RADCLIFFE HOUSE
Specialist Transitional Therapeutic and Rehabilitative
Residential Care for 16 – 25
Statement of Purpose
Health and Social Care act 2012
(Outcome 15, Regulation 12 and Schedule 3 of the
Care Quality Commission (Registration) Regulations 2009)
Registered Provider Nestlings Care Ltd
Responsible individual Mr Anthony Thompson
Manager Mr Mark Stares
CONTENTS:
1. Introduction
2. Philosophy
3. Visions
4. Aims and Objectives
5. Accommodation, Services & Facilities to be provided for Young people
6. Relevant Qualifications And Experience Of The Registered Manager
7. Relevant Qualifications and Experience of Responsible Individual / Nominated individual
8. The Number, Qualifications and Experience of Staff Employed in The Home
9. Organisational Structure & Governance Structure
10. Services & Facilities To Be Provided For Young people.
11. Range of interventions offered at Radcliffe House
12. Regulated Activities
13. Referral and admission Criteria and Process
14. Arrangements for Dealing With Review of the Young people’s Plan
15. Arrangements For Educational, Social Activities, Hobbies & Leisure Interests
16. Arrangements for contact between Young people and Carers
17. Privacy and Dignity
18. Diversity and Inclusion
19. Personal Belongings
20. Health and Wellbeing
21. Medications
22. Arrangement for Dealing with Complaints
23. Fire Precautions and Emergency Procedures
24. Smoking Policy
25. Safeguarding Policy
26. Consent, Capacity (MCA) and Deprivation Of Liberty Safeguards
27. Behaviour Management
28. Sanctions/Consequences
29. Equalities Policy.
1. Introduction:
Radcliffe House is part of Nestlings Care Ltd, organisation offering specialist transitional therapeutic and rehabilitative residential placements for young people & young adults with complex and challenging presentation in the context of mental health problems and neurodevelopmental disorders e.g. Autistic spectrum Conditions.
At Nestlings Care LTD, we recognise that young people aged between 10 and 19 account for over 12 percent of the UK’s total population in 2003 (Census, 2011) and adolescents who are “Looked After, have a history of mental health disorders, suicide attempts and who self-harm are at much higher risk of transition problems” (Model of transition specifications by NHS England 2015).
Radcliffe House offers placements for young people & young adults of mixed gender, aged between 16-25 years. The placements aim to offer consistent specialist care, treatment, management and rehabilitation during transition, by a highly skilled multidisciplinary team: registered manager, registered mental health nurses, support workers, Clinical Psychologist, Psychodynamic Psychotherapist, Music Therapist, Occupational Therapist and Consultant child and adolescent psychiatrist. The team offers 24/7 crisis management through mental health on call. We provide care and treatment for Young people under Mental Health Act 1983 (revised 2007), community treatment orders under Mental Health Act (1983).
The team at Radcliffe House have extensive clinical, operational and management experience in the provision of mental health care in young people & young adults in- patient settings and residential care gained over the last 17 years. Through these strengths Nestlings Care Ltd aims to become the leading provider of specialist residential placements for young people& young adults in the North West.
The service aims to offer safe and comprehensive care in the community in partnership with young people, carers, stakeholders and other agencies. The team has specialist clinical expertise and specialist skills through a range of therapeutic interventions for Depressive Disorders, Psychotic illness, neurodevelopmental disorder; Autistic spectrum disorders with co morbid presentations, Attachment problems and Emerging Emotionally unstable personality disorders with complex co- morbid challenging presentations: risk of aggression and self-harm.
The TRACK study15
CAMHS are designed to
Radcliffe House is registered with CQC in order to promote and provide seamless evidence and outcome based high standards of health and social care for young people. This will occur through transition into adulthood in a homely environment which meets their developmental needs and offers emotional, relational and environmental security.
Communication with young people and carers:
The team identifies the importance of simple, open, transparent and non-challenging communication with young people and young adults according to their understanding, experiences and level of emotional and cognitive development. Young people and young adults with mental health problems and complex challenges, struggle to trust professionals due to their authoritative role, perceiving the professionals and adults in their life taking control away and disempowering them, which in turn has significant impact in building therapeutic relationships. We recognise adolescence to be an important stage of development of identity and self-control which can only be achieved in collaboration with young people and support them through adulthood.
Young people and carers are supported to actively participate in the treatment and care offered through informal verbal discussion, meetings and information leaflets. The team identifies the importance of communication with referrers, commissioners, Local authorities and other relevant agencies.
Individualised consistent and collaborative care:
The team identifies that each young people is a unique individual with a distinctive life story and set of events (internal and external) that have led them to have complex difficulties. Each young people is considered and treated as a whole person within the context of their current situation. The placements will care plan individual’s needs with young people and carers, facilitate recovery to their optimal functioning level. This in turn enables them to progress along the pathway of recovery, ultimately enabling the successful return home or to independent community living.
The team aims to offer consistent care through transition into adulthood and has experience in meeting complex needs through positive relationships whilst taking therapeutic risk by offering intensive bespoke care package and crisis management in community in order to facilitate seamless transition into adulthood.
Giving chance for independence through intensive rehabilitation:
Young People & young adults with mental health problems and complex needs don’t always have opportunity and chance to live in positive and emotionally safe environments in community with holistic view of their needs. They require significant support within socialisation and social opportunities. We believe in taking innovative and creative approaches to enable them to overcome barriers and integrate these young people & young adults to be part of community.
Equality and Inclusion:
We recognise that this particular group of young people are faced by several emotional, psychological and cognitive challenges. We have identified these young people as having right to be respected, treated equally and valued. It is the policy of Nestlings Care placements to provide residents with a homely environment in which the principles of individual rights, including privacy, choice, safety, equality, diversity and freedom of choice are respected and actively encouraged by every staff member.
