AIMS OF THE BUSINESS - COMMITMENT
The Bill House is committed to giving their residents the highest standards of care and the residents are encouraged to lead full and active lives. The values of staff and management and the principles, which they seek to uphold, are fully in line with those of the commission for social care inspection. The staff and management are committed to the European Union’s Policy of promoting quality assurance in care and staff training. By taking part in both the Investors In People Awards and ISO-9902, the Bill House’s aim is to enable the development and delivery of care services to the standards required through a well-trained and motivated staff.

PHILOSOPHY OF CARE
Elderly residents with mental inequities may be able to live a fuller life if given the support, encouragement and a conducive environment. Management and staff aim to provide a secure, relaxed, caring and homely environment. Residents will be able to preserve and maintain their individuality, privacy, dignity, fulfilment, choice, independence and rights. The Bill House will offer facilities and caring staff with communicative skills to enable service users to respond and express themselves freely. Communication and stimulative activity helps to expand their concentration span, which can release motivation and initiative. Each resident will be treated as an individual and his or her needs will be recorded and monitored in a personal care plan. This will be reviewed as often as possible to reflect changing circumstances. Needs may be medical, physical, cultural, psychological, spiritual, social or emotional.

PERSONAL AIMS AND OBJECTIVES - VISION
The proprietors of the Bill House believe in a commitment and keep an open mind in the interest of improving all areas of care delivered. Knowledge in the field of caring has implications for the promotion and delivery of quality care and we aim to base our practices on researched based theories rather than traditional methods alone. In order to implement new care principles, the proprietors recognise the need for staff training and development systems to maintain progressive care. We accept that as a precursor to these lines of communication, the organisational and quality culture, which was introduced some time ago, has greatly improved the need to achieve excellence. The proprietors believe that training and a systematic approach to continuing good practice through monitoring, recording and constant evaluation of targets are essential ingredients for quality.

ADMISSION CRITERIA & PROCEDURE
Admission to the home need not be permanent. New residents are only admitted once the manager of the Home has made a written assessment. Men and women over 65 and over will be admitted with a mental disorder diagnosis, confusion, a loss of memory and dementia or Alzheimer’s disorder. Loss of memory due to alcohol or substance misuse and dependency may not be admitted.

A consultant and the Home manager to verify that the person seeking admission meets the criteria shall carry out an initial assessment. The new admission will undergo a trial period of up to six weeks. At the end of this period, the new admission would be reassessed to satisfy the management of the Bill House, that his/her needs could be fully met. This period if in doubt may be extended to three months.The Bill House will not admit persons under the age of 65 and those with severe physical or mental disabilities, those confined in bed or any other person with severe behavioural problems.A detailed assessment will be carried out within six weeks of admission following constant observation and monitoring. Based on the results of the assessment, the manager, key worker and service‘s representatives and relatives will set up a care plan for a period of six months. This care plan can then be set out based on medical, physical, mental and emotional needs. A care analysis will include strengths and weaknesses and potential or long-term development.

CODE OF CONDUCT

PRIVACY - The right of a Service User to be left alone and undisturbed whenever they wish. The Bill House provides sensor movement and intruder alarms as well as a nurse call system to alert staff to residents needs, accidents or incidents.

DIGNITY - The understanding of a Service Users needs and treating them with respect; the Bill House provides mechanical aids

and toileting facilities to allow residents and carers to carry out their tasks in privacy and in a dignified and respectful manner.

INDEPENDENCE - Allowing residents to take calculated risks, to make their own decisions, think and act for themselves.

CHOICE - Giving a Service User the opportunity to select for themselves from a range of alternative options including menu, drink, activity or leisure.

RIGHTS - Keeping all basic human rights available and encouraging Service Users to access all facilities in the community.

FULFILMENT - Enabling the Service User to realise their own aims and helping them to achieve these goals in all aspects of daily living.

