Brain & Spinal Injury Handbook- 21/22 by Seven Star Media

2021 /2022 EDITION

Brain & Spinal Injury Handbook COMPLEX CARE

The road accident that changed everything FINANCIAL & LEGAL

Stress points in catastrophic injury litigation LONG-TERM SUPPORT

Why manage posture? CASE MANAGEMENT

Struggling to find trained, rehabilitation assistants who have something special? RECOVERY & REHABILITATION

How to eat well with swallowing difficulties An indispensable publication for occupational therapists, lawyers & other healthcare professionals

We know you will be worried and have questions and concerns... Our specialist trauma lawyers can help

We can help because we understand that a major trauma injury will require early, specialist, intensive and expertly delivered rehabilitation to assist with your important recovery from: 9 Acquired & traumatic brain Injuries 9 Spinal cord injuries & amputations 9 Chronic pain & complex regional pain syndrome

9 Complex & multiple fractures 9 Fatal accidents & nerve damage 9 Psychological injuries such as PTSD & depression

We will guide you through the legal process to obtain the financial security you deserve for the future and to access early rehabilitation through treatment, therapies, care and support. Our award winning personal injury solicitors have experience of successfully dealing with a wide range of catastrophic and life changing injuries.

2021

For a FREE confidential telephone consultation call 0808 250 6017 Our team is available 24 hours a day – on hand to help you and your family. To support our clients during the pandemic we offer video conferencing facilities.

Email: hja@hja.net Web: www.hja.net We are authorised and regulated by the Solicitors Regulation Authority (No 651238)

WELCOME Dear Reader, Welcome to the 2021/2022 edition of this essential publication for case managers, legal professionals, neuro rehab providers, patients, families, friends, healthcare professionals, and all those affected by brain or spinal injury. The Brain & Spinal Injury Handbook is an indispensable publication for occupational therapists, lawyers and other healthcare professionals, who will no doubt agree that this annual handbook creates an important platform for sharing knowledge and experiences, as well as raising awareness around this field of medicine, related law, recovery and rehabilitation. We would like to thank all of our contributors to this issue. If you have something to share about brain and/or spinal injury, please email the editor: lee.gatland@sevenstarmedia.co.uk Until next year. The B&SI Handbook Team

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B&SI HANDBOOK

CONTENTS

2021 /2022 EDITION

SPINAL CORD INJURY 08

The Spinal Injuries Association leads the way in supporting people with spinal cord injuries

RECOVERY & REHABILITATION 10 12 15 18 23 24 26 28 29 30 32 34 36 38 40

43 44 46 48 50 52

UKABIF continues to drive change The benefits of using hydro/aquatic therapy to treat neurological conditions Dedicated rehabilitation creating happiness daily New brain injury awareness programme to support teachers and school staff Complex care services at Hawthorns Care Centre, Peterlee How arts therapies can support the mental health of brain injury survivors Specialist rehabilitation after a brain or spinal injury STEPS has just got even better! New world-leading rehabilitation technology now available Rehabilitation and support for independence How to eat well with swallowing difficulties Improving rehabilitation outcomes… Is food and nutrition the missing link? Think Therapy 1st - A brain injury case study Complete Neuro Rehab - Helping you feel like... you Getting a grip on making rehab fun The Mental Capacity Act, deputyship and empowerment - The impact on occupational engagement Richardson Care’s unique brain injury care and rehabilitation A unique approach to finding and adapting a home Family Focused Interventions - What happens when we bolster family resilience? “I’m so dizzy – My head is spinning” “An ABI can cause hidden disabilities that families may not be expecting” LV Rehabilitation - Unlocking the potential for neurological recovery

CASE MANAGEMENT

53 54 56 58 60 62 64

What makes LDCM different BABICM celebrates its 25th anniversary Be more child-like to remove the barriers As a specialist case management service, what makes Emma Way Associates different? Struggling to find trained, rehabilitation assistants who have something special? A person-centred approach to rehabilitation “Reflections on a year like no other – Adapting case management during a pandemic”

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56 66 68 70 72

Maintaining client care standards - How to plan for a transition during a pandemic Anglia Case Management (ACM) Expert rehabilitation case management services MSP Case Management

MEDICO-LEGAL 73 74

Traumatic brain injury (TBI) and the hidden losses in families Jane James and Associates has been medico-legal reporting for over 35 years

COMPLEX CARE 76 78 80 81 82 84 86 88 89

Promoting mental health as well as physical wellbeing Complete Care Amegreen - Exceptional care for exceptional people Better quality of care for a better quality of life EnViva complex care Superior Healthcare: The road accident that changed everything Outstanding live-in care for clients with clinical needs Health And Social Care Services - Changing lives, one at a time Network Complex Care Team National Nuerological Services - A division of the National Care Group

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B&SI HANDBOOK

128

98 LONG-TERM SUPPORT 90 92 94 96 98 100 102 104 106 108

Vibrations and shocks during manual wheelchair propulsion Why manage posture? DIETZ Power – A masterpiece of empathy Assistive technology provision: Matching the user with the right technology How to find the perfect chair? Historical merged with contemporary - Moving accessibly between the centuries The health & wellbeing benefits of a homelift Brotherwood case study - Ford Tourneo Connect One more step on the road to independence Home Semen Retrieval: Ferticare 2.0 is back

FINANCIAL & LEGAL 112 114 116 118 120 122 123 124 127 128

Release the cash you have tied up in your ongoing cases Reject Alternative Dispute Resolution at your peril... Can the Court of Protection save my means-tested benefits after I inherit? Expert pre settlement - IFA services Why the Serious Injury Team at No5 Barristers’ Chambers prides itself on strength in depth A rehab-focused approach to damages Get 79 leading experts working for you Stress points in catastrophic injury litigation Brain & spinal cord injury: Fighting for what’s right What rehabilitation can help brain injured people live independently?

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EXPERT WITNESS SPECIALISTS

Managing finances following a brain injury

01249 456 360

PERSONAL PROFILES 132

Personal Profiles

USEFUL CONTACTS 136 138

Brain & spinal injury contact information A very special thank-you to all our contributors

Executive Editor Lee Gatland lee@sevenstarmedia.co.uk Art Director Richard Hejsak richard@sevenstarmedia.co.uk Sales Team Claire Hollingdale & Joanne Lewis 01959 543 659 sales@sevenstarmedia.co.uk All other enquiries claire@sevenstarmedia.co.uk

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B&SI HANDBOOK

THE ART OF SECURING A RENTAL PROPERTY

Finding the right property that suits the exact needs of a catastrophically injured client can be a challenge at the best of times. Their needs must be met as soon as possible and this can be difficult when finding and adapting a home for life. It can take a considerable time, particularly when there is so little suitable housing stock on the market.

t is just as well one of PLG’s greatest strengths is our ability to secure creative rental property solutions in record time for clients. How do we do this? Well, we are prepared to think outside the box in a dynamic Phillip Gill way, generally enabling us to find answers to even the most difficult of situations.

They make the impossible, possible MR G, EALING

Creating viable short to midterm solutions for clients that have suffered catastrophic injuries is a critical pathway for giving the highest quality of life possible, and renting a property which meets need is an effective way forward. Renting a property is rarely perfect. Perfection is reserved for the forever home, but it fills a gap between the injury occurring and locating, buying and creating a forever home. We want to restore our clients’ quality of life as soon as we can. It is vital that those with severe injuries can source suitable accommodation quickly so that they can implement therapies and care packages at a really early stage. The sooner these can be put into effect, the better the quality of life for the injured person, the better the prognosis and the sooner family life can return to a degree of normality. Invariably it is very challenging to find, buy and adapt a long-term home within the timescale we believe our clients need to start to

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rebuild their lives. But rental of a suitable property provides an answer. We believe that this solution can reflect the individual situation, family dynamic and location as well as the obvious need. “Why not try before you buy?” Is a question that we frequently put to clients who are cautious about renting and used to home ownership. In our considerable experience we have found that renting a property can also prove to be a fantastic opportunity for our clients to try out individual accommodation solutions and establish what works, an more importantly what doesn’t work, before they permanently install in a forever home. Renting a property may only meet need in the short to medium term, possibly two years or so, but typically this is a crucial time for the injured person, when they need to be able to move forward positively, implementing therapies and interventions at the earliest opportunity, and make the progress which only suitably adapted accommodation can help them achieve. At PLG, we believe that the right rental can “make the impossible, possible” even quicker. And that surely has to be a good thing for all parties. ■

tel: 0333 577 0809 | email: hello@plg.uk web: www.plg.uk sevenstarmedia.co.uk

PLG are the market leaders for disability property. We are a national, multi award winning provider of aspirational homes for those with disability, including regional LABC ‘Best Inclusive Building’ awards. We provide services for every stage of the disability property process, This includes property search, acquisition, project management, architectural adaptations and post-completion support. For us, it’s more than just doing a job. At PLG we pride ourselves on creating unique, inspirational homes not just houses, and taking people to the point where their lives can move forward. We are trusted by many of the leading personal injury and clinical negligence lawyers in the UK

''PLG HAVE BEEN FIRST CLASS''

David M, clients father

Simply put, PLG solve the complex housing needs of clients in a uniquely flexible, supportive and creative way. Working as a team with our clients, their legal and clinical teams we address and solve all of their property related needs.

''THEY MAKE THE IMPOSSIBLE, POSSIBLE'' Mr G, previous client

WANT TO LEARN MORE ABOUT THE SERVICES WE OFFER:

www.plg.uk hello@plg.uk 0333 577 0809

SPINAL CORD INJURY

Spinal Injuries Association Leads THE WAY FOR SUPPORT FOR SCI PEOPLE Spinal Injuries Association (SIA) is the expert voice and leading source of support and information for people with spinal cord injury (SCI). For more than 45 years, we have helped spinal cord injured people throughout the UK lead fulfilled lives and represent the wider SCI community at government and national level.

rom the moment of injury and throughout life beyond, the SCI community wants expert advice and support, and we are here to show that no one need be alone. We are also incredibly proud to be a user-led Sophie Davis organisation that reflects the views of our 13,300 members.

NEW ESTIMATES REVEALED Recent estimates show that the number of people paralysed by spinal cord injury is much higher than previously thought and because of this, SIA is calling on all government departments to ensure every injured person has the care and support they need and deserve to lead a fulfilled and independent life. There are about 50,000 people with a spinal cord injury in the UK and some 2,500 are injured or diagnosed each year – one person every three-and-a-half hours. Previously it was widely believed, including by the NHS itself, that only 1,000 people were injured or diagnosed each year and that the total number of people living with a spinal cord injury was 40,000. Nik Hartley OBE, the Chief Executive of Spinal Injuries Association, said: “The revelation that there are hundreds more people across the UK that will sustain a spinal cord injury every year is stark. However, it is not just the increased numbers; it is the decreasing provision of specialist services alongside this, that is truly shocking. The NHS and wider government must dramatically increase vital and extremely specialist health care and support to the 2,500 people each year who have to come to terms with a life of paralysis as a result of spinal cord injury. We will not stop fighting until that change in investment happens.”

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WHAT IS SPINAL CORD INJURY? The spinal cord can be damaged through accident and injury or because of a health condition that is either diagnosed at birth or later developed, such as a tumour or cauda equina syndrome. Just over half of all new cases are because of injury, while the rest are due to infections or tumours of the spine. For many, this is a life-changing and permanent disability that causes paralysis and loss of sensation below the level of injury. This can mean being unable to walk or losing control of bladder and bowel function. Those with a high-level injury may also have limited or no hand and arm function or be reliant on a ventilator to breathe. Some people may retain the ability to walk, but they may experience other complications. However acquired, spinal cord injury can be devastating. SCI people and their family and friends will also have to come to terms with the psychological impact of a life-changing disability that affects every aspect of their own lives and the lives of those closest to them. Alongside others with disabilities, SCI people also face inequality and adversity. Poor accessibility to buildings and transport, employment discrimination, poor care packages and an

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SPINAL CORD INJURY assumption of mental incapacity are just some of the challenges SCI people confront daily. Nonetheless, SIA believes that with appropriate support, SCI people can – and do – lead fulfilled lives, making a worthwhile contribution to society and family life.

HOW WE CAN HELP Our Support Network team, who all have personal experience of SCI, help newly injured people from the moment of injury or diagnosis, through rehabilitation and beyond. They also support those with longer-established injuries. Our Public Affairs team campaigns for change and fairness, lobbying government and other decision-makers, while our advocacy experts provide support with health and social care matters. Our SCI Nurse Specialists help drive improvements in the quality of care and nursing standards across the SCI community. Our freephone telephone Advice Line answers more than 2,000 calls a year to provide guidance on topics, including access, specialist rehabilitation and benefits. Our magazine, FORWARD, provides the SCI community with a wealth of information on everything from health and daily living to employment. The SIA Academy delivers education and training to professionals through study days, competency training and courses for solicitors, caseworkers and expert witnesses.

OUR SUPPORT GOES A LONG WAY

An estimated 2,500 people each year – 48 per week – are injured or diagnosed with a spinal cord injury in the UK. Previous estimates put this number at 1,000. About 50,000 people live with a spinal cord injury in the UK. Previously, the estimate was 40,000. The NHS Specialised Spinal Cord Injury Services Annual Statement has been published for the last two years. In 2017/18 (the most recent year for which we have full statistics), 2,429 new patients were referred to the eight specialist centres in England and there were 864 new admissions. However, many more people with a spinal cord injury are not referred at all and do not benefit from the specialist care and support available. We have used a variety of reliable sources and methods to estimate the yearly incidence of SCI and the size of the total population. This includes an examination of the NHS’s annual statement, discussions with health service statisticians, consultants and analysing comparative international studies that give incidence and prevalence per million of population.

Find out more about Spinal Injuries Association at www.spinal.co.uk

SIA member Miranda Jenks sustained a spinal cord injury when she was 21 years old. After six weeks in a district general hospital, she was discharged home with little information. “Being in hospital was a scary time,” she says. “I was a young woman surrounded by older people, and there was certainly no support network available. I felt lost and alone and was searching for information.” The search for that palpably absent support in hospital led Miranda to SIA, and our Advice Line and Support Network team. “Sometimes I wonder where I would be now if I hadn’t picked up the phone that day,” she says. “It is comforting just to know that SIA is there with so much knowledge and experience. It’s been amazing.”

SPINAL INJURIES ASSOCIATION Freephone Advice Line: 0800 980 0501 Email: sia@spinal.co.uk Website: www.spinal.co.uk Registered Charity No. 1054097 Spinal Injuries Association (SIA) is the leading national user-led charity for spinal cord injured (SCI) people. We understand the daily needs for life with a spinal cord injury, and we meet those needs by providing services to share information and experience, while also campaigning for change to ensure every person can lead a full and active life.

