Focussed care provision, coupled with suitable and affordable accommodation, provides a vital step towards greater independence for each person
Person Centred Care informed by Positive Behavioural Support
At the heart of every care package is placing the individuals’ wishes, preferences and needs as central to their care and treatment. The individual’s decisions should be treated with respect and dignity. This principle underpins the ethos of the service, and where possible, every decision is inclusive of the individual. Adopting the person centred approach is vital in health care. The approach achieves effective outcomes and satisfaction as such informing high quality care.
The principles of Positive Behaviour Support (PBS) aim to enhance an individual’s quality of life by applying positive behavioural support techniques and implementing environmental reconstructing methods to reinforce positive enduring behaviour change.
A qualified Nurse Assessor (RMN) will provide specialist assessment to the service and ongoing clinical input. This person will support the care team by providing day to day nursing expertise in the safe delivery of care. To add, they’ll play a key role in clinical risk management and monitoring of the service, providing dynamic risk management of each person we support.
Dr Jonathan Rogers (Head of Clinical Research) provides input from both a forensic and neuropsychological perspective. His knowledge and expertise is utilised at the assessment process and throughout an individual’s stay with us. He also provides specialist training and advice to the staff team and plays an integral part within our dynamic risk model.
The process from leaving an inpatient ward is daunting for most. We make this easier for each person by having a dedicated contact to support with the process from initial enquiry all the way to receiving the keys to their new home. They’ll work closely with our partner landlord (Social Care Landlords Ltd) to ensure that all private tenancies are supported and each person in the service is able to transition safely into their new home.
Clinical Involvement beyond the Hospital
During the transition process, each individual has access to relevant clinical support from the Nurse Assessor, and in addition an option of sessional work from other health professionals. They include, Occupational Therapist, Speech and Language therapist, Dietician, Physiotherapist etc. (charged at an additional cost) The health professional involved with each individual is relative to their needs, introducing an integrated care model of multidisciplinary working, allowing improved support of the service and care delivery. Goals will be devised in order for the individual to develop a reduced dependency on services, nevertheless, having access to consistent and effective ongoing clinical support. The goals set will be measured by our service specific, person centred, outcome measure tool.
The governance of the service is overseen by Rav Sekhon to ensure efficient, quality and safe delivery of care. The governance process allows audit and quality assurance of every aspect of the service, ensuring robust, and correct ways of working are maintained.
A Dynamic Risk Management (DRM) model has been developed which allows risk to be managed closely on a daily basis in order to prevent/reduce risk. The DRM model feeds into a weekly Clinical Risk Meeting, which includes our Nurse Assessor and Psychologist to support with managing risk presented in the service. This allows for safe management of individuals that may not be typically be managed safely in the community.
The Clinical Risk Meeting feeds into a bi-monthly governance meeting which will enable the team to critically review incidents across the service and identify service improvements.
All assessments made by Balance Care will be overseen by the Registered Manager Rav Sekhon in collaboration with our head of research Dr Jonathan Rogers and also our Nurse Assessor. We will respond promptly to any assessment requests and would aim to have the report and recommendations completed inside a period of 21 days. In addition, the Enquiries, Admissions and Lettings Coordinator will support this process by enabling a smooth transition of each person into the service from the initial stage.
The BDI- ІІ is an assessment of the severity of depression in psychiatrically diagnosed adult and adolescent patients aged 13 years and above. The BDI- ІІ should be used with caution as the sole diagnostic measure because depression can accompany a variety of primary diagnostic disorders. There are 21 items within the test and the maximum score is 63. There are 21 items within the test and the maximum score is 63. Scores 0-13 indicate ‘minimal’ depression. Scores of 14-19 are indicative of ‘mild’ depression, with 20-28 seen as ‘moderate’ symptoms and 29-63 suggesting ‘severe’ depression.
The BAI is a 21 item scale that measures the severity of anxiety in adults and adolescents. Scores of 0-7 are described as ‘minimal’ levels of anxiety. Scores of 8-15 are described as being ‘mild’ levels of anxiety. Scores of 16-25 are described as being ‘moderate’ levels of anxiety and scores of 26-63 are classified as being ‘severe’ levels of anxiety.
This is a psychometric measure and is considered to be well validated tool. It is a powerful predictor of eventual suicide to enable clinicians’ measure three major aspects of hopelessness: feelings about the future, loss of motivation, and expectations. Responding to the 20 true or false items on the Beck Hopelessness Scale (BHS), patients can either endorse a pessimistic statement or deny an optimistic statement.
A positive therapeutic environment will be central to our service. This will be achieved by maintaining a positive attitude towards the individual which enables them to grow and develop personally. The focus of the service is to support an individual to transition to levels of optimum functioning.
The environment that this change is facilitated in offers the following:
- Reduced rental fee (due to partnership with landlord)
- Pre-admission visit (to give the individual choice of their new home)
We strive to support each individual achieve their goals, desires and in some cases – dreams. We all love to go on holiday and there’s no reason why the people that we support shouldn’t be allowed the same opportunity, all of us at Balance Care think this is important.
We support people to go on holiday. The process is risk assessed and managed safely so that people can enjoy trips away to a location of their preference. As well as supporting people to live successfully in the community, we want people to be happy, we find joy in creating positive memories together.