Merseycare Julie Ann Limited

On this page

• 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 that 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 good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent. The provider was in breach of the legal regulation, safe care and treatment.

This service scored 42 (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 make sure people’s care and treatment was effective because they did not adequately assess, check and discuss people’s health, needs and care, with them on a regular basis.

People told us they were included in discussions about their needs and care when they first started receiving support. We found however people’s needs were not adequately assessed or regularly reviewed following these discussions to ensure staff had a clear understanding of what these needs were and how to support them effectively. Evidence based tools to enable a structured approach to the assessment and monitoring of risk, were not used in respect of health conditions, falls, skin integrity, nutrition and hydration and other risks specific to the individual.

Records in relation to people’s care were not accurate or up to date. When people’s needs changed, their care was not always reviewed to ensure it remained fit for purpose. Care reviews were not always held regularly with people to ensure they were happy with the support they received. These shortfalls placed people at risk of ineffective and inappropriate care which did not meet their needs, wishes or preferences.

The provider did not always work well across teams and services to support people. They did not always have accurate records in place to share the right information about people’s needs and risks when people moved between different services.

Records in relation to people’s needs, risks and care were not always accurate or up to date to ensure people’s care and support was planned and co-ordinated appropriately across staff teams or other professionals. People’s visits were not always scheduled at regular times and staff did not always adhere to the visit times scheduled to ensure people’s care was consistent and joined up.

The provider had not taken effective action to address record keeping or visit irregularity to improve the co-ordination of some people’s care across teams and partners to ensure they worked well together.

However, we saw where people required 2 staff to support them at any one time, visits were co-ordinated well to ensure both staff arrived at the person’s home to do at the same time. Records also showed a consistency in the staff allocated to the visit. We also saw greater consistency with timekeeping when people needed support with time critical medicines, with most people receiving these medicines on time.

The provider did not always work well across teams and services to support people. They did not always have accurate records in place to share the right information about people’s needs and risks when people moved between different services.

Records in relation to people’s needs, risks and care were not always accurate or up to date to ensure people’s care and support was planned and co-ordinated appropriately across staff teams or other professionals. People’s visits were not always scheduled at regular times and staff did not always adhere to the visit times scheduled to ensure people’s care was consistent and joined up.

The provider had not taken effective action to address record keeping or visit irregularity to improve the co-ordination of some people’s care across teams and partners to ensure they worked well together.

However, we saw where people required 2 staff to support them at any one time, visits were co-ordinated well to ensure both staff arrived at the person’s home to do at the same time. Records also showed a consistency in the staff allocated to the visit. We also saw greater consistency with timekeeping when people needed support with time critical medicines, with most people receiving these medicines on time.

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. This was a legal breach of safe care and treatment.

People’s risks were not properly assessed, and staff did not have sufficient information to monitor and mitigate risks to ensure people’s outcomes were positive and consistent. There was limited evidence people’s care was adequately monitored to ensure their support was safe and effective in promoting positive outcomes. For example, some people required their food and drink intake to be monitored to ensure it was sufficient to mitigate risks to their health and wellbeing. Staff however did not always record the amount of food consumed for the provider to be assured risks were mitigated and positive outcomes promoted.

One person lived with serious mental health conditions. Their conditions were not properly assessed and despite the person being previously involved with mental health services, there was little information about their ongoing care or the clinical expectations of mental health professionals. Records showed the person had a recent mental health episode but there was little evidence of any follow up action taken by the provider to monitor and protect the person’s mental wellbeing.

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. This was a legal breach of safe care and treatment.

People’s risks were not properly assessed, and staff did not have sufficient information to monitor and mitigate risks to ensure people’s outcomes were positive and consistent. There was limited evidence people’s care was adequately monitored to ensure their support was safe and effective in promoting positive outcomes. For example, some people required their food and drink intake to be monitored to ensure it was sufficient to mitigate risks to their health and wellbeing. Staff however did not always record the amount of food consumed for the provider to be assured risks were mitigated and positive outcomes promoted.

One person lived with serious mental health conditions. Their conditions were not properly assessed and despite the person being previously involved with mental health services, there was little information about their ongoing care or the clinical expectations of mental health professionals. Records showed the person had a recent mental health episode but there was little evidence of any follow up action taken by the provider to monitor and protect the person’s mental wellbeing.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.Staff understood the importance of gaining consent prior to supporting people with personal care and people confirmed this.

Where people needed help with decision making, the provider had followed the Mental Capacity Act 2005 to ensure people’s consent was legally obtained for any decisions in respect of their care. This included ensuring the correct legal documentation was in place, to ensure relatives or other representatives were able to make decisions on the person’s behalf. Staff received training in the MCA and supporting people with dementia.