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RECOVERY & REHABILITATION

UKABIF Continues to Drive Change

is comprehensive and consistent throughout the he United Kingdom Acquired Brain UK. UKABIF took part in a first ever joint roundtable Injury Forum (UKABIF) continues to raise awareness of ABI in parliament and amongst of APPGs on neurological conditions where the need for a national strategy and central leadership policy makers. Its primary objective is to for rehabilitation was discussed with agreement to ensure that people with ABI have early access to local, continue lobbying for progress. The charity also specialist neurorehabilitation and follow up services in continues to lobby for the use of rehabilitation the community. The ongoing coronavirus pandemic prescriptions. has highlighted the importance of neurorehabilitation in the continuum of patient-centred care, with SUPPORTING THE RETURN TO EDUCATION rehabilitation professionals having a crucial role in FOR CHILDREN AND YOUNG PEOPLE WITH ABI assisting patient recovery from Covid-19-associated disabling effects. May 2021 sees the launch of a much needed resource UKABIF’s current lobbying programmes follow on produced by the National Acquired Brain Injury Learning from the publication of and Education Syndicate Dr Andrew Bateman, UKABIF Chair said: the report ‘Acquired (N-ABLES). UKABIF Brain Injury and established N-ABLES in ABI is a chronic condition with Neurorehabilitation 2019 to raise awareness ‘hidden’ disabilities and life-long – Time for Change’ of the education needs consequences. There’s a great deal of published in October and support required work to be done to change the way 2018 by the All-Party by children and young neurorehabilitation services are delivered people with ABI, and to Parliamentary Group on Acquired Brain Injury but I’m proud of the progress that UKABIF facilitate the report’s (APPG on ABI). UKABIF recommendations. Most has made to date provides the secretariat children/young people for the APPG on ABI and has been instrumental in with ABI return to mainstream education. Their return ensuring the focus remains on achieving the report’s to education is a significant part of the recovery process, recommendations. and a smooth transition is essential. The return can The ‘Time for Change’ report called for immediate be challenging for school professionals and requires action to address the issues surrounding the provision preparation, collaboration and careful coordination of neurorehabilitation services for children, young involving the child/young person, their parents/carers, people and adults with ABI in the UK, focussing on the school and a wide range of professionals. The education, criminal justice, sport-related concussion new booklet and poster ‘ABI Return – Children and and the welfare benefits system. These issues span Young People with Acquired Brain Injury – guiding many government departments including the Ministry their return to education’ will help all those involved of Defence, the Department for Work and Pensions, to prepare for, and achieve, a successful return and the Ministry of Housing, Communities and Local enable the student to progress their recovery. The guide Government, the Department for Education, the is relevant for ages 4-18 years, when the child/young Ministry of Justice, and the Home Office. person is in hospital, recovering at home, or in the early stages of returning to education. Although countries DRIVING CHANGE IN NEUROREHABILITATION within the UK have different education systems and SERVICES policies, the guiding principles outlined apply to them all. A copy of the booklet/poster is available from A national review of neurorehabilitation is recommended in the report to ensure service provision www.ukabif.org.uk/ABIRETURN

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RECOVERY & REHABILITATION IMPROVING THE MANAGEMENT OF ABI OFFENDERS The criminal justice programme is steered by the Criminal Justice Acquired Brain Injury Interest Group (CJABIIG); UKABIF provides the secretariat for this Group. Reform of procedures, practices and processes in the criminal justice system should take into account the needs of individuals with ABI. There is a high incidence of ABI in womens’ prisons which is strongly linked to domestic abuse. The recent debate around the Domestic Abuse Bill lead to meetings with the government. This has resulted in brain injury screening as a routine requirement at the earliest point of contact with the criminal justice system and the implementation of information about ABI in domestic abuse orders used by the police and support staff.

BE PREPARED

••• ••

AWARENESS

• • •

Prepare for re-integration Ensure school are informed Access reports and share the recommendations (include healthcare professional) Assess availability of funding – and apply Share information with support team

GATHER BACKGROUND INFORMATION

Access information about Acquired Brain Injury Identify a Keyworker to arrange and attend meetings Communicate with family, health, education and social care

ASSIGN A KEYWORKER AND ATTEND MEETINGS

N-ABLES The National Acquired Brain Injury in Learning and Education Syndicate

INCLUSION

• • •

Explore the child/young person’s views, wishes, hopes, aspirations and goals Include the Return to Education team in decision making and planning Work with parents and child/ young person as ‘experts’

LISTEN TO THE CHILD/ YOUNG PERSON

READY THE SCHOOL

• • •

NEXT STEPS

• • •

Assess and implement training, information and support for school professionals Inform peers as appropriate Adapt/adjust the environment in the school/college

MONITOR AND REVIEW PROGRESS

MAKE A PLAN

ENABLE PARTICIPATION

• • •

Enable inclusion in all aspects of school life Explore the range of resources and skills you already have to meet the child/young person’s needs Adapt the school day, curriculum and lessons

BE FLEXIBLE

Monitor cognitive, emotional, behavioural and social changes over time Provide continuous guidance and support Take a holistic approach; quality of life matters!

TEACHING AND LEARNING

• • • ••

Use individualised and targeted approach to promote opportunities for learning Recognise and respond to strengths, skills, needs, changes and challenges Share knowledge and understanding of the student with colleagues Review progress Monitor current, emerging and changing needs

UNDERSTANDING

REMEMBER ME

• •

•

Understand the child/young person’s changing/new cognitive, emotional and social needs as well as academic challenges Explore the new ‘normal’ for this student Be flexible

BE PREPARED FOR CHANGE

TRY DIFFERENT LEARNING STRATEGIES

•

See beyond behaviours and understand how the child/young person feels, what matters to them and what might help Remember the child/ young person’s interests, likes, dislikes and friends before their injury Hear their voice and ask for their feedback

ASK FOR THE CHILD/ YOUNG PERSON’S FEEDBACK

RETURN TO EDUCATION WITH AN ACQUIRED BRAIN INJURY (ABI)

These are guiding principles for the Return to Education, with key tips and resources suggested. There is no ‘onesize-fits-all’ plan; it will depend on the needs of the child/ young person, their family and effective communication with school and other professionals.

CONTACT

k @UKABIF.org.u Email: NABLES ES10 Twitter: @NABL

For more information about ABI RETURN and case studies, please read the booklet or visit www.ukabif.org.uk/ABIRETURN

government to take the lead. UKABIF has submitted evidence to the Select Committee for Culture, Media and Sport on the links between sport and long-term brain injury. The Select Committee is considering the scientific evidence for links between head trauma and dementia and how the risks could be mitigated. Evidence is also being submitted by individual players and governing bodies.

UKABIF’S ANNUAL SUMMIT TAKES PLACE ON 8 NOVEMBER 2021 UKABIF’s Annual Summit being held on Monday, 8 November 2021 will focus on the ‘Time for Change’ report, discuss the developments and improvements in the delivery of care for people with ABI. Subject to the continued ease of restrictions around COVID-19, the summit will take place at London’s Royal Society of Medicine, with additional streaming options for those who do not wish to attend in person. The full details will be available soon; please contact: admin@ukabif.org.uk

SUPPORT UKABIF’S WORK - BECOME A MEMBER UKABIF aims to promote better understanding of all aspects of ABI; to educate, inform and provide networking opportunities for professionals, service providers, planners and policy makers and to campaign for better services in the UK. If you would like to become a member and support UKABIF please contact: www.ukabif.org.uk/membership Or consider making a donation https://ukabif.org.uk/donations/donate.asp?id=16665

REFERENCE ‘Acquired Brain Injury and Neurorehabilitation – Time for Change www.ukabif.org.uk/appg_report_2018

RECOGNITION FOR LONG-TERM EFFECTS OF SPORT-RELATED BRAIN INJURY The recommendations for sport-related brain injury emphasise the need for greater awareness and acceptance amongst sporting bodies about the short and long-term risks, the implementation of clear guidance and policies, and the need for

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RECOVERY & REHABILITATION

The benefits of using hydro/ aquatic therapy TO TREAT NEUROLOGICAL CONDITIONS At Askham Rehab, we use hydrotherapy, or aquatic therapy as it is more commonly referred to, to treat a range of neurological conditions including acquired and traumatic brain injuries, spinal cord injuries, and multi-trauma injuries.

n accordance with Aquatic Therapy Association of Chartered Physiotherapists, which states the use of hydrotherapy should be specifically tailored for an individual to maximise function, our purpose-built pool is used as a part of our residents’ rehabilitation programmes, concentrating on a range of physical, physiological and psychosocial neurological deficits. We pride ourselves on providing hydrotherapy to every resident or outpatient that indicates the need for it, with sessions being incorporated into their weekly timetable for therapy and activities.

TAKING THE FIRST STEPS Before beginning their rehabilitation journey with us, residents are invited to attend an initial assessment, where our aqua therapist asks them questions about their condition. Mutually agreed SMART (Specific, Measurable, Attainable, Relevant, and Time-Bound) goals are then set and the resident would be prescribed to a treatment programme specific to their needs.

WHAT WE OFFER Our heated pool, which is maintained at the optimum temperature of 35.5°C, with an ambient air temperature of 31°C, has ladder access and a tracking hoist to allow access to a wide-range of residents and out-patient users. The facilities are completely user-friendly, with level access changing

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rooms and facilities that are suitable for all, including wheelchair users. There are also the extended options of different lighting and a massage pump to allow for true relaxation.

Our heated pool, which is maintained at the optimum temperature of 35.5°C, with an ambient air temperature of 31°C, has ladder access and a tracking hoist to allow access to a wide-range of residents and out-patient users The pool is used for single user occupancy with two trained staff members, and sessions are completely designed around the individual and their needs. Users often comment that their pain disappears and that they can move more freely and feel relaxed. Our hydrotherapy offering is further enhanced by one of our therapists who is currently progressing through to become an accredited aqua therapist, following the completion of her foundation training programme.

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Achieve your rehabilitation goals sooner with hydrotherapy! At Askham Rehab, we have a team of qualified physiotherapists (working within our broader MDT), specifically accredited to provide hydrotherapy and aquatherapy treatments, providing you with some of the UK’s leading expertise to support you in achieving your full potential.

The general benefits of exercising in a hydrotherapy pool include: • • • • • • •

Improved cardiovascular and respiratory function Improved neuromuscular and physical performance Improved posture and appearance Relief of tension Stimulation of mental activity Increased general feeling of health and well-being Delaying of the ageing process

Phone: +44(0)1354 740269 Email: info@askhamrehab.com Website: www.askhamrehab.com

RECOVERY & REHABILITATION THE BENEFITS OF HYDROTHERAPY Utilising the properties of water can provide pain relief and the reduction of muscle spasm. The warmth of the water helps suppress the sympathetic nervous system and stimulates the skin sensory nerve endings. There is also a reduced effect of gravity due to the support of buoyancy in the water, allowing for ease of movement, joint range and flexibility. Improved strength and endurance is also achieved in water as it helps to work muscles in different planes and in ways that often can’t be replicated on dry land. Such properties include the viscosity, weight and density of the water, and force of buoyancy. Water also produces resistance through negative pressure from turbulence and a drag effect. Users also experience enhanced balance, coordination and posture while being unencumbered, with the support of buoyancy and weight-bearing in various positions. The Metacentric effect can be further challenged with assistance or resistance given to the different movements. Furthermore, cardiovascular fitness is improved due to the hydrostatic pressure gradient of the water providing assistance to the circulation. The hydrostatic pressure gradient also enhances blood and exudate fluid circulation which has a positive effect on oedema. The reduction in swelling can ease the ability to move more freely. Wellbeing benefits include enhanced relaxation through the water’s hypnotic effects. Due to its temperature being thermo-neutral, the pool has a positive effect on reducing

pain, allowing people to be more independent and enjoy the freedom it may provide.

The general benefits of exercising in a hydrotherapy pool include; Improved cardiovascular and respiratory function Improved neuromuscular and physical performance Improved posture and appearance Relief of tension Stimulation of mental activity Increased general feeling of health and wellbeing Delaying of the ageing process

COVID-19 RESTRICTIONS Due to the coronavirus pandemic, we had to close the hydrotherapy pool to our users, but since last summer our Clinical Lead has been able to run sessions for the residents. The pool will soon be reopening for out-patients too, which we are very much looking forward too as we see hydrotherapy as a real asset in treating neurological conditions. ■

She comes, and I make my bed with her... I’ve got back to doing it by myself and that corresponds to independance. Without fail every morning it has become routine. The whole point of rehab is getting back to normal, I want to be able to do everything. Anything is possible.

Neuro Occupational Therapy

Clinical excellence and expert knowledge Specialist Occupational Therapy and Vocational Rehabilitation Services for people with brain injury and neurological conditions.

01722 466117 enquiries@krysalisconsultancy.co.uk www.krysalisconsultancy.co.uk

...realising potential, transforming lives 14

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RECOVERY & REHABILITATION

DEDICATED REHABILITATION Creating Happiness Daily CHD Rehabilitation operates two specialist rehabilitation centres, Bagshot Park Neurorehabilitation Centre and Kingston Rehabilitation Centre.

ach of the CHD Rehabilitation Centres are overseen by skilled clinical multidisciplinary teams, who are supported by GP’s and specialist consultants. The services are specialised in delivering neurorehabilitation, complex nursing, tracheostomy care and long-term disability management and are committed to providing the very highest levels of rehabilitation through individually tailored goal driven treatment programmes. Together our teams work to provide excellent treatment and rehabilitation for those in our care. CHD Rehabilitation centres are located in Kingston-upon-Thames and Bagshot, Surrey and are purpose built to provide exceptional care and rehabilitation in comfortable surroundings whilst maintaining personal wellbeing. Therapy facilities at CHD Rehabilitation include fully equipped gyms and treatment rooms, a hydrotherapy pool and occupational therapy kitchen.

OUR AIMS ARE SIMPLE To establish a care pathway that includes patient specific treatment programmes to facilitate the best possible recovery of those in our care. To enable our patients to live as independently as possible, within the scope of their rehabilitation, to enhance their quality of life in a stimulating and caring environment. Personalised rehabilitation pathways are delivered through our expert multidisciplinary teams consisting of psychologists, nurses, occupational therapists, physiotherapists, speech and language therapists and rehabilitation assistants.

AWARD WINNING CARE CHD Rehabilitation is part of CHD Living, an award winning, family-owned group of care services with more than 35 years of experience in providing the

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best quality care and home care services to individuals across Surrey and South London. This coupled with the superior care delivered by our team of carefully selected registered nurses, health care assistants and specialist neuro therapists who work alongside doctors and consultants, help to ensure the best quality of life for our residents whilst enabling them to reach their full potential through individualised rehabilitation programmes. Through the provision of personalised 24-hour care and support we look to maintain privacy, choice and dignity whilst maximising independence.

SPECIALIST SERVICES

Specialist neurological rehabilitation Our in-house MDT can offer a full rehabilitation package to optimise independence and facilitate safe discharge to the community

Complex nursing care Our nurses are highly skilled in the management of symptoms arising from neurological conditions and spinal cord injuries Specialist tracheostomy care Our therapy and nursing team are all trained in tracheostomy care Post-COVID rehabilitation We can offer rehabilitation following hospital admissions and COVID treatments to provide ongoing physical, neurological and respiratory support as well as discharge planning for individuals prior to returning home

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RECOVERY & REHABILITATION THE ONGOING IMPACT OF COVID-19

PATIENT SUCCESS STORIES: MR C

his below knee amputation impacted his balance and mobility and he had difficulties in mobilising through narrow Whilst we are established and NHS In December 2019, Mr C was involved spaces and outdoors. His hoarding preferred providers for acquired brain in a road traffic incident when a car behaviours also meant that his property injury and neurorehabilitation, we collided with his as a pedestrian crossing was not safe for discharge. have recently begun exploring a new the road. As a result of the accident, His rehabilitation programme included provision to our fantastic services as he sustained an acute cervical spine gait re-education and balance exercises there is a new group of patients who injury with anterior displacement of C5 with the physiotherapists, as well as can benefit from our expert support. and C6, two areas of acute traumatic insight, process and strategy training As the COVID-19 pandemic continues subarachnoid haemorrhage in both and brain injury education with the it is becoming temporal lobes, psychologists, and functional re-training increasingly evident vertebral artery At Kingston with the occupational therapists. Mr C that there are dissection, and Rehabilitation Centre, you multiple fractures also engaged with a de-cluttering service significant longerreally can achieve whatever of the sternum and to prepare a safe environment at home term complications for him to return to. for individuals lower limbs. you want Mr C made significant functional following Following the MR C, FORMER RESIDENT, and improvements in all areas of his hospitalisation with accident, Mr KINGSTON REHABILITATION rehabilitation. He was able to mobilise COVID-19 and it C underwent CENTRE safely indoors and outdoors, use public is resulting in an right below knee transport to access the community increased need amputation at St independently and had continually for rehabilitation. This is required for George’s Hospital in London. He then demonstrated and an ability to be those who have been hospitalised with transferred to his local NHS rehabilitation self-caring and manage domestic tasks COVID-19, many of whom are older service for a period of amputee and independently. He also demonstrated and with underlying health problems. neurorehabilitation. However, following a significant improvement in the These patients will often experience this period Mr C remained having ongoing insight and awareness of his cognitive fatigue and reduced cardiovascular neurorehabilitation goals and was unable impairments and how they relate to fitness. Research is also starting to to return home as a his day-to-day highlight possible neurological impacts wheelchair user, and function. of COVID-19 with some patients so was transferred This is a fantastic Following a experiencing stroke or seizure activity to Kingston facility. I am fully confident period of 14 weeks due to abnormalities in blood clotting or Rehabilitation that my partner gets the rehabilitation a lack of oxygen to the brain, resulting in Centre for a further very best care. The staff are at Kingston cognitive impairments. period of specialist Rehabilitation Post-COVID rehabilitation can be neurorehabilitation all warm and friendly, Mr C was complex and requires multidisciplinary input. remaining professional at Centre, discharged to input. In addition to our specialisms of Prior to his all times! return to living ABI and neurorehabilitation, we are able accident, Mr C lived independently in to support all aspects of rehabilitation alone in a 1st floor RELATIVE OF RESIDENT, BAGSHOT his own home. as a result of the COVID-19 pandemic. flat. However, PARK NEUROREHABILITATION At CHD Rehabilitation our highly his property was CENTRE If you would specialist therapists are experienced exceptionally like any further in delivering both neurorehabilitation cluttered with his information on the services and complex respiratory support. personal belongings, newspapers and available at or Bagshot Park or This, combined with our skilled nurses various items which he has collected Kingston Rehabilitation Centres, or and carers, means we are able to for over 10 years. to make a referral: provide the support and rehabilitation The team discussed their findings necessary for those in need throughout with Mr C and set goals for his and following the pandemic, including: placement with a view to returning Visit our website: home to live independently. His goals www.chd-rehab.com were to be able to return home to Call us on 01483 413 121 Neurorehabilitation independent living, to be able to Email us at Strength training and access the community walking with his enquiries@chd-rehab.com fatigue management prosthesis and the aid of a walking stick, Respiratory assessment and to use public transport independently breathlessness management and to understand the cognitive effects Psychological support of his brain injury and how they affect Complex respiratory him in everyday life. management – On admission to Kingston tracheostomy care and Rehabilitation Centre, Mr C presented ventilatory support with dysexecutive syndrome and lacked insight into his cognitive impairments,

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01483 413 121 chd-rehab.com

CHD Rehabilitation REHABILITATION - COMPLEX NURSING CARE - LONG-TERM DISABILITY MANAGEMENT - RESPITE

CHD Rehabilitation operates two specialist rehabilitation centres, Bagshot Park Neurorehabilitation Centre and Kingston Rehabilitation Centre.

