Midway Supported Services Warwickshire

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The providers governance and oversight continued to require improvements.

The provider continued to be in breach of legal regulation in relation to the governance of the service.

This service scored 61 (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 shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

People told us staff were kind and compassionate.

The provider welcomed and supported an open culture which was confirmed by staff feedback to us. Staff were confident to identify poor practice and told us concerns would be acted on. Staff and management fed back passionately about the care being delivered to people and spoke fondly of the people they were supporting.

The provider had inclusive leaders who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. At the time of our visits the service did not have a registered manager. The acting manager had applied to become the registered manager, and we had received their application.
However, we found systems in place were not always effective which led to a lack of oversight of people’s care plans and medicine records. Leadership structures and audits existed, but they were not always effective in ensuring high standards of care or addressing recurring concerns

People, their families and staff knew who the management team were, and how to contact them. People and relatives told us the management team were caring and approachable. One relative told us, “Now there is a better management team and the staff tell me they feel supported. I met them a few months ago at a review meeting. They seemed confident and on the ball. I think the service is well run.”

The management team including locality managers, quality director, operations director, and nominated individual were all receptive to our feedback throughout the assessment. They began making some changes and were committed to continuing to make improvements within the service.
 

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff felt confident to report, whistle blow and raise concerns if needed. Staff were positive about the management who were open, listened and acted upon feedback. The provider had processes to inform staff how to whistle blow. Staff were able to raise concerns.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. Policies and procedures to promote diversity and equality were in place to support staff. There were systems in place for matching staff to people, for example, if a person spoke a particular language or if a person wanted a male or female staff member to support them.

The provider did not always have good governance systems and processes in place. Audits had not enabled the provider to identify and address the concerns we found in relation to the management of medicines, care records and behaviour incident reports. For example, audits completed had not identified some people’s as required medicines records did not include information how to assess the effectiveness and how to escalate if not working. There were a risk people would not receive pain medication when needed.

The provider’s medicine audits had not enabled them to identify and address concerns in relation to handwritten entries. In line with National Institute for Health and Care Excellence (NICE) guidance, all handwritten entries on Medicine Administration Records [MAR] charts should be written in full, dated and checked and signed by 2 trained members of staff.

The provider’s oversight of behaviour incidents required improvements. We found 1 person had many incidents recorded as moderate in severity and 5 of those incidents resulted in as required medicine being administered. There was no documentation as to why staff had chosen to administer medicines on these occasions, when similar incidents had occurred with no medicines been given or a recorded discussion with a manager to discuss the possibility administering medicines or other strategies. We could not be assured the person was receiving the appropriate intervention and they were not in distress without support and appropriate intervention from staff.
 

The service understood their duty to collaborate and work in partnership. They shared information and learning with partners and collaborated with them.

The provider and staff worked with a wide range of relevant external stakeholders and agencies across learning disability and mental health services. To support the provision of people’s care. Staff worked with others to enable people to live were they chose.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

The provider had worked closely with commissioners to improve the quality of care delivered and with care plans. However, improvements were still required in care planning, assessing people’s needs, supporting people with their risks and medicine management to ensure people consistently received safe and effective care, and positive outcomes.