acquired brain injury Archives

The second in our series of blog posts reflecting on the experiences of our management team during the coronavirus pandemic looks at our use of resources. We may have some way to go, but our team’s resilience, strength and adaptability means that we can face the challenges ahead.

Rethinking our use of resources

We wanted to minimise the impact of any changes on our service users, who have learning disabilities or an acquired brain injury. Although we had made the difficult decision to close our doors to family and friends, we knew that we needed to protect our service users, many of whom are vulnerable.

We found different ways to communicate and share experiences. We have all become much more tech-savvy, using the internet, apps, photos and video calls as well as phone calls so service users can keep in touch with their family and friends.

We learnt that many elements of our jobs can be completed using technology, so this can save us time for the things that matter. Regular management meetings went online in early March. These were crucial to keep up with the evolving situation and navigate the way ahead. They provided support, boosting morale when needed, an opportunity to share insight and experiences and to check in with each other.

We’re completing assessments for new referrals using online video tools, which means our admissions team no longer spend hours on the road.

The majority of our service users, whether they have an acquired brain injury or learning disabilities usually take part in a wide range of activities, accessing the community on a regular basis. Coronavirus restrictions meant that more activities would take place in-house.

We deployed central staff to various homes, so each home had enough admin and maintenance support and there was no movement of people between homes. The admissions team stepped in to support the care staff, running a wide range of activities from physical exercise to craft projects, keeping the service users engaged and happy. We also allocated care staff to specific homes, ensuring we had enough staff to operate safely if staff numbers were reduced due to increased sickness levels.

With members of our in-house maintenance team allocated to different homes, it’s meant they have been able to form closer relationships with the service users. Some service users have been helping out with maintenance jobs – developing their fine motor and cognitive skills while completing meaningful activities, they feel valued and gain a sense of satisfaction.

By reducing risk we’ve also found more efficient ways of operating. For example, instead of going out to the shops several times a day, there’s just one trip per day. This means planning ahead, so service users have been helping to plan the menus, write shopping lists and prepare for their daily needs. All these activities are helping to develop their cognitive skills.

The service users remain at the centre of what we do. By rethinking our resources, we have maintained the active, positive, safe and caring community within each home. We have ensured wherever possible that we meet each service user’s individual needs and minimise disruption to their lives.

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As we approach the winter, coronavirus cases rising again and another lockdown, it’s important to acknowledge how far we’ve come and what we’ve learnt. Our experience in supporting people who are rebuilding their lives after brain injury or living with learning disabilities means that we are problem solvers. We support people to overcome challenges every day. Never has this been more important and we’re proud of the way that our management team and staff have responded.

We asked our Homes Managers for their personal views and experiences of the pandemic – from their initial reactions to plans for the future. In a series of blog posts, we highlight what we’ve learnt and how some of the changes we’ve made will continue past the pandemic.

We’re more resilient that we thought

Resilience is defined as: “The capacity to recover quickly from difficulties; toughness” and it’s been demonstrated by our team throughout the pandemic.

We had to deal with something that no one had ever experienced before: a real virus, in real time with real people. Government guidance was changing almost on a daily basis and everyone reacted differently. The initial fear demonstrated by some staff left others having to broaden their shoulders, taking on extra activities within their daily routines. The responsibilities of the management teams have never been greater, we needed to be clear, decisive and robust in our response. We didn’t know all the answers, but we were learning together.

Jane Payne, Operational & Clinical Officer (pictured above), takes us back to earlier this year: “On February 18^th 2020 we informed staff that there was a new virus, and preventative measures were put into place including hourly touch point cleaning, increase in hand washing and an increase in awareness. Ahead of government guidance on March 12^th 2020, we took the very tough, necessary decision to close our doors to family and friends to protect service users. We made sure that all staff worked only in one home, so in the event of an infection, it would not be transferred from one home to another by our staff.”

“The Management team have become incredibly solid; working as one in supporting each other, as and when each has needed, as we live and work through the rollercoaster that is Covid-19. I am proud to lead; and be part of such a strong group of individuals displaying a sole purpose of ensuring the care, welfare, safety and security of our service users and staff. Richardson Care has shown we are more than resilient, we have become stronger through experience. Care: it’s in our DNA.”

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The effects of brain injury are complex and varied, causing a range of physical, psychological and mental health difficulties. A brain injury can affect someone’s personality and behaviour as well as their cognitive abilities and mental health – and all of these aspects can be inter-related, creating additional challenges.