Bagshot Park Neurorehabilitation Centre Bagshot, Surrey, GU19 5HN

Kingston Rehabilitation Centre Kingston-upon Thames, KT1 2TQ

Each of the CHD Rehabilitation Centres are overseen by skilled clinical multidisciplinary teams, who are supported by GP’s and specialist consultants. The services are specialised in delivering neurorehabilitation, complex nursing, tracheostomy care and long-term disability management and are committed to providing the very highest levels of rehabilitation through individually tailored goal driven treatment programmes. Together our teams work to provide excellent treatment and rehabilitation for those in our care.

FEATURES:

SPECIALIST SERVICES

• Fully equipped physiotherapy suites

• Specialist neurological rehabilitation

• Hydrotherapy pool

• Complex nursing care

• Occupational Therapy assessment kitchen

• Specialist tracheostomy care

• Accessible, en-suite bedrooms

• Post-COVID rehabilitation

• Choice of lounge & dining areas • Beautiful, maintained gardens

“At Kingston Rehabilitation Centre, you really can achieve – Mr C, former resident, Kingston Rehabilitation Centre whatever you want!”

Call us for advice on care today 01483 413 121

PHYSIOTHER APY - OCCUPATIONAL THER APY - SPEECH & L ANGUAGE THER APY - PSYCHOLOGY

KEEPING YOU SAFE We are committed to safeguarding residents, staff and visitors during the ongoing COVID-19 pandemic. We have extensive control measures and rigorous Health & Safety protocols in place across all of our sites, including: • Access to COVID vaccinations • Regular COVID testing • COVID safe visiting

Regulated by Preferred provider of care for Acquired Brain Injury & Neurorehabilitation

RAISING AWARENESS IN SCHOOLS

NEW BRAIN INJURY AWARENESS PROGRAMME

TO SUPPORT TEACHERS AND SCHOOL STAFF Authored by Katie Roberts at The Children’s Trust.

Supporting every child in the UK with an Acquired Brain Injury (ABI) is a key part of The Children’s Trust’s new strategy, Hope and Ambition. This is a bold ambition, which plans to ensure every child and family affected by an ABI receives information, advice, and support, at the time of need. To give us a national picture of need The Children’s Trust conducted research to help us understand the unmet needs of children with acquired brain injury and their families, encompassing those with concussion, who are often not recognised as having had a brain injury, through to those who have a confirmed, significant brain injury, here in the UK. This included the number of children affected; where they are based; the difficulties they and their families face at all stages from injury onward; what services and pathways already exist to help them; and where there are gaps. The report confirmed the need to develop a range of support pathways for the child and family, across the spectrum of severity. From an education point of view, the report corroborated a lot of what had already been identified in the All-Party Parliamentary Group ‘Time for Change’ report. With it estimated that one child in every primary school classroom in the UK is affected by brain injury1 , and teachers playing a vital role in a child’s development, it is crucial teachers and school staff have a basic understanding and know where to turn for support should they need it.

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The Time for Change report made some key recommendations for the education sector, to better equip teaching professionals with information to help them understand students with ABI. One such recommendation is that all professionals should have a minimum level of awareness and understanding about ABI, and the educational requirements of children and young people with this condition, and suggests a short online course for all school-based staff.

Katie Roberts

“

Education professionals do not routinely receive training on ABI, and may therefore lack awareness and understanding of the consequences. They may have difficulty identifying what specific support is required and may consequently use inappropriate assessment tools, learning strategies and interventions, and monitor and review the individual’s progress less frequently than appropriate.

”

A HIDDEN DISABILITY Children are constantly developing, discovering new skills, and becoming more aware of social boundaries. The brain is at the centre of this work and a brain injury can affect almost any aspect of the way a person functions. It is important to remember that while some effects of a brain injury can be seen, other difficulties may not be immediately obvious by looking at a person.

Therefore, professionals often compare the effects of a brain injury to an iceberg. The physical effects of ABI can be described as the tip of an iceberg, where there is often a lot more going on under the surface. So, even if a child returns to school and seems back to their ‘normal’ self after a brain injury, this may not be the case. 1. N-ABLES 2019

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RAISING AWARENESS IN SCHOOLS RAISING AWARENESS IN SCHOOLS An ABI can affect a child’s memory, judgement and behaviour – changes that can be missed within a classroom environment. However, if these signs are recognised quickly, early intervention can stop problems from developing into serious long-term issues. That is why The Children’s Trust launched an online awareness

Over the last 12 months, the team at The Children’s Trust scoped the content and developed plans for its online brain injury awareness programme for teachers and school staff. As the UK’s leading Some things charity for you might notice in a child if they have had a children brain injury: with brain movement difficulties injury scar from surgery speech and language difficulties the

Some of the problems or difﬁculties a child

programme in Spring might be experiencing after a brain injury this year to help that may not be obvious to others: teachers understand fatigue memory issues what a brain injury is concentration difficulties and how it could impact a anxiety programme child and their learning. The draws on specialised programme was its renowned also introduced to professionals expertise in at the charity’s National Paediatric providing specialist Brain Injury Conference in May. The support to children idea behind it is simple – the more with brain injury, teachers know, the more confident which spans almost they can be in supporting children. 40 years. Katy James, Head of Community The online course has been Services Transformation at The curated with teachers in mind. It Children’s Trust, explains why provides important information it’s important to not only make that gives teachers and school sure teachers are provided with staff a basic understanding of ABI, the knowledge and tools to fully all set in the context of the school support a child but also to help and classroom. The programme support a child in getting is aimed at all teachers but the a diagnosis: current pilot, funded by a grant “Many children and young people from the Constable Education Trust, with an acquired brain injury return is focused on primary school staff. to school with a range of cognitive, Initial feedback has been very behavioural, psychosocial, and positive, with one primary school physical difficulties that can affect teacher noting that the programme their academic studies and daily was “really professional yet friendly. life. It was communicated in a clear “In some cases, a brain injury can and concise way that gave all the be hidden and as a result often relevant information we need as a missed or misattributed to other school to support a student.” causes, so the right support is There are two information pathway not provided. Without the right options: support, children with ABI are at risk of increased mental health • An initial introductory session difficulties, reduced education to raise awareness of brain injury, plus and employment opportunities, • A follow-up session to gain a antisocial behaviour and deeper understanding of brain involvement in the criminal justice injury system 2.”

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The introductory session is written from a teacher’s point of view, taking the user through the school environment. It presents some of the challenges a child with a brain injury may face during the school day, such as fatigue, difficulty forming and keeping friendships, and memory problems. It then highlights how those challenges may present, from concentration difficulties to not remembering instructions from the teachers in class. The content syllabus covers: • A definition of ABI • Possible symptoms – such as memory loss and fatigue • How symptoms might manifest in a school day and affect learning • How teaching professionals can support children with ABI • Further reading and resources There is a quiz at the end to recap on what has been learned. Delivered online, this session is free to access and can be completed at a time to suit users, taking approximately 30 minutes to complete. To access the programme, teachers and school staff need to register online. They are then sent a link via email. We want to provide teachers with easily accessible resources so they feel confident in supporting a child who may be returning to school after acquiring a brain injury.

“ABI is a hidden epidemic affecting many hundreds of people”3 2. Hoofien et al. 2001, Williams et al. 2015 3. All-Party Parliamentary Group Report “Time to Change” 2018

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RAISING AWARENESS IN SCHOOLS RAISING AWARENESS IN SCHOOLS Tyler was diagnosed with a brain tumour at the age of eight. Following surgery, chemotherapy and radiotherapy, Tyler was doing well and had returned to school. As Tyler transitioned to secondary school, her difficulties with memory, fatigue, concentration, and balance became more apparent. She felt increasingly isolated and was quickly losing confidence. The Children’s Trust online awareness course helps to ensure teachers know what to look out for, and what assistance children might need in class to help them to continue to develop and learn.

Tyler The second part of the information pathway, the more in-depth training, is set to be available virtually or in person. This option can be delivered to all staff from an individual school or representatives from several different schools in a specific area. The team at The Children’s Trust are continuously updating the content and plan to launch the second pathway in the

coming months for teaching professionals who are interested in taking their learning to a more advanced level. The Children’s Trust aims to provide teachers with easily accessible resources so they feel confident in supporting a child who may be returning to school after acquiring a brain injury.

Do you work with primary schools and want to find out more about the awareness programme? Please visit thechildrenstrust.org.uk/teachers or contact The Children’s Trust via email: getinvolved@thechildrenstrust.org.uk Find out more about how we support children with brain injury. 01737 365 000 thechildrenstrust.org.uk/teachers getinvolved@thechildrenstrust.org.uk Registered Charity No. 288018. TCT_1038 April 2021

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Community Community Community Community neurorehabilitation neurorehabilitation neurorehabilitation neurorehabilitation The Children’s Trust Brain Injury Community Service The The The Children’s Children’s Children’s Trust Trust Trust Brain Brain Brain Injury Injury Injury Community Community Community Service Service Service Specialist Specialist Specialist goal-orientated goal-orientated goal-orientated community-based community-based community-based neurorehabilitation neurorehabilitation neurorehabilitation Specialist goal-orientated community-based neurorehabilitation for for forchildren children and and young and young young people, people, people, up up toup up 18 to to years 18 18years years years old with old oldwith with a aaa forchildren children and young people, to 18 old with confirmed confirmed confirmed or suspected or or suspected suspected acquired acquired acquired brain brain brain injury. injury. injury. confirmed or suspected acquired brain injury. Bespoke Bespoke Bespoke assessment assessment assessment and and therapy andtherapy therapy packages packages packages Bespoke assessment and therapy packages delivered delivered delivered in the ininchild’s the thechild’s child’s environment environment environment – at home, ––at athome, home, delivered in the child’s environment – at home, in school ininschool school or a combination ororaacombination combination of both, of ofboth, both, including: including: including:

in school or a combination of both, including:

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•Specialist • Specialist Specialist interdisciplinary interdisciplinary interdisciplinary needs-led needs-led needs-led

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•Tailored • Tailored Tailored community community community therapy therapy therapy including including including

• assessment Specialist interdisciplinary needs-led assessment assessment with with recommendations withrecommendations recommendations assessment with recommendations

• occupational Tailored community therapy including occupational occupational therapy, therapy, therapy, speech speech speech and and language andlanguage language therapy, therapy, therapy, and and education and education education psychology psychology psychology occupational therapy, speech and language therapy, and education psychology • •Skills • Skills Skills packages packages packages also also available alsoavailable available including including including

developing developing independence, independence, independence, memory memory memory management, management, management, • developing Skills packages also available including social social social interaction, interaction, interaction, and and school and school school transition. transition. transition. developing independence, memory management, social interaction, and school transition. Get Get in Get touch in intouch touch to find to tofind out findmore: out outmore: more: 01737 01737 365 864 365 365 864 864out more: Get01737 in touch to find www.thechildrenstrust.org.uk/bics www.thechildrenstrust.org.uk/bics www.thechildrenstrust.org.uk/bics

01737 365 864

www.thechildrenstrust.org.uk/bics

Charity registration Charity Charityregistration registration number: number: 288018. number:288018. Registered 288018.Registered Registered address: address: Tadworth address:Tadworth Tadworth Court, Tadworth, Court, Court,Tadworth, Tadworth, Surrey KT22 Surrey Surrey 5RU KT22 KT225RU 5RU TCT_1039 TCT_1039 TCT_1039 04/21 04/21 04/21

Charity registration number: 288018. Registered address: Tadworth Court, Tadworth, Surrey KT22 5RU TCT_1039 04/21 sevenstarmedia.co.uk

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SPECIALISED NEUROLOGICAL CARE SERVICES AT HAWTHORNS CARE CENTRE Hawthorns Care Centre provides care and rehabilitation services for those who require Specialist and Complex Neurological and Respiratory Care. At the heart of the Hawthorns team is a shared passion to provide the best care possible for each individual.

Hawthorns Care Centre at a glance:

We enable individuals to regain control and independence where possible and ensure that not only the individual, but their families and friends, are supported through challenging times.

– Care for those recovering from traumatic or non-traumatic brain or spinal injury.

Our approach to care is to provide a safe, homely environment in which our clients can achieve their maximum potential. We facilitate this through open and honest communications with the client, their families and all healthcare professionals involved.

– Active rehabilitation packages.

Regular MDT meetings in which goals are set and reviewed enable us to ensure we are meeting the individual needs of our clients, using a holistic approach to their rehabilitation journey.

– Long-term and respite placements.

– Tailored therapy programmes. – Higher dependency floor for those with complex neurological, respiratory care and rehabilitation requirements.

For more information on the types of complex neurological services we care for please visit our website or call 0191

4487 239

www.barchestermentalhealth.com/Hawthorns Hawthorns Care Centre, O'Neill Drive, North Blunts, Peterlee, SR8 5UP

COMPLEX CARE SERVICES AT HAWTHORNS CARE CENTRE, PETERLEE Finding the right kind of care can be difficult for everyone involved, but finding the right care service can relieve worry, knowing that you have found the best possible care for you or a member of your family. Designed with the people we care for in mind, Hawthorns Care Centre provides purpose-built accommodation, specifically created for adults with complex neurological, physical or cognitive needs. Run by Barchester Healthcare, Hawthorns provides neurological care services for those recovering from traumatic or non-traumatic brain or spinal injury. This includes support for those with long-term neurological conditions within a higher dependency unit, where care is provided for people with complex neurological and respiratory care and rehabilitation needs. Our specialist care service provides support for individuals who require higher dependency nursing and multidisciplinary team interventions, as well as patients with complex respiratory needs. In addition, we also support patients with minimal consciousness who require invasive and non-invasive ventilation support.

Active rehabilitation packages at Hawthorns are available for both long term and respite placements. Our goal-orientated therapy programmes are all tailored to an individual’s ability and potential. We’re proud to have a Headway accreditation as an approved provider. Treatment plans use the SMART method (Specific, Measurable, Accountable, Realistic and Time Limited) to provide accurate assessments and treatments. Our experienced and highly qualified care and therapy teams, led by a Consultant in Rehabilitation Medicine, are passionate about independence, dignity and choice for all patients within their care. Our well-trained care staff focus on the individual needs of each patient, developing a bespoke care plan for each and every person.

