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Archived: Midway Care Midway Support Services Good

The provider of this service changed - see new profile

Reports


Inspection carried out on 11 and 16 June 2015

During a routine inspection

This was an announced inspection which took place on 11 and 16 June 2015. We gave the provider 48 hours’ notice that we would be visiting the service. This was because the service provides domiciliary service within supported living services and we wanted to be sure that staff would be available to assist with the inspection.

Midway Support Services specialises in supporting young adults with learning and physical disabilities. At the time of our inspection the service was supporting 16 people in provision across Birmingham and Warwickshire.

At out last inspection in June 2014 there were two areas where the service was not meeting regulations. These related to the monitoring of the service, and the management of medicines. We found the provider had improved the systems in place for the management of medicines and the manager was making progress on ensuring effective systems were in place to assess, monitor and improve the quality and safety of the service provided.

A registered manager is required to manage this service. A new manager was appointed in March 2015 and at the time of our inspection they were in the process of registering with us. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People received a safe service, procedures were in place to reduce the risk of harm to people and staff were trained and knew how to report and deal with issues regarding people’s safety.

People received their medicines as prescribed and safe systems were in place to manage people’s medicines.

Training and supervision was provided for staff, to ensure they were able to perform their role well.

People enjoyed their food and had a choice of food to ensure a healthy diet. People’s health care needs were met.

People received care from staff who were respectful and caring and ensured people’s privacy and dignity was maintained.

People were able to participate in various social activities if they wished. People were encouraged by staff to be independent and were confident their concerns would be listened to and acted upon.

The management structure had been strengthened and steps were taking place to ensure the monitoring of the service was more robust.

Inspection carried out on 2 June 2014

During a routine inspection

The service was providing personal care and support to 17 people who lived in their own home or in supported living accommodation. We visited three houses and spoke with three people who lived there. We also visited the offices where the care was managed from. We spoke with four relatives, seven staff, the provider and the registered manager. We contacted a number of professionals including social workers and community nurses who supported the people who used the service. At the time of writing this report we had received comments back from three professionals.

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.

Inspection carried out on 6 August 2013

During a routine inspection

During our inspection we met with two people who used the service. We also spoke with two relatives, nine staff, two professionals and the provider.

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.

Inspection carried out on 4 January 2013

During a routine inspection

We visited the office of Midway care and we spoke with the nominated individual, the manager, and six staff. Many of the people who used the service were not able to tell us their views, we spoke with two people and we also spoke with two relatives.

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.

Inspection carried out on 20 December 2011

During a routine inspection

The people we spoke with who received personal care from the agency were happy with the quality of care received.

People told us that the agency had carried out an assessment before the service started and that they had a copy of the care and support plan in their home. People we spoke with were confident that they could raise concerns if they were not happy with the care being received and that they would be listened to. A relative of a person that was using the service told us �If I am not happy about something I approach the care workers or the management team. They take things seriously�.

People told us they were happy with the support they received and that it made a difference to their everyday living. People told us that they were treated with respect and that care workers maintained their privacy and dignity. They told us that care workers completed the care and support required. One person that was using the service told us �They are excellent and encourage me to do things for myself. I have got to know the staff and I have not had a problem�. A relative of a person that was using the service told us �The staff are very good. They are open and honest and work really well with my daughter�.

As part of our review we spoke with the local authority who fund people to use the service. This was to find out their views about the quality of service being provided. They told us that they were satisfied that improvements had been made by the agency following a previous concern about the way in which the service was being managed.