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 inspection the rating has changed to good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

The provider was previously in breach of the legal regulation good governance. Improvements were found at this assessment, and the provider was no longer in breach of this regulation.

This service scored 75 (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.

The provider demonstrated a clear and shared vision, strategy, and culture founded on transparency, equity, equality, and respect for human rights. There was a strong emphasis on promoting diversity and inclusion, encouraging engagement, and recognising the needs and challenges faced by people and their communities.

The management team explained the service aimed to promote independence, support individual choice and preferences, and enable people to take positive risks while exploring new opportunities.

Staff showed a strong commitment to these values and were able to provide clear examples of how they applied them in their day-to-day work. They consistently told us they enjoyed working at the service and appreciated the support provided by the management team. Staff highlighted that effective teamwork played an important role in maintaining good standards of care.

The acting manager maintained a visible presence within the service and fostered an open and transparent culture where staff felt confident to raise concerns. Staff demonstrated an understanding of what a closed culture might look like and were assured that any concerns or poor practice would be addressed appropriately by management.

People and their relatives told us that staff were kind, compassionate, and treated individuals with respect.

A relative told us, “The staff are very responsive, a manager will always get back to me’.

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.

The provider’s leadership was inclusive and demonstrated a clear understanding of the context in which care, treatment, and support were delivered. Leaders embodied the organisation’s values and culture, and had the skills, knowledge, experience to lead effectively, doing so with integrity, openness, and honesty.

There was an acting manager in post who showed a strong understanding of both people’s needs and those of the staff team. The acting manager explained that they were well supported by senior management, who maintained a regular presence within the service and were readily available to offer advice and guidance. This support was described as consistent and reliable.

The management team took part in monthly meetings with other managers across the region, where they shared good practice, learning from incidents, and ideas for activities. Staff confirmed that management support was accessible whenever required.

The acting manager spoke positively and with enthusiasm about their vision for the service. They aimed to create an environment where people feel safe, valued, and truly at home, with a staff team that is empowered, motivated, and proud of the care they provide. They also expressed a desire for the service to be recognised for delivering high-quality, person-centred care, where dignity, choice, and independence underpin all decisions, and where families feel confident in the care their loved ones receive.

People and their relatives were familiar with the management team. Feedback from staff, people, and relatives consistently described her as approachable, accessible, and responsive, with an open-door approach and a willingness to listen to and act on any concerns raised.

One relative told us, “I would definitely recommend the organisation to others. From what I can see the management is good”.

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

Staff told us they had positive working relationships with the management team and felt that their views and opinions were valued. A review of recent staff meeting minutes showed a range of topics had been discussed, including keyworker responsibilities, infection prevention and control, lessons learned, staff training, and incidents and accidents.

A whistleblowing policy was in place, and staff demonstrated a clear understanding of its purpose. They were aware of the provider’s procedures and relevant contact details and said they felt confident to raise concerns whenever necessary. Staff expressed assurance that any concerns reported to the acting manager would be taken seriously and acted upon. People using the service and their relatives also said they felt able to raise any concerns with the acting manager or management team if needed.

One relative told us, “Managers are good the new manager is new to the service but very good”.

The provider demonstrated a commitment to valuing diversity within its workforce and promoting an inclusive and fair culture, with a focus on improving equality and equity for staff. The management team explained that flexible shift patterns were available, particularly to support parents with young children, enabling individuals who might otherwise face barriers to employment to access opportunities. Staff has access to counselling, financial guidance and legal advice. Support was also available through a consultant counselling psychologist, who worked with both staff and individuals receiving care, offering debriefing and counselling for work and non-work-related issues on a referral basis, including group sessions and individual follow-up where required. This proved particularly beneficial in supporting staff following traumatic incidents or periods of stress.

The service also showed respect for staff members’ religious, cultural, and personal preferences. Staff described a positive and inclusive working environment where diversity was respected and discrimination was not tolerated. They told us the provider was responsive to their individual needs and made reasonable adjustments to help them perform their roles effectively. Examples included flexible working arrangements and phased returns following periods of illness.