To find out more about our services, please visit our website or call us to arrange a visit:

Tel: 0191 4487 239 www.barchestermentalhealth.com/Hawthorns Hawthorns Care Centre, O'Neill Drive, North Blunts, Peterlee, SR8 5UP

RECOVERY & REHABILITATION

How the Arts Therapies can support the mental health of BRAIN INJURY SURVIVORS By Daniel Thomas, Managing Director & Neurologic Music Therapist, Chroma

uffering a traumatic or acquired brain injury can have devastating physical, mental and emotional impacts upon the individual. Physical rehabilitation through physiotherapy, speech and language, occupational therapy and neurologic music therapy Dan Thomas can all help improve quality of life by improving functional skills and abilities (to the extent for that individual) but, the case remains for improving their mental and emotional function. Acceptance of their post-injury situation and medical condition is difficult, so it is here that arts therapies interventions can play a huge part in rehabilitation following a brain injury. Investigating the effects of art therapy in rebuilding self-identity following a Traumatic Brain Injury (TBI), Di Vita, 2020, observed ‘an increased ability to adapt to the experiences of life as well as a higher level of awareness, social functioning and emotional autoregulation…patients exhibited a reduction in depressive symptoms and in the perception of physical problems.’1 Di Vita surmised that results highlighted the importance of treatments focusing on In effect, arts therapies enable the individual the patients’ emotional needs, in addition to to externalise their inner thoughts and the classic rehabilitation (i.e. physiotherapy, feelings, as a result of a process which cognitive therapy). externalises what is happening internally for In terms of rebuilding self-identity, the the individual. process of mask making can Mask making as an art therapy provide an effective medium Studies have found the arts intervention has proved an in helping patients express their emotions regarding their therapies to be effective in helping TBI effective medium for cases such as these (rebuilding self-identity) condition, how they now see patients with emotional expression, as it represents the face. The face themselves and how they feel is the one part of the body where the world now sees them. This socialisation, emotional adaptation to one can choose to hide or show process provides a voice for mental and physical disabilities, and feelings. Emotional masking exists the patient, allowing them to and can have detrimental effects express their thoughts without communication in a creative and nonupon emotional wellbeing if not saying a word. Art therapy threatening way. addressed. helps to unlock emotions and More girls than boys use to begin rebuilding self-identity. emotional masking according to Davis (1995)3 and Garside and Studies have found the arts therapies to be effective in Kllimes-Dougan (2002)4, which may demonstrate the decisions helping TBI patients with emotional expression, socialisation, children often make to fit with peers, and the possible emotional emotional adaptation to mental and physical disabilities, and strain this has upon them. communication in a creative and non-threatening way.2

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RECOVERY & REHABILITATION Based on such findings, it’s clear how society sees us is fundamental from an early age, so is no wonder significant physical changes caused by a brain injury would require addressing and a process of adaptation begun. Mask making allows participants to reveal thoughts and feelings about themselves which they may find hard to express, or may not have even been aware of, and which may be being expressed through more difficult behaviours. They also create an opportunity for greater communication, allowing therapists to gain a deeper understanding of the client’s thoughts, anxieties and feelings. Mask making can take on many forms. For children who have anxiety issues, superheroes tend to be the creative pathway of choice as it allows the child to feel powerful in a powerless situation. The powers they choose to depict also offer a great way of communicating deeper thoughts and feelings. Communication through the arts therapies can help strengthen personal bonds. This is an essential aspect of rehabilitation for those living with a brain injury as its effects can change a person’s personality which can cause breakdowns within family/friends relationships.5,6 Helping the individual understand their own thoughts and feelings can help them open up to loved ones, which can help promote feelings of closeness once again. Mask making as an intervention is effective is helping adjust a patient’s outlook towards their condition. The result can be to create a more accepting perspective on the reality of their condition, which then may become more bearable, somewhat freeing them from negative thoughts surrounding their injury. Being able to express themselves creatively helps the individual reveal their true feelings which in itself can be cathartic – a relief to release their emotions, in a personal, safe space. Mask making essentially helps the patient externalise and explore their emotions in a fun, safe and creative way. Art as therapy provides a non-verbal creative outlet to freely express emotions. In fact, art can be the voice they truly need and one which therapists can use to try and help them process their emotions and ultimately feel confident to communicate (as much as their injury will allow) with family and friends. Studies show art therapy has a positive impact upon chronic stroke survivors’ mental wellbeing, psychosocial outcomes, cognitive function as well as improving their quality of life (QOL).7,8,9 Sun-Hyun Kim 2011 noted ‘10 weeks of art therapy conducted twice a week, resulting in improvements in the patient’s emotions and cognition. The patient’s artwork provides an especially valuable opportunity for tracking improvements in cognition not easily detected in standard rehabilitation therapy’.7 Following a brain injury such as a Stroke, art therapy is a particularly useful tool in enabling the survivor to express themselves whilst providing the therapist with a basis of which to start helping them address their emotions. The emotional impact of living with a brain injury, affects not only that individual, but family and friends too. Creating art has a somewhat cathartic effect that can help the victim open up and let loved ones in. In terms of PTSD and TBI in the military, Jones 2018 concluded ‘The art therapy journey serves as an agent of change, during which service members establish a new sense of self as creator rather than destroyer, as productive and efficacious instead of broken, as connected to others

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as opposed to isolated, and in control of their future, not controlled by their past.’ 10 This offers a clear depiction of how art therapy can in fact help transform one’s own self-perception and change a negative mind set to that of a positive resulting in enhanced mental wellbeing with improvements in personal relationships. This positive outlook will serve to enhance their QOL and mental wellbeing.

REFERENCES 1

Journal of Health Psychology. Psychotherapy and Art Therapy: A pilot study of group treatment for patients with traumatic brain injury. Antonella Di Vita, Mario Augusto Procacci, Martina Bellagamba, Maria Jacomini, Roberta Massicci, Maria Paola Ciurli. First Published November 2, 2020 https://doi. org/10.1177/1359105320967099 2 Barker & Brunk, 1991; Dodd, 1975; Lazarus-Leff, 1998). Kline (2016) 3 Davis, T. L. (1995). Gender differences in masking negative emotions: Ability or motivation? Developmental Psychology, 31(4), 660–667 4 Garside, R. B., & Klimes-Dougan, B. (2002). Socialization of discrete negative emotions: Gender differences and links with psychological distress. Sex Roles: A Journal of Research, 47(3-4), 115–128 5 The Journal of Neuropsychiatry and Clinical Neurosciences. The Phenomenology of Personality Change Due to Traumatic Brain Injury in Children and Adolescents. Jeffrey Edwin Max, M.B.B.Ch., Brigitte Anna Marie Robertson, M.D., and Amy E. Lansing, Ph.D. 2001 6 Personality and Behavior Changes Subsequent to Traumatic Brain Injury: A Review of the Literature. Sarah McKay. April 2015. International Journal of Emergency Mental Health 17(2):469-474. DOI: 10.4172/1522-4821.1000196 7 Journal of the American Art Therapy Association, Volume 25, 2008 - Issue 3: Special Issue on Art Therapy in Palliative Care. Art Therapy Outcomes in the Rehabilitation Treatment of a Stroke Patient: A Case Report. Sun-Hyun Kim , Min-Young Kim , Jae-Hyuk Lee & Sae-il Chun. Pages 129-133 | Published online: 22 Apr 2011 8 Disability and Rehabilitation Volume 33, 2011 - Issue 22-23. Art after stroke: the qualitative experience of community dwelling stroke survivors in a group art programme. Kerry Beesley, Jennifer Helen White, Megan K. Alston, Anne L. Sweetapple & Michael Pollack. Pages 2346-2355 | Accepted 01 Mar 2011, Published online: 18 Apr 2011 9 Disability and Rehabilitation Volume 38, 2016 - Issue 7. Social context, art making processes and creative output: a qualitative study exploring how psychosocial benefits of art participation during stroke rehabilitation occur. Jacqui Morris, Madalina Toma, Chris Kelly, Sara Joice, Thilo Kroll, Gillian Mead & Brian Williams. Pages 661-672 | Received 12 Dec 2014, Accepted 22 May 2015, Published online: 18 Jun 2015 10 Jacqueline P. Jones, Melissa S. Walker, Jessica Masino Drass & Girija Kaimal(2018) Art therapy interventions for active duty military service members with post-traumatic stress disorder and traumatic brain injury, International Journal of Art Therapy, 23:2, 70-85, DOI:10.1 080/17454832.2017.1388263 11 Journal of Health Psychology. Psychotherapy and Art Therapy: A pilot study of group treatment for patients with traumatic brain injury. Antonella Di Vita, Mario Augusto Procacci, Martina Bellagamba, Maria Jacomini, Roberta Massicci, Maria Paola Ciurli. First Published November 2, 2020 https://doi. org/10.1177/1359105320967099

For more information about Chroma Neurologic Arts Therapies within neurorehabilitation settings, please contact Daniel Thomas, Chroma via daniel@wearechroma.com or 0330 440 1838 www.wearechroma.com

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RECOVERY & REHABILITATION

Specialist rehabilitation after a BRAIN OR SPINAL INJURY Exemplar Health Care is a leading provider of specialist nursing care for adults living with complex needs. Our care homes provide person-centred care and rehabilitation for younger adults who’ve experienced a brain or spinal injury.

ur approach to care focuses on maximising independence, building everyday living skills and empowering people live as fulfilled lives as possible. Here, we share the story of David who, with the support of the Nurseled team at Fairburn Vale, is preparing to move into his own home after a car accident which left him with a C2 and C3 spinal injury.

DAVID’S STORY

the head, to give him more freedom to move around his home and in the community. This care has been invaluable in supporting David to move into his own home, so that he can continue to live an independent and meaningful life despite his physical limitations.

COMPLEX CARE WITH EXEMPLAR HEALTH CARE

David is 28 years old and lives at our Fairburn Vale care home in Castleford. After a car accident left him a quadriplegic, our Care Team has supported him to regain his independence and build his everyday living skills, and he’s now ready to move into his own flat.

Exemplar Health Care has 32 care homes across England that support people on their journey from being in hospital or living in a secure setting to communitybased living, as well as offering longer term support for people living with degenerative or lifelimiting illnesses. Alongside many of our homes, we have OneCare Everyone has been very PRACTICAL SUPPORT services which offer a stepFrom day one, David expressed in and step-out service to welcoming to me since I’ve got his wishes to live independently independent living. The services here. I was anxious about moving - and that’s what we’ve are registered with the Care but it helped being with a mixed supported him to do. Quality Commission (CQC) The Occupational Therapy for nursing care, and provide age group of service users. I will Team at the home has a range of flexible support miss it when I leave because you supported David to adapt his packages that are built around always have someone to talk to if new home to ensure that it people’s needs and goals. meets his needs and supports Our holistic approach to care you’re having a bad day - staff go his independence. ensures that people get the the extra mile And the home’s Activities right care, by the right team, the Team helped David to first time round, which leads to DAVID transform his van so that it’s better outcomes and brings an accessible for his wheelchair- this will enable him to freely end to the cycle of failed placements. ■ attend community activities and live a more independent Tel: 01709 565777 | Email: referrals@exemplarhc.com lifestyle.

IN-HOUSE PHYSIOTHERAPY

Web: www.exemplarhc.com

The in-house Physiotherapy Team has worked with David on an individualised exercise programme to help with his spasticity. The team has also helped him to source a new electric wheelchair which is controlled by sensors at

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RECOVERY & REHABILITATION

STEPS has just got even better!

NEW WORLD-LEADING REHABILITATION TECHNOLOGY NOW AVAILABLE The state-of-the art residential rehabilitation facility in Sheffield welcomes the latest in robotic and VR Technology for use in specialist intensive and ongoing rehabilitation for clients recovering from neurological and multiple trauma injuries.

s the first ‘Fourier RehabHub’ in the UK, STEPS provides upper and lower limb robotic and VR rehabilitation equipment for clients, along with being an assessment centre for the latest in exoskeleton technology. STEPS is the only residential facility in the UK that gives clients access to this new pioneering rehabilitation technology. Clients benefit from having access to an interdisciplinary team that includes Neuro Psychologists, Consultants in Rehabilitation Medicine including specialists in spinal cord injury, stroke, brain injury, complex trauma, amputations, plastics, and neuro anaesthetics. STEPS is a modern, purpose-built centre that offers a unique and homely environment for clients to access the very best in rehabilitation care.

NEW for 2021!

We’re excited to be home to: the first “Fourier RehabHub” in the UK with a suite of upper and lower limb robotics. a ground-breaking VR suite which includes the “MindPod” and “MindMotion Go” from MindMaze. an assessment centre for the ReWalk, ReStore and ExoAtlet II exoskeletons. STEPS training school - providing individual training packages to train care teams in preparation for client discharge. ■

STEPS is the only residential facility in the UK that gives clients access to this new pioneering rehabilitation technology Tel: 0114 258 7769 www.stepsrehabilitation.co.uk

Now home to pioneering robotic and VR technology for use in rehabilitation. STEPS is the only UK residential facility that gives clients access to this new, world-leading rehabilitation technology all under one roof.

New for 2021: • Upper and lower limb robotics from Fourier Intelligence and Thor Assistive Technologies • VR technology developed in Switzerland from MindMaze • Garden room for psychological therapies • Assessment centre for the ReWalk, ReStore and ExoAtlet exoskeletons • STEPS Training School

www.stepsrehabilitation.co.uk Alexander House, 30 Troutbeck Road, Sheffield S7 2QA enquiries: 0114 258 7769 email: hello@stepsrehabilitation.co.uk

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RECOVERY & REHABILITATION

Rehabilitation & Support for Independence

“From initial assessment and recommendation to long term support we work in our client’s best interests to make sure their rehabilitation journey is the best it can possibly be”.

including, neuro rehabilitation, acquired brain injury, spinal injury, education, mental health, splinting, social care, and learning difficulties. Our approachable team offer friendly, professional advice, techniques, and strategies to deal with all complexities. Utilising the latest in occupational science and therapy models to ensure a holistic approach to delivering the following services.

Immediate Needs Assessments Sensory Assessments Specialist OT Assessments and Interventions

Medico legal and Expert Witness Reports Case Management Rehabilitation Support Packages Built on a strong foundation of knowledge and evidence-based best practice, we deliver effective, client centred and individualised holistic interventions to enable clients to achieve their goals within a supportive, approachable, and highly skilled team. ■

t Rehabilitation Our clients are at the heart of the team, leading the and Support for collaboration to achieve their goals. Independence we provide adults and The high quality of extensive assessment expertise children with acquired brain or combined with evidence-based therapy and integrated spinal injuries the best possible rehabilitation journey. We support ensures our clients receive fully inclusive care are confident in our ability to Allow us to provide the that best suits them and their family. deliver holistic, client centred best possible rehabilitation MARK RYBCZYNSKI, CLINICAL DIRECTOR treatment on an individualised, journey for our clients and case-by-case basis, utilising yours. Rehabilitation for standardised assessments and evidence-based client led interventions. Independence | Helping individuals regain independence. Support for Our team of expert practitioners include Case Managers, Independence | Bespoke care for complex needs. Occupational Therapists and Rehabilitation Support Workers. All of whom are passionate about rehabilitation and highly skilled in their 1 The Pavilions, Bridge Hall Drive, Bury, BL9 7NX | Telephone: 0161 area of clinical expertise. Our team have vast experience working with 762 9876 | Email: info@rehabforindependence.co.uk or adults and children in a wide range of specialities and environments Email: info@rfisupport.co.uk | Web: rehabforindependence.co.uk

