Calton House Limited

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 changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulations in relation to consent.

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 provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

A relative told us they, and their family member, had been involved in the development and reviews of care plans. Care managers reviewed care plans every 6 months or when people’s identified needs changed. If people preferred to have care plan reviews more frequently this was supported.

One-page profiles were developed to give a brief overview of people’s needs and preferences. These contained positive information about people.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Not everyone we spoke with said they were involved in choosing and planning meals. One person could not tell us what they were eating later and said staff would choose for them. They did not get involved in food shopping or menu planning. They said, “I used to go food shopping, not anymore.” They were unable to tell us why this had changed.

Other people said staff were aware of their likes and dislikes. We heard one person discuss with staff what they would like for their evening meal, and it was clear this was a meal they had prepared together previously.

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.

There was evidence staff worked with other health and social care professionals to support people’s needs. During our visit to one person’s home, they expressed a wish to see a dentist. A member of staff told them a dentist would be visiting soon and they would add their name to the list of people for the dentist to see.

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.

People were supported to attend regular health checks and staff encouraged people to follow a healthy lifestyle. When appropriate, staff referred people to other healthcare agencies for support. One person was identified as needing additional support to maintain their oral hygiene. Staff had purchased an electric toothbrush and timer to help the person become more effective in this area.

Relatives told us people were well supported with their health needs. One commented, “[Name’s] lost weight and feels better and looks better and says, ‘Look, I’ve lost weight’.”

The provider did not always routinely 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 people themselves.

There was no planned approach to supporting people individually to develop long term plans, goals or aspirations. Most identified goals were short term and were limited by people’s experiences, for example day trips out. There was no ethos of supporting people to be involved in developing skills and being involved in achieving set goals, for example identifying where they wanted to visit, researching costs and transport options or budgeting to save for trips. Staff did not record what people could do for themselves and what they needed support with. This meant there was no information to improve the support people received in developing skill sets or the outcomes they experienced.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

We identified an area of concern relating to housing arrangements and whether people had consented to these. In one supported living setting cameras had been installed in an outside courtyard which captured video and audio recordings. The area was furnished with an outdoor table and benches and regularly used by people. There was no evidence people had been supported to understand the implications of the surveillance technology. The person we were visiting told us they were aware of the cameras. However, they had not signed to consent to the installation and there were no best interest records to evidence the decision taken was proportionate and the least restrictive option. The registered manager told us the cameras were installed by the housing provider and therefore outside of their control. However, service providers should support people to understand any changes to their living arrangements, particularly when these might impact on their privacy and human rights.