Archived: Midway Care Midway Support Services

The summary is based on our observations during the inspection, discussions with people who used the service, the staff supporting them, telephone discussions with relatives and by looking at records. This helped us to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective and, Is the service well led?

Below is a summary of what we found.

The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

One person told us, 'Yes I feel safe here, I like it'. A relative told us, 'It is a good service and I feel that my relative is safe'.

All the staff we spoke with told us that they felt that the people who used the service were well cared for, their needs were met and that people were safe. Staff told us about the on call procedures that were in place to provide advice and support to staff when needed, so that they felt supported and safe in their role.

The care records showed how people wanted to be supported and provided the information that staff needed to ensure people's wellbeing and safety.

Staff we spoke with had a basic knowledge of the Deprivation of Liberty Safeguards (DoLS) process. DoLS is a legal framework that may need to be applied to people who lack capacity and may need to be deprived of their liberty in their own best interests to protect them from harm and/or injury. The registered manager told us that to date there had been no application made to the local authority regarding a DoLS issue. However they were going to review each person's care and if needed an application would be made. This meant that the registered manager had taken appropriate steps to ensure the service operated within the legal framework.

We determined that the management of medication administration needed greater diligence. This included assessing any risks to people and ensuring that documentation recorded the support people needed so that people received their medication safely.

Overall, we found that some improvements were needed to meet the requirements of the law to ensure the service was safe.

Is the service effective?

One person told us, 'I like it here this is my home'. We also observed two people who looked comfortable and relaxed in their home.

All the staff we spoke with told us they felt people's needs were met and that people were well cared for.

People had their needs assessed and care records showed how they wanted to be supported.

One person told us, 'Staff ask me and agree with me how I want things done'.

Arrangements were in place to ensure that people had been supported to meet their health and medical needs. Systems were in place to identify changes in people's needs so that people continued to receive the care they needed.

We found that auditing and monitoring systems had not always been effective in identifying shortfalls, for example, information to support medication administration did not detail all the information needed and risk assessments had not been completed.

Overall, we found that some improvements were needed to meet the requirements of the law to ensure the service was effective.

Is the service caring?

One person told us, 'Most of the staff are good'. A relative told us, 'The staff seem very kind and caring, it's a shame when some staff leave, but they cannot do anything to stop that'.

When we visited the different houses we observed interactions between staff and the people who lived there. We saw that staff showed patience and spent time sitting, talking and listening to people. People were happy and relaxed around staff members.

Staff that we spoke with knew the care and support needs of people well enough to ensure personal care was provided.

Overall, we found that the provider had adequate processes and systems in place to meet the requirements of the law in relation

to ensure that the service was caring.

Is the service responsive?

We found that meetings had taken place with people that used the service and their representatives. This meant that people had the opportunity to raise issues. One person that used the service raised some concern with us during the inspection and we saw that these were dealt with by the registered manager. The registered manager told us that some concerns passed on from a relative would be dealt with through the complaints process. This showed that the provider was willing to listen to the views of the people that used the service to improve the overall provision.

People that used the service had been supported to take part in a range of recreational activities in the home and in the community which was organised in line with their preferences.

When people had become unwell or their care needs had changed staff had noticed this and taken action, for example medical input had been sought or increased staff support provided.

We found that the provider had taken note of the findings from our previous inspection. They had taken some action to address issues to improve, for example, improving written information about people's care so that care was delivered as needed.

Overall, we found that the provider had adequate processes and systems in place to meet the requirements of the law in relation to ensure that the service was responsive.

Is the service well lead?

There was a registered manager in place who was aware of their legal responsibilities. The provider was also involved with monitoring the service. A management team was in the process of being developed to support the on-going development of the service.

All the staff we spoke with told us that they could raise any concern about poor practice in the service and these would be addressed to ensure people were protected from the risk of harm.

Arrangements were in place to ensure that staff knew how to act in the event of an emergency so that people were safe.

Overall, we found that the provider had adequate processes and systems in place to meet the requirements of the law in relation to ensure that the service was well lead.

All the people we spoke with told us that they were happy with the service. One person told us, 'I am really happy, I like the staff'. A relative told us, "My relative has choices now about what they do and they are now able to go out and enjoy doing things in the local community".

All the people we spoke with told us that they were happy with the staff . There were systems in place to recognise and report any abuse so people were protected from the risk of harm.

Systems were in place to ensure that only staff that were suitable to work with vulnerable people were employed.

Staff had received the training and support they needed to meet the needs of the people who had used the service.

Some improvements had been made to the service but quality monitoring systems had not been fully implemented to manage and assess risks to people.

Records were not always accurately maintained which had put people at risk of unsafe care.

We were told by the manager that they were supporting 16 people in mainly single occupancy houses across a wide location covering Birmingham, Solihull and Warwickshire. All of the people they were providing a service to had a learning disability and most were receiving 24 hour support.

People that we spoke with said 'I like my house the staff are okay'

A relative told us 'My relative has progressed greatly they are more independent and they make more choices about their life'.

People received support to help them make decisions about their life.

Staff recruitment procedures did not ensure that robust systems were in place to prevent unsuitable staff being employed.

Not all staff had received the training they needed to do their job and meet people's needs.

Staff supervision was inconsistent and appraisals had not taken place which meant staff were not getting the support they needed to do the job well.

There were systems in place to monitor quality but these had only been recently introduced so the effectiveness of these were not known.