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21st December 2020 Life in Our Homes0

After the most challenging year that many of us can remember, we look forward to 2021 with hope. We will be ready to offer our service users the Covid-19 vaccine as soon as it’s available to them. In the meantime, Christmas preparations are well underway.

Christmas in our care homes is usually a lively time with much excitement. This year is no exception. We have adapted to staying at home and finding ways to keep our service users active, engaged, safe and happy. They are supported to take decisions on what happens within the home, and we have a wide range of festive activities going on, including:

  • The summerhouse at 8 Kingsthorpe Grove has been converted into a beautiful grotto ready for Santa to visit
  • The team at The Richardson Mews had a fun, Australian-themed Christmas barbecue with a visit from ‘Kenny the Kangaroo’ to distribute presents!
  • Saturday nights in December are Christmas movie nights at 144 Boughton Green Road
  • Christmas karaoke is always popular at 23 Duston Road
  • There’s also mince pie making, cookie decorating, making cards, decorations and Christmas wreaths, carol singing, Christmas bingo and much more…

We would like to thank the staff teams in each home, who have come together and supported each other to ensure that we provide the best possible care for our service users. It’s been incredibly tough and we’re very proud them.

With best wishes for Christmas and the New Year,

Laura & Greg Richardson-Cheater
Directors


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The importance of communication is the subject of the fourth blog post in our series about what we’ve learnt so far during the pandemic. It may sound obvious, but it’s easy to get it wrong. The situation was changing on a daily basis and the pressure and expectation on the management team was extraordinary. Never had the responsibility of being a Registered Homes Manager been so great. Here we share some of their thoughts and experiences.

Open communication channels

We learnt the importance of honesty, with ourselves, with our staff, with our service users, with our families and with each other as a management team. Had it not been for the openness that we have adopted in all our communications then this period would have been more challenging. It brought a sense of togetherness, a shared experience and an opportunity to change the way in which we build our relationships both professionally and personally.

None of us had ever experienced anything like this before so we were all learning together. We didn’t pretend to know all the answers, but we listened to WHO advice and took decisions swiftly in the interests of our service users. We reduced risks as much as possible to make our homes as safe as we could – both for our service users and our staff. We didn’t have all the answers but we did what we thought was best with the information that we had available at the time. We didn’t want to look back and wish we’d acted sooner.

We had to be honest about our fears and anxieties so we could support each other in finding ways to overcome them. It was important to maintain a positive attitude as we knew our response would affect the atmosphere within each home and impact our service users. They need to feel safe and secure within their home.

Our management meetings moved online. Although we couldn’t meet in person, we all took part in weekly management meetings, which were crucial in ensuring the smooth running of the homes. Facing the crisis together and being open and honest with each other has given all of us a better understanding of each other’s role and greater respect for each other. Together we worked out solutions to difficulties that arose, assessed risks, made contingency plans and boosted morale. It was vital to keep all communication channels open.

We managed staff teams so that there was no movement of staff between the homes. This had the positive effect of more continuity for service users. They had more 1:1 time with support workers so bonded more with staff. In some cases this has improved their communication skills, and some have demonstrated more empathy towards each other.

We’ve realised the importance of open communication, showing how we value, support and appreciate each other, talk more, respect and, most importantly, listen to each other. We’ve learning that praising and valuing people is so important in these difficult times.

We’re hugely grateful for the support of service users’ families, who have been unable to see their loved for long periods of time. We explained the difficult decision to close our doors to them and they understood that we had the service users’ interests at heart. We kept in touch as much as we could, getting to grips with new technologies, until they were able to meet in person again. They showed a lot a love and appreciation for all the staff, working under very difficult circumstances.

As the pandemic continues for longer than many of us expected, reflecting on how far we’ve come helps us to remain positive. We have protected our service users, kept them engaged and happy, and supported their families. We know we have the strength and resilience to continue.


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7th December 2020 Life in Our Homes0

As we’re always supporting our service users with acquired brain injury or learning disabilities to move forward, we rarely reflect on how far we’ve come. Our short series of blog posts looks at the views and experiences of our management team during the pandemic: what we’ve learnt so far about ourselves and how we manage our specialist residential care services. Although we have never experienced anything like this in our 30-year history, we have always focussed on the needs of the individual service users in our care. Every individual, whether they have a brain injury or learning disabilities is different. Therefore in order to deliver person-centred care, we often have to be creative in our approach.