Consultant Neuropsychiatrist, Dr Seth Mensah, is a key member of our team, supporting service users by treating and managing a range of mental health conditions. Here he gives his view on acquired brain injury rehabilitation.

“It has been widely established that acquired brain injury can result in significant and lifelong psychiatric and neuropsychiatric complications, which are responsible for at least as much disability as the associated physical symptoms.

These psychiatric effects of ABI: (i) interfere with rehabilitative interventions, (ii) are often associated with risks such as family disintegration, loss of accommodation, reduced access to rehabilitation or community facilities and conflict with the law, and (iii) more importantly, affect the survivor’s ability to function autonomously following their discharge from structured medical rehabilitative settings and place untold limitations upon their attempt to reintegrate into family and community life.

Neuropsychiatric disability, as sequelae of acquired brain injury, often limits participation in post-acute neurorehabilitation, which consequently leads to failure to exploit and attain the full potential for recovery for the survivor of brain injury. For families, this poses difficulties in terms of acceptance and adjustment.

Hospital-based and community-based rehabilitation, the goal of which is to help the survivor of brain injury achieve the maximum degree of return to their previous level of functioning, is therefore particularly crucial for those who develop neuropsychiatric disability.

Richardson Care blends an enabling and safe environment together with a very highly skilled and experienced specialist multidisciplinary clinical and care team where the service user, the survivor of acquired brain injury, is at the centre of all care, treatment and rehabilitation. This sets Richardson Care apart from many other community-based acquired brain injury health and care providers across the United Kingdom.”

Dr Seth Mensah MB ChB, MSc, DPM, MRCPsych
Consultant Neuropsychiatrist

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The CQC Emergency Support Framework (ESF) was launched on 1st May, running until 30th September. Due to the coronavirus pandemic, routine inspections of residential care homes and other providers were suspended, so the ESF offered a structured framework for regular conversations between the CQC and care providers. Although they were not inspections, the ESF provided a source of intelligence the CQC could use to monitor risk and identify where providers needed extra support to respond to emerging issues, and to ensure they delivered safe care which protects people’s human rights. It was also designed to aid understanding of the impact of coronavirus on staff and people using care services.

The ESF covered the following four areas:

Safe care and treatment
Staffing arrangements
Protection from abuse
Assurance processes, monitoring, and risk management

During this period the CQC contacted our specialist residential care homes for adults with acquired brain injury at The Richardson Mews, The Coach House and 144 Boughton Green Road and our specialist residential care homes for adults with learning disabilities at 2 & 8 Kingsthorpe Grove.

For all of the homes contacted, the CQC concluded:

Infection risks to people using the services are being thoroughly assessed and managed.
The services have reliable access to the right personal protective equipment and C-19 testing for both staff and people who use the services.
The locations’ environments support the preventing and containing the transmission of infection.
Working arrangements and procedures are clear and accessible to staff, people who use the services, their supporters, and visitors to the services.
Medicines are being managed safely and effectively.
Risks to the health of people using the services are being properly assessed, monitored and managed.
There were enough suitable staff to provide people with safe care in a respectful and dignified way.
There were realistic and workable plans for managing any staffing shortfalls and emergencies.
People were being protected from abuse, neglect, discrimination, and loss of their human rights.
Safeguarding and other policies and practice, together with local systems, are properly managing any concerns about abuse and protecting people’s human rights.
The provider is monitoring and protecting the health, safety and wellbeing of staff.
The provider’s systems and methods for monitoring the overall quality of the service and for responding to business risks and issues as they arise are effective.
Staff are supported to raise concerns and give feedback about the service.
Care and treatment provided to people is being properly recorded.
The provider is able to work effectively with system partners when care and treatment is being commissioned, shared or transferred.

In addition, the summary from 2 & 8 Kingsthorpe Grove reported:

You had encouraged anyone with symptoms to self-isolate in their rooms. Staff engage all people with activities and help them make video calls to family and friends. You are supporting people to understand the risks associated with COVID 19 and to wear appropriate PPE as required. You are kept updated regarding COVID 19 through newsletters and government updates. You are sharing good practice, offering and gaining support from other care homes.

With regard to The Richardson Mews and The Coach House, the ESF summary reported:

From our discussion and other information about this location, we assess that you are managing the impact of the COVID-19 pandemic. You have systems in place which have ensured you have remained up to date with all relevant guidance. Management plans are in place to manage the assessed risk around COVID 19. To date there have been no confirmed cases of COVID 19 in either home.

