Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Acorn Specialist Centre For Working Aged Dementias and Alcohol Cognitive Impairment, Illnesses and Disorders Statement of Purpose Acorn Specialist Centre has been set up in response to the stated facts that 60% of people with alcohol related illnesses and disorders are misdiagnosed or not picked up until it is too late and brain damage has already taken a permanent cost to the individual’s physical and social life. The Centre’s commitment to the local and wider community will be to provide a tailored quality service to persons with a diagnosis of: Working aged dementia (18-75) including vascular dementia, pre-frontal lobe type and movement disorders with a dementia diagnosis. This will exclude Altimeters type dementia Cognitive impairment, illness and disorder caused by alcohol abuse including Wernicke’s encephalopathy and Korsakoff Syndrome The centre’s aim will be to promote an effective ‘person centred care’ based on recovery, which provides the opportunity for clients to take back and lead a self-directed and meaningful quality of life. It is Acorn Specialist Centre’s premise that everyone deserves to have the opportunity to recover no matter what the level of illness or problem. The Centre’s vision is to be the service of choice in providing individualised care to those suffering from Alcohol related cognitive impairment illness or disorders. To achieve this, care will be provided within a learning environment that uses the most up-to-date diagnostic and therapeutic community recovery modalities. There is more to developing a Centre than what is written within this ‘Statement of Purpose’ therefore this should be taken and applied in conjunction with the wider policies, procedures, practices and protocols of the centre as well as the service user’s guide. This ‘Statement of Purpose’ demonstrates Acorn Specialist Centre’s willingness to operate within the requirements and regulations of the Essential Standards of Quality and Safety and meet its outcome measures, which enhances the improvements developed by the National Minimum Standards and the Standards for Better Health. Although registered under the service type ‘Care Home Service with Nursing’ the centre will take in aspects of ‘Rehabilitation Services’ and ‘Long-term Conditions Service’ and this is further discussed within the model of service. The ‘Statement of Purpose’ will be made available to Commissioning Services, current and prospective clients, their families or representative, and any other parties such as stakeholders with an interest in the centres care provision. Whenever any significant part of the ‘Statement of Purpose’ changes, the Registered Manager will ensure that copies of the updated ‘Statement of Purpose’ are provided to the regulating body and commissioning services within 28 days of that change. Acorn’s Vision To actively contribute and give support to a positive care pathway that allows individuals to direct their own care within a recovery model. ‘Statement of Purpose’ Version 4 February 2013 Page 1 of 16 Acorn Specialist Centre for working age dementia and cognitive impairment, illnesses and disorders caused by alcohol abuse This is based on robust evidence and operates within a holistic and open manner in the way it provides care. In demonstrating best practice skills, contemporary knowledge and therapies, the specialist centre will, by its actions, minimise the illness impact to clients within a transactional recovery model by making sure that: Working age dementias (18-75) will have the opportunity to be assessed against our therapeutic programme and those with other types of dementia who would benefit will also be offered placement. The care approach will specialize and seek new innovative ways to manage within a recovery model, as well as treat, the psychological and emotional problems related to cognitive impairment, illness and disorder caused by alcohol abuse. Develop understanding of illnesses and disorder comorbidity; staff will develop new learning opportunities within the care provided and therapeutic options that maintain the individual’s independent life choices, self-esteem, health and well-being. The Centre will develop an enlightened and well-motivated workforce that will be underpinned by a dynamic approach to training and development within a learning environment. Acorn’s Objective To provide a working environment that protect clients and staff from abuse or the risk of abuse and individual human rights are respected and upheld. As a service provider, Acorn Specialist Centre will take action to identify and prevent abuse from happening as well as responding appropriately and in a timely manner if abuse is suspected. Each staff member has a ‘duty of care’ to report any direct or suspected abuse, any operational or clinical risks to care, health and safety and breaches to infection control. This will be met by staff working: Within a ‘Learning Organisational’ model where treatment and care offered ensures it has the right leadership, effective and efficient organisational support, training and development that meet healthcare standards, legislation and best practice models suggested by the regulatory bodies; By the use of appropriate assessment (both pre and ongoing assessments)that leads to effective individual care plans that identify needs and provide safe treatment within a therapeutic milieu; Develop partnerships with commissioning services and stakeholders in achieving common objectives in developing individual recovery; Gain value from the resources by using evidence based research that promotes safety and positive risk taking; Challenge inequality and combat unlawful discrimination including monitoring of ethical practice and embrace, respect and ensure understanding of diversity; Committed