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RECOVERY & REHABILITATION

How to eat well with SWALLOWING DIFFICULTIES

aving dysphagia (also known as swallowing difficulties) shouldn’t get in the way of anybody’s road to recovery. It can be difficult to manage changing the texture of food as well as ensuring the individual eats enough food and drinks enough fluid to maintain a healthy, balanced diet. Eating food that isn’t the right texture can have frightening and dangerous consequences. Whilst some people can successfully blend their own foods to a safe texture, this is not always possible for most, and can lead to the meal becoming unsafe. It can also be a time consuming and stressful experience; not only making sure the food remains hot, but ensuring it is nutritious as well as delicious is hard for most to achieve. In addition, the nutritional content can also be significantly reduced when water or other fluids are added. Whilst the texture needs to be safe first and foremost, ensure small quantities of water are added at a time, so as to avoid any reduction in nutritional value. It’s really important that meals look as good as they taste, and unfortunately home blended food can often not look as appetising. If meals don’t look good, we tend to not eat as much of them and this can mean we’re not getting the vitamins, minerals and calories we all need. There are different consistencies of food that you may be recommended to eat and these will depend on what texture a Speech and Language Therapist (SLT) has suggested to you. For example, a Puréed diet, Minced diet, or a Soft and BiteSized diet. If you have been recommended to have a purée consistency by your SLT, your food should meet several criteria, such as to all be of a consistent puréed texture, without any lumps, and not require any chewing. This can be very difficult to achieve using home-blending equipment. Did you know you can get ready meals that are specifically made for those with swallowing difficulties? Not only is the nutritional content great for those in recovery and available to view on the packaging, great care is also taken to ensure the meals look appetising. When texture modified meals resemble the appearance of regular food as much as possible, it makes it easier to enjoy a meal with friends or family. Just because someone has a swallowing difficulty, it doesn’t mean they should have to compromise when it comes to flavour. Do you miss fish & chip Fridays? Or your regular weekend curry? The award-winning Softer Foods range from Wiltshire Farm Foods has plenty of variety, including its Purée Petite Fish and Chips with an innovative finish on the chips making them appear beautifully browned; Purée Chicken Tikka Masala with the ground-breaking addition of shaped rice and snacks such as Purée Beans on Toast and the nation’s favourite: a Purée

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Bacon Sandwich. There’s also the added convenience of having meals delivered straight to your door, at no extra charge, as the company has a number of local branches across the country. Ready-prepared texture modified meals tick multiple boxes. Not only is the nutritional content carefully controlled and available to view on the packaging, great care is also taken to ensure the meals look appetising. When texture modified meals resemble the appearance of regular food as much as possible, it makes it easier to enjoy a meal with friends or family. Just because someone has a swallowing difficulty, it doesn’t mean they should have to compromise when it comes to flavour. When someone is experiencing difficulties with their nutrition due to dysphagia, it can be easy to focus purely on what they are eating. Yet, how they are eating is of great importance too. We know that this is a condition which can lead to isolation, due to potential feelings of embarrassment around eating a meal that looks ‘different’ to everyone else’s. The ability to enjoy eating with others can often prove problematic, especially given the coronavirus pandemic where many of us are seeing friends and family less often. By having a great looking and tasting Softer Foods ready meal you can join in with family Fish & Chip Fridays! You’ll probably even be eating more too, getting those vital calories you need. It is essential that people living with dysphagia and those who may be caring for them, are aware of the ways in which they can maintain or improve their nutritional intake. Ensuring they dine with dignity by providing tasty, nutritious and recognisable meals, not only aids with eating socially but ultimately means they benefit from the vital nutrition that they require. Food is one of life’s greatest pleasures – why compromise when you don’t have to? Having won a Craft Guild of Chefs Award and Queen’s Award for Innovation, Wiltshire Farm Foods prides itself on creating and delivering texture modified meals that are ideal for anyone living with swallowing difficulties. Its in-house Dietitian and passionate chefs work hard to create meals that have the finest ingredients, delivering flavours you love at a texture you need, so you can celebrate mealtimes again. ■ For tips and practical advice on how to eat and live well with dysphagia and to order a Softer Foods brochure visit: wff.link/brainspinal

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Meals for swallowing difficulties

FLAVOURS YOU LOVE IN A TEXTURE YOU NEED Enjoy good food every day in a texture that’s right for you with the Softer Foods range by Wiltshire Farm Foods. Carefully created meals for those experiencing swallowing difficulties. Made by award-winning chefs from quality ingredients, we have something for every meal of the day. Each dish is nutritionally balanced and made in line with IDDSI guidelines, so that you can eat with confidence. Just simply cook from frozen and serve it’s that easy.

Available in three textures,

Puréed, Minced and Soft & Bite-Sized.

Over 85 delicious dishes in flavours you know and love.

Delivered straight to your door by friendly local drivers.

Easy to order

by phone, online or with your driver.

No contract. No commitment.

For your FREE brochure call 0800

680 0655

or visit us at: www.wiltshirefarmfoods.com

RECOVERY & REHABILITATION

Improving rehabilitation outcomes… IS FOOD AND NUTRITION THE MISSING LINK? Sheri is the Director of Specialist Nutrition Rehab and a Specialist Rehab Dietitian. Sheri leads a team of dietitians who provide comprehensive and cuttingedge medical nutrition therapy in the community for clients after a brain injury, spinal cord injury or orthopaedic injury.

ow many of your clients have seen a dietitian since their initial hospitalisation? When someone is recovering from a brain injury or spinal cord injury, nutrition is not usually the first Sheri therapy to come to mind. However, eating habits and weight can have a massive impact on recovery, rehab potential and even the energy levels needed to engage with physio, neuropsychology and other forms of therapy.

dehydration, all of which can prevent the client from achieving their rehab goals.

TOP 7 NUTRITIONAL CHALLENGES FACED BY CLIENTS AFTER A BRAIN INJURY OR SPINAL CORD INJURY:

Weight and body composition

High levels of inflammation from the trauma, combined with insufficient calories or protein and reduced mobility, means many clients lose significant amounts of muscle mass in the first 3-6 months after their injury. As muscle mass is what burns the calories, clients then HERE’S WHY NUTRITION IS IMPORTANT… end up with calorie requirements as much as 50% lower than Think of your body like a house with a 24-7 live in their pre-injury levels. Many clients struggle to adjust to this renovation team. Anytime there is and many end up gaining significant After someone has a dent or something breaks down, amounts of weight in the years that your renovation team is there experienced a brain injury or follow. This not only affects their repairing the damage as quickly support package (eg. Do they need two spinal cord injury, their body support workers to transfer or one), but as possible. After someone has experienced a brain injury or spinal also whether they need standard grade (or “house” in this analogy) cord injury, their body (or “house” or bariatric equipment. It also increases has been through the in this analogy) has been through their risk of developing type 2 diabetes equivalent of a hurricane. the equivalent of a hurricane. and cardiovascular disease. There is cosmetic damage, structural damage and damage inside the “house.” As you GUT ISSUES can well imagine, the quality of the repair job that their Abdominal pain and constipation are incredibly renovation team is going to be able to do, will be highly common after a major trauma. Nerve function to contingent on the building materials that the client makes the gut can be impaired and clients are often prescribed available to them. Are your clients consuming a diet high pain medication which contributes to constipation. in vegetables, fruit, protein, healthy fats and calcium-rich Combine this with a low fibre diet and inadequate fluid, foods? As these are the nutritional equivalent of highand clients can end up extremely constipated and on quality building materials like brick, marble and high-quality multiple laxatives. Abdominal pain often comes from the paint. They provide key building blocks and materials which constipation itself, the laxatives and/or Irritable Bowel will help repair damage within the body. Syndrome (which often develops after a major stress or Sadly, due to pain, fatigue and other issues, many clients trauma). This pain can prevent clients from engaging in other forms of physical therapy. end up consuming diets high in processed foods. These foods provide inadequate levels of the necessary building FATIGUE materials, such as protein, vitamins and minerals, needed While many clients after a brain injury may to repair the damage. The consequence of this can be experience neuro-fatigue, all clients should have the the development of nutrient deficiencies (such as iron following blood tests completed to make sure that other or vitamin D deficiency), reduced muscle mass and even

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RECOVERY & REHABILITATION medical factors are not contributing to the problem: full blood count, ferritin, urea and electrolytes, vitamin B12/ folate, thyroid function (including T3 and T4 for people with a brain injury), Hba1C (for blood sugar levels) and vitamin D. After all, you can have more than one thing wrong with you at a time. For example, you can have a brain injury AND you can have iron deficiency anaemia. You can have a spinal cord injury AND be deficient in vitamin D.

TASTE AND SMELL LOSS

Taste and smell loss are incredibly common, particularly after a brain injury where the olfactory (smell) nerves are often damaged. Since the sense of smell actually provides over 70% of the flavour from food, a reduced or absent sense of smell results in food ‘tasting’ bland. Smell training, combined with compensation strategies that focus on stimulating the trigeminal nerve of the tongue, can help give clients some joy and pleasure with eating again.

SLOW WOUND HEALING

Skin is literally made out of nutritional building blocks, which means clients will need extra protein, vitamin C and zinc if their pressure sores (and other wounds) are going to heal. The dressings provided by the district nursing team will have a limited effect without adequate nutrition.

Is the client overweight, underweight or has there been an unintended weight change of 10% or more in the last 3-6 months?

Is the client experiencing any gut related issues, such as constipation, diarrhoea or abdominal pain?

Does the client have a chronic disease requiring nutritional management, such as diabetes or coeliac disease?

HIGH BLOOD SUGAR LEVELS

If a client loses muscle mass and gains significant amounts of body fat, their risk of pre-diabetes and diabetes goes up considerably. Even clients who are under the GP and on medication for diabetes, often still have high blood sugar levels (eg. routinely over 10mmol/L). High blood sugar levels can contribute to fatigue, challenging behaviour, urinary tract infections and slow would healing, not to mention cause permanent damage to the eyes, kidneys and nerves.

people giving conflicting advice. “Dietitian” is a legally protected title which denotes someone has a degree in nutrition and is regulated by the Health and Care Professions Council around conduct, ethics and continuing professional development. Clients in need of nutrition advice after a brain injury or spinal cord injury, should be referred to a dietitian (NHS or private). This is so that their medical history, medication and blood test results can all be considered in combination with their eating habits. Here’s what case managers and solicitors should be looking for to know when to refer:

DYSPHAGIA

Speech and Language Therapists are the ones who actually diagnose whether someone has dysphagia and determine if texture modified food or fluid are required. Dietitians can then help ensure that clients are consuming a varied, delicious and nutritious diet. Don’t let clients get stuck in a rut of mashed potatoes, yogurt and nutrition supplements. Texture-modified diets can be beautifully presented and delicious with the right advice and support.

WHEN AND WHERE TO REFER? Nutrition can be quite an unregulated industry, with many

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Does the client have excessive fatigue interfering with their rehab?

Does the client have taste and/or smell loss?

Does the client have a Grade 3 or Grade 4 pressure sore or a slow healing wound?

Is the client struggling to eat a nutritious diet because of dysphagia, limited food preferences, lack of mental capacity, limited cooking skills or another reason? Nutrition and eating habits, while often overlooked, can significantly improve a client’s rehab and recovery. For more information, to make a referral, or to sign up for a free e-newsletter for case managers and solicitors, go to: www.specialistnutritionrehab.co.uk.

Call us on 0121 384 7087 or Email: info@specialistnutritionrehab.co.uk Web: www.specialistnutritionrehab.co.uk

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RECOVERY & REHABILITATION

Think Therapy 1st A BRAIN INJURY CASE STUDY When our clients were told: “You can’t” we helped them show they could!

I Emma Roddis

’M Gary Mackinder. On the 28th August 2019 at roughly 11:30pm my life changed in an instant. I was cycling home when I was hit by a car. I was unconscious for 3 days with a double fracture at the base of my skull and a bleed on the brain as well as other injuries.

After 1 week I was home, little did I know that the brain injury would take 18 months of my life and still counting... Initially my attitude was ‘I will be ok’ but after 8 weeks I realised how wrong I was! Then I was offered help from Think Therapy 1st (TT1st). From day one it has been amazing. In my first assessment with Emma Roddis (Clinical Lead Neuro Specialist Occupational Therapist) it was decided that I needed to have specialist therapy.

IMPACT AND EFFECTS

forklift truck even though a consultant told me I never would, (Emma made sure I could do that too). Coming to terms with my injuries, learning to understand them and dealing with my frustrations that was massive. I’m back to 95% of my old self. I have learned to use strategies; I plan and prioritise. My decision making is more in-depth, I weigh things up more. I’m not put off by busy places anymore and I can remember what I’m doing when I go out. I can shop, enjoy meals out, I don’t get lost or confused. I now walk 7 miles a day, I redecorated (that was one of my projects) and I enjoyed it! If I wouldn’t have had Occupational Therapy I would be nowhere near where I am now, I wouldn’t even be 60%, I wouldn’t have been anywhere near able to go back to work, I wouldn’t have been back on a bike - I would never have faced that. Samuel McFadyen from Hudgells Solicitors said: “Think Therapy 1st have been pivotal in identifying, recommending and delivering a first-class rehabilitation package. The return to work was of the upmost importance and a significant goal for our client. Emma has been a vital linchpin in the rehabilitation process for our client and equally valued and trusted by both solicitors in the case to ensure the I would have no best possible input and outcome”

My brain injury involved: Fatigue, loss of purpose, short term memory loss, post-accident amnesia, no sense of smell or taste, headaches, vertigo, muffled hearing in one ear, intolerance to loud noises, avoiding crowds, loss of appetite, no attention span, no balance and muscle weakness in all parts of my body. Emma got me physiotherapy hesitation in recommending and a neuropsychologist which Think Therapy 1st made a huge difference. But it was the Occupational Therapy with Samuel McFadyen - Hudgells Solicitors Emma that helped me achieve the big milestones like: Creating a daily routine - managing household duties, cooking meals again, being able to enjoy watching documentaries (remembering what was in them!!), playing on PlayStation.

Contact: Helen Merfield, Managing Director Mobile: 07971-798462

MY GOLDEN MOMENTS AND ACHIEVEMENTS One of my biggest achievements was getting back on my bike and returning to my full time job. I’m back to driving a

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People Therapy Rehabilitation By structuring rehab to rebalance lives, Specialist Rehabilitation Occupational Therapy is not a chore, but purposeful and nearly always fun! Think Therapy 1st (TT1st) is a highly specialised Occupational Therapy service. Our Specialist Rehabilitation Occupational Therapists (SROT) work with people with physical, mental and cognitive difficulties. Developing, recovering or maintaining independence in daily living, work and leisure skills, by using dynamic, multifaceted and meaningful activities to restore the highest possible level of function. Our interventions are highly effective, with one activity often fulfilling the same role as 3 or 4 traditional exercises.

What We Commit To:

• Providing high quality, evidence based, hands-on Therapy (SROT) Services • Providing value for money by delivering a ﬁxed fee, time limited, goal focussed, outcome-based service • Continually measuring our progress to ensure we meet the goals set out in our assessment • Making working with us as simple and easy as possible • “Do what we say we will, when we say we will, at the price we say we will” • Never doing anything for the client that they can do for themselves Think Therapy are diﬀerent. They are not case managers in the recognised sense of the term. They are hands on therapists that work with injured claimants/clients to help maximise their potential. I have used Think Therapy on a number of my claims. While they are ‘claimant focussed’ and work closely with the client and their family, they don’t attempt to turn the case into something it isn’t and, refreshingly, will say when they think their job is done or can do no more. Manager of Large Loss Catastrophic Injury Claims at a Major Insurer

When our clients were told: “They Couldn’t”, we helped them show that they could! Consultant said:

Think Therapy 1st:

“You’ll Never ...”

Helped Them To...

Walk Again

Do a 3 mile sponsored walk

Play badminton again

Play badminton 4 times a week

Go home and will need care for life

Return home independently and look after son twice a month

Our Outcomes Speak for Themselves*:

43% *Full data available on request

Average Function at Initial Needs Assessment

OVER 100% T: 07971-798462

www.thinktherapy1st.co.uk

91%

Average Function at End of Therapy

IMPROVEMENT

from Initial Needs Assessment to End of Therapy

E: helen@thinktherapy1st.co.uk

RECOVERY & REHABILITATION

Helping you feel like…you COMPLETE NEURO REHAB Complete Neuro Rehab provide high intensity Physio, OT and rehabilitation for patients across the midlands to help clients regain independence and freedom.

aving worked in prestigious hospitals and rehabilitation centres across Birmingham and the Black Country, Complete Neuro Rehab was established in 2008 by Neurological Physiotherapist Linsey Swinburne. The ethos of the company is simple, to create intensive, engaging and effective treatments supported by the latest rehab technology for those affected by neurological or complexed conditions. We have taken the unique approach to remove some of the formalities traditionally applied to medical care and create therapy sessions that involve fun, laughter and hard work. The scientific research is quite clear, that compliance to rehabilitation is the single most important factor in achieving long term rehabilitation goals. When we see a client for the first time we want to know what makes you tick, what do you enjoy, what are your hobbies and most importantly, what would YOU like to achieve from your therapy that will help you to continue to live a fulfilled and vibrant life post injury.

