Care Aims

Kate Malcomess is best known for her development of a philosophy of care known as the Malcomess Care Aims Model developed whilst she was working in the Croydon Speech and Language Therapy Service in South London, England. The model was designed to support practitioners to demonstrate evidence-based practice through systematic reflection.

The Care Aims model has now been adopted by a large number of professions within a significant number of services and organisations across the public sector in England and Scotland and is beginning to be used in Northern Ireland and Wales. In July 2005, practitioners in the Waitemata Health Board, Auckland, New Zealand, were also trained in its use. Over 3000 practitioners in approximately 120 teams have been trained in the use of the Model.

The Care Aims Model is a philosophy that has proven to be extremely versatile and can be adapted to any practice context, team structure or professional group. Because it focuses on outcomes for clients, it leaves the practitioner free to vary the detail of the intervention offered, resulting in its particularly broad applicability across disciplines.

The main benefits identified by services and teams using it are that the model offers:

• a standardised way of capturing and communicating clinical reasoning
• a clear and comprehensive way of demonstrating clinical effectiveness
• a systematic way of supporting and demonstrating clinical reflection
• an ability to focus resources where they can make the most difference by being outcomes driven and not demand led
• a sound framework for managing caseloads and workloads
• a framework to support service design, planning and evaluation

Any team or organisation considering implementing the model should consider that adopting this model usually represents a change in culture and practice. The best results have been seen where implementation has been viewed as a medium-to-long-term project requiring strong leadership and considerable commitment.

Client story: Anne's Care Aims Story

Professions who have been trained to use the model include:		Settings that the Model has been applied to:
Art Therapists Clinical Psychologists Dieticians District Nurses Nurses in Neuro-Rehabilitation, Learning Disabilities Doctors including GPs, Elderly Care Consultants, Paediatricians Heath Visitors Music Therapists Neuro-developmental Therapists Occupational Therapists Orthotists Physiotherapists Podiatrists Radiographers School Nurses Social Workers Speech and Language Therapists Teachers		In-patient Care Child Development Teams Community Health Elderly Care Intermediate Care Learning Disabilities Mental Health Neuro-rehabilitation Special Education Settings

Publications in which you can read more about the Care Aims Model:

Beirne, P.: (2005) Implementation of the Care Aims Model: Challenges and Opportunities in Anderson, C and van der Gaag, A (eds.) Speech and Language Therapy: Issues in Professional Practice. London: Whurr Publisher's Ltd.

Burns, K.: (1995) Focus on Solutions: A Health Professional's Guide. London: Whurr Publisher's Ltd.

Malcomess, K.: (2005) The Care Aims Model. in Anderson, C and van der Gaag, A (eds.) Speech and Language Therapy: Issues in Professional Practice. London: Whurr Publisher's Ltd.

Malcomess, K.: (2001) The Reason for Care. Royal College of Speech and Language Therapist's Bulletin, November. Issue 595. pp12 - 14.