Finding innovative solutions

For many service users, routine is a major part of their life. When their usual activities are no longer possible – no home visits, day services, community activities – we need to support and reassure them, creating new routines and structure in their lives. We have promoted health and exercise as well as bringing joy and laughter.

Although the service users have missed going out, we have had plenty of scope and opportunity to develop in-house activities. Our large gardens and outdoor spaces have been used for gardening: we’ve grown our own vegetables for the first time. We’ve had al fresco lunches and barbecues with a disco, played sports and games, done trampolining and completed treasure hunts. The in-house ‘coffee shops’ have been a great success, giving service users an opportunity to relax and build relationships between each other – often finding that spending more time together enables a greater understanding and appreciation of each other.

Restricting family visits was really tough, but we’ve maintained family contact through Skype, WhatsApp, Facetime and Zoom, as well as phone calls and letters. We even managed to track down a service users’ mother who had lost contact with her son several years ago. We were able to reunite them virtually using Skype, and this lead to seeing other family members too. This was a very positive and emotional experience for all.

At The Richardson Mews (inspired by Joe Wicks) the day now starts with ‘Morning Motivation’ – exercising to music every day to improve fitness, flexibility and well-being. We’re also making more use of our in-house gym equipment. One service user who has a brain injury thrived during lockdown: he was in a wheelchair in February and now he can walk 70 lengths of the parallel bars.

Staff have stepped into new roles – organising craft activities, baking sessions, quizzes or film nights. Some service users have also found new roles within the home too – one of the guys has become the house DJ!

We’ve celebrated birthdays with gifts, parties and barbecues. We’ve maintained structure when needed, providing mental stimulation, social interaction and fun, while supporting well-being and skills development.

We have always strived to create a relaxed family environment within each home. Facing the challenge of coronavirus together has brought everyone closer. The whole team and service users have felt and behaved even more like a family – there are good friendships and strong bonds. As we approach Christmas we maintain our focus on keeping everyone happy, safe, healthy and secure.


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23rd November 2020 Life in Our Homes0

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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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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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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The Coronavirus lockdown is affecting people in many different ways, but it can be particularly difficult for people with learning disabilities, autism and complex needs. They often need routine and structure, which has been disrupted as we’re no longer able to go out and about, visiting the usual places, doing the usual things. People with learning disabilities may not fully understand why their life has changed, or may not be able to verbalise their frustrations. We are supporting them in various ways:

Enhancing understanding

Everyone is different so we are supporting all of our service users according to their own needs and abilities. This can involve using non-verbal communication techniques such as Makaton, TEACHH or the PECS picture exchange system to explain the situation and what we need to do to stay safe.

Well-being

We’re being creative and introducing new structures and routines to keep everyone calm, entertained, safe and happy. We’ve been able to welcome back Martin the Music Man, whose music sessions enrich the lives of the service users in many ways. He’s been singing and playing his guitar in the gardens of the homes, while maintaining a social distance.

We’ve also had several birthdays to celebrate recently so we’ve made them special with garden parties, pamper sessions or parties in the homes with balloons, cakes, treats and gifts.

Trusted relationships

Many of our service users with learning disabilities have been with us for years, so we have a deep understanding of their likes, dislikes, needs and preferences. They have developed trusted relationships with our care support workers, which means that we are better able to support them in difficult times.

Feedback from families

We are also keeping in touch with their loved ones and are very grateful for the feedback we have received from families. Here are some examples:

“We spoke on the telephone this morning and I am writing to you to reiterate what I said to you on the ‘phone…

“There was a feature on this morning’s TV News about the very difficult time many autistic people and their carers are having during the Covid-19 lockdown.  As I watched it, I was reflecting on how very fortunate we are that our son is in your care and that he is being so well looked after and even more importantly, kept safe.  We are truly thankful for your care and for the brilliant work your staff at all levels are doing at during these difficult times. Please circulate this letter to your staff or post it in a prominent position so that all can read it…

Dear Friends

I just wanted to write to you as a parent of one of your residents to say how very grateful I am for the care you are providing for my son and the other residents during these difficult times.  I know you are doing your very best not just to care for our loved ones but to provide them with as varied and stimulating a time as possible.  I know that, like all of us, you are concerned about your own safety and well-being of yourselves and your families and this makes us doubly grateful for the excellent work you are doing.