PART OF THE COMMUNITY Part of the vision for starting Complete Neuro Rehab was to create a community where everyone feels included, valued and accepted. When you come for treatment with us you become part of that community, where everybody looks out for each other and cheers each other on during their sessions. We remain a family owned and run business and have grown our team over the last 10 years to a staff of 12 including Neurological Physiotherapists, Paediatric Physiotherapists, Occupational Therapists, Psychologists, Nutritionists and Rehabilitation specialists providing expert treatment and rehabilitation services to patients and case management professionals working with Spinal injury and Brain injury clients. Our intelligent software provides detailed reports on rehabilitation progress and graphically displays outcome data for easy incorporation into patients reports and legal documents.

WORKING SMARTER Over the last decade the field of technology for use in rehabilitation has progressed significantly. Based on gross motor relearning, in which the more a movement is practiced

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and repeated the quicker function is restored, it was evident that technology had a significant role to play, not only in motivating our clients but also allowing them to maximise their time with us, by simply doing more in each treatment session. Complete Neuro Rehab were an early adopter of rehabilitation technology, with the application of robotics and game-based rehabilitation from 2014. Fast forward to the present day and you can find us working from our brand new, 2000sq ft, state of the art rehabilitation centre based in Stourbridge in the West Midlands. Equipped with the latest in robotic, anti-gravity and virtual reality equipment to assist with rehabilitation of the client as a whole, including cognitive gaming, balance training, gait re-education and upper limb rehabilitation. ■

WHAT OUR CLIENTS SAY “Moving away and not coming to Physio any longer, It is actually a very sad thought for me after 3 years and will remain as one of the most memorable and important times of my life. I will take so much away with me from everything I have learned from you, it’s unquantifiable.” BM “I live in Solihull, but am so thankful that my consultant Neurologist recommended Complete Neuro Rehab after my stroke. Their specialised machinery and expert practitioners have been extremely beneficial for my disability and recovery, both practically and emotionally, as well as to my wife as my full time carer. Support both on site and remotely via Zoom during lockdown has been second to none. I cannot recommend this clinic more highly.” NT

For more information or to discuss your needs please get in touch using the details below. Web: www.cnrehab.co.uk | Email: hello@cnrehab.co.uk Tel: 01384 476028

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WELCOME TO COMPLETE NEURO REHAB We are an intensive neurological rehabilitation centre based in Stourbridge, West Midlands. We utilise the latest in rehabilitation technology to assist you in regaining as much function as possible. Your sessions with us will be engaging and varied to keep you motivated to push your boundaries.

WHY CHOOSE US? Tailored sessions dependent on your requirements Our advanced technology allows you to do more in each session We offer packages from 1hr to 25hrs per week Our detailed reports help you track your progress

Complete Neuro Rehab Cranham House, High Street, Amblecote, Stourbridge DY8 4BU

01384 476 028 hello@cnrehab.co.uk www.cnrehab.co.uk

RECOVERY & REHABILITATION

Getting a grip on MAKING REHAB FUN Studies show that the more repetition and strength training a person performs, the greater their chance of restoring movement after a brain or spinal injury. However, keeping up with a rehabilitation regime, no matter how willing you are, is a grind, with many traditional therapies being both unmeasurable and unmotivating. But technology can hold the key to unlocking motivation, as Dr Paul Rinne CEO and co-founder of GripAble explains. says was tedious and demotivating, Peter’s OT introduced him to GripAble. Peter uses his GripAble daily and tracks his activity. He told us that: “GripAble is an amazing, dead neat bit of kit. I love that I can work on my grip strength, and I can see how I am doing.” GripAble was also introduced to 12-year-old, wouldbe drumming legend, Max. His dad explained: “GripAble is a game-changer! Max is so motivated by seeing his rehabilitation as a game, not therapy. Over the last 11 years we have tried lots of different kinds of therapies, but the sessions were really stressful as the work was hard and our son wasn’t motivated. He didn’t grasp the importance of therapy since his brain injury also left him with learning difficulties which made it more difficult to encourage him to engage in the sessions.”

THE REHAB CHALLENGE GripAble is a smart mobile assessment and training device, designed to help people work on their hand and arm movement and grip strength, by training core movements in an engaging way. The handheld device connects to a mobile app and activity levels are measurable and trackable for home-based users, and as a handy assessment tool for healthcare professionals. The highly sensitive device has been developed over several years in partnership with thousands of occupational therapists, physiotherapists and patients across multiple clinical conditions and leading academic institutions including Imperial College London and within Imperial Healthcare NHS Trust.

After just a couple of weeks training on GripAble, Max’s dad said he was able to grip the sticks for short periods at a time and continues to make progress, something he fully attributes to his engagement with the system – and proof that GripAble rocks! After just a couple of weeks training on GripAble, Max’s dad said he was able to grip the sticks for short periods at a time and continues to make progress, something he fully attributes to his engagement with the system – and proof that GripAble rocks!

REMOTE REHAB AT THE HEART

Alongside putting the fun into rehab, GripAble has been developed with remote rehab at its heart, and can be delivered within 24 hours, with full set-up and support from the dedicated team. ■

THE WINNING FORMULA Winning is a habit and so being able to track progress is just about the best motivation you can get. One user, Peter, needed daily exercise to rehabilitate compressed nerves that were affecting his ability to grip. After several months of exercise, mostly squeezing putty, which he

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Tel: 0207 661 4018 | Email: hello@gripable.co Web: www.gripable.co sevenstarmedia.co.uk

Struggling with putty and pegs? GripAble can support you along your therapy journey, with engaging and measurable hand, wrist and arm activities designed with brain and spinal injury survivors and their therapists. Connecting to an app on a tablet, GripAble empowers you through your training - face-to-face or remotely.

HAVE A GRIPABLE SENT TO YOUR THERAPIST OR DIRECTLY TO YOUR DOOR Get in touch to buy now – or request a trial

VISIT WWW.GRIPABLE.CO EMAIL US AT HELLO GRIPABLE.CO CALL+44 (0)207 661 4018

RECOVERY & REHABILITATION

Mental Capacity Act (MCA), deputyship and empowerment THE IMPACT ON OCCUPATIONAL ENGAGEMENT Adam Ferry is an occupational therapist and Director of The OT Service with a background in neurological rehabilitation

he Mental Capacity Act (2005) is designed to not only protect but also empower a person deemed to lack capacity for either welfare or property/affairs1. The protection element is generally wellAdam Ferry established and applied but the use of the act to empower individuals may be less explicit. Let us first consider the idea of using the MCA to empower an individual who lacks capacity, using the NHS 6 C’s as a way of providing practical examples to illustrate application: MCA principle

Empowering application

4th

Decisions for a person who lacks capacity must be in their best interests. Consider past beliefs, values and wishes.

1st

Someone may be able to make some decisions and not others. Don’t use assumption of capacity to do nothing or lack of capacity to ‘impose’ views or decision.

Competence

5th

Actions must be least restrictive as possible. Use positive risk assessments and may mean accepting their attitude to risk is different to yours.

Communication

2nd

Take all steps to support a person to make decisions themselves.

3rd

People have the right to make unwise decisions. Take care and have courage to understand the balance of choices a person may make trading costs and benefits that are meaningful to them.

All

Improving the care and experience of clients and their families requires commitment from all professionals to ensure the empowerment ethos of MCA is reflected in practice.

Care

Compassion

Courage

Commitment

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Table 1 (see left): Adapted from: NHS England (2016) ‘Linking the empowering ethos of the Mental Capacity Act principles with the person-centred principles of the 6Cs’

The key statements from the table above are best interests, least restrictive, right to make unwise decisions; although they should be very familiar to members of the multi-disciplinary team (MDT) as values of the MCA it is important that we reflect on whether their application is consistent in the context of empowerment as well as protection. As part of the reflection on the impact of financial deputyship and occupational engagement, let’s consider the roles of a deputy for property/affairs and an occupational therapist within the MDT.

OCCUPATIONAL THERAPY Empowerment forms a strong part of occupational therapy practice, with the overall aim of using client centred, holistic assessment and intervention to maximise independence and engagement in meaningful occupations. The World Federation of Occupational Therapists define occupation as: ‘…the everyday activities that people do as individuals, in families and with communities to occupy time and bring meaning and purpose to life. Occupations include things people need to, want to and are expected to do.’2 The terms ‘want’ and ‘expected’ are crucial within the definition in the context of empowerment as they extend the scope of intervention beyond ‘need’ as may be traditionally covered within statutory services provision. The occupational therapist’s role is therefore to enable participation in everyday tasks and positively assess risk in the context of what is meaningful to the person.

FINANCIAL DEPUTY A deputy is appointed to support a person make decisions or indeed to make decisions for that person. For property and affairs this means ensuring that finances (including any estate) are secured, protected and managed in accordance with principles of the Mental Capacity Act Code of Practice3. The Deputy, under the MCA is permitted to make or support decision as per the court’s direction, but including a wide range of decisions made, or actions

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RECOVERY & REHABILITATION taken, on behalf of people who may lack capacity to make specific decisions for themselves. These can be decisions about day-to-day matters – like what to wear, or what to buy when doing the weekly shopping – or decisions about major life-changing events, such as whether the person should move into a care home or undergo a major surgical procedure. Appointment of a deputy for property & affairs is intended to assist and support people who may lack capacity and to discourage anyone who is involved in caring for someone who lacks capacity from being overly restrictive or controlling. But the Act also aims to balance an individual’s right to make decisions for themselves with their right to be protected from harm if they lack capacity to make decisions to protect themselves. (MCA Code of Practice).

CHALLENGES What seem like perfectly aligned values can become challenges when applied from different angles or perspectives. For example, consider the case in table 2; this client has a court appointed deputy for property & affairs who has to ensure that the client, who is at risk of financial abuse, remains safe and his funds last him his lifetime.

Person

The client is male in his mid-twenties who had a TBI as a child resulting in high level cognitive deficits. He is able to function effectively with most daily tasks but has significant executive function difficulties including attention control, working memory, reasoning, problem solving and self-regulation. These difficulties often result in spontaneous decision making, particular in relation to spending.

Environment

The client lives with his wife and young child in a property purchased from capital funds. The client’s mother-in-law visits regularly but otherwise he is quite socially isolated with no apparent close group of friends.

Occupation

He spends time driving, although often with no destination, and enjoys being in the car. He has a games console and likes to buy new games. He also uses this for streaming services. He has a lot of spare time and often fills it by spending money online. Accessible funds have recently been significantly reduced to minimise ‘waste’ spending and re-instate some financial control.

Table 2: Applying PEO model of practice (Law et al, 1996)

Application of the MCA to protect in this case is explicit; limit immediate access to money so that the client and indeed his money are safeguarded. However, the application should consider both protection and empowerment and raises important questions: 1. 2. 3. 4.

What is the holistic impact on the person? How is a ‘reasonable’ weekly budget determined? Is this the least restrictive solution? Does this impact on a therapy plan?

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The client is a husband and father, so it is crucial to understand the importance placed on these roles. Limiting access to funds may impact on how he perceives himself and how he is perceived by others. The process of requesting additional funds for spending outside of the weekly budget requires thought. The person needs to be empowered and creating layers of process may create a feeling of passiveness at best or despair at worst. The determination of budgets with opinions provided about what is reasonable is often subjective. We must never lose sight of how the term reasonable does not mean ‘need’ and take the person’s ‘wants and expectations’ into account. An imposed budget that does not allow flexibility or take this into account results in the loss of the least restrictive principle. As part of the therapy plan an occupational therapist will be working to maximise independence. This will include the development of skills to achieve goals which may, as part of daily living activites, include financial management. Significantly limiting access to funds may in some cases inhibit the therapy process by reducing choice and therefore the opportunity to work on reasoning and self-regulation. The therapy plan by nature of being clientcentred is intended to empower, therefore application of the MCA in an attempt to protect in this instance would be fundamentally dis-empowering. Ultimately decisions need to be balanced, ensuring that protection and empowerment are considered in equal measure. Acknowledgement that any decision made ‘for’ the person, or that restrict the person’s options, has an impact on other aspects of occupational performance or engagement is crucial so that consideration can then be made about ‘least restrictive’ and ‘best interest’. Risk assessment should be built around balanced and positive risk taking to ensure that the person is not occupationally deprived or disempowered by the MCA, instead focusing on the person’s potential to reach goals and maintain successful, fulfilling roles through engagement in meaningful occupation.

REFERENCES

1 Mental capacity Act (2005) at a glance’ (2020): Social care institute for excellence. 2 https://wfot.org/about/about-occupational-therapy 3 Mental Capacity Act (2005) code of practice: Available at https://assets.publishing.service.gov.uk/government/uploads/ system/uploads/attachment_data/file/921428/Mentalcapacity-act-code-of-practice.pdf

Contact Adam Ferry, Director and Occupational Therapist | Tel: 0333 444 0062 Web: www.theotservice.co.uk

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RECOVERY & REHABILITATION

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RECOVERY & REHABILITATION

ONE OF A KIND Richardson Care provides unique residential care and rehabilitation for adults with brain injury.

hat makes Richardson Care stand out is its uncompromising commitment to placing service users at the heart of decisions made about their care. An independent family business with a 30-year track record, Richardson Care appreciates that everyone who has a brain injury is unique and has different and complex needs. The care provided is truly person-centred and each individual is supported by a multi-disciplinary team of therapists. A Consultant Clinical Psychiatrist and Consultant Psychologist work in partnership with an experienced Physiotherapist, Occupational Therapist, Speech & Language Therapist, Care Managers and Activity Leaders to develop and implement care plans. These support the emotional and physical well-being of service users to advance their cognitive abilities and skills of daily living. This means that each individual has the opportunity for a

rich and fulfilling life within a supportive home environment. Never was the sense of community and family more important than during the Coronavirus pandemic. The unique character of Richardson Care homes and the positive relationships between the service users and their care teams helped them to be resilient, active and happy during difficult times. Richardson Care homes are designed specifically to create a ‘home from home’. Central to this ethos is spaces which are uplifting, naturally lit and practical, allowing all occupants to move freely in and around their home.

The care provided is truly person-centred Richardson Care has a portfolio of six specialist homes in Northampton for adults with acquired brain injury and separately for adults with learning disabilities. It caters for adults with complex needs and offers a range of services including short-term rehabilitation, long-term rehabilitation and a home for life. ■

Call Richardson Care on 01604 791071 to find out more or Email: admissions@richardsoncares.co.uk Web: www.richardsoncares.co.uk

Respect & Restore Specialist residential care and rehabilitation for adults with acquired brain injuries. • Portfolio of services to meet a variety of needs • Innovative person-centred care • Unique ‘family’ environment • Focus on social integration • 30-year proven track record Proud to be an independent family business.

Call us on 01604 791071 to find out more or email admissions@richardsoncares.co.uk

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RECOVERY & REHABILITATION

A unique approach TO FINDING AND ADAPTING A HOME Design for Independence offers bespoke, cost-effective housing occupational therapy.

eople with catastrophic injuries have no ability to adapt themselves to the environment around them, unlike able-bodied people. Our pupils dilate for the amount of light around us, for example, or we stand on our toes to reach an object on a high shelf. We unpick problems and assess risks, often without realising we’re doing it. But someone with life-changing injuries that cause sensory, cognitive or physical impairments is left restricted and inflexible. To be able to live as independently as possible, they need a tailor-made environment designed to overcome the complexities of their injuries. That’s why we focus on harnessing the abilities each individual still has – rather than adopting a one-size-fits-all approach. Our designs are as unique as the care needs and rehabilitation goals of our clients. Design for Independence is led by an occupational therapist – so people with disabilities are front and centre of each and every project. Property searches and adaptations are tailor-made to accommodate the specific requirements of our clients – adults and children with brain and spinal injuries, as well as amputees. The Design for Independence experts have years of experience working with the construction industry and specialise in designing for sensory and cognitive impairments, not just physical disabilities. This enables the team to think outside the box and come up with unique solutions for even the most challenging cases, in the most restricted spaces.

ONE-STOP SHOP There are no finder’s fees to pay – and the Design for Independence service is exempt from VAT as it is completed by an occupational therapist. Once we understand an individual’s unique requirements, we can introduce an architect, structural engineer, quantity surveyor and builders to make it all possible. All work is then closely supervised, and we source all equipment fixtures and fittings. In the case of rental homes, our team ensures any adaptations don’t incur high reinstatement costs at the end of the tenancy. We also provide manual handling training for the care team when a client moves in.