2. Philosophy:
The team identifies these young people and young adults with complex mental health problems posing ongoing risks to self or others can slip through the gap during transition. Some of key areas identified to improve transition from CAMHS to AMHT are:
· Single point of communication to all agencies involved.
· Transition to be coordinated with integrative care planning and communication to all agencies, young people and carers.
· To have specialists team in order to offer evidence based care for wide range of mental health presentations including Autistic Spectrum Disorder and ADHD (neurodevelopmental disorders)
· Young people and Carers to have information about each stage of transition and are actively involved in the process as much as possible.
The placements offers planned admissions from inpatient hospital settings or other settings due to complexity of presentation requiring a bespoke package, delayed discharges due to limited local resources or lack of specific provision in the community or as step down from secure inpatient services. Placements are offered to young people and young adults with history of readmissions or deterioration in community due to non-adherence to treatment, non-engagement and admission to inpatient setting is not indicated or has limited interventions to offer or deemed to be counterproductive. Admissions are offered to young people and adults from social services placements teams, CCGs, CAMHS, EIS and AMHT following a detailed review of case and risk assessment.
2. Vision:
· To comply with and exceed all regulatory and statutory requirements.
· To meet additional standards of quality assurance and other specialist accreditations.
· To treat young people with dignity and respect at all times.
· To offer safe and compassionate services for most vulnerable group.
· To safeguard young people from any form of harm.
· To provide a safe and therapeutic environment and bespoke model of care and treatment.
· To use evidence based treatment and individualised care plans in collaboration with young people and carers.
· To understand and meet young people’, carer’s and stakeholders’ needs on a timely basis.
· To consult with young people about decisions that affect them and keep carers, responsible local authority staff and purchasers informed of decisions in an open and honest way.
· To offer value for money services and offer competitive terms and conditions to our staff. Encourage teamwork, personal growth and development to our staff through training and supervision and opportunities to progress.
· To enrol with Apprenticeship Programme to transfer skills and offer opportunities to engage local youth and individuals to develop career choices.
· Increase the provisions of specialist healthcare services in community for young people and young adults across the UK.
3. Aims & Objectives:
Provision of specialist transitional therapeutic and rehabilitative residential service working in partnership with young people and all relevant agencies with 24-hour crisis management from registered mental health nurse, consultant psychiatrist, psychologist and registered occupational therapist, providing a level of comprehensive care which will differentiate Radcliffe House from other providers.
To comply with and exceed all regulatory and statutory requirements and Key Lines Of Enquiry (KLOE):
· Safe
· Effective
· Caring
· Responsive
· Well Led:
In order to achieve these aims Nestlings Care LTD by ensuring that:
· Each young people is protected from harm.
· The young people are protected under safeguarding policy and every staff member have Level 3 safeguarding training. The staff are provided with guidance regarding reporting safeguarding concerns and allegation. The new staff attend an induction programme prior to undertaking any duties and will have an identified mentor from the senior staff team.
· Safe recruitment with robust recruitment and vetting processes are in place.
· Adequate staffing (minimum of 1:2 staffing with waking staff) with wide range of skills and gender mix.
· Right staff skill mix is available to meet young people needs by investing in staff development to provide a progressive and expert care workforce. And to value each of our staff equally for their expertise and experience they bring to the team and to provide our staff with a working environment within which effective teamwork, where appropriate, and personal and group development are actively encouraged and supported.
· Young people have comprehensive risks assessment and management care plans which includes their involvement and agreement as much as possible.
· Young people’ rights are safeguarded through active listening, being transparent and use of advocacy.
· Young people are given information about medications and interventions offered and encouraged to self-medicate where appropriate.
· To foster independence by being responsive to the young people’s ideas, views, wishes and respecting their potential.
· Staff to have understanding of Mental Capacity Act and Deprivation of Liberty safeguards through specific training and management supervision.
· All nutritional needs and health care needs are identified and met as and when necessary with easy access to health professionals.
· Young people have private space for their visits, activities and can personalise their living space.
· To provide specialist multidisciplinary holistic assessment and management of young people’s needs and risks with comprehensive care planning, key working and specific interventions suited to individual needs, diversity and risks.
· Each young people will have an identified key worker from the staff team to develop trusting relationships centred on the needs of the young people, their hopes and aspirations, to ensure a high quality, holistic and consistent approach.
· Facilitating optimal recovery with young people and carer, measured through young people and professional rated health outcomes.
· Achieve an excellent standard of care for young people by receiving feedback from young people, carers/parents and stakeholders through questionnaires and feedback developing innovative ways of working to facilitate rehabilitation.
· Working closely with carers to build on protective factors, strengths and potential for improvement. A great emphasis is placed upon the involvement of family, other carers and significant people in the life of the young people. Key workers will establish and maintain regular contact with family, carers or any other significant relationships and offer support and psycho education with a view to rebuilding their relationships in order for the young people to return home.
· Working in collaboration with local authorities, CAMHS, EIS, CMHT, Commissioners and relevant agencies in order to offer seamless, timely and comprehensive packages of care for young people into early adulthood. To seek advice or support, when necessary, from Educational Welfare Officers, the Police, the Youth Offending Service, Community Projects which support Black and Minority Ethnic People, Youth Link, the Voice of the Child in Care and others.
· Standard of care and provision of individualised care to be regularly assessed and reviewed through Governance framework and audits to ensure that regulatory standards and organisations aims are maintained through robust clinical governance structure.
· Within the Governance framework the team takes a “reflective and learning approach” toward any incidents that may occur or any complaint. Any further training or development if highlighted will be provided.
· Team will work cohesively to maintain and improve standard of care for the young people and young adults through staff meetings, training and supervisions.
