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Case management

Management during a pandemic: what we’ve learned

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As the country faces the second wave of the coronavirus pandemic, the management team at Richardson Care reflect on their experiences so far. Richardson Care has six specialist residential care homes – three for adults with acquired brain injury and three for adults with learning disabilities. Caring for up to 78 people, many of whom are vulnerable brings added responsibilities and pressures, as well as additional skills.

Our experience in supporting people who are rebuilding their lives after brain injury or living with learning disabilities means that we are problem solvers. We support people to overcome challenges every day. Never has this been more important and we’re proud of the way that our management team and staff have responded.

We asked our Homes Managers for their personal views and experiences of the pandemic – from their initial reactions to plans for the future. We discover what we’ve learnt, and how we can change things for the better.

Resilience
‘The capacity to recover quickly from difficulties; toughness’ has been demonstrated by our team throughout the pandemic. Jane Payne, Operational & Clinical Officer at Richardson Care, takes us back to the beginning of the year: “On February 18th 2020 we informed staff that there was a new virus, and preventative measures were put into place; including hourly touch point cleaning, increase in hand washing and an increase in awareness. Ahead of government guidance on March 12th 2020, we took the very tough, necessary decision to close our doors to family and friends to protect service users. We made sure that all staff worked only in one home, so in the event of an infection, it would not be transferred from one home to another by our staff.”

“The management team have become incredibly solid; working as one in supporting each other, as and when each has needed, as we live and work through the rollercoaster that is Covid-19. I am proud to lead; and be part of such a strong group of individuals displaying a sole purpose of ensuring the care, welfare, safety and security of our service users and staff. Richardson Care has shown we are more than resilient, we have become stronger through experience. Care: it’s in our DNA.”

Jacky Johnson, Registered Manager at our Boughton Green Road home for adults with acquired brain injury talks about the realities of dealing with something that no one had ever experienced before. She says: “We were dealing with real disease: a real virus, in real time with real people…The guidance received from various governing and public bodies changed before the ink could dry…The initial fear demonstrated by some staff left others having to broaden their shoulders… taking on extra activities within their daily routines…The expectation on myself as a Manager weighed heavily, it felt like I should know all the answers to the questions they asked… I was clear of my expectations from my team and them of me… Resilience: it’s not about how many times you fall… it’s about how many times you stand up and face another day.”

Teamwork
It was important to create a positive spirit as we knew our response would impact our service users. Central staff were redeployed so each home had enough admin and maintenance support in their team. This means they have been able to form closer relationships with the service users, some have been helping out with maintenance jobs – developing their skills and feeling valued while completing meaningful activities.

The teams within each home became closer, bonding more as they faced challenges together. No job was too big.

Weekly management meetings moved online in February. The Managers have worked more closely together while being socially distanced. Helen Petrie, Manager at The Richardson Mews adds: “No-one has ever been in this position before. We’re all learning together and supporting each other. We’re there to boost morale when it’s needed, sharing experiences and insight to keep our service users and staff happy and safe.”

Resourceful
We’ve found more efficient ways of operating – reducing risk while continuing to help our service users develop their daily living skills. For example, instead of going out to the shops several times a day, there’s just one trip per day. This means planning ahead, so service users have been helping to plan the menus, write shopping lists and prepare for their daily needs. These all require cognitive skills.

We have all become much more tech-savvy, using the internet, apps, photos and video calls as well as phone calls and letters to keep in touch with service users’ family and friends. We’ve also been checking in with each other more too.

Wendy Coleman, Registered Manager at our Duston Road home adds: “For service users, routine is a major part of their life. When their usual activities are no longer possible – no home visits, day services, community activities – staff have shown how well they have supported service users, reassuring them throughout all this. They have also been dealing with more challenging behaviours due to service users’ complex needs and lack of understanding of what is happening. We have created different routines and activities, promoting health and exercise.”

At The Richardson Mews (inspired by Joe Wicks) the day now starts with ‘Morning Motivation’ – exercising to music every day to improve fitness, flexibility and well-being. We’re also making more use of our in-house gym equipment. One service user who has a brain injury thrived during lockdown: he was in a wheelchair in February and now he can walk 70 lengths of the parallel bars.

Although the service users have missed going out, we have had plenty of scope and opportunity to develop in-house activities. Our large gardens and outdoor spaces have been used for gardening, ‘coffee shops’, sports and games, trampolining and treasure hunts. Our indoor communal spaces have hosted quizzes, craft activities, music and karaoke sessions. We’ve celebrated birthdays with gifts, parties and barbecues. We’ve maintained structure when needed, providing mental stimulation, social interaction and fun, while supporting well-being and skills development.

Appreciating each other
“The new normal is valuing and appreciating the simple things in life and each other, focusing on the positives,” adds Wendy Coleman. As we have gone through the months, we’ve noticed positive changes in service users – improved bonding with staff due to them having much more 1-1 time. Individual service user’s communication skills have also improved.

