Midway Supported Services Warwickshire

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 63 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were assessed prior to moving into Midway Care Midway Support Services. One person’s care record confirmed staff members spent time within their previous care placement to complete a pre-assessment and to understand the person’s individual needs. One staff member told us, “We spent time with [name of person] at their previous placement. We shadowed staff and spent time with [name of person] to understand their needs, like and dislikes.”

Assessments of need considered aspects of people’s care and support such as people's healthcare background, mobility, personal care and safety requirements.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Care records included some information on people’s likes and preferences. However, some sections where people’s preferences should be recorded contained incomplete or minimal information. Some people’s records contained no evidence people, their families or their legal representatives were involved in discussions around what was important to them. We found some people’s care records had not consistently been reviewed. This meant they could not be relied upon to ensure appropriate care was provided.
 

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The provider worked in partnership with various health and social care professionals and agencies, who regularly liaised with the care home. This included external community-based GPs, local authority social workers and speech and language therapists. Health professionals spoke positively of the service. One external professional told us, “The locality manager has presented as professional and attentive to the needs of the service user I am working with.” Another external professional told us, “The service user that lives there has complex needs. The locality manager and staffing team are working well with the service user and have made some amazing progress since being discharged from hospital.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were supported to access external health care professionals. This included supporting them when they expressed that they were in pain or discomfort or showing signs of an infection. People had health action plans and hospital passports in place which were used by health and social care professionals to support them in the way they needed.

People were supported to attend annual health checks, screening and primary care services. Staff ensured people routinely attended scheduled health care appointments and had regular check-ups with a range of community health and social care professionals. This included GP’s and district nurses. In addition, people received support to eat and drink to maintain a balanced diet.

The service did not always effectively monitor people’s health conditions or ensure that records related to their care remained relevant and up to date to ensure improvements.

People’s health monitoring records were not always completed effectively which increased the risk of people experiencing poor outcomes and receiving care that may not meet their needs. For example, if an approach was no longer meeting the needs of a person, it was not always documented, updated or removed from the person’s care records. One relative told us, “Changes with the service just happen. There is no formal contact from head office which would be good. The only feedback I give is to contribute to the care plan review.”
 

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Improvements were needed to mental capacity assessment records and best interest decisions. Some records completed by staff did not evidence who was consulted as part of the decision-making process, such as relevant professionals, families or advocates.

Some people did not have mental capacity assessments completed in relation to administering medicines prescribed as and when required. We could not be assured their ability to inform staff of being in pain or being uncomfortable had been appropriately assessed.
One person who received their medicines covertly did not have the correct authorisations in place in accordance with the Mental Capacity Act 2005 (MCA). Covert administration is when medicines are administered in a disguised format. There was no evidence that a best interest meeting had taken place before considering covert administration, in line with the principles of the MCA, to confirm this decision was in their best interests or the least restrictive option.

Staff told us how they supported people to make their own decisions and in people’s best interests. Staff received Mental Capacity Act training and told us how they used the training to ensure people were given choice and control over their care needs. Care records in relation to consent indicated some staff members did not fully understand the importance of recording decisions and outcomes that demonstrated people had been given a voice. This meant the training had not been effective as some staff had not fully understood or were not competent in supporting people under the MCA.
Following our feedback, the provider informed us they had taken steps to ensure people’s rights under the Mental Capacity Act were more fully upheld. This included reissuing the template used to record mental capacity assessments and conducting a training session for managers on mental capacity assessments and Community DoLS expectations.