In the latest of our case management focus features, we meet Anglia Case Management and learn about how its commitment to supporting clients and staff has resulted in ongoing expansion, a first-rate reputation and an Outstanding rating from CQC. Sue Stoten and Ros Ashton tell us more
Tell us why was Anglia established and what was the ambition at the outset?
Anglia Case Management (ACM) was founded in 1998 by Caroline Ferber, who was working as a freelance occupational therapist, and was asked by a leading local solicitor if she could case manage one of his clients. This led to her receiving another referral, and once the ball started rolling, it didn’t stop!
Caroline retired from her role as managing director in 2018 and now concentrates on her work as care expert. The company has grown to 65 members of staff, with over 50 case managers, OTs and care experts.
Initially ACM only provided case management to clients with brain injuries, but our staff expertise has grown and we now provide case management to clients with spinal injuries, amputation and polytrauma. We have recently started work with clients who have PTSD.
In addition to extending the range of clients we can work with we also cover a wider geographical area; having been based predominantly in Suffolk and Norfolk, we now work with clients throughout Eastern England and London and Kent.
Our services have developed too – we started a Community Rehabilitation Service in 2007, providing neuro occupational therapy to clients. We have a growing expert witness team, providing care reports for the Court, and we have a manual handling team, providing training and assessments. In addition we have a care management team, who recruit, train, supervise and manage over 250 support workers who work with our clients.
ACM has always been client-centred, focussing on the needs of our clients – whether the needs are immediate, or wishes and goals to aim for. Case management and therapy has always been delivered face to face because we believe that is best for our clients.
Our USP is our strong team ethos and focus on learning and development which we know is valued by our teams. Staff have an office base in Suffolk, and are required to come into the office regularly; this enables them to meet up with their colleagues which we think is really important for staff development, team spirit and reinforces our core values. We think that this is what makes us different to other case management companies. In addition, all ACM staff are permanent employees, and receive regular supervision, peer support and training.
We value learning and development, and have been accredited as Investors in People since 2012. Four years ago we decided to trial an in-house Professional Development Programme, and we are now in the second cycle of the two-year programme which covers a wide range of topics and ensures that all our case managers and OTs have the skills they need to carry out their role to benefit our clients. It ensures continuity of standards of service and new staff tell us it is one of the reasons they chose to work with us. The PDP can also be accessed by members of the Admin team, should they want. We also host a further four training days each year for staff, in addition to them attending external training if its relevant.
Staff numbers have increased over the years, and we’re proud that we have a low ‘churn’ rate. ACM has been recommended as an employer by several members of staff to their friends – so we know that they value all that we provide.
How did the team respond to the significant challenges presented by COVID-19?
When COVID-19 hit, the team adapted incredibly well, continuing to provide services to our clients but with some adjustments to the way we work.
ACM has always provided face-to-face case management and therapy to clients but in March 2020 we immediately had to adapt, and rise to the challenge of working virtually. It was a bit of a shock to start with but we successfully rolled out virtual working across the ACM teams, and our clients were able to adapt, and welcomed all the input that we could give.
Because our clients are classed as clinically vulnerable, many had to isolate from their friends and families, and so our contact became increasingly important to them. Some clients were able to have more input from us than pre-COVID, because the visits were virtual and there was no travel time involved. Once PPE was sourced, in-person visits were able to recommence, after rigorous risk management plans were drawn up. Many visits took place outside and we provided staff with a fold up chair if they didn’t have one they could use – thank goodness for fine summer weather!
Our rehab team provided some innovative sessions and sourced some great equipment for clients – including teaching laundry and iPad use by Zoom, bespoke beds, all-terrain wheelchairs, a Lego Landrover, robotic lawnmowers, and vegetable growing. Despite the restrictions of COVID, we were able to support several clients to move house, out of residential homes into their own homes. Other clients got their first jobs, thanks to our support.
We’ve been running an out of hours and duty service for over ten years, but since March 2020 calls to these services tripled, as we have had to deal with COVID-related calls from clients, their families and their support workers. It has been really reassuring for us to know that we are available to deal with client issues as and when needed, rather than the client or their support staff having to wait until the office opened – and we know that our clients and their families have valued this too.
We continued to recruit support workers during the pandemic, and actually recruited more people than in the previous 12 months, with most recruitments moving to a virtual platform. Zoom interviews became the norm, as did zoom staff training. Sometimes clients wanted to be involved with support worker interviews, and in-person interviews did take place, with PPE and social distancing – one client interviewed potential support workers walking round a park!
One surprising benefit was that support worker training was better attended when virtual, and the costs to clients were less as there was no travel time involved – needless to say, we will continue to have virtual support worker training although we recognise the value of continuing with some face to face training.
Another of the surprising benefits has been having virtual MDTs. We’ve found that it’s much easier to organise an MDT with no travel time, and that it is more cost effective for clients. Our admin team have been involved in taking minutes of remote meetings, which would have been impossible if they were held in person, and this enables the case manager to concentrate on chairing the meeting, and it is run more effectively and efficiently with the minutes being produced more quickly. We will definitely be continuing to meet with MDTs via Zoom where it’s appropriate.
In addition to client wellbeing, one of the main concerns for the senior management team was to maintain the wellbeing of staff – if staff weren’t well, then working with our clients would be much harder. Positive staff morale had always been a focus but became more important as face-to-face contact was halted and became virtual. There were additional informal team meetings and the senior management team hosted virtual coffee breaks and lunches where work conversations were ‘off limits’. Bespoke yoga sessions were sourced and additional supervision and support was provided. We also had remote facial reflexology sessions.
Our office remained open, and the staff who needed to attend were welcomed with virtual open arms! These additional measures ensured staff were able to work effectively in a safe environment to support clients.
We continue to use technology with colleagues, clients and support staff, but for us, remote client meetings will never be able to take the place of face to face contact – we believe it’s essential to meet our clients in their own environment, see and read their body language, assess their requirements, whether spoken or unspoken, and meet their family members and carers.
What are your priorities going forward?
Our priorities haven’t really changed – client achievement remains central to what we do, as does the welfare of our staff team.
It was interesting as prior to the pandemic we had started looking at our core values and involved all staff in their development. We finalised a new set of core values in mid 2020 and have had really positive staff feedback. This was a really heart-warming exercise and staff really appreciated being consulted, and it reinforced their positive views of working at ACM. We’ve now incorporated the core values into annual reviews for all staff.
We recently ran a recruitment drive to expand our case management team, and had several applicants who said they had been watching our vacancy page for several months because they wanted to work specifically for ACM because of our values and ethos. It doesn’t get much better than that.
Client safety and wellbeing drives all we do, and this is reflected in our CQC rating, which has been Outstanding since 2017. Our registered manager works hard to make sure that we maintain our Outstanding rating!
Enquiries and referrals are continuing to increase and so we know that there is a demand for our services. We had planned to expand the range of our services but the pandemic made things trickier but not impossible. In the last 18 months we have introduced several new roles and services such as a bed rails champion, mental capacity assessors, an epilepsy champion and infection prevention and control champion. There will be more developments – watch this space …
What does the long-term future look like for Anglia?
The long term future for ACM is bright. We have a stable and excellent staff team, who are dedicated to working with our clients, enabling them to achieve their goals. We continue to recruit new case managers and OTs, and have a more defined career structure, with greater opportunities for development. We are open to new ideas and suggestions for services, and welcome ‘bright ideas’ from staff.
The ambition hasn’t changed from day one, we still provide excellent services (whether they are case management, rehabilitation or expert reports) just on a larger scale, with increased diversification to meet the needs of those who commission our services and to benefit a wider range of clients.
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