ACCOMMODATION EXPERT

Anava Baruch

Managing director Anava Baruch acts as an accommodation expert under part 35 of civil law. Her background in occupational therapy gives her a holistic view of a client’s accommodation needs.

Tel: 01799 588056 Email: info@designforindependence.co.uk Web: www.designforindependence.co.uk

PROPERTY SEARCH AND ADAPTATION The first step is an in-depth understanding of what a client and their family need – not just now but in the long term. How do they use their living space and transfer from various pieces of equipment and furniture? Is space required for carers? What type of therapy will take place at home and what equipment is likely to be purchased to support that? What activities can they get involved in that will enrich their lives and improve their interaction with others? These are all valuable clues to the size, location and configuration of the desired property – and what adaptations might be required to make it just right for each individual client. A house on a busy road, for example, could be dangerous for someone with cognitive impairment. If someone has vision problems, a home with plenty of natural light might be crucial. And if memory is the issue, intuitive kitchen design can help maintain an individual’s independence.

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The housing occupational therapy specialists

Design for Independence is a private housing occupational therapy company, searching, designing and adapting homes for the less able. We cover all areas of physical, sensory and cognitive disability, and work both nationally and internationally. These are just some of the services we offer:

Property search for suitable accommodation

Creating specifications for the building work required

Sourcing all equipment fixtures and fittings for the client

Sourcing and liaising with building professionals

Working closely with the contractors during the adaptation work

Sourcing contractors for internal work

Visit designforindependence.co.uk to find out more

RECOVERY & REHABILITATION

Family Focused Interventions WHAT HAPPENS WHEN WE BOLSTER FAMILY RESILIENCE? By Bridget Smyth Head of Children and Youth Services Brain Injury Matters (BIM) NI

cquired brain injury (ABI) is a complex condition, with injuries varying widely in terms of origin, severity and longer-term impact. The challenges children and their families face after sustaining an ABI have been the subject of international debate over the last 15 years. Many children will be left with no physical indication of their injury, but are at risk of experiencing difficulties in terms of their thinking, their functioning in activities of daily living and emotional experiences. It is not uncommon for these issues to only become apparent after returning to everyday life at home or school. Importantly, as the brain is still developing throughout childhood and adolescence, the impact of an injury sustained at this time may not be known for a number of years. In addition, numerous studies demonstrate that children following an ABI are at risk of underachieving in education, developing mental health and mood difficulties and are disproportionately represented in the juvenile (and adult) justice populations.

THE IMPACT OF ABI GOES BEYOND THAT The impact of ABI goes beyond that of the child and can adversely affect families. Living with a child with ABI, or the ‘invisible disability’ as it is commonly referred to, places enormous stress on the family and, if not managed or supported, can tear family units apart. There is consistent evidence that suggests that healthcare professionals focus on the medical aspects

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of recovery, rather than taking a holistic, family-centred approach to care. Often upon discharge from hospital families have described a realisation that the family must now go-it-alone, which often creates a sense of abandonment and anxiety amongst families.

They have given my child coping mechanisms which will benefit him throughout his life PARENT OF ABI SURVIVOR Studies have shown parents to experience post-injury depression, guilt and anxiety which is not entirely surprising given the unpredictable nature of ABI for families. Furthermore, some families in the wake of ABI can experience deteriorations in their socio-economic standing due to having to change or quit jobs to care for their child and the financial burdens this incurs. Equally research has indicated that for young people whose brother or sister has an ABI, poorer quality of life may result for these siblings in comparison to peers. A Northern Irish sibling controlled study conducted by Jebb and Colleagues (2012) that examined the behavioural outcomes of childhood ABI, reported that siblings of children with ABI demonstrated more deficits than reference norms on teacher reportedbehavioural and social measures of adjustment.

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RECOVERY & REHABILITATION the Kings Outcome Scale of Childhood Head Injury. These are FAMILY FOCUSED INTERVENTIONS children and families who, because they do not have a “severe” Studies conducted in NI and internationally have demonstrated disability, can sometimes fall below the threshold for specialist that interventions that promote family functioning and the capacity to meet the changing needs of the injured child over time neurology and other disability services. In relation to child specific factors, the evaluation found have better outcomes for children with ABI. Family functioning, that the children referred to the service were generally which includes family cohesion, good communication, and better in the clinically significant range with respect to elevated coping resources, have been found to be reliable predictors for behavioural difficulties and positive child and family outcomes compromised social and post injury. (McCusker et al 2012, academic competencies (data Absolutely perfect service, McCrudden, Fitzpatrick, Allen & from the Child Kirby, 2018). very helpful for understanding my collected Behaviour Checklist). Following In Northern Ireland there are no child’s condition Family First intervention, these specific regional or HSC Trust wide children displayed a reduction community services for children PARENT OF ABI SURVIVOR in these difficulties across with ABI, nor specific statutory time and showed a statistically services designed to holistically significant increase in child competencies. Similarly, in terms meet the needs of children with ABI. This prompted BIM to of psychological adjustment, children involved with the establish a specialist service to work with families to support and Family First Service did not perceive themselves as having any empower them to meet the challenges of parenting their child psychological difficulties, and often scored themselves within (0-18) with an ABI. the ‘normal’ range in standardised measures. Nevertheless, these children displayed an increase in self-concept, and a FAMILY FIRST SERVICE decrease in psychological difficulties following Family First The Family First Service has a Family Focused Approach intervention. Specifically, these children showed a statistically working with all the family, to intervene early with children significant decrease in anger and disruptive behaviour. and young people to support long term outcomes, and hopefully prevent these from escalating. The service works CONCLUSION regionally in Northern Ireland and is funded by The National The independent evaluation also highlighted that Family Lottery Community Fund and delivered in partnership with First had a positive impact on the service landscape for The Department of Psychological Services BHSCT. Family children with ABI. From thematic analysis of referrer feedback First is a multi-disciplinary team, consisting of a wide variety there emerged the themes of “filling a gap” and “enhancing of professional backgrounds including Speech and Language, capacity of statutory services”. This suggests that intervening Psychology, Social Work, Nursing and Play Therapy. at the environmental level with these families enhances the Family First offers a bespoke service and interventions are capacity of other professionals to understand and work with tailored to meet the family needs specific to their child’s ABI. children with ABI. Overall the evaluation has highlighted how Interventions are evidence-based and evidence informed bolstering family resilience can support long-term positive and often draw on existing literature and research in the outcomes for children with ABI. fields of brain injury, trauma, mental health, play, and sensory integration. Furthermore, the interventions do not ignore the wider systems surrounding a child, and therefore are McCusker, C.G., Doherty, N., Molloy, B., Rooney, N., Mulholland, C., Sands, delivered in a family-focused way, teaching parents problemA., Craig, B., Stewart, M. & Casey, F. (2012) A randomized controlled trial of solving skills to empower them to generate solutions and interventions to promote adjustment in children with congenital heart advocate for their child’s needs. disease entering school and their families. Journal of Paediatric Psychology, The Family First Service places particular emphasis on Advance Access, 1-15. engaging with not only the child’s immediate family, but also Fitzpatrick, M. McCrudden, E.& Kirby, K (2018) A Pilot Investigation of a extended family, school and educational professionals and Parenting Intervention for Parents and Children with health care professionals to support the wider environmental Neurodevelopmental Disorders (NDD), Child Care in Practice, DOI: context. This is particularly important as it has been argued 10.1080/13575279.2018.1446906 To link to this article: https://doi.org/10.10 that family functioning and environmental influences are the 80/13575279.2018.1446906 greatest predictor of long-term outcomes in childhood ABI. McCusker, Quinn C., Smyth, B. & McCrudden, E. (2020) The Family First For that reason, Family First considers child-related factors Project Piloting a New Family Focused Intervention Service for Children such as age at injury, pre-morbid functioning, and severity with Acquired Brain Injury in Northern Ireland. Brain Injury Matters of injury and location of injury, in the context of family and Service Evaluation Report. environmental factors.

IMPACT OF FAMILY FIRST SERVICE Key findings from an independent service evaluation conducted by Consultant Clinical Psychologist Dr Chris McCusker in 2020 indicated that approximately half of the children referred to Family First had sustained a Traumatic Brain Injury, but there was also a wide variety of other mechanisms such as childhood stroke, tumours, infections such as meningitis or encephalitis, or hypoxic events. Most children also fell into the ‘moderate’ neurodisability range based on sevenstarmedia.co.uk

For further information, please contact Bridget Smyth – Head of Children and Youth Services Email: bridget@braininjurymatters.org.uk Website: https://braininjurymatters.org.uk/

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RECOVERY & REHABILITATION

“I’m so dizzy – MY HEAD IS SPINNING” Differential diagnosis and treatment of vestibular problems in TBI

Andrew McVittie, Chartered Physiotherapist, SP Therapy Services

VESTIBULAR DYSFUNCTION AND REHABILITATION IN TBI It is well known that traumatic brain injury (TBI) is the most common cause of disability in the general population under the age of 40. TBI diagnosis is increasing as clinicians recognise the potential long-term impacts of even mild TBI. Around a 1/3rd to over ¾ of this population also report chronic symptoms of vestibular dysfunction when investigated. It is perhaps not so commonly known that longterm unemployment can be up to three times higher in TBI survivors with chronic vestibular dysfunction. Yet vestibular dysfunction appears under diagnosed and treatment complicated. Vestibular dysfunction can alter balance and bring an associated lack of movement confidence. This directly impacts quality of life, involvement in activities of daily living and mobility. Altered balance and associated loss of confidence, are recognised as two major risk factors for future falls. Dizziness, another commonly reported vestibular symptom, doubles the risk of a person falling. Add to this the greater consequences of a fall for those already having suffered a TBI and vestibular rehabilitation is clearly an area where accurate diagnosis combined with evidenced treatment could make a huge difference. This prompted the Physiotherapy team at SP Therapy Services to produce a practitioner treatment guide to be used as a screening tool at all assessments involving TBI.

TBI, leading to them being under reported. These vestibular related issues are almost expected to self-resolve post acutely and it often appears that they do. But it is now thought that chronic adaptive brain mechanisms uncouple vestibular symptoms from signs effectively masking them. The brain and body adapt around the deficiencies. This extra level of processing, in a population often already experiencing cognitive difficulties, results in decreased capabilities. Complicating matters further are symptoms sometimes taking weeks to become apparent. This may not be recognised as a new symptom, or one associated with the TBI, when presented to health care practitioners who may not be trained, or attuned, to identifying vestibular problems. Perception issues can also leave TBI patients unaware they are even experiencing vestibular dysfunction symptoms.

Andrew McVittie

HISTORICAL UNDERDIAGNOSIS Vestibular dysfunction seems to have been historically under diagnosed in the TBI population. Acute vestibular symptoms are often expected by the patient following a

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Not just an inner ear problem

COMPLEX PRESENTATION Classic symptoms that are frequently associated with vestibular dysfunction conditions such as Benign Paroxysmal Positional Vertigo (dizziness and nausea) are easily recognised by most practitioners. But the complex presentation of a TBI with its associated cognitive, communication, fatigue, mood and perception problems can mean symptoms are not so easy to tease out. Those with vestibular dysfunction in the TBI population are roughly equally split between those with a peripheral issue (eyes and ears), a central issue (dysfunction within the areas of the brain that interpret the information and control balance) and a mix of both. This complexity of presentation, with symptoms caused by two systems, can make diagnosis and treatment very difficult. There is often a pattern of patients having seen many different health professionals, in different settings, over a long period of time, but without receiving a clear diagnosis leading to effective treatment. sevenstarmedia.co.uk

RECOVERY & REHABILITATION be aware of their symptoms. Therefore knowing what questions to ask, or signs to be aware of, relies on a detailed knowledge of what they may be and how they may present in a TBI patient.

HOW CAN WE HELP?

Information received from afferent sensory pathways is interpreted centrally

ASSESSMENT

Where appropriate, assessment should include all aspects of the postural control system, motor, sensory and cognitive. Muscle strength testing, sensation, range of joint motion, coordination and tone are all potential contributory factors. Observation of posture and gait, and assessment of neck range of motion is also suggested. As community-based Physiotherapists these are tasks we perform daily and we are ideally suited to restoring function, balance, and strength through exercise. If a patient has subconsciously compensated for their deficits, or has cognitive impairment, they may not even sevenstarmedia.co.uk

The ultimate aim of rehabilitation is to help patients become as fully functional as possible, within all aspects of their lives in the context of their disability. For a patient with the complex presentation of vestibular dysfunction combined with TBI assessment and treatment requires an understanding of the complex inter related nature of both conditions Vestibular rehabilitation is a programme which includes the administration of a set of graduated, customised exercises. It may also, where appropriate, include additional components such as education and referral to MDT colleagues. Rehabilitation should be customised to the individual, and thus is not purely dependent on the diagnosis. Again as Physiotherapists working with patients in their own environments we can obtain an holistic picture of their situation and individualise treatment accordingly. At SP Therapy services our Physiotherapists and Occupational Therapists are passionate about patients with complex needs and strive to provide the best possible care to people with neurological conditions. Therefore, we are inclusive to all and we have developed problem, rather than, diagnosis specific protocols. Following the evidence we gathered in peer support sessions we have an improved ability to screen patients for vestibular symptoms that may otherwise have been un-detected. When symptoms are identified we are able to provide comprehensive vestibular assessment, risk assessment and individualised treatment. We are happy to collaborate with local health care providers and other services. We regularly share our experience and knowledge and speak to our colleague therapists, local patient groups and charities to benefit the wider community, especially patients with complex needs like those who sustain TBI.

Tel: 0161 764 3799 Web: www.sptherapyservices.co.uk

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RECOVERY & REHABILITATION

“An ABI can cause hidden DISABILITIES THAT FAMILIES MAY NOT BE EXPECTING” QEF’s Clinical Psychologist, Dr Holly Hurn highlights some of the hidden disabilities that can result from an acquired brain injury (ABI) and how QEF supports people after such a traumatic event.

“A

brain injury can really affect how we process the world around us and can cause hidden disabilities that families and friends may not be expecting. At QEF’s Care and Rehabilitation Centre, the Psychology team work closely alongside Occupational Dr Holly Hurn Therapists, Physiotherapists and Speech and Language Therapists to enable individuals to understand and adjust to their neurological injuries and rebuild core life skills and independence. It is very common to feel high levels of fatigue following a neurological injury. Reduced attention span and processing

speed can make seemingly simple activities like following a TV programme challenging. Working memory can also be affected, impacting someone’s ability to follow a conversation and retain the content. These can all be very subtle changes but can make a seemingly ‘normal’ day exhausting. Emotions, personality and behaviour can also be affected - people can suddenly become tearful, laugh inappropriately or feel more irritable. Others may feel ‘emotionally numb’. These changes can be especially hard for family and friends to understand. Managing stress is a very important part of neurological rehabilitation, as stress can impact on cognitive processes creating a vicious cycle. At QEF we give clients tips and strategies to cope with, and adjust to, any such changes. Where possible, we also try to involve family and/or friends in a client’s rehabilitation journey.” ■

Read Dr Holly Hurn’s full blog at www.qef.org.uk/ hidden-disabilities

Rebuilding lives and

creating futures Expert neuro rehabilitation and nursing care in a modern, spacious centre

“The neuro rehabilitation package that QEF delivers is so comprehensive and holistic, and in my view a real leader in this speciality.” NHS neuro rehab placement manager

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Losing a limb is traumatic But Blesma believes there is life after limb loss

Blesma is the leading charity for limbless veterans We help all serving and ex-Service men and women who have lost limbs, the use of limbs or their sight, to rebuild their lives by providing emotional, financial and practical support. For life. To find out more call 020 8548 7089 or visit

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RECOVERY & REHABILITATION

LV Rehabilitation

TAKE THE FIRST STEP TOWARDS YOUR RECOVERY AND ACHIEVE

Rehabilitation is an emerging Neurological Rehabilitation service catering to the needs of medico-legal cases for the adult brain and spinal cord injury population. Situated on the south coast, LV Rehabilitation is in the catchment area of two National Spinal Cord Injury units and two Neurosurgical units. The companies key objective is in striving to unlock each individual’s potential for neurological recovery. Years of diversified and specialised experience in neurological physiotherapy and rehabilitation have enabled LV Rehabilitation to utilise their skills creatively, providing a tailored rehabilitation solution for each client. Utilising the concepts of neuroplasticity and enhancing these with the use of technology and exercise optimises recovery by stimulating the body’s critical systems: nervous, muscular and cardiovascular. As part of their service offering, LV Rehabilitation can offer clients home-based therapy plus access to excellent LV-Rehab-Advert March-2020-A5-HR.pdf 1 09/03/2021 15:47

land and hydrotherapy facilities on an outpatient basis. Placing a significant emphasis on living well with a neurological condition, LV Rehabilitation provides empowerment with a vision to achieve goals while always remaining focused on providing a service where rehabilitation remains fun and engaging. ■

Tel: 01243 943023 Web: www.lvrehab.co.uk Email: info@lvrehab.co.uk

Brain Injury Cerebral Palsy / Selective Dorsal Rhzotomy

LV Rehabilitation lies within the South Coast catchment area of two National Spinal Cord Injury Units and two Neurosurgical Units.

