Midway Care Midway Support Services

Updated 15 December 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by three inspectors. Two inspectors visited the office location and all three inspectors carried out telephone interviews to staff and relatives.

Service and service type

This service is supported living. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission (CQC) at the time of this inspection. However, the provider was making some changes at registered manager level. So the registered manager for this service was overseeing another registered service for the provider. The person referred to in this report as the manager was in the process of registering with us.

Notice of inspection

We gave the service 48 hours notice of the inspection. This was because we needed to be sure the provider or manager would be in the office to support the inspection.

Inspection activity started on 29 October 2020 when two inspectors visited the office location. One inspector carried out telephone interviews to staff and relatives on the 29 October 2020. Further telephone interviews took place on 02 and 04 November 2020. Formal feedback to the provider took place on 10 November 2020.

What we did before inspection

We did not ask for a provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We took this into account when we inspected the service and made the judgements in the report.

We reviewed the information we held about the service, including statutory notifications the provider had sent us. A statutory notification provides information about important events which the provider is required to send us by law. We also contacted health and social care commissioners who place and monitor the care of people at Midway Care.

During the inspection

We spoke on the telephone to nine relatives. We also spoke with 14 staff at the office location or on the telephone. This included care staff, senior care staff, team leaders, locality managers, manager and the provider.

We reviewed a range of records. This included four people’s care records and three people’s medication records. We looked at three staff files in relation to recruitment. We also looked at records that related to the management and quality monitoring of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at information about people’s care needs, staff training and quality assurance.

Updated 15 December 2020

About the service

Midway Care Midway Support Services provides personal care for younger adults with learning disabilities, autistic spectrum disorder or mental health needs. People received support in their own homes or supported living services. At the time of our inspection the service was supporting 25 people living in 17 houses or flats across Warwickshire and Worcester.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do will also consider any wider social care provided.

People’s experience of using this service and what we found

There was a lack of provider oversight which meant risks to people’s safety had not been responded to appropriately. Systems to monitor the quality and safety of the service were not always effective and placed people at the risk of harm. The systems in place failed to identify the areas for improvement found at this inspection.

Risks to people were not always robustly managed. Care records and risk assessments were not always reviewed following an incident or change in a person’s need.

Infection control systems were in place but needed to be consistent throughout the service and required strengthening to limit the risk of infection.

Most staff felt supported in their role. Training updates were needed, and plans were in place to address this. Staff were kind and caring and spoke in a person-centred way about the people they supported.

Relatives had mixed views, some were happy with the service and felt their family member was well cared for. Some relatives felt improvements were needed. Most relatives told us communication needed to be improved.

The provider was aware that improvements were required to the service. They were strengthening the systems in place and reviewing the structure of the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 28 September 2017).

Why we inspected

The inspection was prompted due to concerns about the service in relation to allegations of unsafe practice, not reporting incidents, staff conduct issues, poor staff culture and not following infection protection and control guidelines. The local authority had also let us know they had concerns. A decision was made for us to inspect and examine those risks.

We reviewed the information we held about the service. We only looked at safe and well led during this inspection. We did not look at the key questions of effective, caring and responsive. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Midway Care Services on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have identified two breaches in relation to safe care and treatment and good governance at this inspection. Please see the action we told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress.