Kalm Living

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.

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 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.

People’s care and support plans were not always personalised, holistic and strengths based. They did not always promote strategies to enhance independence nor demonstrate evidence of planning and consideration of the longer-term aspirations of each person.

Care and support assessments, including medical, psychological, functional, communication, preferences and skills were not always up to date. For example, in regard to a person’s cardiovascular health.

Support plans did reflect an understanding of people’s communication and sensory needs.

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

The provider did not always ensure staff were up to date with national legislation, evidence-based good practice and required standards. The provider had not ensured compliance with 'Right support, right care, right culture' which is the statutory guidance from the Care Quality Commission (CQC). This document sets out how it regulates services for autistic people and people with a learning disability. It focuses on ensuring people lead independent lives with choice and control.

People were involved in choosing and planning meals. A person confirmed the menu was chosen by everyone living in the house and this then informed the house shop.

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.

People were supported to see appropriate health professionals when they needed, to meet their care needs. For example, their GP, dentists, and various health related consultants.

Health and social care professionals confirmed the service worked alongside them to ensure people’s care and support needs were met. A professional commented, “I have a client placed with them who is struggling with mental health, and I have found them to be proactive in getting him the help he needs, working with outside providers to arrange appointments. [Registered manager] always attends reviews and understands the clients’ needs well.”

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. When appropriate, staff referred people to other healthcare agencies for support.

People demonstrated a good understanding about their own health care needs. For example, one person told us about a care review which was due to take place with their psychiatrist, and another person told us about an upcoming cataract operation. Relatives told us, people were well supported with their health needs.

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 real ethos of supporting people to be involved in developing skills and being involved in achieving set goals.

Staff did not always record what people could do for themselves and what they needed support with. This meant there was limited information available to help staff support people to gain independence and develop new skills.

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

The service was not working within the principles of the Mental Capacity Act (2005) MCA. We found no evidence of mental capacity assessments and best interest decisions being completed.

There was evidence of restrictions in people’s homes which had not been agreed in collaboration with them and those who mattered to them. Restrictive practices had not been accurately reported, which meant necessary application to the court of protection had not been made.

Staff did not demonstrate best practice when assessing mental capacity, supporting decision-making and best interest decision-making. Their understanding of the Mental Capacity Act did not evidence the importance of adopting the least restrictive options to ensure people received appropriate care and support.