to eliminating racism, sexism and all forms of discrimination and will not discriminate on grounds of age, colour, disability, ethnic origin, gender, gender reassignment, culture, health status, marital status, social or economic status, nationality or national origins, race, religious beliefs, or non-beliefs, responsibility for dependents, sexuality, trade union membership or hours of work Provide appropriate (individual)‘person centred care’ within a recovery model; Make the difference that counts to all who are involved in providing or receiving care Recognises that this requires action through positive policies that redress inequalities and meet all aspects of the Equality Act 2010; and Cooperate with others involved in the care, treatment and support of a person who uses services when the provider responsibility is shared or transferred to one or more service, individuals, teams or agencies. ‘Statement of Purpose’ Version 4, February 2013 Page 2 of 16 Acorn Specialist Centre for working age dementia and cognitive impairment, illnesses and disorders caused by alcohol abuse Acorn Principles In all aspects of care, the centre will apply known best practice that offer clients individual life choices that enhance both their health and well-being. Through good workforce management the centre will provide effective recruitment and workforce development that supports the therapeutic environment (within a learning organisational model) and provide the opportunity, by employing quality staff that allows each client to develop independence to their capability. By assessing risk and proactively adapting the care process to meet client needs, will allow individuals to be treated with dignity, respect, decency and holistically. This will be achieved by: Provide accommodation and hotel services that meet individual needs; Provide effective personal care planning procedures and “Good Practice” policies with appropriate care models within a range of effective interventions; Provide effective clinical audit & monitoring by implementation and maintain clinical governance and quality assurance documentation; Act on concerns and complaints in a pro-active and effective manner; Implement and maintain effective procedures that protect and minimise against abuse; Maintain effective records in accordance with data protection, confidentiality and freedom of information policies; Ensure effective building maintenance and internal decoration; Establish and maintain effective fire precaution policies and procedures; Maintain clients’ personal and financial records; Establish a transparent fee structure which is openly available and maintain occupancy levels which ensure financial viability and sustainability; Notification of a death happening on the grounds of the Specialist Centre and the individual is treated with dignity and care; and Staff will respond appropriately at all times in accordance with all Acts and Legislation pertaining to the care being provided within Acorn Specialist Centre. Aims Acorn Specialist Centre has been built to provide continuing care for persons suffering from Working Age Dementia including Alcohol related cognitive impairment illnesses or disorders with up to 22 single bedrooms, which are designed to provide a step up/step down transitional rehabilitation programme. Acorn Specialist Centre Acorn Specialist Centre is designed to maximise space in a large Victorian house with modern extensions that provide comfortable living, activity rooms for therapeutic programmes and life skill development with a designated external smoking area. The grounds are large enough to include a secure garden and a market garden to produce self-efficiency in organic fruit and vegetables. Every effort has been made within the building design to ensure that individual bedrooms are comfortable and safe with the provision that each individual can develop their room with personal furniture and mementos. Those clients assessed to have any degree of physical risk will be located on the ground floor with a passive alarm system in their bedrooms if necessary, which activates the nurse call system when the client gets out of bed at night. All bedrooms ‘Statement of Purpose’ Version 4, February 2013 Page 3 of 16 Acorn Specialist Centre for working age dementia and cognitive impairment, illnesses and disorders caused by alcohol abuse have lockable doors and clients in accordance with the individual’s mental capacity and based on a risk assessment may be given a key to their room. Admission Policy (Pre-Admission and Admission Protocol) The pre-admission and admission protocol ensures a formal and structured process of assessment and transitional transfer of care. In the first instance, a written referral will be discussed by the Acorn Specialist Centre Multi-Disciplinary Team (MDT) to ensure the client needs can be met. If the client is thought suitable, a pre-admission assessment will be carried out by a member of the assessment team. The assessor will arrange a visit with the perspective client and family in his/her own home, in hospital or a current residential unit. This will involve a review of the medical and multidisciplinary notes, treatment and care plans, risk management plans and a mental state examination. Following the completion of the report and discussion by the MDT about meeting clinical care and treatment requirements, a decision on acceptance will be made and shared with the Commissioning Service or individual requesting admission to Acorn Specialist Centre. Following the admission acceptance, an agreed ‘transitional care plan’ will be formulated which will allow staff from Acorn Specialist Centre to work with the Commissioning Service, client, their family or representative in orientating themselves to the Centre, the staff and other clients where