Mersey Care NHS Foundation Trust

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

Staff met each day to review new referrals. The service had clear admission criteria to ensure equity in access. Once a referral was accepted, the person was assessed and treatment began within 28 days. Staff responded to individual needs, providing person centred support and empowering people to make decisions. The service investigated and responded to complaints in accordance with its complaint’s procedure. Staff and managers monitored outcomes. People were discharged from the service once the programme of interventions was complete. We found no breaches of regulations in relation to this key question.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff based care around individual needs and preferences. For example, staff arranged meetings at the service, the person’s home or in community settings where the person felt comfortable. Discussions with people who used the service focused on matters that were important to the person or were causing the person to be worried. For example, we observed during an appointment someone talked about their fears and difficulties and staff responded in a caring and supportive manner. Staff provided encouragement and positive feedback about things that had gone well for the person.

Staff empowered people to make their own decisions about their care and treatment. People consistently told us that staff engaged in open and honest conversations about how to manage their mental state. Staff gave people practical advice, such as listening to music to distract them from voices. They also explained treatment options, such as using psychology to help manage negative thoughts.

Staff informed and involved families and carers appropriately. The statement of purpose for the services highlighted that the involvement of peoples’ carers and family members led to safer and more effective care. The services provided family behavioural therapy. The service monitored its compliance with the triangle of care model of family and carer involvement. The services were seeking to improve engagement with carers through creating a carer engagement team and improving the ways in which staff recorded carer data on the electronic patient record.

Staff ensured that people had access to education and work opportunities. The services worked with a local community organisation that provided an individual placement support programme for people seeking employment. The service provided practical advice on applying for work, as well as more personalised sessions on identifying barriers that may have prevented the person starting or remaining in employment.

Staff supported people to maintain contact with their families and carers. Staff involved families in discussions and decision making whenever people wanted this.

Staff made notifications to external bodies as needed. For example, the service submitted notifications to the CQC, the NHS and local authority safeguarding teams.

Information governance systems included confidentiality of care records. The trust had a comprehensive information governance policy. This policy included instructions to staff on ensuring patient confidentiality.

Staff ensured that people could obtain information on treatments, local services, their rights, and how to complain. Each service displayed information in waiting areas about the Mental Health Act, patient advice and liaison services and data protection.

Between April 2024 and April 2025, the community mental health services had received 72 complaints. Approximately 70% of these complaints related to clinical treatment. The trust provided details of the last five complaints where investigations had been completed. Of these, three were partly upheld, one was not upheld and one was resolved. Complaints from people using the services typically involved concerns about medication or discharge from the service.

People knew how to complain or raise concerns. Staff displayed information about how to make a complaint on notice boards in waiting areas.

When people complained or raised concerns, they received feedback. Once a complaint investigation was completed, the complainant received a letter giving details of the investigation.

Staff knew how to handle complaints appropriately. The trust had a policy on the management of complaints and concerns. This policy included guidance on how to handle and investigate complaints.

Staff received feedback on the outcomes of investigations of complaints and acted on the findings. For example, one service had recently received complaints about telephone calls not being answered. The investigation found that new administrative staff had struggled to answer calls when more experienced staff were on leave. The service provided extra support for new staff and introduced enhanced monitoring of call response times. At another service, a person who used the service was unhappy that staff called their name out very loudly. This concern was fed back to staff who responded by calling patients in a more sensitive manner.

The services involved people using the service in the co-production of initiatives. For example, the early intervention team in Sefton and Kirkby had arranged an event at which people could share their personal stories of mental health illness and recovery in order to provide support for each other.

People using the services and carers had opportunities to give feedback on the service they received in a manner that reflected their individual needs. Services displayed QR codes on the premises to enable patients to easily give online feedback.

Staff received feedback from people who used services and their families using the ‘Friends and Family’ test. Between January and April 2025, the services we visited received 273 responses with an average positive response rate of over 95%.