RESIDENT’S CHARTER - We at the Bill House recognise our residents as individuals, each with different requirements. Our philosophy is that all residents have the right to:
Lead a full and independent life and be treated with dignity and respect.
Have the full support of a caring and trained staff to assist them when required.
Maintain the practice of their religion and attend religious services.
Lead lives free from any form of discrimination regardless of their race, sex, religion, colour or disability.
Regain/change their doctor and receive high quality care according to needs and in privacy.
Be informed of all aspects of their condition and proposed care, including alternatives available, unless they or their representatives express a wish of the contrary.
Have privacy when receiving counselling, treatment or personal care, and access to a quiet area to communicate with family, friends, clergymen or any other person.
Confidentiality on all personal, financial and medical records (subject to statutory or other legal provisions).
Have access at any reasonable time to the manager or person in charge.
Be provided with nourishing meals and snacks in accordance with dietary needs.
Have access to a telephone and be able to send and receive private correspondence.
Bring with them such items of personal furniture and belongings as they wish, and can be reasonably accommodated.
Make a complaint and have it investigated thoroughly, quickly and impartially and be informed of the result without fear of recriminations.

POLICY ON HARASSMENT - All residents and staff are entitled to reside and work within the care home environment without harassment. The organisation of the residents day and night should be as such as to allow maximum enjoyment of their lives.

Staff should be aware that their approach to the care of residents directly influences the atmosphere within the Home. The manager is responsible for setting an atmosphere within the care home, which allows for the development of relationships between residents/staff/relatives on a friendly basis. Individual staff members are responsible for starting each shift in a positive and calm manner with a view to promoting sound working relationships. The importance of good staff/resident and staff/staff relations is emphasised if a convivial atmosphere is to be achieved. Within this atmosphere, harassment of any person should be minimised.  Any resident who feels harassed by a member of staff should be free to approach the manager/person in charge in order to complain. Any complaint will be fully investigated and action taken by the manager.

Staff found to be harassing residents will be counselled and/or disciplined according to the Home’ss policy. Dismissal will occur if harassment of a resident does not cease.

EQUAL OPPORTUNITIES POLICY - The Bill House is fully committed to the broad principles of social justice and the acts of promoting equal opportunities in the provisions of all services, specifically with regard to minorities and disadvantaged groups. Residents will, therefore, not be intentionally discriminated against on the grounds of race, ethnicity, gender, sexuality, age or disabilities.

POLICY ON RISK TAKING AND USE OF RESTRAINT
At The Bill House, we believe that all individuals should be allowed to live their lives in as ‘normal’ fashion and with as few restrictions as possible, provided that this does not interfere with the lives of others.

‘Normal’ life is full of risks, and every day we all make decisions about what risks we should take or avoid. Whilst we, at The Bill House, recognise that our duty involves caring for the residents of the home, we feel that this should not involve restricting their right to take calculated risks in order to maintain an acceptable quality of life.

Restraining someone without their consent is unlawful. Restraint can take a number of forms; physical, emotional, attitudinal and financial. At The Bill House, we aim to avoid any form of restrain in the care we provide to our residents, whilst taking all possible, sensible steps to safeguard their well being, as we would within our own homes and daily life.

In this aim, we have adopted the following practices with regard to risk taking and the use of restraint:
Restraining chairs will not be used.
Restraining bedding will not be used.
Furniture will not be placed so as to restrict residents movement.
Cot sides will, in general, not be used.
Medication will not be used as a method of control.
Residents will not be confined to their rooms or any specific part of the home as a means to control their movements.
Those residents with restricted mobility will be assisted around and outside of the home by staff and/or relatives.
All residents will have a nurse call facility within easy reach to allow them to summon assistance.  Those residents who are prone to wandering outside the home will be supervised in an unobtrusive and non-custodial manner.    

Members of staff will accompany any resident on his or her wandering. The homes ‘Missing Resident’ procedures will be immediately instigated should a any resident wander away unnoticed.  No resident will be addressed as if they were a young child in order to persuade them to comply with the wishes of the staff.  Residents will be encouraged to express their feelings openly, to complain if they feel the need to, without fear of reprisals from staff within the home.

Note: We fully realise that some residents e.g. those who fall frequently or who wander, may be putting themselves at risk from time to time.

In these cases, the situation will be discussed by the manager with the resident and his/her relatives/advocate. The degree of risk will be assessed and appropriate action agreed upon. The result of this decision will be documented in the resident’s care notes which will be available to the resident and his/her relatives for their information.

Any resident and/or relative who are concerned about risk taking and restraint is welcome to discuss the matter with the Manager at any time.