4. Accommodation, Services & Facilities to be provided for Young people:
Radcliffe House is a typical Semi-detached house in a Family orientated location. There are 3 bedrooms, 2 bathrooms, a large through lounge and a spacious kitchen/Diner.
Radcliffe House offers modern accommodation whilst retaining a homely appearance that retains character; the home has been built to high standards. All rooms are tastefully furnished to a high standard, providing television point and computer access points with Wi-Fi available throughout the home. The local amenities and facilities are within walking distance in the town of Radcliffe. The house is easily accessible through motorways and is less than thirty minutes away from Manchester. There are good transport links, with bus and tram routes within proximity to the home.
Young people will have their own private bedroom, and will be given a key to that room depending on risks assessment and agreement with young people. Spare keys will be kept by staff in a key safe in the staff office and would only be used in an emergency. Young people will have free access to all communal areas of the home.
We will always try to allocate the room that each individual has expressed a preference for, although this is largely dependent on availability at the time of admission and subject to any specific risk assessment etc. Should an individual wish to change rooms at a later date, or a room which is more suitable becomes vacant it is possible to relocate at that time.
There is a charge for accommodation and treatment at Radcliffe House. These fees are paid by the referring Local Authority and CCGs at an agreed rate and paid directly to Nestlings Care Ltd.
Matters Listed in Schedule 1:
The name and address of Registered Provider:
Nestlings Care Limited
185 Grove Lane
Hale
Cheshire
WA15 8LU
The name and address of the Responsible Individual:
Mr Anthony Thompson
2 Osbert Road
Blundellsands
Liverpool
L23 6UP
Manager:
Mr Mark Stares
Radcliffe House
26 Eastfields
Radcliffe
Manchester
M26 4QE
5. Relevant Qualifications and Experience of Manager:
Mark Stares has over 20 years’ experience working in the residential care setting. Mark has completed his Diploma 5 in Leadership and Management and has also gained his NVQ Level 4 Registered Managers Award. Additionally, Mark has completed training in Safeguarding, CAMHs Caregiving in Children’s Homes, Restorative Justice, Safer Recruitment, Child Protection, Self-Harm Awareness, Drug & Alcohol abuse, Food Hygiene, Fire Safety, Equality & Diversity, Supervisions and Appraisals, Therapeutic Crisis Intervention, as well as many other training courses. Mark has experience of managing dual homes for young people with complex and challenging presentations as well as experience of working in Residential Schools for Local Authority, Charitable and Private organisations. Since 2016, he has been a registered manager within Nestlings Care LTD managing specialist residential provision for young people aged 10-18 with mental health problems (registered with CQC &Ofsted) before transferring to Lang Riggs House which caters for the 16 to 25-year olds. Mark will be jointly managing both provisions and will be supported in each home by a qualified and competent staff team.
6. Relevant Qualifications and Experience of the Responsible Individual/ Nominated Individual:
Mr Anthony Thompson:
Mr Anthony Thompson holds extensive experience in representing mental health and learning disability services within the public and Independent services. He has published and edited numerous professional text books and journal articles, particularly within the area of inter-professional working and education.
His career has spanned decades in the statutory services domain. This includes positions held as Senior Inspector of Training schools (General Nursing Council for England and Wales). He is the former Education officer and Professional Advisor the English National Board for Nursing, Midwifery and Health Visiting. He has held senior lectureship in Higher Education and appointment as external examiner to Universities including, Dundee, Queens Belfast, Ulster, Sheffield and the South West.
Previous service positions include Director in High Secure care and the Independent Sector. Currently he is a senior associate of caring solutions UK Ltd specialising as an Independent Investigator of Serious Incidents within the NHS and he is a Director of a non-profit organisation Bridge R&D UK. He retains interest in the Independent Mental Health sector as RI for Roefield and Debdale Care Ltd and is associate visiting manager (MHA) for Care UK and J. Munroe Hospital group.
7. The Number, Qualifications and Experience of Staff Employed in the Home:
At Radcliffe House, we have staffing level of a minimum of 1:1 during day and 1 waking staff and 1 sleep in at night with appropriate number of staff team who are suitably qualified, skilled and experienced.
Staff employed to work at Radcliffe House will receive Clinical and Managerial Supervision from Qualified Nurse and Registered Manager. Staff also receive support from Clinical Psychologist through formulation meetings.
A list of the names, qualifications and experience of staff working in the home is available for inspection at any reasonable time from the Manager’s office.
Provision is made for Qualified Nurses to be available for consultation 24hrs per day 365 days per year and further compliment of multidisciplinary team:
The Specialist Multi-Disciplinary Team:
· Consultant Psychiatrist
· Specialist Mental Health Nurses
· Clinical Psychologist
· Psychodynamic therapist
· Occupational Therapist
· Music Therapist
8. Organisational Structure:
·
Governance Structure and Processes:
Statement of Purpose
Date of Issue:
September 2017
SOP
001
Date of Review:
Department:
Operations
© Nestlings Care Limited
9. Range of interventions that Radcliffe House is intended to offer:
Activity:
How Delivered
Approved by:
Delivered by:
Specialist Psychiatry input
Psychiatric assessment
Mental State Examination
Examination/Ongoing Reviews
Medication Review
Prescribing medications and monitoring response
Treatment Plan
MDT Meetings & Risk assessments and management
Psychiatric Reports
MHRT, Responsible clinician role for CTO.
1.1 assessment by Consultant psychiatrist on weekly/biweekly basis to offer assessment, review primary diagnosis or current mental state or changes from last assessment.
1.2 Implementation and review of management plan.
1.3 prescription of medications
1.4 Out of hours On call
Consultant Psychiatrist
Rationale: To identify and confirm diagnosis of mental illness and assess mental state for treatment in a community rehabilitation setting. Regular review of progress and mental state allows the Consultant Psychiatrist to tailor medication and treatment plan to be optimally effective, appropriate to their condition and within BNF limits.
