Mia Care Services Ltd

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment, the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 81 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Care workers completed daily progress notes which included recording any incidents and accidents that had occurred when supporting people.

The provider maintained an ‘incident and accident matrix’ which included all the incidents that had taken place, along with outcomes and any learning from them. These were shared with the care staff to embed learning.

Staff were supported with training to improve their skills and knowledge. Mandatory training was refreshed regularly which meant they were continuously updating their knowledge and skills.

The provider always worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was always continuity of care, including when people moved between different services.

There were robust systems in place when accepting new referrals. This helped to ensure that people transitioned into the service safely by working with health and social care professionals and commissioners to ensure people’s needs could be met.

Initial assessments were carried out by the provider, which often included shadowing visits with the outgoing provider to gain a deeper understating of people’s needs and to ensure these could be met. Risk assessments were completed which were then further developed during the first few weeks to effectively capture people’s needs. Care teams were also introduced to the people and their relatives to ensure they matched closely with people and had shared interests.

Comments from relatives were overwhelmingly positive about the settling in process which they described as extremely thorough. These included, “My son was referred to the service by his social worker as he has challenging behaviour. Once I received the support from Mia our quality of life changed from 0% to 95%”, “In the beginning the carers spent time with both me and my son observing how I interacted with him and how to deal with him during a crisis”, “The company went to great length to match the right carer to suit my daughter”, “One of the managers played with my son, whilst the other spoke to me to complete a care plan, identify needs and do a thorough risk assessment” and “The carers initially would observe my interaction and management of my son to ensure they knew his routine so he would feel confident and comfortable.”

A healthcare professional said, “Their care planning is detailed and genuinely reflective of each young person’s needs. A good example is a child where previous services struggled to meet his needs and their communication was inconsistent. Since Mia Care took over, the difference has been very clear — their reporting is thorough, their support has been consistent, and the overall stability has improved significantly.”

People experienced positive outcomes as a result of this through transitioning process, including stability in the care and support that was delivered. Comments included, “Having this care company to support my son has been a game changer. “It has made me step back as I can see with their encouragement he has been able to do more than I have ever thought” and “Themanager said that the care planning takes time to ensure we have the best carers with the skills and knowledge to deal with my daughter. The service has had such a positive effect on my daughter’s life, she is more active and taken to the swimming pool, she goes trampolining and the carers take her for walks to the park.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People were safeguarded from abuse and improper treatment. People and their relatives told us they were safe in the presence of care workers. Comments included, “She constantly needs safeguarding and the manager and carers were well aware of this as a thorough history was taken”, “He has 2 carers that take him out into the community so that he is safe” and “The carers really do keep him safe as he used to run away from school, but since Mia have been supporting him, this has not happened.”

Training records showed that staff undertook safeguarding training in adults and children to identify types and signs of abuse which was refreshed annually.

Staff understood what safeguarding meant and the steps they would take if they suspected people were at risk of harm. Staff were also clear on safeguarding reporting procedures and the action they would take if they had concerns.

The provider always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them.

People’s risks were identified, assessed and mitigated. Staff had guidance in care records to keep people safe.

Systems were in place to ensure risks people might face were continually assessed, monitored and reviewed. Risk assessments were reviewed when people’s needs changed, which meant that people were kept as safe as possible.

Staff were aware of the risks to people, including their behaviours and how to support them when out in the community. Relatives of people using the service told us that staff did all they could to keep their family members as safe as possible. Comments included, “The carers understand the risks of when a seizure can occur and she has 2 carers at each session of care”, “They are patient with her when she eats and has managed to stop her from shovelling food quickly and reduce the risk of choking”, “The carers have access to his emergency medication that is given in the event of him having an episode that requires additional medication. The carers know as and when it needs to be given and they also have a process for recording what is given if the need arises.”

Care workers supported people to manage risk in a way that improved people’s independence. One relative told us, “Her mobility was poor and I used to carry her, but since the carers have been supporting her, she is now walking up and down the stairs.”

Where people had behaviour that could be seen as challenging, staff followed both proactive strategies included in Positive Behaviour Support plans to anticipate these and also reactive measures when the behaviour occurred. Relatives said, “If he is having a tricky time which could make his behaviour spiral, then the carers recognise this and he goes to his safe space and the carers recognise when he needs this space”, “They have had a very positive influence on my daughter’s life as she is more involved in community activities” and “My sons’ behavioural issues have much improved. He is happy and joins in activities and enjoys life now.”

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider completed environmental risk assessments prior supporting people and at regular intervals thereafter. This helped to ensure that people were cared for in an environment that was both safe for them and for care workers.

Risk assessments included risk in relation to both the environment and any mobility equipment in people’s homes, such as hoists.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People using the service and their relatives told us that care workers were good with their time keeping and they were supported by a dedicated team of care workers who were competent and trained to carry out their roles. Comments included, “He has regular carers that know him well and understand his needs”, “They are on time, they never reduce the time agreed to support my son”, “The carer is always on time meeting me and my son at school to escort him in. When he has social visits, they are always on time to take him out. They have never let me down or missed a call.”

Staff recruitment practices were robust and only fit and suitable staff were employed to work at the service. Staff files contained evidence of robust recruitment checks including application forms, references, interview questions and right to work and identity checks. The provider completed Disclosure and Barring Service (DBS) checks. This helps employers make safer recruitment decisions by processing requests for criminal record checks.

Staff were provided with regular training that as relevant to their role. This included mandatory training and also specific training that was based on individual needs such as Positive Behaviour Support (PBS), epilepsy awareness, paediatric first aid and diabetes. One relative said, “They are highly skilled”. Another said, “The well-trained carers have made an enormous difference to my life as well as my sons.”

Staff had the opportunity to reflect on their working practices, including identifying any training needs, through regular supervision. They were also observed on their working practices through spot checks. A relative said, “If a new carer is to be involved then I always meet the new person first to decide with the manager whether they are going to be suitable” and “The manager always arranges shadow sessions for the new carer.”

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The provider completed risk assessments in relation to infection control and cleanliness.

People told us care workers wore Personal Protective Equipment (PPE) when supporting them and staff confirmed they had access to adequate supplies of PPE. Comments included, “PPE is worn and they will always wash their hands and change their gloves before dealing with his PEG”, “They wear their PPE” and “If my son has an accident they will assist him with personal care and always wear their gloves and aprons.”

Training records showed that infection prevention and control and food safety training was delivered as mandatory training.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

People told us staff supported them to take their prescribed medicines as and when they should. They said, “He has rescue medicine in the event of him requiring intervention to calm him and the carers know exactly what to do in such an event.”

Care plans included guidance for staff about how people’s medicine support needs including any prescribed medicines they took and their preferences.

Staff received relevant training and their competency to continue managing medicines safely was routinely assessed.

The provider carried out regular audits of medicines, including any missed medication or gaps in medication administration which were then explored further to identify any root causes.