Keem Healthcare Ltd

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.

This is the first assessment for this service. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 63 (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.

The registered manager told us they assessed people before a service was provided. Those assessments included the person and any family members or their representatives. It was evident from care plans, people’s involvement, wishes and expectation formed an important part of people’s individual care requirements for staff to follow. The assessment process included a review of any specialist equipment needs and how many staff would be required to support people. In a recent multi-disciplinary meeting, 1 person’s mobility needs were assessed, and a new wheelchair ordered for them.

The provider planned and delivered people’s care and treatment with them, but this was not always followed. They did not always do this in line with legislation and current evidence-based good practice and standards.

Both people required staff to help them at mealtimes and with drinks throughout the day. Where people had swallowing issues that put them at risk when eating and drinking, it was clearly recorded in their care plans. However, for 1 person who had thickened fluids to reduce the risk of choking, staff did not always follow this guidance or record that the person had chosen to drink at risk and consume normal fluids. The registered manager said they had contacted the speech and language therapist for advice. However, better recording was required in the person’s care plan and daily records to evidence staff had followed the guidance given.

The provider did work 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.

One person required specialist input from a variety of services to help maintain their overall health and wellbeing. The registered manager said they supported this person by working alongside other professionals, such as the learning disability team, psychologists, psychiatrists, speech and language therapists and nutrition teams. Another person received regular intervention form a district nurse team. We recommended the registered manager contacted the district nurse team who provided care to this person, so they had some written information to show how treatment was progressing.When staff identified any concerns, they contacted the GP or emergency services.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. However, a lack of effective recording and monitoring did not always support people to live healthier lives and where possible, reduce their future needs for care and support.

People’s care records included information about their health conditions and what was important to them. Care packages supported people to live the lives they wanted, and staff were encouraged to support people to do the things they could do. However, where people chose not to follow advice from other healthcare professionals that was recorded in their care plan, records failed to evidence that staff had reminded the person of the importance of doing what had been agreed. This meant if a person’s decision making caused a problem, their records would not provide a true picture so the most appropriate help could be promptly arranged.

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.

We were relatively confident from speaking with staff, and from reviewing minutes from multi-disciplinary meetings, people were checked to ensure their care remained positive and met their needs. However, monitoring and oversight of people’s care information needed further development to identify possible complications when they had identified risks to their health. For example, we found a lack of person specific information and a lack of records from external health professionals for 1 person. This meant we could not be confident the support they got met their needs and consistently promoted positive outcomes. We were unable to speak with this person to check, however the registered manager said they had contacted the person to check on their wellbeing. One relative had completed a survey and were positive about the care their family member received.This reduced assurance that people’s health needs were consistently met.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

The registered manager and staff understood the importance of consent and assuming people had capacity to make decisions about their care and support under the Mental Capacity Act 2005 (MCA). Managers understood their responsibilities to protect people's rights and what to do when someone might not have the capacity to make their own decisions, so decisions made on people's behalf were made in their best interests.

At the time of our assessment, both people receiving a regulated activity had capacity to make decisions, and they were involved in all aspects of their care. Where a person made it clear of their intentions, this was followed. Staff understood people had capacity and could make unwise decisions. However, we discussed with the registered manager the importance of maintaining detailed records of how people had been supported to understand the decision to be made and the impact of their decision making on their health and safety. Staff recognised seeking consent was an important part of making sure, people were involved and in agreement. One staff member said, “If people don’t want to do anything, we don’t force it.”