appropriate, prior to admission. Staff Training Staff will be supported to provide care and acquire updated skills and qualifications that are relevant to their work. Staff will be supervised and appraised in relation to the work that is undertaken. Training and gaining new experiences will play a crucial role in ensuring that risk practises, treatment and care plans are fully implemented. The strategy for training will include a staff induction programme, and on-going training for all staff in various aspects of clinical and non-clinical care. It is possible that a client could be placed or arrives under an Order of the Capacity Act 2005 (DoLS) due to their mental capacity and/or behaviours that could place the client or others at risk and clients under an Order of the Mental Health Act who come from a psychiatric facility on a mental health aftercare order. Staff training in challenging behaviour, Mental Health and Capacity Acts will make sure that all staff respond appropriately to client needs at all times. The induction programme covers all aspects of mandatory training, staff and organisational expected behaviour, with the development of specialist knowledge of persons suffering from working age dementia. Induction and mandatory training highlights the main issues of risk and safety. Clients with working age dementia may develop disorders that will often produce challenging behaviour where there is a need for all staff to understand and apply de-escalation techniques together with both theoretical and practical management of aggression. Nursing and support staff training is co-ordinated by the Registered Manager who will provide a calendar of training and updates specific to individual training requirements. Monthly supervision and an evidence based practice training programme, which documents critical and clinical evidential learning will be reviewed yearly. Registered Provider 1st Care Ltd 90B Handsworth Wood Road Birmingham B20 2PL ‘Statement of Purpose’ Version 4, February 2013 Page 4 of 16 Acorn Specialist Centre for working age dementia and cognitive impairment, illnesses and disorders caused by alcohol abuse Ownership Acorn Care Home is owed by 1st Care Ltd. The Proprietor and MD for 1st Care Ltd is Mrs Jagruti. The address for 1st Care Ltd. is: 90B Handsworth Wood Road, Birmingham B20 2PL Tel 0121 554 5024 Email [email protected] Web www.acorncarehome.com Information regarding Jagruti Patel, Managing Director: Qualifications: BSc Pham, MRPS. Relevant experience: Mrs Patel has some thirty years plus in care home management and her clinical background is as a qualified pharmacist. Responsible Individual Mr Peter Hetherington Contact details As under ‘Owenership’ Information regarding Mr Peter Hetherington, Responsible Individual: Qualifications RMN, Cert Ed (FE), ENB998, Cert. Management, Cert Clinical Sup. Relevant experience Extensive experience in healthcare, which includes 31 years as a Registered Nurse. Direct experience within the Care Home sector for over 20 years, this includes 7 years as a Registered Home Manager and 10 years as Director of Operations for a Care Home provider (1st Care Ltd). Responsible Individual for Orrell Grange Nursing Home (Liverpool) since 2004. Orrell Grange is accredited at Five Stars (excellence) with Sefton local authority (2009 to date). Also Responsible Individual for Stubby Leas Nursing Home (Staffordshire) and Hawthorne Nursing Home (Nottinghamshire). Range of Service Users previously worked with Working with a range of adults with varying health needs. This includes supporting older persons with mental health needs and younger persons with enduring mental health needs and/or with challenging behaviours including open forensic environments. Length of time with each group or category. Over thirty years specialising in the care of adults with a mental health need. Protect work, professional involvement, memberships and teaching experience Have worked extensively in auditing and raising care standards, crisis resolve within health settings and project management. Managed NVQ training and led a training & assessment centre. Devised a teaching pack for the delivery of the core value unit for NVQ in Care and has taught students of nursing and BTec Learners in Care. Former Member of Policy & Procedure Committee for a large health care provider and Member of Steering Group for Standards of Care for Adults with Complex needs. Care Manager Information regarding Mrs Elaine Jean Lancelott, care manager Qualifications RGN, SCM, RMA (level 4) ‘Statement of Purpose’ Version 4, February 2013 Page 5 of 16 Acorn Specialist Centre for working age dementia and cognitive impairment, illnesses and disorders caused by alcohol abuse Relevant experience Considerable experience as a nurse and as a care manager. Trained as a nurse locally in Birmingham over thirty years ago and worked as nurse-manager within the NHS for some 16 years prior to care home management from 1992 to date. This includes managing a 40 bed home in Birmingham for frail elderly for 5 years and a 76 bed care home, also in Birmingham with specialist dementia care units for some 8 years. Elaine is in the process of applying for registration with CQC as a registered manager for Acorn Organisational structure Staffing Configuration 1 Registered Manager 1 Deputy Manager 4 Registered Nurses 2 Senior Care Assistants – (NVQ3 or working towards NVQ3) 10 Care Assistants – (NVQ2) 1 Administration 1 Housekeeper 1 Chef 2 Housekeeping ‘Statement of Purpose’ Version 4, February 2013 Page 6 of 16 Acorn Specialist Centre for working age dementia and cognitive impairment, illnesses and disorders caused by alcohol abuse 1 Laundry 1 Handyman/Gardener Additional Support will be provided by 1st Care (HR and Payroll) Medical Cover The Surgery 2 The Slieve Handsworth Wood Birmingham