With regard to 144 Boughton Green Road, the ESF summary reported:

You have enough staff on duty and have a contingency plan in place if staffing becomes a concern. You support staff by completing risk assessments, team meetings, providing specialised PPE and through supervisions.

As we are moving into the next phase of this pandemic, we want to thank our dedicated teams of managers and staff as well as our service users. They have all demonstrated strength, reliance, creativity and patience during this very challenging time.

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Once again, Admissions & Referrals Co-ordinator Ebony has come up with a novel idea to engage our service users, who have acquired brain injuries, in a range of activities. With the usual activities restricted due to the Coronavirus safety measures, we have been finding new ways to keep service users active and engaged, supporting their mental well-being, physical health and cognitive skills. This time we present The Richardson Games!

We are fortunate to have a large hall at The Richardson Mews, which we use for a wide range of activities. On this occasion, we set up a range of activity stations where service users worked on a one-to-one basis with a staff member. Each pair then worked their way around the hall.

Having various games and activities happening at once boosts a variety of skills such as adapting to change (stopping the activity they are doing and moving on to something else) orientation (to the new task at hand) and, of course, provided some healthy competition, exercise and fun!

Each pair had to read the instructions of the game/activity upon arrival to the activity station. The activity stations were:

Balloon Tennis

Balloon tennis is the same as table tennis, but we use a balloon instead of a ball. This allows us to slow down the game, ensuring all our service users have an equal opportunity to play and join in the fun. It’s a favourite amongst our service users and it’s sometimes difficult to encourage them to come away from the game to have a rest or do something else. So it was great to have this as part of The Games, making it easier to encourage service users to move on to another task.

Pairs

A simple game of pairs, using colours: turning two cards over with the aim of making a colour pair. Everyone enjoyed this game, which works on short term memory skills by encouraging our service users to remember the placement of the cards in order to match and make pairs.

Cups

With little instruction, our service users were given plastic cups and were asked to make a tower using all of the cups. This encouraged cognitive skills such as planning (the structure of the tower) along with other skills like coordination and balance. It was just as fun knocking down the towers at the end as it was to build them!

Bowling

Who doesn’t love bowling? Our service users really enjoy this activity as it is inclusive of all presentations with minimal support. We were all very surprised when our service user John, got several strikes in a row with complete ease. He had kept his bowling talents a secret from us!

Rest

This was the least popular station, but it was important to include the opportunity to have a rest alongside lots of games and exercise.

The Richardson Games were a great success, bringing everyone together in a fun activity, boosting morale and supporting skills development.

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Activities of daily living require a huge range of cognitive skills, which we develop from childhood as we grow. However, someone who has an acquired brain injury has to re-learn many of these skills. At Richardson Care we take an holistic approach, where members of our clinical team work with each service user to develop the skills they have lost. These include communication and cognitive skills, physical abilities and mental well-being.

In addition to the therapeutic interventions from the clinical team, our service users take part in a wide range of daily activities, depending on their personal preferences. We aim for these activities to be fun and inclusive, catering for a wide range of skill levels and tastes so the service users enjoy the activities and engage in them. These activities support the work of the therapists, without actually feeling like therapy, and can have a positive and lasting effect.

During the coronavirus pandemic, we have had to be more resourceful and creative as our service users have not been able to access the local community for their usual range of activities. This has meant providing a varied schedule within the home, and these ‘science experiments’ were an imaginative way to support cognitive skills in a group setting.

Experiment 1: Travelling Rainbow Water
This simple experiment shows colours travelling through kitchen roll and mixing together to make new colours. We started with three cups of water, one red, one blue and one yellow. We separated the cups of coloured water with empty cups and connected them all with kitchen roll. It takes a bit of time for the magic to happen, but the group were very patient with the experiment and the results were definitely worth the wait.

Experiment 2: Storm in a Cup
With water, shaving foam and food colouring, we recreated the science of the rain clouds! We half-filled our cups with water and added a layer of shaving foam, ensuring it floated flat above the water. We then added coloured water, drop by drop to the shaving foam. When the water became too heavy for the foam, the sudden swirling clouds of colour sparked plenty of gasps and giggles.

Experiment 3: DIY Lava Lamps
We made our own lava lamp reactions using vegetable oil, water, food colouring and an Alka-Seltzer tablet – the contents of the cup bubble around together mimicking the reaction of a lava lamp.