Psychological input
Psychological Assessments- psychological Formulations
Cognitive Assessments
Direct/indirect Psychological Interventions
Multi-Disciplinary Team feedback
Risk formulation
Teaching and Training
Supervision. Debriefs
1:1 assessment (with staff and Young people)
Observation
1:1 Intervention
Group Intervention (If appropriate)
Indirect Intervention
Contribution to MDT
Behavioural Management Plans
Supervision of other Clinical Staff
Formulation Meetings
Teaching and Training Sessions
Tailored made psychological interventions
Consultant PsyhciatristClinical Psychologists
Rationale: As a result of the structure of psychology services, all young people will receive direct and/or indirect psychological input into their care, both in terms of assessments and interventions. On an individual basis, individuals have access to a range of psychological assessments and interventions to help them to identify their psychological difficulties and work on overcoming them. All psychological input into an individual’s care is agreed and co-ordinated by the MDT and CPA process.
Activity:
How Delivered
Approved by:
Delivered by:
Specialist Nursing Input
Holistic Assessment of Needs
Risk Assessment & Care Planning
Active Interventions
On-going monitoring and evaluation if care plans
Collaborative working
Administration and management of medication
Relapse Prevention
Preadmission assessment
1:1 sessions with young people Recovery Model
Risk assessment and formulation with Care staff
Individualised Care Planning
24hr Crisis management through On call
Medicine management and audits
Registered Nurses (via MDT)
Team workers & Support Workers
Rationale: To work collaboratively with young people to promote self-management. To support individuals over 24-hours in meeting their mental health and personal needs and to provide a systematic approach towards regaining their independence through rehabilitation.
Occupational Therapy input
Personal independence and social skills. Domestic and community living skills. Leisure. Work/Occupation.
ACTIVITIES:
Kitchen Assessment
Supported cooking sessions
ADL’s
Relaxation
Baking
Community skills
Facilitation of College and further education courses
Budgeting and financial management
Risk Assessments and individual programme planning to include:
· Therapy sessions
· Individual sessions
· Access to community resources
Occupational Therapists
Registered Manager
HCAs
Support Workers
Rationale: To enable and empower Young people to meet the requirements of the transition to community living. Supporting individuals to find and maintain positive community links, such as paid employment or educational courses. This has a positive impact on self-esteem and coping capabilities and is intended to reduce relapse rates. The main aim is to facilitate recovery that is directed by the individual themselves.
10. Regulated Activities:
· Accommodation for persons who require nursing or personal care
· Treatment of disease, disorder or injury
Statement of Purpose
CONTROLLED DOCUMENT
·
Date of Issue:
September 2017
SOP
001
Date of Review:
Department:
Operations
© Nestlings Care Limited
11. Referral and Admission Criteria and Process:
It is anticipated that young people will be referred to Radcliffe House from a range of sources including:
· Step down from acute and secure adolescent units (NHS and Independent sector)
· CAMHS (Child and Adolescent Mental Health Services)
· Social care placements
· Criminal justice system
· Youth offending teams
Radcliffe House will offer specialist interventions for following:
· Depressive disorders with self-harm
· Psychotic illnesses with history of non-adherence or repeated admissions
· Hyperkinetic conduct disorder & other neurodevelopmental disorders
· Attachment Disorder
· Autistic Spectrum Disorder with co morbidity or challenging presentation
· Mild or Specific learning difficulties with co- morbid mental health problems
· PTSD with Challenging behaviour; aggression and self-harm
· Eating Disorders with co-morbid PTSD, Emerging Personality Disorder, self-harm etc
· Emerging personality disorder
· Forensic history with mental health problems (involvement with YOT or CJS)
Other admission criteria are:
· All Residents must be regarded as capable of living in a communal living scheme.
· All Residents must undergo a full assessment of their needs through pre-admission assessment.
· The Registered Manager must agree that the individual will benefit from treatment
· No Residents will be admitted whose presence would breach any condition of registration from The Care Quality Commission
· Residents must have been stable for a period of time prior to admission and not in an acute phase of their illness
· Residents should be considered capable of self-caring as far as possible
· Residents should see the move as beneficial to themselves in their treatment plan.
An admission of a young people is the start of a journey through the care pathway and it is essential that pertinent information be gathered, in order to develop individual care plans for young people, which will address identified needs. This process will ultimately assist patients to achieve outcomes specific to their own care pathway.
The admission criteria for accessing services at Radcliffe House are clearly stated in our
policies and procedures manual. The criterion ensures that only those individuals who have
been fully and professionally assessed for their suitability for a community therapeutic and
living scheme will be accepted.
ADMISSION PROCESS:
The preadmission care plans that are developed will assist our staff members to implement the appropriate care meeting individualised needs which in turn offers reassurance to the young people, carers and referring bodies alike. Equality of access will be promoted for all Young people.
All prospective young people will receive relevant information about the service to enable them to make an informed choice about their treatment and care. The team at Radcliffe House will ensure that all admission procedures are carried out to the highest standards and in line with this policy.
Individual treatment plans are agreed with young people to meet their holistic needs. Best Practice guidelines (e.g. NICE) always inform decision making, and a range of interventions are offered through the MDT; including psychiatrist, psychology, psycho-social interventions, activity therapy and social skills, as well as psychotropic medication. An underlying philosophy based on “Recovery” ensures that individuals are empowered towards achieving their own goals.
12. Arrangements in Dealing with Review of Young people’s Plan (Schedule 15(1))
Young people’s health care will be planned in consultation with young people, staff members, and carers and MDT as appropriate. Other appropriate health care professionals are also involved in the planning of Young people’s health and social care.
Young people who will be referred to Radcliffe House are under the Care Programme Approach (CPA).
It is expected that the nominated Care-Co-ordinator with the specialist team is to undertake this role throughout the young people’s stay at Lang Riggs House.