B20 2NR Pharmacist Cover: All medicines are given safely, securely and appropriately and within published guidance within polies and procedures. We have entered into an arrangement with a local Pharmacy. Our lead Pharmacist is Mr Surjit Pawar BPHarm(Hons)Lon,MRPharmS Medex Health Ltd T /A Brutons Pharmacy Head Office 101 High Street Moxley Walsall WS10 8RT The services to be provided are as follows: A Monitored Dosage System (MDS) namely the NOMAD CONCISE monthly system Provision of training and Standard Operating Procedures (SOP) Prescription collection and delivery service Supply of compliance aids for self medicating residents Maintenance of patient medication records Quarterly audits including medication audits, weight management, safe keeping of medication, records etc Pharmaceutical advice and access to resources Medication Use reviews (Pharmacists involved are MUR accredited) Management of medicines as per regulations and standards, wherever possible, clients and staff will have information of the drugs function and contraindications and its prescribed use and limitation as well as administration times. Other external professionals who are available to attend the Centre include: Dentist Chiropodist Pharmacist Hairdresser Chaplain Mental Health Advocacy Dealing with complaints, Comments and Suggestions Acorn Specialist Centre takes complaints seriously and encourages comments and suggestion as to further improve the services and address any issues of concern or uncertainty. It is also important to respond appropriately as this provides the Centre with an opportunity to identify and understand areas of concern to the health and well-being of clients, by staff, their families or representatives. ‘Statement of Purpose’ Version 4, February 2013 Page 7 of 16 Acorn Specialist Centre for working age dementia and cognitive impairment, illnesses and disorders caused by alcohol abuse The complaint policy clearly states the response following the receipt of a complaint and it will be the centre’s intention to respond as per the policy in a timely manner and there will always be a senior person on duty to receive concerns or a direct complaint. If individuals are not satisfied with the response, a complaint form and an envelope addressed to the Registered Manager will be provided who will investigate the complaint in line with the Centres complaints policy. An initial response will be forwarded within five working days. Pending further investigations the manager will respond with the outcome detailing any actions required to resolve the issue within 28 working days. If any individual feels the issue has not been resolved or handled appropriately, they may also raise the issue with: Care Quality Commission at National Correspondence, Citygate, Gallowgate, Newcastle upon Tyne, NE1 4PA, Telephone the National Contact Centre on 030000 616161 or email to [email protected] The notice board in the reception area will have a clear statement of the Centres complaint concerns and suggestions procedure and the complaint form and envelope available at the reception. Acorn Specialist Centre will maintain and operate a complaints procedure in accordance with relevant policy based on recommendations made by the Care Quality Commission (CQC) Nursing & Midwifery Council (NMC) and National Institute of Care of Excellence (NICE) and ensure that there is no discrimination against anyone for making a complaint. Annual audits in respect of complaints procedures will be provided and reviewed by the appropriate management committees of: Staff Training and Development, Clinical Care Management and Governance Development As part of the ongoing clinical management a monthly meeting between the centre’s client’s and management will take place where comments and suggestions will be discussed to resolve any issues that may, if not discussed, turn into a complaint. There is a comment and suggestion box in the reception area if a client wishes to remain anonymous. This box will be cleared of contents for each meeting. Safeguarding This policy applies to all levels of staff in the involvement of vulnerable people aged 18 years and over. The underpinning guidance is provided by the document “No Secrets” which makes it clear that “abuse is a violation of an individual’s Human and Civil Rights”. Where the Council of Europe defines abuse as “any act or failure to act, which results in a significant breach of a vulnerable person’s Human Rights, civil liberties, bodily integrity, dignity or general wellbeing; whether intended or inadvertently; including sexual relationships or financial transaction to which a person has not or cannot validly consent or which are deliberately exploitative”. Each staff member needs to understand the role of the independent Safeguarding Team and their duty of care and responsibility to report any act or suspected act of abuse to the Registered Manager who will report such acts to the Safeguarding Team. This statement is written with a broad approach as it is impossible to cover every eventuality and each allegation or incident will be dealt with on its own merit. ‘Statement of Purpose’ Version 4, February 2013 Page 8 of 16 Acorn Specialist Centre for working age dementia and cognitive impairment, illnesses and disorders caused by alcohol abuse (It is not the Registered Manager or seniors’ job to interview or have any discussion with the staff member or client about any allegation of abuse; this is the Safeguarding Team’s responsibility). All abuse or suspected incidents of abuse need to be reported to the Safeguarding Team as soon as it is known. Who carries out the investigation will be determined by the Safeguarding Team and will investigate the allegation of abuse and what level of response is necessary, but the main role is to make sure that the victim