The Jersey Practice

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

We looked for evidence that staff involved people in decisions about their care and treatment and provided them advice and support. Staff regularly reviewed people’s care and worked with other services to achieve this. At our last assessment in April 2016, we rated this key question as good. At this assessment, the rating has changed from good to requires improvement because of the concerns we found such as a lack of targeted support for carers, recording mental capacity of patients, health check reviews for people with learning disability and autistic people.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service 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. Feedback from people using the service was both positive and negative. Staff were aware of how to escalate any emergency to relevant clinicians when necessary. Staff were aware of the needs of the local population and supported patients to have reviews relevant to their health conditions. However, our review of records showed that completed health check reviews for autistic people and people with a learning disability showed evidence of incomplete care plans. Following the site visit, the service informed us that the clinicians will ensure adequate completion of care plans in the future.

The service 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. Systems were in place to ensure staff were up to date with evidence-based guidance and legislation. Clinical records we saw demonstrated care was provided in line with current guidance.

The service worked well across teams and services to support people. Staff had access to the information they needed to appropriately assess, plan and deliver people’s care, treatment, and support. The service worked with other services to ensure continuity of care.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives through referrals relevant to the needs of the patients. However, patients with caring responsibilities were not given needed support. The provider completed a search to identify patients who had caring responsibilities during the site visit and 215 patients were identified. There was no evidence of any support given to them prior to CQC visit such as health checks and signposting to relevant support services. Following the site visit, the provider informed us that a carers information leaflet had been sent to the patients coded as carers, signposting them to support services and offered carers’ health checks to them. The service did not share evidence of completion of these health checks with us.

The service did not always monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of the people. The service did not meet national targets for screening and immunisations. The service informed CQC that there was a process to recall affected patients who did not take up the offer of these health screenings and services but the impact of the recalls on the uptake was not yet known.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff understood and applied legislation relating to consent. We saw from our review of records that Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions were appropriate and made in line with relevant legislation. However, we found a record for a patient whose DNACPR record did not include an assessment of mental capacity. Following the site visit, the service informed us that the highlighted patient will be reviewed and the clinicians have been reminded to do so for the future. In addition, there was a housebound patient that did not have a record of DNACPR on file but the practice was in communication with the social care provider and Multidisciplinary team to review the patient’s care.