ACCOMMODATION & FACILITIES

The accommodation consists of 28 bedrooms: 26 single and 2 double. There are two lounges overlooking the formal gardens and the sea and a separate dining room. Most the bedrooms have pleasant views overlooking the sea or gardens. All have en-suite facilities and many have showers or baths. The public bathrooms are equipped with hoists and a medical bath. Hot water temperatures and radiators are controlled and protected from scalding. All bedrooms, hallways and public rooms are tastefully decorated with oil paintings, plants and flowers. Bedrooms are provided with a wardrobe, a chest of drawers, a bedside chest, two armchairs, nurse call and movement sensors. There is also a nurse call by the ensuite toilet. Service Users can bring their own furniture if they wish. Sizes of rooms are listed at the Home and potential Service Users are free to request a copy. They should also ensure that the room size details are enclosed in their contract.

The gardens extend to the beach and are totally enclosed and surrounded by hedges of escallonia, tamarix, ennuymous and several other hedging trees. The gardens are divided into four parts, East, West, South and formal gardens. These are well laid out with shrubberies and flowerbeds and easily accessible, both by foot and wheelchair. In addition, the summerhouse, directly overlooking the sea has nearby toilet and tea making facilities. There are also two Victorian greenhouses, which Service Users can access at any time. The living rooms have adjoining access to a very large patio with beautiful views over the formal gardens, the wild flower garden and the sea. There are two other patios, one in the east garden and a very large one by the beach and summerhouse.

Residents have access to a payphone (Tel No. 01243 603915), where they can make and receive calls at any time. Alternatively, we can provide a radio-telephone (portable handset). The Tel No. for the Bill House is 01243 602567(2 lines), Fax No. 01243 604746. Email: thebillhouse@selseypc.com website: www.thebillhouseselsey.com

The Home provides hoists to assist residents for toileting and bathing. A number of wheelchairs are also provided but residents are advised to bring their own. Residents have access to living rooms, one of which is quiet, for reading. The greenhouses and the summer house can be accessed through the west side exit doors. The summer house is equipped with armchairs and tables for tea. It is also used for activities. There are 2 adjoining toilets and a small kitchen for tea making and snacks The central heating system is fuelled by Gas to a boiler capacity of 475,000 BTUS. The radiators are temperature controlled and provided with guards. The hot water system is also gas fuelled from another boiler and provides constant hot water, which is reduced at the outlets to 43 degrees C to prevent scalding. There is a passenger lift for a maximum of 7 people, equipped with an emergency alarm and lighting and can comfortably take a wheelchair and a Care Assistant.

The fire alarm system is the most up-to-date system and is self-addressable, incorporating 108 zones and can instantly identify the location. The system is maintained by a reputable specialist firm. The movement sensor monitoring system covers bedrooms and is individually controlled. All exits are alarmed and transmitted to panels, pagers and computer print-outs.

Laundry facilities are available on the premises and are equipped with 2 commercial washers and a tumble dryer. Machines are programmed to wash practically anything, including sluicing but woollens should be identified and clearly marked so that they can be washed separately. The washing machines are equipped with self-dispensing detergent and conditioner to the quantities required according to fabrics. Residents who are capable of ironing their own clothes will be encouraged to do so.

The kitchen is well equipped with a 6-burner gas stove, grill, double deep fryer, electric trolleys and tea trolleys. The kitchen preparation room includes a dishwasher, freezers and refrigerators. Readings are taken daily. Food deliveries and storage include date of arrival, freezing temperatures, sell by date, customer rejection and suppliers are checked to verify quality and traceability of product. Food rotation, cleanliness of receptiles and utensils and all prepared food in the refrigerator are identified and dated. Food is prepared from fresh and seasonal ingredients and no pre-cooked foodstuffs are used.

The menu offers a nutritious, well cooked and presented food to suit customer requirements. There are always alternatives available on request. These include low fat and low cholesterol, high fibre, vegetarian and allergies or mineral eficiencies.

Service Users with restricted use of arms or hands will be assisted with feeding. The food preparation areas are inspected by the environmental health authority, the Fire Regulations by the Fire Officer and other areas covered by the health and safety executive as well as the National Care Commission.

The Home provides all the necessary equipment, shampoo extraction and neutralisers, ionisers and air purifiers and a self dispensing system of odour neutralisers. Windows are regularly opened during the day. The Home operates a COSHH policy, which clearly identifies chemicals and their appropriate use. Further more the safety of cleaning chemicals is controlled electronically by a dispensing system, which automatically dilutes chemicals to a safe degree. Chemicals are stored outside the building for fire safety. The cleaning rota is very comprehensive and maintenance programmes are adhered to. Contractors can be called on emergencies on: electric, gas, boilers, central heating, water, plumbing, fire alarms, nurse call and sensor monitoring equipment, telephone, fax, printers and computers.