is protected, if abuse had been taking place that it has been stopped and the appropriate action has been taken. Model of Service The service model will be appropriate to the Centre’s defined client group (working age dementia and alcohol related cognitive impairment, illnesses and disorders) and will be agreed with each Commissioning Service. The service model will include the components in Table 1. Table 1: Service Model Therapeutic Community ethos Care Programme Approach Multi-disciplinary working Interagency working Advocacy Referrals Risk assessment and management Physical environment and security Pre-admission protocol Admission protocol Treatment care plans Throughput arrangements and protocols Discharge arrangements Aftercare formulation Up-to-date operational policies and procedures will be made available to relevant bodies on request. A Care Pathway protocol will be in place and made available to the Commissioning Service and/or referring agencies. Acorn Specialist Centre retains the authority to determine client access and termination of contract due to physical or psychological risks not able to be met by the Centre within agreed contracts. A recovery-focussed therapeutic community model will be integral to provide treatment and care that will support individuals by: Understanding the therapeutic community ethos Focusing on the person and adapting through a stepwise progression; Monitoring outcomes rather than performance; Emphasising strengths rather than deficits or dysfunction; Combating stigma; Fostering collaboration between those who need support and those who offer support and is not coercive; Enabling and supporting self-management; and Promoting autonomy and, as a result, decrease the need for people to rely on formal service and professional supports. During periods where it is necessary to increase a client’s level of observation the Centre will endeavour to respect their privacy and dignity whilst maintaining well-being and quality of life. Consideration will be balanced against clinical risk and where this is temporarily withheld, will be restored at the earliest possible opportunity. ‘Statement of Purpose’ Version 4, February 2013 Page 9 of 16 Acorn Specialist Centre for working age dementia and cognitive impairment, illnesses and disorders caused by alcohol abuse Notification of any person going absent without leave (AWOL), notifiable infections, abuse and incidents/accidents as listed in the policy and procedures will be acted upon in a timely manner and reported to the appropriate people or authority body. As part of the service model staff development and training becomes an important part of the client’s care as well as the team approach in obtaining and maintaining best practice. As part of reaching stated standards, each staff member has a duty of care to maintain their skills to meet individual client care. This places a responsibility on the senior staff to maintain vigilance and support to junior staff to make sure that quality care practices are maintained. The importance of maintaining the client’s care plans with factual information about the individual’s day-to-day care, allows reviews to update care to meet the clients changing needs. Monthly audits allow, not only that the entries meet the prescribed standard, that it also provides evidence that the care plan is meeting individual client needs. Monthly supervision of all staff by appropriate senior staff and a yearly staff development programme provides each staff member the opportunity to improve knowledge and improve individual skills to benefit the care clients receive. Evaluation of Care Monitoring the programme treatment integrity and delivery will be an integral part of service provision; There will be ongoing evaluation of the treatment’s impact on clients and staff delivering the treatment programme; Recognised Clinical Outcome scales will be used to measure clinical progress; and Evaluation of the short and long term risk effects of therapeutic interventions will be monitored and used as informed service delivery expectations and reliance for ongoing improvement. Clinical review process (Personal Care Plan) The Centre will implement a full Clinical Review Process to reflect the individual needs of all clients (Care Programme Approach and National Service Framework NICE and CQC guidelines). All clients will have a review when necessary or a review every three months and discussed at weekly clinical team meetings. Physical Health Monitoring for clients Developing and maintaining optimum physical health as part of the holistic care intervention strategy. Severely mentally and cognitive impaired clients have been found to have greater rates of physical illness than the general population. Epidemiological and clinical studies have demonstrated that various psychological factors can influence and exacerbate physical illness. The Centre will provide measures to try to ensure that physical health is maintained; problems recognised and any deviation from the individual’s normal base-line of physical functioning will be quickly detected and treated accordingly. All clients will be reviewed regularly and as necessary by the dedicated GP service. Clients will also be able to access a wide range of (NHS) healthcare services, as appropriate. These include; dentist, physiotherapist, chiropodist, dietician, optician and any other specialist provision as required. All clients will have a quarterly health review, documented in the individual’s care management notes, which will include general base-line observation, (weight, blood pressure, pulse, ‘Statement of Purpose’ Version 4, February 2013 Page 10 of 16 Acorn Specialist Centre for working age dementia and cognitive impairment, illnesses and disorders caused by alcohol abuse monitoring), blood testing may also