Merecroft

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 remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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 people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Relatives gave mixed feedback about their involvement in care plans and regular reviews. One relative said, “It’s been about nine years, and I don’t think I’ve seen a care plan. There are no reviews that I’ve been to, and I’ve seen a social worker twice in nine years. It’s been alright otherwise.” Another relative said they had been involved in the care plan but were unsure whether formal reviews took place, although issues were discussed and the person’s funding was reviewed annually with the local authority. A further relative said, “I’m always involved in care plans and reviews.” We shared relatives feedback with the registered manager who confirmed they had scheduled to meet with all families separately to review their family members care and support plans.

Care plans we reviewed reflected people’s assessed needs and included information relating to health, communication, mobility, nutrition and hydration. This helped staff understand how to support people and promoted positive outcomes.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Some people expressed their feelings in a way which they risked causing harm to themselves, staff or other people. These support needs were assessed and documented. Records included guidance for staff on recognising potential triggers, and how to respond to incidents of concern. Monitoring tools were used to record incidents. This helped staff to identify patterns, analyse trends, and review interventions to ensure safe, positive outcomes.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Systems were in place to support effective staff communication and ensure any changes to people’s needs or routines were shared promptly. Regular handover meetings provided staff with opportunities to exchange information and maintain continuity of care. During the inspection, we observed staff communicated well with each other, discussing plans and activities, so everyone was aware.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff supported people to access healthcare services, including doctors, dentists, chiropodist, when needed. Records showed routine health appointments took place for people. Staff made appropriate referrals. People had hospital passports in place to take with them if they needed to go into hospital. These detailed important information hospital staff would need to know about the person. People were supported to maintain a healthy, balanced diet. Staff involved them in decisions about food and drink and, where people could make choices, encouraged healthier options such as low-sugar alternatives and appropriate portion sizes. One relative said, “It’s about the diet, but we can only do it in little steps.” Another relative said staff planned weekly menus which included fish and vegetables, with a treat on one day. They also described the activity plan in place for their family member which included using a trampoline, going to the gym and walking with staff to help the person manage stress.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff monitored people’s wellbeing during their shifts, and any concerns would be reported to the senior on duty. Staff told us how they would recognise if people who were unable to tell them verbally if they were unhappy or unwell or in pain by their change in body language or behaviour.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

We observed staff seeking people’s consent before providing care and support. One relative explained how staff supported their family member, who did not communicate decisions verbally, to make choices and said, “Staff use symbols and pictures to show [person] the planned activities for the day and talk them through together. If [person] is unhappy with an activity, they remove the symbol, so staff know they do not want to do it.”

The service was working within the principles of the Mental Capacity Act. Mental capacity assessments were completed with people and those involved with their care. Where people were unable to make specific decisions or consent to their care, processes were in place to ensure decisions were made in their best interests.