All referrals are assessed by appropriate member(s) of the multidisciplinary team prior to admission. All risk factors, both in the context of the person’s own life story and with consideration to the current population at Cornerstone House are considered.
Assessment includes an examination of the individual’s social, interpersonal, clinical and psychological history, current diagnosis, behavioural patterns and forensic history.
Referrals are discussed with the referring team colleagues who must also consider the placement as being an appropriate for the individual. All available recent risk assessments, CPAs and clinical notes are reviewed.
In cases where an admission is required more urgently, an initial assessment will be made on the basis of the information provided by the referrer. In all such cases, agreement will be reached amongst the senior managers of Cornerstone House, as to the appropriateness of the admission.
New admissions and potential referrals are routinely discussed in the Senior Management Team Meetings (SMT).
A full life history is obtained at a level determined by the individual which for many will be an on-going piece of work. A full review of any previous notes available is made. Interviews with family members, carers and friends are conducted (where the appropriate consent is given).
Treatment starts with a full review of an individual’s physical and mental health needs conducted by members of the multidisciplinary team. The team consists of a Consultant Psychiatrist, Specialty Doctor in Psychiatry, Registered Mental Nurses, Art Therapist, Occupational Therapist, Occupational Therapy Assistants, Clinical Psychologist, Assistant Psychologists, and Mental Health Support Workers. Cornerstone House contracts a local Consultant Physician working in Acute Hospital Medicine and Consultant Physician working in Accident and Emergency Medicine to visit the Hospital on a weekly basis. Their responsibilities include supporting the management of physical health needs and advice and management of self-harm and trauma. All People are registered with a local GP.
A Responsible Clinician (RC) assumes clinical responsibility for a person during their stay, unless there is an agreement for the referring community RC to retain this function. The RC is supported by a Specialty Doctor in Psychiatry. This function in turn is supported by a team of Registered Mental Nurses and Support Workers.
Following the MDT review care plans are devised in collaboration with the person. The content of each care plan varies between individuals as a reflection of peoples specific needs.
Extended assessment period
There is an initial assessment period of 12 weeks, which allows:
- A comprehensive review of an individual’s psychiatric, medical and psychosocial history.
- An extended period of risk assessment with particular reference to the environment at Cornerstone House
- A continued assessment of a person’s potential to benefit from rehabilitation activities.
- An individual’s own assessment of the benefit of a continued stay.
- The involved of family/carers and significant people as identified by the individual.
Following this period, a written report contributed to by members of the multidisciplinary team, is used to inform the first CPA meeting within 13 weeks of admission. The person is provided with the opportunity to review and discuss their report prior to the meeting and their view actively sought during the meeting.