This activity lasted for over an hour and all service users who took part were engaged for the entirety of the session and helped to clean up afterwards. This activity promoted cognitive skills such as reading and following instructions, patience, coordination, listening to direction, creativity and curiosity. Members of the group were also encouraged to think about how the reactions worked. A number of them commented on the difference weights of the materials in the Storm in a Cup activity, how the materials separated in the DIY Lava Lamps and how the tissue paper absorbed the colour to make the Travelling Rainbow Water.

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Gill Ayris talks about her role at Richardson Care and why she loves it so much.

“I moved to Richardson Care from the corporate world six years ago, swapping event management and promotions for the complex processes of Admissions & Referrals. I was made to feel really welcome: it’s a great team and there’s good support from the business owners and managers. In March 2019, I became Admissions & Referrals Manager.

“Along with Admissions & Referrals Co-ordinators, Sharon & Ebony, we are responsible for promoting our services to social workers, case managers, solicitors and other professionals. We attend events as well as keeping in touch by phone and email. As Richardson Care has been established for over 30 years and we accept service users from all over the country, we have a large network of contacts to manage. Thanks to our track record and the reputation of our services, many of our referrals come from word of mouth.

“I love my role. What gives me the most job satisfaction is receiving a referral and following it through to the end. That means securing a placement in one of our homes, knowing that we can support the person’s needs and knowing that they will fit in with the current population. I love seeing them settle in and watching them progress in their therapies and their behaviours, and improving their quality of life. And it’s really rewarding to see them move on – either back home or to supported living. Even if they stay with us over the longer term, it’s lovely to see them develop their daily living skills and be happy.

“That’s what it’s all about. If you’re working in care you have to have that passion to improve someone’s life. At the end of the day, we’re dealing with real people. If someone’s had a brain injury, they are still that person. They are still Joe Bloggs. They might have a diagnosis now, but they are still Joe.”

“When we receive a referral, we need to assess whether we can help that person and whether they will fit in with the current population in that home. This is crucial – we are very mindful of this being a person’s home, where they feel safe and happy. We don’t want to disrupt life for our existing service users by introducing someone who won’t fit in. Consequently, we require a lot of information at the point of referral. We need full disclosure of the individual’s current conditions, living skills, cognitive abilities, mental capacity, risk behaviours and medications, as well as their medical and forensic history.

“Then if we feel that they would indeed fit into our community, we arrange an assessment. Under normal circumstances, we travel all over the country to complete assessments. It’s usually the admissions team member who has been dealing with the case, along with the appropriate home manager, who will go. We consult with our clinical team and if we feel that we can support that person, we make an offer by letter. The offer letter details the level of specialist care provision and associated costs.

“At Richardson Care, although we have a strong clinical team, this is not a hospital setting: it’s much more like a home from home. For example, the staff don’t wear uniforms, so there’s more of a relaxed feeling, it’s more of a family environment. Whether you have a brain injury or whether you have a learning disability, when you’re coming to one of our homes, from that time on it’s your home. You wouldn’t wear a uniform at home. We want everyone to feel comfortable and relaxed, so I think the no uniform policy makes a big difference.

“We have six care homes and I always say to families, friends and professionals who come to visit our homes prior to a referral is that they must look at all of the homes. If you walk into a home and half the service users aren’t there – they’re out doing this activity or that activity – it’s completely different to seeing everyone sitting in the lounge not doing anything. By visiting the homes, you can feel the atmosphere. You have to walk out of that home feeling happy and comfortable with leaving your loved one or client there.

“Of course, life has changed for everyone during the Covid-19 crisis. For me and my team, this means that our focus has been more on supporting the service users in our homes. We’re based at The Richardson Mews, so we’ve been going shopping for the service users here or supporting them with activities within the home. Sharon has been providing admin support at 23 Duston Road as staff have not been going from one home to another. In general, the morale has been fantastic and everyone has pulled together to keep our service users safe and happy. When we go back to our normal roles full time, I’m sure we’re going to miss seeing so much of our service users!”

You can contact Gill Ayris and her team on 01604 791071 or email admissions@richardsoncares.co.uk

See Gill Ayris talking about her role in this video, recorded in January 2020.

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Each service user at our specialist residential care homes has their own individual care plan, which is designed to provide therapies and activities to meet their needs and help them to reach their personal goals. These therapies may include psychological support, psychiatry, speech & language therapy, occupational therapy, physiotherapy as well as exercise and activities of daily living. Our aim is for these activities to be enjoyable and stimulating; not to necessarily feel like ‘therapy’ but to be part of the individual’s weekly routine.

