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 that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met. This was a legal breach of safe care and treatment.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There were shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

People’s care was not always efficiently co-ordinated or properly joined up so that choice and continuity were maximised. Inconsistent and irregular visit times and the lack of adherence to visit rotas by staff meant the provider could not be confident the care needs of people were being met. Despite this no effective action had been taken to address this and understand the impact this had on people’s day to day care, choice and continuity.

People who had regular staff supporting them were happy with the care they received. Most people told us the same staff supported them most of the time. This helped ensure good continuity of care and helped staff build positive relationships with the people they supported.

It was unclear however how staff worked with other health and social care professionals to ensure people’s care was joined up, flexible and supportive of choice. The majority of people’s care plans and daily records did not document the ongoing involvement of other health and social care professionals or how staff worked with these professionals. When asked, people and their relatives were unsure whether staff liaised with and worked in tandem with other professionals to support their health and welfare needs.

Important information from other professionals in relation to people’s care had not always been obtained on discharge from hospital or when other professionals such as district nurses or mental health teams supported the person in the community. We also saw that where professional advice had been given, people’s care plans had not always been appropriately updated.

There were shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

People’s care was not always efficiently co-ordinated or properly joined up so that choice and continuity were maximised. Inconsistent and irregular visit times and the lack of adherence to visit rotas by staff meant the provider could not be confident the care needs of people were being met. Despite this no effective action had been taken to address this and understand the impact this had on people’s day to day care, choice and continuity.

People who had regular staff supporting them were happy with the care they received. Most people told us the same staff supported them most of the time. This helped ensure good continuity of care and helped staff build positive relationships with the people they supported.

It was unclear however how staff worked with other health and social care professionals to ensure people’s care was joined up, flexible and supportive of choice. The majority of people’s care plans and daily records did not document the ongoing involvement of other health and social care professionals or how staff worked with these professionals. When asked, people and their relatives were unsure whether staff liaised with and worked in tandem with other professionals to support their health and welfare needs.

Important information from other professionals in relation to people’s care had not always been obtained on discharge from hospital or when other professionals such as district nurses or mental health teams supported the person in the community. We also saw that where professional advice had been given, people’s care plans had not always been appropriately updated.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People did not have access to information on the times of their visits or which staff members would be attending to provide support. People also told us that they were not always informed when changes were made. Comments included, “I have no rota, so staff tell me who is coming next” and “They come in the morning and the evening and sometimes its different people and I can’t really rely on the times as they don’t tell me. No they don’t let me know if they are going to be late”.

Some people told us they had a copy of their care plan to refer to, whereas others told us they did not. It is important for people to have access to their care plan so they can understand their own care needs and the support to be provided. It also enables them to actively participate in and feel in control of, discussions about their ongoing needs and care.

Staff told us they had access to policies and procedures in respect of their role. Staff accessed people’s care plans and shared information about people’s daily care using handheld devices which linked to the provider’s electronic care planning system. One staff member told us, they only knew how to access the person’s care plan which listed the tasks they needed to undertake. During the assessment, we had to show them how to access other important information such as the person’s assessment and risk management information.

People’s care records held information about their communication needs and staff spoken with were aware of these needs. People’s personal information was collected and stored in line with data protection legislation.

People using the service received a newletter every 6 months with updates about the service, which could be produced in different formats if people required.

People's care was not regularly reviewed by the provider to ensure it continued to meet their needs and wishes. People were not always consulted when changes to their care were made. The provider did not always listen to and respond to people’s concerns in an effective way.

We were not assured the provider carried out regular care reviews with people using the service. Data shared by the service in respect of the number of care reviews undertaken showed a significant number of people had not had their care reviewed either by a telephone review or face to face meeting for over 6 months. This was not good practice. It did not show people were actively involved or encouraged to participate in discussions about their care and their satisfaction with the service.

Some people told us they had raised concerns about the lack of consistent visit times with the provider but no positive changes had been made. This did not make people feel as though their concerns were listened to. People told us it was sometimes difficult to get in touch with the office to raise concerns or to speak with someone about their care.

There was a system in place to ensure complaints were responded to. Records made in respect of concerns and complaints showed trends in the type of concerns/complaints reported. This included late visits, visit incorrectly cancelled by the provider, poor personal care and staff leaving people’s homes unsecure. Concerns and complaints were individually logged and investigated but records of the action taken were not always fully completed. There was also a lack of provider oversight or action taken to address recurring themes and trends to drive up improvements.

The provider conducted an annual satisfaction survey to seek people’s views and feedback on the service. The last survey dated December 2024 indicated 45% of people surveyed felt improvements were needed with the way changes to staff attending their visits was communicated. Almost a third of people surveyed felt the provider’s response to complaints and concerns required improvement. The annual survey also noted, “The lack of communication between the office and service users has been a recurring theme from previous survey feedback”. These findings did not demonstrate the provider effectively always listened and responded to people’s feedback.

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.

At the time of the assessment, the people whose care we reviewed had not been asked about their end of life preferences, and there was no one currently supported by the service who required this type of support.We saw however confirmation of people’s advance decisions in respect of cardio-pulmonary resuscitation in the event of a health emergency had been obtained.

A health and social care professional we spoke with also gave positive feedback on their experience of working with the provider to support a person receiving end of life care. They told us the provider ensured a flexible package of support was in place for the person, which the provider increased as required. They said staff had provided the person with good quality support at the end of their life.

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.

At the time of the assessment, the people whose care we reviewed had not been asked about their end of life preferences, and there was no one currently supported by the service who required this type of support.We saw however confirmation of people’s advance decisions in respect of cardio-pulmonary resuscitation in the event of a health emergency had been obtained.

A health and social care professional we spoke with also gave positive feedback on their experience of working with the provider to support a person receiving end of life care. They told us the provider ensured a flexible package of support was in place for the person, which the provider increased as required. They said staff had provided the person with good quality support at the end of their life.

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.

At the time of the assessment, the people whose care we reviewed had not been asked about their end of life preferences, and there was no one currently supported by the service who required this type of support.We saw however confirmation of people’s advance decisions in respect of cardio-pulmonary resuscitation in the event of a health emergency had been obtained.

A health and social care professional we spoke with also gave positive feedback on their experience of working with the provider to support a person receiving end of life care. They told us the provider ensured a flexible package of support was in place for the person, which the provider increased as required. They said staff had provided the person with good quality support at the end of their life.