Managers and staff had access to feedback from people, carers and staff and used it to make improvements. Staff said they had responded to feedback about waiting areas. This had led to the service installing televisions in waiting areas. Services also displayed ‘You said, We did’ notice boards, showing the actions staff had taken in response to feedback. The early intervention teams facilitated service user and carer engagement groups.

The service had clear criteria to describe which people they would offer services to. Community mental health teams accepted referrals for people aged between 18 and 70 who were experiencing complex mental health difficulties and interventions within primary care services have not been successful. People were usually registered with a GP in the geographical area covered by Mersey Care. Early intervention services accepted people aged over 14 who had not received treatment for mental illness before. These services typically accepted 20% of referrals, amounting to 5 or 6 new patients for each service every month.

The service met trust target times for seeing people from referral to assessment and assessment to treatment. For each service, the target time for referral to assessment was 28 days. All services consistently met this target, with an average referral to treatment time of 27.5 days. The average number of days from referral to the start of treatment was approximately 44 days in community mental health services and 10 days in early intervention teams. There were waiting lists for people seeking individual psychology. The waiting time for psychology was between 32 and 65 weeks. Referrals for psychology could be seen sooner if the referral indicated risk relating to acute symptoms, being a military veteran, perinatal mental health or the person is subject to community treatment orders.

Staff tried to engage with people who found it difficult, or were reluctant, to seek support from mental health services. When people were referred to the service, staff made a call to welcome them. During this call, staff explained what the service could offer and sought to reduce any anxiety the patient may have about attending their first appointment. When people were reluctant to attend the service, staff met them in cafes or other community settings.

Staff tried to contact people who did not attend appointments and offer support. Within community mental health teams, there were 110 people open to teams who had not engaged in a follow-up appointment within the previous 12 months. This amounted to 1% of all the people who used services. If someone did not attend an appointment, staff contacted the person to offer an alternative appointment. If they were unable to contact the person, staff would discuss the matter in a multidisciplinary team meeting, setting out the potential reasons for disengagement. The multidisciplinary team would then develop a strategy to re-engage the person. Staff would often go to the person’s home to check they were there. They would also make phone calls, send letters, contact family members and contact other professionals involved with the person such as a GP or probation officer. The services did not discharge patients for not attending appointments.

People had some flexibility and choice in the appointment times available. Staff agreed appointment times with people using the service. The service was engaged in a pilot to extend availability to seven days each week. This programme was being evaluated.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. The service was implementing the Patient and Carer Race Equality Framework (PCREF), led by the Chief Nurse. At the PCREF steering group in April 2025, staff began work on producing patient experience and outcome data on protected characteristics.

The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage. The service routinely carried out equality impact assessments using a standard template. The purpose of these assessments was to identify and address health inequalities. Staff were aware of the impact that inequalities had on people using the service. They consistently told us that many people using the services experienced multiple deprivation. Services were based in economically deprived areas. Some people were prone to self-neglect, exploitation or domestic abuse. Staff explained that poor provision for people who were homeless meant it could be difficult for staff to locate people, and make it difficult for people to ensure the safe storage of medicines. Staff supported people to access food banks. They also made sure that people were not left without gas or electricity.

The service could support and make adjustments for people with disabilities, communication needs or other specific needs. For example, they ensured that British sign language interpreters were available for people who were deaf.

Staff were trained in equality, diversity, inclusion and human rights. Across community mental health services, 97% of staff had completed mandatory training on equality, diversity and inclusion.

Staff supported people to make decisions about their care and treatment and their future. For example, one person had made it clear to staff that they were anxious to avoid any further admissions to hospital. Staff worked with this person to ensure they were aware of relapse indicators, and knew what action to take to address these, in order to prevent a deterioration in their mental health that would require an admission.

Staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of people with complex needs. For example, staff invited colleagues from substance misuse services to attend multidisciplinary team meetings for people who used both services. Similarly, staff worked closely with district nurses to support patients with complex physical health needs.