I hope that you and your families remain well and look forward to being able to resume my regular visits.”

 

“Dear Jane [Service Manager]

I’m writing to say how thankful I am for the care my son has received while having another chest infection. He’s fine now thanks to your great staff. It must be so hard to keep everything germ free.

What really prompted me to contact you is the great idea of the cafe/tuck shop in the garden. That must make all the difference for everyone to go outside in the sun with their little coupons and buy something. I’m sure there are many challenges with everyone inside. Anyway thanks to all of you for a great job.”

We would like to thank all of the families who have sent in messages of support or gifts, and of course, thank our wonderful team of managers and staff. They are being amazingly positive, creative and dedicated, working hard to support our service users with learning disabilities, complex needs and acquired brain injury in these difficult times.

 


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17th March 2020 Life in Our Homes0

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.

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As our service is expanding, we need to recruit more care support workers so we decided to create a video to show that working in care can be truly rewarding.

The video shows care support workers and managers talking candidly about why they love working for Richardson Care, and the satisfaction that they get from supporting the service users. For example, Tracey, an Activity Support Worker says: “I’ve worked in care for over 20 years and this [home] is just perfect!”

Other staff talk about the support they are given by managers and team leaders and that they are empowered to provide the best care to meet each individual’s needs. They give plenty of examples of the variety in their role and the activities they take part in with the service users.

We’re very proud of our team and are fortunate to have a relatively low turnover of staff. Not only do we offer a range of employment benefits, but we strive to create a happy working and living environment. We know that the demand for care workers is high so we thought we’d try a different approach of creating a video to encourage more people to come and join us.

Please watch and share our video.

 


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The Coach House is our newest specialist residential care home and our third dedicated to adults with acquired brain injury. It is adjacent to The Richardson Mews and under a joint CQC Registration. It is a self-contained home and run by Registered Homes Manager, Jo Wilkins.

We launched The Coach House on 24th January 2019 and the CQC registration process was completed last summer. The first service users arrived in August and after just six months, we’re pleased to report that one of them was able to be discharged earlier this month.

Goal setting and care plan

Andrew* had sustained an hypoxic brain injury following a cardiac arrest 14 months prior to his arrival at Richardson Care, and came to us from a hospital neurological rehab setting. Members of our multi-disciplinary team (MDT) assessed Andrew and prepared a care plan for him. Goals were set for Andrew at the point of admission, with the aim of enabling him to move to a location closer to his family.

Andrew’s goals included:

  • Increasing his independence with personal care
  • Maximising his engagement in community access
  • Reducing his frustration in relation to his limitations
  • Reducing his wandering at night
  • Participation in elements of meal preparation

A small consistent care team supported Andrew on a daily basis, reinforcing the therapies implemented by the MDT. He built a good rapport with some of the members of the team, which was instrumental in his support and rehabilitation.

Gains achieved

Andrew made good gains in personal care and in mobility. He has been receptive to daily walking practice and he has been supported to access the community every day, which he does using a wheelchair due to stability and fatigue issues. He can also transfer more independently. Although The Coach House is located in private grounds, it has a wide range of shops, cafes, etc. in the immediate vicinity. Richardson Care has a good relationship with local businesses, which enhances the experience of service users when accessing the local community.

Although Andrew still presents with challenging behaviour, he has been able to reduce his frustrations and manage his behaviour more effectively. He engaged well with his care team, who found that distraction and diversion techniques were effective in reducing Andrew’s agitation due to his cognitive deficits.

Regarding elements of meal preparation, Andrew now actively participates in selecting menu choices every day with the support of staff. He will also initiate helping himself to a drink left on the table beside him without prompts from staff. These make important contributions to his overall well-being.

Positive outcome

Within six months, Andrew had made sufficient gains in all of his goals to enable him to be discharged to a residential setting closer to his family. It is hoped that with continued close supervision and increased family contact, he will be able to continue his rehabilitation from his brain injury.

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


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