be required, in addition to the above, clients will be offered a full annual health screen by the GP. Health education will be promoted within the therapeutic programme. Opportunities will be provided within the care programme to participate in regular exercise. Healthy eating will be promoted and special dietary needs will be catered for. Risk Assessment Risk Assessment and management will incorporate the principles of areas for concern, risk reduction, risk elimination, risk evaluation and a recognised risk communication process. An up-to-date Risk Assessment will be in place in each individual’s care plan to support clinicians in making day-to-day decisions about individual client’s care. The service will implement and maintain a risk assessment model to support the evidence and develop and monitor the Centres Improvement Plan. This will detail the provision of staff resources and other resources required to safely and appropriately minimise risk issues, and set down a contingency management plan in case of untoward events. All available and suitable equipment needs to be safe and no client should be placed at risk from unsafe or unsuitable equipment or by bad practice of medical and non-medical equipment, furnishings or fittings. Training is provided to all staff and auditing of the effective use of equipment will be reviewed monthly. Risk reduction will be assessed and evidenced throughout treatment providing a clear care pathway. The individual’s care plan is developed from the risk assessment and presented to and discussed with the client and his key worker/clinician. MDT and any agencies or services that the client will access as part of the individuals rehabilitation will also be consulted. Staff will participate in CPA Reviews, where necessary, share any findings and recommendations with Commissioning Services that changes the care being provided. The Centre will ensure that the National Suicide Prevention Strategy complying with the DoH Guidance on ‘Management of Violence and Aggression’ is in line with; The Mental Health Act 1983 (2007) Capacity Act 2005 and Criminal Justice Act 2003. Confidentiality All staff that work for the Acorn Specialist Centre will not disclose to any third party information which concerns the identity or personal details of any individual without that person’s consent, except where legally required doing so. Confidentially is a crucial part of maintaining the client’s anonymity and should only be discussed with people who need to know as part of their treatment and care provided at the Centre. All Staff, as part of their induction, are provided with the Centres policy on confidentiality and the consequences of it being breached. Auditing and Monitoring In order to audit and monitor the quality and safety of the service, regular monthly checks are undertaken by the Registered Manager or a nominated person and independent contracted services annually by the registered provider. The areas which are monitored include: Health and safety including clinical accident/incidents; Infection Control Clinical Issues including medication and health and welfare; Operational Audit; An action plan is reviewed and updated following each audit; and ‘Statement of Purpose’ Version 4, February 2013 Page 11 of 16 Acorn Specialist Centre for working age dementia and cognitive impairment, illnesses and disorders caused by alcohol abuse A copy of the report(s) go to the monthly management meetings for discussion; and the Clinical Governance body who sets and monitors standards of practice throughout the Centre. Security The Centre security shall ensure that the following are provided at all times:- The entrance to the Centre will be via a secure access via the reception and visitors, contractors and any other person needing to do business or see a client can be safely escorted into the centre; Security checks (I.D. etc.) will be undertaken on all visitors to the Site and will be entered into a visitor’s log; Clients’ visitors may be searched for contraband if risk assessment identifies need; There will be a regulation of people and restricted items into the secure perimeter of the Centre. This will be governed by Acorn Specialist Centre’s policies on visitors and prohibited items and search procedures; There is limited access to parking facilities and will be at the owner/drivers own risk; and Where the fabric of any part of the building of the Centre acts as part of the secure perimeter, the specification shall be such that it will prevent external access to the Centre ensuring that contraband items cannot be passed over a fence/wall or through a window. Internal environment of the Centre will ensure the following: Areas such as bedrooms, corridors, bathrooms and toilets are provided as outlined in ‘Safety, Privacy and Dignity in a Centre guidance on mixed sex accommodation (not applicable) for mental health services (National Executive, 2000). The Centre at this time is male only, but if this changes appropriate notification and timelines will be applied prior to this happening; Provision of exercise space with access to fresh air within the service perimeter; Educational, rehabilitation, therapy and recreational facilities for clients sited within the Centre; Provision of alarm systems appropriate to the functions of the Centre and procedural security checks (insecurity policy); Locked doors to regulate access and movement of clients and visitors within the Centre; Specific child visiting area, supported by specific policy within the Centre, but not within a clinical area; Effective designs based on a risk assessment of the environment e.g. pipes, wires, heating are hidden and inaccessible to clients; Wall mounted emergency buttons with audio/visual output are installed as they also offer protection for clients. Religious needs