Midlands Care Direct

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

This is the first assessment for this newly registered service. This key question has been rated Good. This meant people’s needs were met through good organisation and delivery.

This service scored 68 (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 made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

The person who used the service told us they received care and support that was individualised to their care and support needs, wishes and preferences.

The person also told us about the support they received to pursue their interests, hobbies and social activities. Records confirmed staff provided support that reflected the person's individual preferences and promoted their wellbeing and quality of life. This included attending the gym, going on long walks, which the person particularly enjoyed, visiting favourite restaurants, attending hairdressing appointments and accessing activities within the local community. Staff encouraged and enabled the person to participate in activities that were meaningful to them while maintaining choice and control over how they spent their time.

Care records demonstrated that support was tailored to the person's individual needs and aspirations. Staff monitored changes in the person's circumstances and worked with them to adapt support where required. This helped to ensure the person's care remained relevant, responsive and focused on achieving outcomes that were important to them.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Records showed staff and the registered manager maintained effective communication with a range of external professionals and organisations involved in the person's care and wellbeing. This included healthcare services, social care professionals and other agencies where appropriate. Information was shared to support coordinated care and to ensure relevant professionals were aware of any concerns, changes in needs or risks.

The person told us staff supported them to access healthcare services when needed and helped them to make decisions about their care and support. They described positive relationships with staff and said they felt supported to maintain their independence while receiving the assistance they required.

Staff demonstrated a good understanding of the person's needs and were able to explain how they worked with other professionals to achieve positive outcomes. They told us effective communication and partnership working were important in ensuring consistent support and helping the person access the services they needed.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The Accessible Information Standard (a legal requirement for social care providers to ensure information and communication is provided in a way that meets people’s needs and can be understood) was met.

At the time of the inspection, the person did not have any identified communication needs that required additional support. However, discussions with the registered manager provided assurance that any future communication needs would be assessed and appropriate support put in place to ensure the person could access information and express their views effectively.

Staff confirmed the person was able to communicate their needs, wishes and preferences without the need for specific communication aids. However, they demonstrated a good understanding of how to support people with a range of communication needs and were able to describe approaches they would use to promote effective communication. These included providing information in easy-read formats, using visual communication aids, adapting language, speaking clearly, using short sentences and checking people's understanding.

The provider's service user guide contained information about the service and what people could expect, including details of how to contact the provider and raise concerns. The registered manager told us this information could be made available in alternative formats to meet individual needs, such easy-read versions and translations into other languages.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result. However, shortfalls were identified in record keeping.

The person told us they felt able to speak openly with staff and the registered manager and confirmed they were regularly involved in discussions about their care and support. They described positive relationships with staff and said they felt listened to when expressing their views, wishes and preferences.

The provider had a quality assurance process which invited people and their next of kin and or family, to provide feedback of their experience of the service. However, there was no evidence that the person and others had been given this opportunity.

The registered manager maintained regular contact with the person and sought their feedback about the support they received during their informal discussions. However, this was not consistently reflected within the care records reviewed. This meant there was limited documentary evidence to demonstrate how feedback had been sought, how the person's views had influenced decisions about their care, or what actions had been taken in response. We discussed this with the registered manager who agreed to review their systems and processes.

The person told us they were aware of how to make a complaint and felt confident to do so if they were unhappy with any aspect of their care or support. They said they felt able to raise concerns directly with staff or the registered manager and were confident they would be listened to.

The provider's complaint records showed the person had raised concerns and complaints when they felt this was necessary. Records demonstrated that complaints had been acknowledged, investigated and responded to in line with the provider's complaints procedure. Documentation showed appropriate actions had been taken to address the issues raised, and outcomes had been discussed with the person to ensure they were informed of the findings and any improvements made as a result.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

The provider operated a 24-hour support service, ensuring the registered manager or other appointed out of office on call, were available to respond to requests for assistance from the staff. The person had onsite staff support 24 hours a day. The person told us they were able to access support when required and knew how to contact staff if they were in the community independently but needed help or advice.

Records demonstrated that staff responded promptly when concerns arose and took appropriate action to secure additional support from other services where necessary. This included liaising with healthcare professionals, arranging appointments and supporting the person to access medical treatment when required. Staff also worked with external agencies to help promote the person's safety and wellbeing.

The registered manager maintained oversight of the person's needs and worked with partner agencies to help ensure care and support remained appropriate. Staff told us they would raise concerns without delay and were confident action would be taken to ensure the person received the support they required.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The person using the service told us they felt respected and treated fairly by staff. Care records reflected consideration of the person's individual needs, preferences and circumstances.

The registered manager and staff team demonstrated an awareness of the potential impacts of discrimination, disadvantage and inequality on people's experiences and outcomes. They understood the importance of ensuring care and support were delivered in a way that respected the person's individuality, protected characteristics and human rights.

The provider had an equality and diversity policy which provided staff with guidance on the importance of treating people fairly, promoting inclusion and challenging discrimination. This was further supported through mandatory staff training, which helped to ensure staff understood their responsibilities in providing equitable and person-centred care.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Whilst the person's future wishes regarding end-of-life care had not been discussed or formally recorded, there was no current indication this was immediately required. The registered manager had supported the person to consider their future aspirations and longer-term goals. However, improvements were needed to ensure these were clearly planned, monitored and reviewed.

Care plans were written in an outcome-focused way and identified a range of personal goals and aspirations that were important to the person. These included exploring opportunities for voluntary and paid employment, developing daily living skills and increasing independence with the aim of living more independently in the future.

Although these aspirations had been identified, records did not consistently demonstrate how progress towards achieving them was being supported or measured. There was a lack of clear action plans, timescales and documented reviews to show what steps had been agreed. what progress had been made or whether goals remained relevant to the person's wishes and circumstances.