We observed that appropriate risk assessments were in place for staff, including those with dyslexic traits and for pregnant employees. The service also actively promoted LGBTQ+ inclusion. Staff had been recruited from a wide range of backgrounds, reflecting the diversity of the local community.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

At the last inspection, we found that audit processes had not been effective in identifying and addressing concerns relating to the management of medicines, care records, and behaviour incident reports. For example, audits had not identified that some ‘as required’ (PRN) medication records lacked guidance on how to assess effectiveness or when to escalate concerns if the medicine was not working. This presented a risk that people may not receive pain relief or other medication when needed.

At this inspection, improvements had been made. Documentation relating to medicines and care had been strengthened, with clearer guidance now in place to support safe administration and monitoring. PRN protocols had been improved to include more detailed instructions, helping staff to assess effectiveness and take appropriate action where required.

We also found improvements in how behaviour incidents were overseen. There was now a stronger focus on the use of de-escalation techniques, alongside more effective monitoring of PRN medication given in response to behaviours of distress.

However, we found further improvements were required regarding the consistency of medication competency assessments. In some cases, identical timings had been recorded across multiple staff records, and there were discrepancies in dates within documentation. These issues could reduce confidence in the accuracy of records. We raised this with the management team, who confirmed that additional checks would be introduced to improve the accuracy and ensure records were completed contemporaneously.

The provider had clear roles, responsibilities, and systems of accountability in place to support effective governance. These systems were used to deliver care that was safe, sustainable, and of a good quality. The provider acted on available information relating to risks, performance, and outcomes, and shared this appropriately with relevant parties when needed.

The acting manager and management team completed regular audits across the service, including reviews of medicines, finances, the environment, staff training, health and safety, leadership, and incidents. Additional monitoring included checks on staff rotas, training compliance, fire safety drills, and records of incidents and accidents.

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

The provider recognised the importance of collaboration and partnership working to ensure people experienced seamless, coordinated care. Information and learning were shared with partners to support continuous improvement.

The acting manager worked closely with a range of health and social care professionals, including the local authority commissioning team. They reported that the advice and support provided by the local authority were helpful and contributed positively to service delivery.

The service engaged proactively with external organisations to support individuals, build community connections, and improve outcomes. Staff explained that referrals to health and social care professionals could be made through the management and nursing teams, and relatives confirmed that appropriate professionals were involved in people’s care.

Feedback from health and social care professionals during the assessment process was positive, highlighting effective working relationships and a shared commitment to enhancing people’s health, wellbeing, and quality of life.

The provider worked in partnership with people, their relatives, and professionals to promote coordinated care. Relevant information was shared appropriately with relatives when health-related decisions were required, and staff had access to specialist advice through well-established healthcare partnerships.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

For example, the provider introduced a regulatory tool to support managers in assessing individuals’ regulatory status and storing this information centrally. This enabled ongoing review and monitoring of any changes over time. In addition, a new care and support plan format and supporting documentation had been implemented to improve the quality and clarity of information provided to staff. Specific health plans had also been developed for managers to use alongside care and support plan, covering conditions such as nutrition, asthma, sleep apnoea, and diabetes. These tools offered clearer guidance and prompts for both managers and staff when developing and reviewing care documentation.

The provider had recently begun working with Imperial College London on the SPECTROM project, which involves training support staff to enhance their confidence in contributing to medication reviews and appropriately challenging prescribing practices. The programme equips staff with a detailed understanding of psychotropic medication, enabling them to question inappropriate use, including avoiding the prescribing of such medication for behaviours that challenge and supporting safe dose reduction or withdrawal where appropriate. It also promotes alternative, non-medication-based approaches, ensuring staff are better equipped to respond to behaviours that challenge in a person-centred way.

Staff reported that they were well supported in developing their skills, and several shared positive experiences of progressing into more senior roles within the organisation. The provider had systems in place to regularly review training needs and career goals, ensuring staff were given ongoing opportunities for professional development and progression.