There are 4 main elements to CPA:
· Systematic assessment of an individual’s health and social care needs
· Development of an agreed care plan to meet those needs
· Allocation of a care coordinator to offer consistency in delivery of care
· Regular review and monitoring of an individual’s progress and ongoing delivery of the care programme to meet individual needs
The Registered Manager undertakes regularly audit the effectiveness of the CPA process and invites feedback from all parties.
To ensure that we provide the highest level of care to our Young people’s, our staff will prepare various reports to inform the CPA review meetings; including psychiatric, psychological, occupational therapy, music therapy and nursing perspectives.
Young people will be encouraged to be fully involved in the creation, documentation and review of their care plan. Each individual will be encouraged to contribute and sign their care plan and a written copy will be given to them.
Young people’s may request access to their Health Records under the Data Protection Act 1998. The young people will be aware that their records contain the details of their care needs and the services provided to them, and are updated regularly. They are strictly confidential and won’t be seen by anyone who isn’t involved in their care. If young people would like to see their records then they must write to Registered Manager, if they need help with this then they can ask a member of staff.
Each Young people will have an individually tailored care plan, based on assessment, which will incorporate core areas from Recovery STAR Model:
1- Safe transition into the community:
2- Building therapeutic relationships with care staff:
3- Management of challenging presentation & Management of risks to self and others:
4- Awareness of mental health problems
5- Adherence to medications
5- Managing physical health and self-care:
6- Education and Work
7- Responsibilities
8- Relationships
9- Living Skills & Independence
10- Trust and Hope
11- Identity and self-esteem building
13. Arrangements for Social Activities, Hobbies & Leisure Interests:
Young people and young adults referred to Radcliffe House with established activities will continue to be supported to access such activities. All young people are encouraged and supported to access a wide range of activities designed to assess their level of functioning, offer therapeutic benefits within the home to help with their rehabilitation programme and integrated community access as part of their progress along a recovery pathway.
The MDT, including Occupational Therapy, will complete a holistic assessment, including identification of the young peoples’ ADLs, strengths, interests, hobbies and unmet needs.
A process of collaborative working will ensure that treatment and care is directed towards achievement of mutually agreed goals, including accessing any educational/ vocational, social activities, hobbies and leisure interests.
Gathering information about activities is seen as an equally valid exercise as the activity itself; providing opportunities for social integration, problem solving, and building trust, taking responsibilities and personal development.
14. Arrangements for Contact between Young people Family/Carers:
Young People and young adults are supported to make, and to maintain contact with family/ carer, including involving them in decisions about their care and treatment, its application, and review, including attendance at CPA meetings etc. where clinically appropriate to do so.
Staff gather all relevant family history, information regarding the nature of relationship the young people has with parents/carers, and any safeguarding concerns which would be relevant. This information is incorporated in young people’s placement care plan, contact list, and if there are any ongoing concerns, clarification will be sought from the Social Worker and young people’s protection will be paramount. If indicated, young people will be supervised during contact visits.
During the introductory visit to the home, young people will be able invite a family member or a representative with them.
The views of family/ carers are sought through regular meetings and “Feedback Questionnaires” when reviewing the achievement(s) of the home in meeting the needs of the individual.
15. Arrangements for Young people to attend Religious Services of their Choice:
As far as is practicable, all young people and young adults will have the opportunity to attend religious services of their choice.
The religious beliefs of a young people and their request to attend religious services are respected and, as far as is practicable, all young people and young adults will be supported to attend to their religious or cultural needs within the home, as appropriate within a communal residence or in the community.
16. Privacy and Dignity:
Each young people will retain the right to be treated: as an individual, with care, consideration,
dignity, courtesy and respect at all times, irrespective of ethnic origin, gender, sexual orientation
religious beliefs or the nature of any health problems.
No consultation or treatment will be carried out in a communal area and young people has the right to choose to be accompanied at all consultations, examinations and treatments. This choice extends to choose the gender of staff that carry out treatment or personal care, however young people are advised that it may not always be possible to ensure that staff of a chosen gender are available at that time and a period of delay might result.
It is the right of each young people to exercise their preference for privacy. This is acknowledged and appropriate measures are implemented by staff in order that the Young people wishes concerning their privacy are respected.
All our policies and procedures have been written to reflect current “best practice” and ensure that all young people’ rights are observed and promoted. This includes respecting individual rights to privacy and dignity.
17. Diversity and Inclusion:
Young people will be given the opportunity and encouraged to exercise their right to choose and be involved in the planning of their care and to pursue activities both within the environment and outside in the wider community.
Inclusive practice is a process of identifying, understanding and breaking down barriers to participation and belonging. Inclusion is about ensuring that young people and young adults, whatever their background or situation, are able to participate fully in all aspects of the life in community and educational/ vocational placements. Inclusive practices will ensure that everyone feels valued and has a sense of belonging. Inclusion is not about viewing everyone as the same or providing the same work, but about providing the same opportunities and access to a high quality of education. In an inclusive environment there is recognition, acceptance and celebration of difference’s and similarities.
18. Personal Belongings:
On admission, staff record details of all clothing and personal belongings which young people brings into the home. There is a banned items list which would be discussed with young people and if necessary such items will be kept secure by staff. These records are updated when new items are brought onto the premises or when old ones are discarded. This ensures, as far as possible, that these items can be traced back to its rightful owner should they become lost. Young people will be encouraged to notify staff of new items of clothing so that they can be properly labelled and recorded.
Whilst young people are encouraged to carry out their own laundry (under supervision initially), there may be occasions where this is carried out by staff and labelling makes identification much easier.
The level of support required is identified through ADL assessment in order to maintain independence and is reviewed regularly to track progress made.