“Staff have done all this whilst dealing with the impact on their own lives. I feel through all this we all have changed our priorities, we have learnt different coping skills, adapted to change, and have gained new skills.

“It is important to show how we value, support and appreciate each other, talk more, respect and most importantly listen to each other. Learning that showing praise and valuing people is so important in these difficult times.”

Never has the responsibility of managing specialist care services been so great. As we prepare for the next phase of the Coronavirus pandemic, we know that we have the experience, skills and resilience to face the challenges ahead.

Richardson Care provides specialist residential care and rehabilitation for adults with acquired brain injury and learning disabilities. An independent family business with a 30-year track record, it has six residential care homes in Northampton. Find out more at www.richardsoncares.co.uk

Case management

New case management business continues to grow

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One of the most recently-established businesses in UK case management is growing strongly, with ongoing recruitment and an increasing case load. 

Birchwood & Co was formed in December last year as a specialist complex injury case management company and has already assembled a sizeable team of case managers with expertise in a host of areas. 

The business is also the only case management company nationally to have in-house clinical psychology expertise. 

While having only been in business for four months, Birchwood & Co – based in Sheffield with a satellite office in London – is continuing to win new work nationally, and is recruiting in case management, business development and marketing roles as it aims to keep pace with its fast-developing workload and profile. 

Partner Jordi Brunes, who left JS Parker to establish Birchwood & Co, believes its complex injury specialism sets it apart in the field. 

“For me, I think a lot of case managers overlook complex injury, so that’s where we really come in as that’s one of our unique selling points,” says Jordi. 

“I have worked in A&E theatres with people who have had catastrophic injuries in road traffic accidents and other incidents, and then moved into physiotherapy where I’d be treating these people, and after that came into case management.  

“Our team understands complex injury – my own expertise is in orthopaedic, spinal, brain injury and amputation, and as a business we are able to offer this complex specialism to get great results for our clients. 

“The training in complex injuries is lacking, whereas there is so much out there in areas like traumatic brain injury, and that’s why we have the specialism we do.  

“The fact we have clinical psychology in-house is also important – having Dr Kate Woollaston on board means we can refer to the right therapy quickly and avoid delays for our clients.” 

In establishing a new business, Jordi and his team are developing solutions which will make the process more efficient for their national network of referrers. 

“From the companies I’ve worked with previously, I’ve taken both advantages and disadvantages of how I think they work, and we’re creating something here which is very different and is what our clients and the solicitors and insurers need,” he says. 

“For example, we will fund treatments as long as we have authorisation from insurers, and then send one invoice every month. You have to be mindful that some insurers have 250 cases on their workload, so we’ve recognised the need to streamline the process of sending invoices. 

“We’re also looking at creating specialist groups of case managers, which can focus our resources and specialism into these areas and will hopefully make it easier for solicitors to match with their clients. 

“One of the biggest challenges in building a new business is finding the right people. We’ve built a great team so far but there is more to do. There are a lot of people who are probably still quite reluctant to change and wonder whether now is the right time, but now that we’re hopefully coming out of lockdown, we hope people will consider whether we could be their next move.” 

Having considered setting up in business for the past two years, Jordi decided to establish Birchwood & Co even despite the challenges of becoming a business owner during a pandemic. 

“It was probably January last year when I knew I was going to do it, but then COVID came and it became a case of knowing when was the right time,” he recalls. 

“But the support of JS Parker was crucial, we were able to bring quite a few clients over from them to us, and that has been important in enabling us to grow quickly. 

“Despite what is happening in the world, the clients are still there and they still need the support, the only thing that has really changed is that we had to step back from seeing clients face to face. 

“We’ve been lucky to work with a lot of private therapists who are doing some really innovative work in enabling them to continue treating clients, there has been some very good innovation in how to deliver services – but apart from the delivery, the focus on clients and the fact they’re our priority is the same as ever.” 

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Case management

Case managers support heroes to rebuild their lives

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Seriously injured armed forces personnel are being helped to rebuild their lives through the work of a case management company in their support of Help for Heroes. 

AJ Case Management has enabled the much-loved charity to build their own case management service, to serve the unique requirements of service men and women who are injured in action and enable them to access the healthcare they need. 

In addition to the in-house support they have enabled at Help for Heroes, AJ Case Management supports a number of veterans directly in securing the specialist rehabilitation package for their needs. 

The work with Help for Heroes is part of AJ Case Management’s commitment to the armed forces, with the business also being part of the Armed Forces Covenant. 

“We were initially approached by Help for Heroes to do a bespoke report for a very seriously injured serviceman, and I think they liked our very pragmatic approach,” says Ali McNamara, clinical director of AJ Case Management. 

“Securing a package for someone isn’t about it being all bells and whistles, it’s about making it exactly what they need. We’re very experienced in case management and deliver a holistic service, we know the private sector well so can get the very best package together for the person concerned. 

“These men and women have been injured serving us, serving this country, and while the NHS meets their needs in their early recovery, we are helping to take that forward and help these service men and women in rebuilding their lives.