The Bill House offers a choice of activities which include: ball and board games, listening to music or watching TV, flower arrangement, quiz games, memorabilia and gardening. Residents are encouraged to use the facilities provided to pursue their favourite hobbies. In addition there is a weekly session with an activity instructor, a singer and monthly concerts. Weekly hairdressing, aromatherapy and manicure occur fortnightly.

There is a pest and insect control service.

The Home provides a safe for valuables and personal money allowances with records of expenditure with up-to-date balances.

Relatives will be issued with receipts when depositing money or cheques.

Health care services include visits from chiropodists, opticians and community nurses with occupational therapy/physiotherapy requirements being dealt with by the Home and the residents own GP. An activities instructor visits the Home weekly. In house entertainment is provided on a regular basis as well as trips to local shops and Chichester. The local minibus will also pick up and return residents from Sunday service. A hairdresser visits weekly but staff take every care to offer grooming assistance residents may require.

The Health Centre in Selsey (Tel: 01243 604321) house two medical practices, which provide an excellent service to the Home through Doctors Wilcox, Howarth, Platts and Miller and Doctors Murphy, Harris Chiswick and Lacey. Equally excellent is the community Nursing Service. Psychiatric consultants are based at Graylingwell Hospital, Chichester and all other treatment is provided by St. Richard’s Hospital, Chichester.

Should residents have to go to hospital, they are accompanied by a member of staff who will have all the necessary information with them. That member of staff will stay through the admittance and settling in procedure.

The Bill House Residential Home provides the following:-

Residential Care for Dementia and Alzheimer’s
Long and short term care
Respite care
Emergency care

PRINCIPLES AND VALUES
The values of the staff and management and the principles which they seek to uphold are fully in line with those of the commission for social care inspection. The staff and management are fully committed to the County Council’s policy of promoting quality assurance and continuity of service. To this end the Bill House has developed Quality Assured Systems to the standard of ISO-9001 and Investor in People.

BILL HOUSE TRAINING POLICY
The proprietors of the Bill House are committed to a policy of continuous care quality improvement through staff training, development and open communications. This commitment is demonstrated through statements made in the employment contract and staff handbook. Staff are expected, as part of their contract with the employer, to share in this commitment.

Each new member of staff will be formally inducted into the home, the staff team and their work role. Subsequently, each staff member will progress directly onto an internal programme of skills and competence development, culminating into NVQ qualifications wherever appropriate. Training programmes to achieve planned staff development will be a continuous feature underpinning the annual staff assessment and performance review process. Staff and Quality meetings will be used as an open forum for discussion of matters arising, which affect the quality of care our residents receive. All meetings will be minuted and the minutes are both circulated and posted for all to see.

COMMUNICATION
Communication is an essential element in our business. Information is channelled regularly through documents, notice boards, managerial and staff meetings. Communication among the staff has also released a number of initiatives and has helped to increase the level of competence.

The aims and objectives are communicated to all staff through meetings, notice boards and more effectively through Training and Development and good practices.

The commitment to training is equally important and will intensify to ensure staff maintain and improve the high standards required to meet the constantly changing demands and needs of our customers within the Health Care sector. Training will include bed care, lifting and transferring of residents to other areas.

STAFF AND STAFF DEVELOPMENT
It is the policy of the proprietors of the Bill House to include all staff in a curriculum of skill development, seeking to combine flexibility of role performance with competence. To this end a programme of NVQ implementation has been ongoing. The remainder of the staff participate in an in-house programme of personal health development based on training handbooks. The programme also includes the requirement of Health and Safety and Environmental Legislation, Lifting and Handling, Health and

Hygiene, Food Handling, First Aid etc. Besides the nurse/manager and nursing consultant, there are 6 senior carers and 15
care assistants. Each shift includes one senior carer and 3 care assistants, 2 awake night staff, manager and 2 assistants on call.

Action programme: The manager is organising and supervising staff development in care skills, the use of mobility equipment and time management skills, better use and understanding of care planning, documentation, observation and communication skills to enable staff to recognise, report and monitor more efficiently. Mental health courses will continue to fill gaps, especially in the field of understanding and communication with the residents.

Management meetings are held weekly and progress evaluation meetings in January and July. Staff meetings are held monthly.