One of the psychological therapies we provide is Cognitive Stimulation Therapy. It’s a weekly group activity and each session has a different focus, for example current affairs or creativity. Cognitive Stimulation Therapy aims to promote and reinforce growth in areas such as memory, concentration and communication. It also stimulates social interaction, increases confidence and well-being. The Cognitive Stimulation Therapy sessions are designed to be fun, and are person-centred, tailored to meet each individual’s needs and preferences.

In this blog post, we take a look at a recent Cognitive Stimulation Therapy session for some of our service users who have an acquired brain injury; what the session involves and how it benefits the individuals taking part. The session starts with orientation: reinforcing the time, date, place, season, etc. Then moves on to the activity of the week.

This time it’s creativity: making personal globes.

Each service user started by making their own personal paper mâché ‘globe’. This involved lots of PVA glue and tissue paper, stuck onto an inflated balloon. The service users chose the colours they wanted and got stuck in with the creative mess. This particular session was attended by several residents who don’t often engage in group activity, so this was amazing progress.

Once the paper mâché was dry, we popped the balloons and asked the guys to illustrate the globe with pictures that represented them as people. The results were quite amazing! On this occasion, Assistant Psychologist, Olivia, ran the session and was supported by Admissions Co-ordinator, Ebony. They had spent some time sourcing lots of images that may resonate with the service users, such as images to convey emotion, relationships, hobbies, family, careers and their brain injuries.

They jumbled all of the images around and, without much direction, the individuals started to pick out the images that spoke to them. This was such a great activity: it enabled the service users to express elements of their lives before their injuries and who they are as a person. As you’d expect, there were huge variations – one resident looked for an image of a diamond ring to represent his engagement, while another illustrated his many years as a taxi driver and love of chicken!

Ebony worked on a 1:1 basis with Andy*. He picked out the images and Ebony prompted him to think about why he chose them and how they resonate with him as an individual. This is what he said.

Smiling face: “I like this because he’s laughing. He represents my humour”

Water: “Because I love to swim.”

Glasses: “I wear glasses: they represent me physically.”

Watering can and growing plants: “Because I really like gardening – it could represent personal growth too”.

Couple in love: “This one represents my need to love and be loved. I would really like to get married one day.”

Hard hat: “This represents my former job as a labourer and how I really want to get back to work. I’d like to be a plumber or a bricklayer.”

Dog: “This represents my family dog and my love for animals.

Two men hugging: “This reminds me of my Dad. I have a very close relationship with him and it’s important to include this – he has grey hair too!”

Knife and fork: “I’m a typical man, always thinking about food!”

Yin and Yang: “I associate this with Thai Chi martial arts – my Dad teaches Thai Chi.” After a bit of research Andy decided to include it in his project as he felt it represented ‘life’.

A hospital: “This is a big part of my identity, I spent a lot of time in hospital, but that wasn’t necessarily a bad thing.”

Ebony expressed how proud she was of Andy, as this was the first activity that he had fully engaged in enough to complete. He said he thought it was because it had really got him thinking and had been fun to do.

No two brain injuries are the same and person-centred care is all about treating the person, not the injury. Individuals are shaped by the lives that they had before their injury and we respect that person, aiming to restore as much of them as we can.

*We have changed the name of the service user to protect his identity

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Many of us who are fortunate to have a garden are giving it much more attention since the Coronavirus restrictions started. The gardens in our specialist care homes are no exception. Not only are the gardens benefiting from extra TLC, so are our service users.

All of our homes have large gardens and/or outdoor space that is used for a variety of activities, depending on the needs and preferences of service users.

The Mews – home for adults with acquired brain injury

One of our service users had taken ownership of some raised flowerbeds, which had been neglected, and as we’re all confined to the home and garden, he had some helpers. He trusted Ebony and Paige (two of our Admissions & Referrals Co-ordinators) along with another service user to get involved. They revamped the whole patch: dug, weeded, replanted some of the existing plants and added new ones. They planted herbs and vegetables as well as sowing some seeds.

Everyone enjoyed it, and one of the guys who suffered low mood said he had a really great day. Research, as well as anecdotal evidence, has shown that gardening activity has many well-being benefits – it’s mindful and calming, reducing stress and the symptoms of anxiety. It’s a meaningful activity, providing focus and hope – seeing plants grow and develop gives us something to look forward to in these uncertain times. In addition, neurological injury can impact on the brain’s ability to control physical movements, so weeding and planting seeds, for example, can help to improve fine motor skills.

The large garden at The Mews was perfect for our Easter treasure hunt and is also used for a wide range of games and activities.

