Merseycare Julie Ann Limited

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. There was an effective system in place to assess people’s needs before care commenced. A relative told us, “Before we started using them, they sent out a co-ordinator who did a risk assessment and [Staff] have everything on their phones they need to be aware of.”

Following our last assessment, the provider had made improvements to their assessment systems to ensure information shared by external professionals regarding people’s health conditions was reflected in people’s individual care plans.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They mostly did this in line with legislation and current evidence-based good practice and standards. For example, we found the provider used nationally recognised assessment tools to assess risks relating to people’s skin. However, some people’s care records did not reflect best practice guidance issued by The National Institute of Health and Social Care Excellence (NICE) in relation to specific health conditions such as diabetes or the safe management of medicines. We signposted the provider to this guidance during the assessment.

People’s food and drink needs, risks and preferences were recorded in their care plans. Staff described in detail how they supported people according to their preferences and told us how they were mindful of food expiry dates and overall food safety and hygiene practice.

Policies were up to date and reflected current guidance and were linked to relevant legislation. People told us staff were mostly well trained and understood their needs, especially regular staff.

The provider worked well across teams and services to support people. The provider understood their responsibility to work collaboratively with external stakeholders to ensure they had the information to deliver people’s care and support effectively. Advice from external health professionals was included in people’s care plans. For example, where people required modified diets to reduce risks associated with choking, we saw guidance from speech and language therapists was included in care plans to guide staff on how to deliver effective support and reduce risk.

Where health professionals were involved in people’s day to day care, such as diabetic nurses, staff told us how care calls were planned to ensure they could support people with their nutritional needs effectively around these visits.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. We saw many examples of partnership working with GP’s, pharmacies, district nurses and other external professionals to ensure information was shared about people’s current health needs so they could receive the necessary treatment and support to stay well. A person told us, “They look after the catheter as well, they are very good with it and will ring the nurse if there’s a problem with it."

The provider routinely monitored people’s care and treatment to continuously improve it. Since our last assessment, the provider had worked hard to ensure people’s care and support needs were regularly reviewed. We noted significant improvements in the number and quality of the reviews carried out. The increased monitoring led to people achieving good outcomes. For example, during a recent review for a person, they described their goal was to be able to get out of bed and sit in a chair. The provider worked alongside external health professionals in relation to a manual handling plan. Through this action, the person achieved their goal in a timely manner.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People’s consent to care was recorded. Staff told us they gained people’s consent before delivering care and people and relatives confirmed this. Comments included, “They generally ask me before personal care begins. They never presume anything, they always ask” and “They introduce themselves, request consent to perform personal care, and when they are doing the meals they will ask what [Person] wants."