us they made decisions in relation to their daily activities. One person said, “We’re always out and about.” Care plans contained information about people’

This agency operates as a ‘case management’ service. This means that Westcountry management staff do not provide the care and support themselves but assist clients to employ their own workers.

Workers are employed by the people using the service or have an agent acting on their behalf. The service oversee the recruitment process, training and performance management of the case managers and support workers on behalf of people using the service.

For the purpose of this report we will refer to case managers and support workers as ‘workers’.

The main office based in Bishopsteignton in Devon. At the time of our inspection they were providing a service to 50 adults and children from South Wales down across the South West of England.

People told us they were very happy with the service they received from this service. comments included,“all of my support workers understand my needs and allow me to live my life as independently as possible”.

People told us they had been able to make choices and decisions in relation to their care planning. Comments included “an excellent team who understand me and help me make decisions”.

Training records showed that all workers had received mandatory training and additional training specific to the people they supported.

People told us that they felt the workers had the necessary skills and time to meet their care needs.

We saw that the agency monitored their service and sought regular feedback from people.