Merseycare Julie Ann Limited

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• 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 the provider met people’s needs.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to 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 did not always make sure person-centred information was included in their individual care plans. We found several examples where descriptions of people’s health conditions were generic and could be better tailored to how they affected them. Further improvement was required to ensure all records such as risk assessments contained person specific information about the person’s health conditions and how this specifically affected them.

Staff and people told us improvements made since our last assessment in relation to the regularity of their care staff had helped them to develop better relationships which in turn promoted person-centred care. A staff member told us, “I see the same service users now, so many benefits to this. I know their routine, what they want, how you conduct the call, their preferences. Also, you get familiar with them, and they share more with you, I have a good bond with 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. Since our last assessment, improvements to call rostering systems meant continuity was maximised.

We noted improvements in the regularity of staff teams to better promote familiarity and positive relationships built on trust. The provider had effective oversight of their progress against their continuity aim and could demonstrate how they were working to continually to improve this.

The provider was responsive to issues that could affect the local community and negatively impact care continuity such as weather warning alerts and driving safety. We saw several examples where the provider had sent communications to staff to reduce risks that could affect the continuity of care.

The provider supplied appropriate, accurate and up-to-date information in formats tailored to people’s individual needs. Care plans took account of people’s specific communication needs and guided staff accordingly. For example, a person’s care plan contained information on how they used non-verbal communication to make choices in their day-to-day care.

The provider had a range of methods in place to provide information to people. For example, face to face and telephone reviews, in person group meetings and newsletters. The provider was able to adapt written information into different formats, and we saw how people were consulted on what format they wanted their care plans. A service user guide was shared with people to give them information about the service including how to contact them. A person told us, “I had a welcome pack, information as to who the company were, how long it has been running."

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. The provider held in person group meetings for people in their local community and sent surveys to seek people’s views and their experience of the care provided. There was an effective complaints management system in place. The provider understood the importance of using people’s feedback to improve the quality and safety of the service.

Staff involved people in decisions about their care. People and their relatives told us they took part in regular reviews. Comments included, “Care plan reviews and home visits just to check all is well is appreciated,” “Twice a year and every quarter they ring me on the phone. A month or so ago they came out and they went over everything with me” and “At first, I was experiencing difficulties in having the co-ordinator call me back, but now the telephony team are very good at communicating. In the last 8 to 10 weeks there’s been a marked improvement."

The provider made sure people could access the care, support and treatment they needed when they needed it. People told us the process to access care was professional and straightforward. Once a referral was received, the provider had a range of processes they followed to determine if they could safely and effectively meet a person’s needs. They ensured a timely initial assessment of their needs and care plans were put in place. A person told us, “It was easy to set things up at a time when the care was so desperately needed and the agency were so helpful.”

The provider was flexible and could make changes to people’s support to better meet their needs in conjunction with the local authority.

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

Care reviews took place regularly to reduce the risk of care inequality and poor outcomes. Overall, people’s experience of care was positive, and they felt the support met their needs. A relative told us, “I ask the carers assess and evaluate [Person’s] wellbeing as I am only with her every few weeks and they do this so well and call me if there is a problem and then call the GP.”

Staff were aware of both physical and social barriers people may face and tried to alleviate these when required. A staff member described how responsive the provider was when people’s circumstances changed. They said, “I will tell them things that need sorting out and they never brush me off, and they listen. One person’s [Relative] passed away, and the [Person] was left with no shopping, I reported it to the office and they told the local authority and now she has a shopping call in place."

People were not always 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. Where people had made advanced decisions regarding their rights to resuscitation, this was recorded in their care plan. However, there was limited evidence to show how the provider had worked with people to plan for their future care and support needs including their preferences for care at the end of their lives.

Leaders were responsive to our feedback and made immediate updates to their assessment processes to better capture people’s end of life wishes.