Head First

Updated 9 January 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection team consisted of one inspector and an assistant inspector. The assistant inspector undertook telephone interviews with people who used the service.

Service and service type

Head First is a specialist service that assesses people who have an acquired brain injury, then provides personal care and support to these people and their families. Some people live in their own houses and flats and some are supported in care settings, such as nursing homes.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave the service 48 hours’ notice of the inspection. We needed to be sure that the registered manager would be in the office to support the inspection. The inspector visited the office of the provider to talk with staff and review records on 18 October 2019. The provider later sent us a spreadsheet of people we could contact. The assistant inspector made telephone calls to people and their relatives on 15 November 2019.

What we did before the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support out inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service and one relative. We also spoke with the registered manager, two case managers and the HR manager. We reviewed a range of records. This included three people’s care records and records relating to the management of the service, including policies and procedures. We looked at two staff files in relation to recruitment and staff supervision.

Updated 9 January 2020

About the service

Head First (Assessment, Rehabilitation and Case Management) LLP, referred to as ‘Head First’ throughout this report, is an independent organisation specialising in providing assessment, rehabilitation and case management for adults, and some young people and children, with an acquired brain injury. The organisation works with approximately 100 brain injured people, their families and care workers, and over 40 people are directly supported by the service. This includes supporting people who use the service to directly employ support workers, some of whom may provide personal care. The service primarily supports people in their own homes but also people in rehabilitation centres and care settings. The majority of people who receive a service live in Sussex (West and East), Hampshire, Kent, Surrey, Essex, Hertfordshire or Berkshire. The service also supports some people who live further afield across England.

People’s experience of using this service and what we found

People’s care and support needs were personalised and they received a bespoke service from Head First. People spoke very positively about the service and the staff who supported them. In addition to people the service directly supported, Head First were proactive in helping people and their families who had not received compensation through legal channels, but were living with an acquired brain injury. This was achieved through sharing knowledge about acquired brain injury, in this country and around the world, to improve people’s lives and support professional knowledge and development.

The service had been instrumental in setting up conferences about brain injury in the UK, invited speakers, including people and their families, at local and national events. Campaigning and promoting the use of bicycle helmets had also helped raise awareness for people about the risk of cycling without head protection, and fund-raised for a local group and the national charity. All these initiatives, and more, had a positive influence and impact on people living with an acquired brain injury.

People were complimentary about the service and staff who supported them. One relative had written, ‘My uncle has some fabulous support workers and they always seem to be trying new ideas to support his progress and improve motivation and quality of life. They show a genuine interest in him and talk positively about him’.

Staff were recruited at the point people were assessed as being suitable to receive a service at Head First. People’s specific needs were identified, new staff were recruited and training was tailored according to what people needed and wanted. Staff had regular supervisions with their line managers. Staff enjoyed working at the service and felt well supported in their roles. Working practices were discussed and areas for improvement were identified at staff meetings.

People were protected from the risk of harm by trained staff. Risk management was pre-emptive and people’s risks were managed effectively.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported by kind and caring staff who knew them well. Overall management of people’s care and support needs was overseen by case managers. One person commented, ‘Head First have been my happiest care. I feel they’re trained well and know how to assist me specifically’. People told us that their support staff arrived on time.

People were involved in all decisions relating to their care and support needs. Care plans were detailed and personalised. People knew who to contact if they had any concerns or wished to make a complaint.

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

Rating at last inspection

The last rating for this service was Good (report published 17 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow-up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information, we may inspect sooner.