Through comprehensive care planning, religious needs of the clients are identified. Clients who are able to use community facilities will be able to attend religious services at local places of worship of their choice. A Minister of Religion of the client’s choice will be contacted to attend the Centre for those clients unable to access the community regularly or unescorted. Specialist Therapists Any specialist therapies or non-typical therapeutic interventions will only be administered following a comprehensive review with the client and the multi-disciplinary team. Acorn Specialist Centre will act at all times in accordance with the Mental Health and Capacity Acts ‘Statement of Purpose’ Version 4, February 2013 Page 12 of 16 Acorn Specialist Centre for working age dementia and cognitive impairment, illnesses and disorders caused by alcohol abuse and other legislation pertaining to specialist needs. It is recognised that obtaining full informed consent from the client is fundamental if the individual has the capacity to do so. Client Satisfaction All clients will be encouraged to play a part in the development of the service and the Centre will hold weekly community meetings in order to gain a collective opinion of progress as well as individual perceptions of the service. A ‘suggestions box’ is located in the reception area in order that clients, family or representatives may raise issues anonymously. A client, family representative, Commissioning Services and other stakeholders’ satisfaction survey will be requested annually and the information collated and used to improve the level of service. It is important that all clients feel that their views are listened to and acted upon. It is imperative that all views are given importance regardless of where they came from. Staff must be able to demonstrate that they listen and act upon client’s views, encourage discussion and act on issues raised. The Organisational management within the Centre will create an open, positive and inclusive atmosphere in order for clients to benefit. An individualised approach tailored to the client’s preferences, circumstances and resources is critical. The Centre’s open philosophy increases opportunities for the client to feel more involved in planning their own care, and empowered during the care or treatment process. Clients Relatives or Representatives The Centre values and recognises the importance of the opinions of relatives and significant others. Regular discussions will be held and questionnaires distributed. As part of the therapeutic community programme clients are involved in the opportunity to play a key role in their own treatment. This will also involve forming strong family related networks and an opportunity for relatives to become a member of the Relative Committee. Great emphasis will be placed upon the links with the client’s family and friends and uppermost at all times will be the client’s wishes. Visitors will be welcome at appropriate times and visiting rooms and areas are available away from the main areas. Some relatives and some clients may not want this level of engagement and we understand the impracticality at times and that there may be many reasons for this. In maintaining contact with friends and relatives, the decisions to prohibit a visit by a person who the client has requested can be regarded as a serious interference with the human rights of the client and can only be made in exceptional circumstances. Any decision to exclude a visitor will be fully documented and available for independent scrutiny. The Mental Health Act recognises two principle grounds, which may justify the exclusion of a visitor and these will be reflected in the Centre’s Operational Policies. These grounds for exclusion are identified as being (1) restriction on clinical grounds dictated by the Multi-disciplinary Team (2) restriction on security grounds that places the client or others at risk. The Centre has identified written policies pertaining to arrangements for the visiting of clients by children under the age of 16 years. A visit by a child will only take place following a decision that the said visit will be in the child’s and client’s best interest. The well-being and development of the child is paramount. The decision to allow such visits will be based on a multi-disciplinary risk assessment and will be reviewed on each request. Client Relationships It is recognised that physical relationships between clients can be open to manipulation, particularly where a client is vulnerable due to their presenting mental state or illness. ‘Statement of Purpose’ Version 4, February 2013 Page 13 of 16 Acorn Specialist Centre for working age dementia and cognitive impairment, illnesses and disorders caused by alcohol abuse Relationships between clients will be closely monitored and supervised whilst respecting the individual client’s human rights. Encouragement of appropriate social relationships and every opportunity will be made for clients to develop positive interpersonal relationships with their fellow peers. Advocacy Through the implementation of the advocacy system, it is intended that clients may use an advocate if a complaint needs to be raised with the clinical team. Leaflets will be provided to clearly identify the use of an advocate. Contact names and addresses Heart of Birmingham Voice Advocacy Scheme 17 Braithwaite Road, Sparkbrook, Birmingham, B11 1LB Tel: 0121 212 8424 Email: [email protected] Care Quality Commission Citygate, Gallowgate, Newcastle upon Tyne, NE1 4PA Telephone the National contact centre on 030000 616161 or Email [email protected] Mental Health Act Commission: Is now under the Care Quality Commission and can be contacted on the CQC web site, telephone numbers and email Quality Assurance Acorn Specialist Centre will carry out the services