Young people are encouraged to bring photographs, favourite ornaments or other treasured keepsakes or small items of furniture that may help to personalise their room and make it feel more comfortable. There are, however, limits on some items either due to size or value or risk assessment.
While we will encourage to bring personal items with them into the home to help feel at home, we would suggest that because of the risk or damage or loss, these items should not be of a valuable nature.
All items of electrical apparatus over 12 months old must be PAT tested to ensure that they are in good working order before they can be used. This can be arranged by the staff and there is no charge for this testing.
Any items of furniture must be in good condition and must conform to current Fire Regulations for being flame retardant.
In each bedroom, there is a secure place where young people can lock away small articles of value. There is of course suitable hanging and storage space for clothes.
We don’t advice young people to keep cash (unless agreed with carer/ social worker), expensive items of jewellery or valuable ornaments in their room. In case of loss, damage, or theft we cannot accept responsibility. Young people are supported and encouraged to develop skills of budgeting and saving by opening a personal bank account for the safe keeping and management of their finances.
19. Health and Well-being:
In addition to our experienced staff members who will look after young people’s care and welfare, further support is provided by a number of other healthcare professionals from a variety of disciplines to ensure that we are able to provide a comprehensive care and treatment rehabilitation package.
All young people will be registered with a local GP practice or Health Centre to ensure continuity of medical treatment. For some Residents this means that they may be able to retain their own family GP, whilst for others it may mean registering with a new GP.
The young people will be registered to GP, local dentist and optician, as soon as agreement and funding to transfer is in place.
The home provides access to a range of advocacy services which will be useful where the individual wishes to make their views ad wishes expressed through an independent person.
20. Medication:
The young people residing at Radcliffe House may already be on medications which would require supervision and the visiting Consultant psychiatrist may prescribe medication as part of the young people’s treatment plan. Young people will be given information (written and verbal) about their medication or any other aspects of their care. There will be leaflets available for mental health information from Royal College of Psychiatrist.
Staff on duty will ensure the safe and timely administration of all young people’ medication. It the aim of the clinical team that services are supported to self-administer medication, but this may be easier to achieve for some than others. There is a self-medication policy / procedure which may be implemented following capacity to consent and detailed risk assessment by the members of MDT involved depending on young people’s age and risks.
21. Consultation Procedure Regarding Operation of Radcliffe House:
Young people are expected and encouraged to participate in their individual therapeutic programme as well as participating in the recreational activities of the home. The team will encourage them to express their views on the various aspects of living at Radcliffe House through key worker sessions and community meetings, providing a forum, which ensures that each individual has a “voice” on how their care is provided. These meetings are documented and the records of such meetings posted in the home.
The meetings will be informal in nature to encourage young people to talk openly and freely, however there are ground rules and a pre-identified agenda to ensure that there is productivity to the meetings.
Clinical Governance and Health and Safety meetings will be held at Radcliffe House, a representative from young people (if appropriate and possible) are invited to attend, where individuals are able to represent the views of peers. Both young people and carer can put forward ideas and suggestions for improvement in services that we provide and these will always be given consideration, and where possible these will be implemented. However, it may not always be possible to respond positively to all suggestions made, in which case we will provide a reason why not.
A monthly newsletter will be completed by the young people in the home, this will be an update of what the services users have been doing and it will be sent out to community, parents and carers, local authority and to inspectorate bodies.
Young people will be encouraged to participate in staff recruitment and appraisals.
From time to time we will actively seek young people’ views on how we are providing for their needs. This will be done by issuing a ‘feedback Questionnaire” that we will ask young people and carer, to complete and return to us. Individuals may ask a member of staff to help them complete the form if they wish.
The results of our young people surveys will be included with the Young people Guide which is given to every new young people and available from staff on request.
Each month an unannounced visit takes place by a member of the clinical or operational management team, at which residents are consulted regarding their views.
All such visits are documented and comments analysed to see if improvements to the service can be made. The service will benefit from audits being examined by the Nominated Individual. This person will visit regularly to ensure appropriate supervision and support is available to the manager and that the Company is advised as to operational development.
22. Arrangements for Dealing with Complaints:
The following guide will be made available to individual residents;
At Radcliffe House, the team will strive to ensure that in your dealings with us, you will find our staff and services meet with both your expectations and your approval.
If ever these standards fall below that which you find acceptable, or if there is anything else that you are unhappy about, we would ask that you tell us as soon as possible.
If you wish to complain about anything that you are unhappy about (either a formal or informal complaint), you should:
1. Tell a member of staff that you wish to complain or, write your complaint either on a Complaint Form (available from staff) or in a letter to Registered Manager.
2. The Manager will acknowledge your complaint within 2 days.
3. The Manager will inform you of how the complaint is to be handled and who will carry out investigations into your complaint.
4. Your complaint will be investigated and the findings reported back to you within 20 days from the Manager receiving it.
5. If it is not possible to complete the report within 20 days, you will be kept informed of the progress and the likely completion date.
6. When your complaint has been investigated you will be invited to meet with the Manager and / or the investigating manager to discuss the findings of the complaint.
7. You have the right to appeal against the findings of the investigation.
8. In addition, you have the right to have your complaint dealt with under the NHS Complaints procedure. If you wish to use this process, please tell a member of staff.
9. If there is not an agreed outcome to the complaint, you have the right for your complaint to be referred to the Care Quality Commission.
10. You have the right to refer your complaint to the Responsible Individual and the Care Quality Commission at any stage of your complaint.
Care Quality Commission
City Gate
GallowgateNewcastle upon TyneNE1 4PA
Tel: 03000 616161Fax: 03000 616171
Email:[email protected]
end_of_the_skype_hig
23. Fire Precautions and Emergency Procedures:
All Radcliffe House staff will receive annual fire safety training. Suitable fire safety equipment is available on the premises in accordance with fire safety regulations, including a fully integrated fire alarm system.