The Coach House – home for adults with acquired brain injury

Adjacent to The Mews, service users at The Coach House have access to all of the gardens. They also have their own outside space with patios next to some of the bedrooms and a lovely sunny terrace at the front of the home. The service users have been enjoying the sunshine – having lunch outside, playing giant noughts and crosses, listening to the birds and enjoying nature.

144 Boughton Green Road – long-term home for men with acquired brain injury

The large rear garden has a big lawn, which is great for football, badminton, croquet and outdoor darts. Families have been very supportive and donated some outdoor games, including giant Snakes & Ladders and Jenga. The patio is perfect for sitting in the sun and chilling out – just being outside has benefits of engaging all the senses, Vitamin D absorption, improving sleep and general well-being. We also have some extra gazebos, so there is plenty of shade and the guys have been eating alfresco when the weather’s been good. We had a barbecue one Friday and everyone really enjoyed themselves. One of the service users was the DJ for the day, and has now nominated himself as the home’s DJ!

There’s also been plenty of gardening activity – we’ve started a vegetable and herb garden, sowing seeds, and potting up plants. We’re hoping to grow potatoes, carrots, sweetcorn, tomatoes, cucumbers, aubergines and chillies.

23 Duston Road – home for adults with learning disabilities and complex needs

The back garden at Duston Road has a summerhouse, trampoline, tables and chairs, so can be enjoyed for a variety of activities. There was great joy recently when Martin the Music Man came to visit. He usually comes to the home every week, but had stopped coming because of social distancing rules. However, an improvement in the weather meant that he could play his guitar and sing, while maintaining a social distance. The guys and girls were really pleased to see him and he spread some musical cheer to everyone at the home.

2 & 8 Kingsthorpe Grove – homes for adults with learning disabilities and complex needs

The garden and patio provide some lovely outside space for games and other activities. However, the service users’ favourite thing at the moment is our new shop! They are all missing their trips to the local shops and cafes so we’ve converted the summerhouse. Tables and chairs are set up in the garden and they are all loving it.

We are trying to provide a sense of normality and routine, as well as some fun, during these difficult times. Outdoor space (especially when the weather is good) gives us additional opportunities to do this. A whole range of activities contribute to well-being and rehabilitation in a number of ways from enhancing mood to improving physical skills.

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We often receive lovely comments from both family members and professionals about the specialist residential care that we provide, especially after they have been to visit their loved one or client. Here is a small selection from last month:

“Thank you for managing so much. It’s hard not having him near us, but knowing he is improving is the main thing” – family member
“I cannot say how good getting him to shower has been, that in itself is a great achievement. Thank you for keeping in touch”– family member
“I had a lovely visit with [him] on Sunday.” – family member
“Thanks for the warm welcome from you and your team” – Clinical Co-ordinator
“We had a really good visit, lunch [at the home] was first class.” – Case Manager

These comments relate to service users with acquired brain injury, but we have the same focus on quality of care for everybody, whether they have learning disabilities, acquired brain injury, dual diagnosis and/or complex needs.

Person-centred care

One of the things that sets us apart from other specialist residential care providers is our ethos of putting the service user at the centre of everything we do. This combined with our emphasis on dignity, respect and community underpins all the decisions that we make.

Having six care homes means that we can provide specialist care and support for adults with acquired brain injury and separately for those with learning disabilities. This also gives us the flexibility to offer short-term rehabilitation as well as long term rehabilitation and a home for life. We always take into account the needs and personalities of the current residents when considering new admissions.

Quality of the home environment

The quality of physical environment is also crucial to service users’ well-being. Experience has shown us that the right environment helps people with acquired brain injuries to better engage with their rehabilitation. It can also reduce anxiety and stress.

Of course, our homes are clean and safe, and we also try to make them as homely as possible, without being cluttered. This includes encouraging service users to bring their own belongings and we can decorate their room to their taste. It also means being innovative in our choice of furniture and furnishings, so that they are practical but look like something that you would have at home or find in a hotel instead of in a residential care setting. A good example of this is the new purpose-built wet-rooms that we have in The Coach House. They are accessible, single-level, fully-tiled rooms and the showers have a grab rail incorporated into their design. The style is ‘sleek and modern’ rather than ‘institutional’.

In addition, our specialist care homes are designed with plenty of communal space: separate dining rooms, a couple of lounge areas, tables and chairs in the garden. This means that service users can feel at home with the benefits of social contact and community, along with the space and opportunity to have some quiet time without being confined to their room.

By providing the right physical environment, along with experienced, caring staff, we can support all of our service users to live happy and fulfilling lives.