“There’s a big push from major trauma centres at the minute for the NHS and case managers to work collaboratively, and I think our work with Help for Heroes is a great example of how collaboration can work.” 

The requirements of service personnel can often be unique, says Ali. 

“Very often in case management, it’s a priority to get people back into their own homes, or to find a new suitable home. But often with service personnel, they’re used to living with their mates and fellow personnel, they don’t want to live on their own,” she says.

“I think this is the true person-centredness of what we do, as we’ll always do what’s in the best interests of the client. If they’d rather be part of a community than on their own, then we will support them, and that’s what Help for Heroes is really fantastic at doing. It’s great to work with them.”

Carol Betteridge, head of welfare and clinical services at Help for Heroes, says: “AJ Case Management are a professional, dynamic and efficient case management team. Help for Heroes has employed them to provide holistic assessment and detailed case management to a number of complex cases. 

“The veteran population are sometimes a challenge to work with, they have often been left to their own devices or are only being supported by their families. It requires tact and patience to build trust and understand their unique needs. 

“AJ Case Management have demonstrated their ability to do this whilst understanding the need for flexible and innovative thinking to ensure the veterans receive the care they deserve. 

“They also have the ability to think out of the box as veterans do not receive the financial assistance that some civilian cases receive. As well as ensuring statutory services are in place, they ensure any private care gives value for money.”

Having signed up to the Armed Forces Covenant, AJ Case Management’s proximity to RAF Cosford means they are committed to offering opportunities to former military people and current reservists, as well as to the partners of serving service personnel. 

“We like to do things differently here and look at the bigger world and how we can help. Through the Armed Forces Covenant, we have the platform to offer training and careers to those who have links with the forces and support them in building a career for themselves,” says Ali. 

“For many who leave the army, they’re used to having a really active life and the opportunity of working with clients with brain injury is very varied. It could be things like supporting young men in going to the gym, not what people may have in mind as a ‘traditional’ role in health and social care. 

“One of our team was a medic on the frontline but when you leave the forces, those skills aren’t transferable, so she’s building a new career with us. Also, for women with children whose husband is serving, we can offer opportunities there too. 

“It’s a great way of us supporting our local community too, being so close to RAF Cosford, and being part of the Armed Forces Covenant is something we’re really proud to do.” 

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Case management

Case management community expands nationally

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A community established to support independent case managers is expanding across the UK.

3HUB was created to help self-employed, independent case managers with both clinical and business-related aspects of running their own venture, while also providing valuable access to peer support through them becoming part of the community.

By bringing together case managers from across the country, 3HUB also provides a single resource for referrers to match the expertise of members of the community with their clients’ needs.

The national network, which has a sizeable membership in its native South East, is growing strongly across the UK, and recently added its first case manager in Scotland.

A new model for the market, 3HUB was established in 2018 by directors Viv Cooper, Sophie Greengrass and Kaaren Wallace, to create alternative opportunities for case managers, away from the traditional corporate ways of working.

As experienced case managers, Viv, Sophie and Kaaren recognised the need to offer case managers the opportunity to work for themselves but in a supported way.

“We’ve turned the traditional model upside down. We are empowering case managers to make a cultural shift in their working practices by offering them choice around how they work and the opportunity to take the step into independent case management,” says Kaaren.

“Previously, there was little choice if you wanted to progress your career and earning potential as a case manager; you could head into management, or take the brave leap from the of the traditional structure of an employed position to working for yourself.

“3HUB seeks to address this by enabling case managers to take that leap into independent work, but in a supported and safe way. Working for yourself has many benefits, it means you have choice over your caseload, work/life balance and earning capacity.”

Having set up a charity for refugees using Community Organising as a tool, Kaaren could see the power in bringing together people with shared interests and help them work collaboratively towards a common aim.

The 3HUB community model offers case managers, who are all fully qualified healthcare professionals, membership of a structured and governed case management community with the shared aim of providing an individualised and comprehensive case management service to their clients.

“We support our community with everything from business, tech and office support, through to the clinical support needed to practice as a case manager, from an extensive programme of training events to supervision and support to become CQC registered,” says Kaaren.

“While case managers often have amazing clinical skills, none of us trained in order to be business people, we’re all from NHS or health and social care backgrounds – but the support now exists so case managers have another way; they can be independent – together.”

And through its unique offering to case managers, 3HUB is growing strongly, with the home working and flexible patterns necessitated by the pandemic showing many Case managers the benefits of having more freedom permanently.

“We’re all now very used to working with technology through the pandemic, so I think that will give even more case managers the confidence to become part of the 3HUB Community as they recognise the benefits from both the real and virtual world support the community offers,” adds Kaaren.

“We started in the South East so most of our members continue to be based here, but we are growing organically and reaching a wider geographical base.

“We are excited about the future to see 3HUB grow and offer case managers and clients all the benefits that come with working as an independent.

“The 3HUB Community provides a safe, supportive and innovative environment for case managers to work independently so they can excel at what they do best – helping clients rebuild their lives.”

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