Fire procedure notices are displayed throughout the home and all young people will be made aware on admission of the local procedure in the event of a fire.
All Young people have an individual fire evacuation plan in their clinical file that staff on duty are aware of.
All fixtures and fitting comply with fire regulations; where individuals wish to bring their own furniture into the home this is at staff discretion and will only be permissible if they meet fire safety regulations.
The Registered Manager will ensure that all staff working at Radcliffe House receive statutory fire safety training and subsequent annual refresher training.
24. Smoking Policy:
Radcliffe House provides a non-smoking, health-promoting environment, which is as risk free as possible from either smoke or “passive smoking”.
For the continuing safety and wellbeing of all at Radcliffe House, we do not permit smoking in any of our bedrooms, communal rooms, or other places within the building.
If any young people wishes to stop smoking, the staff will ensure that they are fully supported through a “smoking cessation” programme and encouraged to partake in a healthy living programme of eating and exercise.
25. Safeguarding Policy:
Nestlings Care is committed to effectively protect every young people who is cared in any of our provisions. It refers to any activity that is undertaken to promote welfare and protect specific young people and young adults who are suffering, or are likely to suffer, significant harm. Nestlings Care aims:
· All prospective/new staff are subject to an enhanced DBS check prior to them commencing work within the organisation.
· Interview Process incorporates Value Based Questions in order to assess values, experiences and attitude of potential employee
· All staff receive formal training, supervision and mentorship as part of their induction and prior to any lone working and that this is evidenced and entered into a database which is subject to local and organisational governance audit.
· Mandatory training focuses on safeguarding young people, which includes protecting them from all forms of exploitation, including sexual exploitation
· To ensure that young people and young adults cared for in any of Nestlings Care provisions are protected from any significant harm.
· To ensure that all young people and young adults cared for at Nestlings Care provisions are entitled to unconditional right to be kept safe and free from Harm.
· To ensure that Nestlings Care meets the expectations set out by of Health and social care Act 2000, The Human Rights Act 1988 Article 3, CQC national minimum standards, HM Government “Safeguarding vulnerable adults from sexual exploitation” and the key principles, roles and responsibilities and preventative measures therein and the local authority’s safeguarding policy and guidelines.
· Staff to adhere to safe caring policy and minimise physical contact with young people.
· Each staff Member to have clear understanding of their responsibility in relation
reporting to any disclosure of abuse, documenting, reporting and to ensure that any
allegation is managed appropriately.
· An Audit of Safeguarding processes will be carried out on all sites at least every 6 months.
· The results of the Audit will be discussed at Integrated Governance meetings and an action plan will be developed as required.
Links will be made with the Missing From Home Co-ordinator, and clear procedure guidelines in place should a young people go MFH, will be displayed in the office.
A copy of the LSCB, Safer Working Practice for Adults who work with Children & Young People is available in the office, along with contact details for the LSCB.
A copy of Young People from Sexual Exploitation supplement guidance for Working Together to Safeguard Children and Adults is displayed in the home, along with telephone numbers for the relevant CSE teams.
Written records are made of all circumstances of any young people or young adult who may abscond or go missing from home, all action taken by staff, the circumstances of the return, any reasons given by the young people, and any action taken.
Any notification of Significant Events will be made within 24 hours to all relevant parties.
26. Consent, Capacity (MCA) and Deprivation Of Liberty Safeguards:
Nestlings Care is committed to safeguard young people’ right to make decisions regarding their care and treatment through assessment of capacity and following best interest guidelines where necessary.
The team follows the principle that there is an assumption that young people has the capacity, unless doubt or proven that they don't.
Our aim is to:
· To ensure that all young people in our care are encouraged to make their own decisions.
· To safeguards young people rights and liberty.
· Staff to maximise potential and support young people to give valid consent.
· To ensure that every effort is being made to empower young people and to protect vulnerable young people who are unable to make their own decisions through legal framework provided by the Mental Capacity Act 2005 (16+) and Deprivation of Liberty Safeguards (18+).
· To understand, incorporate and implement Best Interest Guidelines and Advance decisions in every aspect of care offered to young people.
27. Behavioural Management:
· Nestlings Care provisions aims to provide a sensitive, supportive environment which is consistent for young people and young adults described as having mental health, emotional and challenging behavioural difficulties. Our aim is to engender equality of opportunity and maximise the potential for integration into mainstream society.
· Traumatic early life experience can lead to young people developing coping mechanisms, which can present at times, in forms of anti-social and challenging behaviour.
· In order to respond appropriately to young people exhibiting such behaviours, staff need to understand their own emotional manifestations within the complex task of caring for and controlling emotional and behavioural difficulties.
· Staff will be skilled in self-awareness and evaluation, in order to deal positively and competently with problematic situations. Every effort must be made to develop strategies for early intervention; in an attempt to de-escalate potentially violent incidents and positive methods of control will be encouraged.
· By providing a positive, supportive and safe environment, staff may be able to divert a young people’s energies away from destructive and negative behaviour without the need for physical intervention.
· From induction onward, all staff are trained and mentored/supervised in developing person-centred care, risk and behaviour management plans in collaboration with individual young people and, where appropriate, their families/carers, which provide a detailed plan of support; this includes areas such as avoiding challenging behaviour incidents, the management of challenging behaviour, known diversion and de-escalation techniques and other relevant interventions. Central to this is a robust risk assessment and the development of individualised planned, positive interventions which avoid or lessen incidents and crisis.
· Staff at Radcliffe House always ensure that young people understand the rationale for any decision or intervention, so that they don’t feel disempowered, and are given equal opportunity for change in their behaviour.
· Team acknowledges that the positive challenge is a key part of adolescent ‘s development, so higher risk environments/activities are not necessarily avoided, but young people and young adults are often introduced to them incrementally, with their safety and the safety of others being paramount.
