Merline Healthcare Ltd

On this page

• 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.

This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant people’s needs were not always met.

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.

The provider did not always make sure records were detailed and centred around people’s needs.

We found examples where people’s preferences and clinical needs were recognised, including the use of communication aids and trauma‑informed approaches for people with complex needs. However, care records did not always provide clear or complete guidance for staff on how care should be delivered in line with people’s needs.

Relatives spoke positively about staff being caring and responsive, but we found limited evidence of regular reviews which meant the provider could not demonstrate that care was always adjusted in response to people’s changing needs.

There were some 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 received care from staff who knew them, and the service worked with other professionals such as district nurses, GPs and specialist teams. However, records did not always evidence that care was delivered as planned.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Relatives told us they felt able to speak with staff and management, and there were policies in place to support information sharing.

Information about people’s communication needs was included in care plans.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

Relatives who shared feedback during this assessment told us they had not needed to make complaints and generally felt listened to. However, we found limited evidence that feedback, including concerns about late visits, was analysed or used to improve how the service was managed.

The registered manager told us care reviews took place, but there was not always documentary evidence of this. This meant we could not be assured that people were routinely involved in reviewing and shaping their care.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

There were systems in place to monitor visits, however, we identified several late calls and issues with rota planning, including a lack of allocated travel time. This increased the risk that people did not always receive care at the planned time.

People’s protected characteristics were considered as part of the planning of their care.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

We saw examples where people with complex needs received compassionate support and where relatives spoke positively about the care provided. However, gaps in documentation, such as incomplete reviews, inconsistent medicines records and unclear risk management guidance, meant the provider could not always demonstrate that outcomes were monitored and improved consistently for everyone.

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.

Some people receiving end‑of‑life care had plans in place, and the provider worked with other professionals to support these pathways. However, key elements such as ‘as and when required’ medicine protocols and advance care planning were not always fully documented.

Reviews of care plans and risk assessments could not always be evidenced, which limited assurance that the provider was proactively planning for changes in people’s needs.