in accordance with best practice and shall comply in all respects with the standards and recommendations: Issued by the National Institute of Clinical Excellence; Issued by Care Quality Commission or any other relevant professional body; From any audit and Adverse Incident Reporting; Healthcare Standards; Work towards the Investors in People Standard; Work towards the ISO 2000 Standard; and National Guidance, Policies and Procedures, which relate to service provision. Acorn Specialist Centre shall ensure that all staff adherence to such standards and performance is routinely monitored so that remedial action is promptly taken where such standards are not attained. Clinical Audit is an integral part of service provision / culture in order to monitor service responsiveness to the various aspects of care. Effective monitoring of clinical care with high quality systems for clinical record keeping and the collection of relevant information is maintained at all times. Assessing and Monitoring the Quality of Service Provision Acorn Specialist Centre will: Identify, monitor and manage risk to people who use, work or visit the service; Take professional advice about how to run the service safely, where Acorn Specialist Centre does not have the expertise or knowledge; ‘Statement of Purpose’ Version 4, February 2013 Page 14 of 16 Acorn Specialist Centre for working age dementia and cognitive impairment, illnesses and disorders caused by alcohol abuse Take into account comments and complaints, investigations into poor practice and records held, advice and reports from the Care Quality Commission; Attend and participate in Contract Review Meetings with Lead Commissioners; Allow Commissioning, their servant or agents to attend and inspect the premises or when required, for the purposes of quality monitoring visits; Allow Commissioning, their servant or agents to attend and inspect the premises in direct response to incidents or to preserve Lead Commissioners confidence in service provision. Allow Commissioning, their servant or agents the right to initiate and commission independent service and specific incident reviews; Ensure that clients are involved at managerial and monitoring levels of service provision; and Provide reports requested by Lead Commissioners to further explore trends highlighted by Key Performance Indicators (KPI’s.). Acorn Specialist Centre will improve the services offered by learning from any adverse events, incidents, errors and near misses as well as the outcomes from any complaints to improve service outcomes. Acorn Specialist Centre will ensure compliance with the Essential Standards of Quality and Safety and its Outcome Measures as well as any other pertinent best practice guidance and will self-review performance against the standards on an annual basis. The results will be published in a local report and shared with the CQC, Commissioners and other relevant parties, to reduce the need for repetition. Client Satisfaction Acorn Specialist Centre will provide a system for monitoring and reporting client views and presented in the annual report on client satisfaction surveys and the results will be sent to the Commissioning Services and made available on request. Documentation and Good Record Maintenance All clients’ personal records with documented care plans and all medical and personal care are accurate, fit for purpose, are held securely and remain confidential. All records will be kept in line with appropriate policies and procedures and made available to the Care Quality Commission for inspection of documents in relation to the management of client regulated activity. Serious Untoward Incidents Serious Incidents will be notified to the Commissioning Services and Protection of Vulnerable Adults as appropriate with a review report subsequently prepared and shared as per policies and procedures. Where a report raises a commissioning issue; the matter will be included at the next review meeting with the Commissioning Services and an appropriate response agreed. Freedom of Information Appropriate safeguards to govern access to and storage of confidential client information as recommended in the Caldecott Report and the Data Protection Act 1998. Information will be made available as per the Freedom of Information policy. Race Equality / Cultural Sensitivity of Services ‘Statement of Purpose’ Version 4, February 2013 Page 15 of 16 Acorn Specialist Centre for working age dementia and cognitive impairment, illnesses and disorders caused by alcohol abuse The Centre is committed to equal access to the services provided by Acorn Specialist Centre for clients from all ethnic (BME) groups. Acorn Specialist Centre will ensure there is absolute compliance with the Race Relations Act 1976 as amended and the Guidance for Ethnicity and Diversity as provided by the Commission for Racial Equality. Progress on these matters and issues identified will be monitored via regular review meetings. Further Service Requirements Acorn Specialist Centre shall ensure that: The Mental Health Act 2007 and Criminal Justice Act 2003 are complied with, and all child visiting arrangements adhere to HSC 1999/222 ‘Mental Health Act amendments 2007 and its Code of Practice: ‘Guidance on the visiting of psychiatric clients by children’ and any amendments; Demonstrate adherence to the Research Policy Framework, as specified by PiC Research and Ethics Committees; and The centre complies with any subsequent or successor guidance, Acts and any prevailing law that effects the Centre carrying out its duty of care. Full address and contact details Acorn Specialist Centre 88 Handsworth Wood Road Handsworth Wood Birmingham B20 2PL Tel: 0121 507 1763 Fax: 0121 554 4624 ‘Statement of Purpose’ Version 4, February 2013 Email [email protected] Web www.acorncarehome.com Page 16 of 16