· Team at Nestlings Care works closely with carers and other professionals involved in young people’s care in order to ensure a consistent approach toward untoward behaviour incidents and to further ensure appropriate dissemination of information, including best practise and methods of achieving positive outcomes.
· Regular monthly audits are undertaken relating to behavioural management incidents across the service, with the manager being required to action plan accordingly, in order to reduce these events.
· Radcliffe House have a behaviour management programme that incorporates having one to one time with individual young people at the home. This is based on how, as a team, we can come up with strategies to maintain a calm atmosphere; the young people have participated in creating individualised Behaviour Management Plans which enable staff to understand the young people’s behaviour, enabling them to deal with it more appropriately.
· At Radcliffe House we believe in positive reinforcement through praise, non-verbal communication, and incentives. Consequences must be used cautiously for dealing with difficult behaviour, as they can lead to resentment from the young people. However, whenever there is a need for a consequence to any given situation, it is vital that the consequence is:
· Understandable to the individual concerned;
· Directly related to the incident;
· Individualised – relevant to age and understanding; there should not be a prescribed tariff of behaviour and consequences (blanket rules);
· Timely – as close to the episode as possible;
· To be realistic, sensitive, enforceable and achievable, and seen to be proportionate to the behaviour in consideration;
· To be non-disruptive to other residents.
28. Sanction/ Consequences:
· At Radcliffe House, given the age range of young people, we believe in positive reinforcement through praise, non-verbal communication, and incentives. Consequences must be used cautiously for dealing with difficult behaviour, as they can lead to resentment from the young people. However, whenever there is a need for a consequence to any given situation, it is vital that the consequence is:
· Understandable to the individual concerned;
· Directly related to the incident;
· Individualised – relevant to age and understanding; there should not be a prescribed tariff of behaviour and consequences (blanket rules);
· Timely – as close to the episode as possible;
· To be realistic, sensitive, enforceable and achievable, and seen to be proportionate to the behaviour in consideration;
· To be non-disruptive to other residents;
· No consequences should involve or lead to the humiliation of a young people, and staff should ensure that the young people is able to retain their dignity and self-respect after the imposition of any consequences.
· Whenever a consequence has been applied, it is important that it is discussed fully with, and is as far as possible, understood and agreed by the young people.
29. Equal Opportunity Policy:
Nestlings care Ltd is committed to promote equality for all by encouraging diversity and challenging and eliminating discrimination in both its role as an employer and as a provider of services. Nestlings Care Ltd aims to create a culture that respects and values each other’s’ differences, that promotes dignity, equality and diversity, and that encourages individuals to develop and maximise their true potential. We are committed wherever practicable to achieving and maintaining a workforce that broadly reflects the local community in which we operate.
The purpose of this policy is to provide equality and fairness for all in our employment and in the provision of services and not to discriminate on the grounds of gender, marital status, race, ethnic origin, colour, nationality, national origin, disability, sexual orientation, religion or age. Organisation Name opposes all forms of unlawful and unfair discrimination. None of these issues of difference will effect an individual’s position within the home or their access to achievement.
Stereotypical thinking in relation to age, gender, sexual orientation and able-bodied status will be challenged.
Sexism, racist attitudes and prejudices towards disability will be actively challenged.
In recognition that young people from minority ethnic backgrounds have particular needs relating to their cultural differences, such as, personal care, diet, religion, language and education; there will be measures in place in caring for young people from ethnic minorities so they feel comfortable with the attention and care they are given. Young people are given skills to challenge discriminatory remarks themselves.
The above principles equally apply to all young people and young adults who are placed in our care.
All employees, trustees and volunteers, whether part-time, full-time or temporary, will be treated fairly and with respect. Selection for employment, promotion, training, volunteering or any other benefit will be on the basis of skills and ability. All staff will receive training in Equality & Diversity issues, the manager will ensure that staff have access to relevant information that assists them in understanding and meeting the care needs of all the residents within our services.
We are committed to achieving equal opportunities in everything we do, and to meet these aims we will:
· Not tolerate racist harassment or intimidation, and respond to all reports of this.
· Combat prejudice and stereotyping, particularly in relation to heritage, ethnic origin, geographic origin, race or religion.
· Encourage all individuals to apply for employment without discrimination.
· Responding to the needs of young people and staff from diverse community’s means having robust systems, policies and procedures in place which support equality and diversity.
· The manager has a responsibility to ensure that a culture is created in which the promotion of race equality and race relations becomes an integral part of everyday work.
· Both staff and young people are reminded that they have a duty to report any suspected racial incident or racial harassment perpetrated by others.
Nestlings Care LTD
Responsible Individual/Nominated Individual
Registered
Manager
Directors
Mental Health MDT
Team Leaders
Shift Leaders
Senior Support Workers
Team Audits
Team Action Plans
Feedback to Managers meetings and Mapped to Governance Agenda
Governance Meeting
Decisions Made and Feedback to Team
Managing Directors and Responsibel Individual/NP can evaluate and use effective outcomes for Residents
Safe+Effective Practice ( Reasearch and Evidence Based Practice) Risk management/Adverse Incidents
Flexible & Responsive Care Involvement of Young People, Integrated Team Working
Effective Accountability & Information, Infomation Management, Health Outcomes, Audits, Copmpalints/compliments
Leadership & Accountability (Supervision, Appraisal, Company Learning, CPD, Human& Financial resources & Management
Directors Anthony Thompson ( NI)
Mark Stares(Registered Manager)
Audits, staff Meetings, Supervision
Reports/ Minutes of meetings
written Feedback from Multidisciplinary Team
CQC
Service Users & carers involvement in service provsions, care planning, feedback from Service Users & Cares/complaints
Response to Service Users & Carers, feedback