We are a small, friendly provider that supplies a tailored neurological physiotherapy service. Our emphasis is on helping individuals with a neurological condition, empowering them to achieve by providing the tools and vision needed to succeed.

CMY

Mutiple Sclerosis Parkinson’s Disease Spinal Cord Injuries Stroke Transverse Myelitis Other Conditions

Visit us online at www.lvrehab.co.uk Email info@lvrehab.co.uk or call us on T: 01243 943023

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CASE MANAGEMENT

What makes LDCM DIFFERENT We constantly reflect how we can evolve to offer a truly bespoke and client centred service.

e have over 20 years of experience between our small yet highly skilled team so we can offer everything and more in a truly personal and cost effective way. Our ethos has always been to provide an individualised and family centred service to our clients with a personal touch. Our case managers work with children and adults who have experienced brain or complex injuries. Complimenting the case management service is an HR generalist and a logistics assistant. Our HR Generalist helps our clients to manage the employment of their support team and our logistic assistant, with his background in the building industry, supports our clients with ensuring they are managing their home environments and equipment to an optimum level. With this skill set we can provide a cost-effective service to the client and ensure that they receive advice and support from specialists in their own field. The case manager can focus on doing what they do best – supporting our clients to achieve their goals.

WHY CHOOSE US?

CASE STUDY

A client was referred with a team of 5 support workers already in place. Case management hours were spent on staff management, supporting their needs with training, appraisal supervision, payroll, and administration. The client lives in her own home and with the repairs and maintenance to the home, garden, and hydrotherapy pool, as well as environmental risk assessment and equipment regulations there was very little time left in the week to ask the client what it was that they wanted to achieve. Support staff admin was taken over by HR support and our logistics assistant worked with the case manager and the financial deputy to ensure the environment is managed. This has allowed us to focus on building the clients independence through recruiting a therapy team to work on very specific functional goals, a dream holiday for the client, a new vehicle and voluntary work is all on the agenda for the coming year. HR and logistics work is charged out at a reduced fee to case management, which means the client only pays case management rates for case management work. A win win situation for us and the client allowing our employees and associates to focus on their areas of expertise and for the client in getting a cost effective and specialist service. ■

We provide a bespoke case management and therapy service to adults and children who have an acquired brain injury or complex physical injury.

LOUISE DENZEL

CASE MANAGEMENT

Caring Case Management

We’re a small company committed to focusing on the client, their journey and the personal aspects of Case Management.

Sensitive To The Client’s Needs

We build a supportive relationship with the client to achieve their goals in the short and long term.

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Understanding & Listening

Through the process of assessment and planning we help the client to understand their injury to aid adjustment and acceptance.

A Collaborative Pathway To Care

We are committed to working closely with our client’s families, care and therapy teams and legal representatives to guide our clients through their journey of rehabilitation.

0115 871 7607 A Client-Centered Approach

We Focus On Wellbeing

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We Maintain Dedicated The Highest CQC in-house HR support Compliant Standards for the client

louise@louisedenzel.co.uk

BRAIN INJURY & COMPLEX CASE MANAGEMENT

ldcasemanagement.co.uk

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CASE MANAGEMENT

BABICM celebrates its 25TH ANNIVERSARY The British Association of Brain Injury and Complex Case Management (BABICM), the professional organisation for case managers, is celebrating its 25th Anniversary this year.

his is a significant milestone for the organisation and Angela Kerr, the current BABICM Chair said: “I’m so proud of all that BABICM has achieved over the years; the journey has been influential in many ways for both our clients and members”. The last 25 years has seen significant changes in the delivery of care and rehabilitation for people living with brain injuries and complex conditions. BABICM’s growth - it now has over 850 members - has laid down the solid foundations and structure for the professional advancement of case management. BABICM provides the education, training and support required to ensure case managers meet the necessary professional standards, practice competencies and uphold the BABICM Code of Ethics. As well as undertaking the appropriate training and continuing professional development, BABICM members also have to confirm their ‘fitness to practise’ annually. This professional development and commitment has enabled members to address and manage the ever changing needs of individuals with brain injury and complex medical conditions, and to deliver best practice for clients and their families.

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BABICM’S AIMS To share knowledge and excellence in brain injury and complex case management To lead the way in related research and evidencebased practice To influence and shape national policy through collaborative working To maintain the highest professional and ethical standards

LOOKING BACK – THE EARLY DAYS OF CASE MANAGEMENT IN THE UK In the 1980s Dr Neil Brooks, a UK neuropsychologist, was working in the USA and encountered case managers, a profession unknown at that time in the UK. The remit of these case managers in the USA was to assess, manage, quality assure, and obtain the best and most effective outcome for their clients with brain injuries.

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CASE MANAGEMENT The case managers were also able to demonstrate that One of the most important milestones in BABICM’s their service was clinically and cost-effective and provided history has been the development of its competencies, a better outcome for their clients. Dr Brooks, who was to first published in 2010. The organisation recognised the become BABICM’s first Chair said: “I remember meeting my importance of developing competencies as a consistent first case manager in the USA and thinking this just makes so measure of performance, in a common language and much sense”. using agreed tools. The BABICM professional standards, On his return to the UK Dr Brooks, together with Dr Bill practice competencies and Code of Ethics are all updated McKinlay, also a neuropsychologist, set up the first case and revised regularly to address the constant changes in management practice in Britain. the management of people with brain injury and complex In 1992, following publication of research supporting the medical conditions. case management model in the UK, the so-called ‘Brain A NATIONAL VOICE FOR CLIENTS AND MEMBERS Injury Case Management Steering Group’ was established, the forerunner to today’s BABICM. This Steering The last 25 years has seen BABICM recognised as an Group subsequently laid down the building blocks for a influential and powerful organisation constantly fighting on professional organisation that behalf of its clients for improved would set, meet and maintain care and service delivery. Over standards and create a culture the years BABICM has raised that could attract and inspire its its profile significantly and members. its opinion is now frequently In 1996 the British Association sought on national policy. The of Brain Injury Case Managers organisation is proactive in was officially launched. From shaping national policy and the outset the organisation was ensuring that best practice and a forum for communication care for its clients is at the top between members, the pooling of the agenda with influential of knowledge, experience and organisations and government. ideas, and for mentoring those BABICM collaborates with many new to the field by experienced organisations such as the Care members. Members were able Quality Commission, Court to influence the development of Protection, Department of of case management and to Health and Social Care, Law Commission and Office of the ensure their voice was heard in Public Guardianship, on issues decisions affecting its future. In 2019, in recognition of It is all too easy for someone that affect clients and impact on brain injury and complex medical members not only managing to claim expertise which is not conditions case management. clients with severe brain injuries built on solid foundations, and a but also many other complex BABICM MEMBERSHIP medical conditions, the good track record can be a you would like to join BABICM organisation changed its name valuable guide to real expertise. Ifthere are various memberships to the British Association of That is what BABICM has created available from Registered Brain Injury and Complex Case Practitioner, Student, Corporate Management. for itself, and also for its Associate to Charity Associate. members. I see membership of MEETING TODAY’S A peer review system has BABICM as a gold standard. CHALLENGES developed over the years so BABICM has established that Advanced Practitioner BILL BRATHWAITE QC various subgroups to facilitate membership can be achieved and support the work of the following peer review and Chair. The Professional Practice evidence of working at the Membership Group champions best practice, promotes upper level across competencies. All practising members professional standards, and oversees BABICM membership. have their name on the BABICM website. At an early stage BABICM recognised that training was critical in driving standards and competencies. The Training and Events Group has a programme of educational events throughout the year, including webinars which have become popular during the pandemic. The Children and Young People group identifies and addresses the issues that are specific to this client group and provides tailored information, training and support. The Research Group For further information, please visit collaborates on research-based studies with universities. www.babicm.org

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CASE MANAGEMENT

Be more child-like to REMOVE THE BARRIERS Following trauma or catastrophic injury, many people, as well as their friends and family, struggle to come to terms with loss and adjustment, forming a key barrier to rehabilitation.

t Bush & Co, we believe that all challenging behaviour is only an attempt to get needs met, presented in a way that it is not yet understood. Each person presents with their own challenges and family dynamics; no two people and situations are the same. For this reason, our service is centred on bespoke packages put in place around the client and in many cases, around the family too.

All ages can display behaviour that is difficult to manage however with young children the challenge is how to ensure their voice is heard. Parents will advocate for their child but often have their own experience of trauma and post-traumatic stress which can hold back the process for the child. When a child is engaged in many therapies at an early age, it is important that they understand that they have a voice, they are listened to and everyone is there to support them and make them part of that process. This is where play and creative arts therapy comes into its own. The focus is primarily on the child and the child gets power through non-directed play therapy where by the child brings their story to the process. Play and creative arts therapy slows the child down, keeping them in the moment to then be able to uncover barriers, anxieties, hopes and desires; key elements to a child’s behaviour and rehabilitation that can be shared back with multi-disciplinary team to take stock and understand the next steps. Our teams get increased engagement in rehabilitation from the child but another vital outcome is that those around the child should take time to listen and respect the child’s voice.

HOW DOES IT WORK? The therapist provides a toolkit which they present to the child so they can use creativity as a metaphor to explain their story. Using tools is less traumatic and eventually means the child can voice their issues. Play therapy and creative arts therapy engages children in a process that is relevant for them and not a generic process where they don’t understand the language spoken or the people in the room. Our therapists go at the child’s pace. As adults when working to demonstrate outcomes, there can be a tendency to hurry up a process to get to the end goal.

Our associate behaviour specialists work to interpret the misunderstood language, make sense of what is happening for all involved and implement tools and strategies for children, young people and adults to move forward in their rehabilitation.

To find out more contact

enquiries@bushco.co.uk.

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SUPPORTING OUR CLIENTS TO LEAD FULFILLED LIVES SIA Case Management is the UK’s largest case management service working solely with adults and children following a Spinal Cord Injury. Our expert team works closely with clients and their solicitors to identify, plan and meet specific needs to help rebuild lives following a spinal cord injury. To access our online case manager search tool, make an enquiry and to find out more visit: www.siacasemanagement.co.uk

SIA Case Management delivered by: Bush & Co Registered Charity No. 1054097 Charitable No. 3175203 The SIA Case Management logo is a trade mark of Spinal Injuries Association

@SIA_CaseMan

THE UK’S LEADING CASE MANAGEMENT SERVICE FOR CHILDHOOD BRAIN INJURY Our UK-wide service is passionate about the individual needs of each and every child we support. All levels of injury are assessed to achieve the right outcomes for each child and your case manager will ensure that through assessment, care planning and rehabilitation each child is placed at the heart of every decision.

To access our online case manager search tool, make an enquiry and to find out more visit:

www.cbirs.co.uk

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CASE MANAGEMENT

As a specialist case management service what makes

EMMA WAY ASSOCIATES DIFFERENT?

A client told us that their case manager was, ‘the voice I didn’t have who knew where all the pitfalls were to help me navigate through. They were experienced with the people skills and wisdom to network to my advantage’. Knowledge and experience may be key reasons to choose a specialist case management company but what makes EWA so different?

ll our clients at Emma Way Associates (EWA) have sustained a spinal cord injury (SCI) or amputation. We provide a truly bespoke, relevant and ultimately successful service to those with very specific needs. Aspects to consider are:

page, heading in the same direction with shared goals.

4. A DEEP UNDERSTANDING

Thoroughly knowing the likely pathways ahead, combined with taking time to understand an individual’s unique situation, enables our case managers to prepare clients to make informed choices and decisions and provide perspective.

CLINICAL 1. SPECIALISED KNOWLEDGE

We deliver case management services based on a foundation of frontline, best practice, clinical knowledge. The experienced team incorporates stillpractising NHS nurses and therapists, including team leaders from neurological and national spinal units, often blending personal experience with professional expertise within spinal cord injury, catastrophic injury and amputation.

PERSONAL SERVICE

With a professional perspective balancing the needs of the legal team, we determine goals to ensure our intervention is tailored to each client’s particular needs and desires, and look to enhance clinical and litigation demands with positive, exciting life experiences.

5. TEAMWORK My world was in chaos and I felt very alone. My case manager understood me and my situation, provided structure, made me feel safe and confidently gave me belief. She encouraged me to learn how to fight my own corner again. Thanks to her resourcefulness and drive, skilfully finding solutions specific to my own challenges, I am able to live my best life with a disability.

Specialist knowledge is freely and regularly shared within the team at EWA. Through reflection on interventions, the team is able to learn from each other’s past experiences to ensure that innovative solutions to challenging scenarios can be determined.

Contact us to find out more about how we will support you and your client every step of the way so they can ‘live their best life with a disability’. Email: office@emmaway.uk Tel: 01664 840730 Web: www.emmaway.uk

3. DYNAMIC AND RESPONSIVE

Each case manager has a manageable client base, is adaptable and able to action their client’s needs quickly and efficiently. Using a problem-solving approach ensures we meet these needs as the client, or even the health and social care industry, change. Regular updates to clients, therapists and the legal team ensure that everyone remains on the same

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Struggling to find trained, rehabilitation assistants who Struggling toto find Struggling findtrained, trained, rehabilitation assistants who have have SOMETHING SPECIAL? rehabilitation assistants who

CASE MANAGEMENT

RECOVERY & REHABILITATION

SOMETHING SPECIAL? have SOMETHING SPECIAL?

Maia Rehabilitation have been building Rehabilitation have MaiaMaia Rehabilitation rehabilitation teams been haveclients beenbuilding building around who have rehabilitation teams rehabilitation teams received catastrophic around clients who have injuries for over 12years. around clients who have received catastrophic received catastrophic injuries for over 12years. e have injuries experienced for over 12years.

e have

the difficulties experienced in finding and e havethe experienced difficulties keeping support workers the difficulties in findingin and keeping supportand workers with the skill and finding passion tokeeping with theneeds skill and passion to support workers meet our client’s and meet and skill our andclient’s passionneeds to meet who with can the accurately identify whoneeds can accurately our client’s and who identify can and record their findings. andidentify record their findings. accurately and record Because ofBecause this, weof this, wethis, we their findings. Because of developed developed our own Seriousown Seriousdeveloped our ownour SeriousInjuryInjury-RehabilitationInjury-RehabilitationRehabilitation-Service (SIRS). Service (SIRS). Service (SIRS). Our very carefully selected teams Our veryselected carefully selected Our very carefully are often psychology graduates teamspsychology are often psychology teamsorare often experienced personal with personal knowledge of graduateswith or experienced Experts, Neuro Psychologist and training team. Experts, Neuro Psychologist and training team.the graduates or experienced with personal knowledge of knowledge of injuries, an learn, observe, feel NeuroWe Psychologist training We ensure injuries, an ability toability learn, to observe, feel compassion ensure theand most recent team. medical We ensure the most recent medical injuries, an ability to learn, observe, feel compassion compassion and encourage. We can them equipwith them with recent medical are we implemented and encourage. We can equip tools to be most developments aredevelopments implemented and work with, and encourage. We can them with tools to be developments are implemented wewith, work tools tofully be fully aware and weand work andwith, aware andequip tuned-in to the and listen to the client’s fully and aware and tuned-in to theWe provide listen client’s We strive to identify and and symptoms of clients. case managers, adjusting tuned-in to the listen toto thethe client’s case We strive to identify and We strive to identify and necessary training wherever the support package symptoms of clients. WeWe provide case managers, adjusting symptoms of clients. managers, adjusting maximise potential and growth possible for training the client they work accordingly. We believe necessary training wherever support package provide necessary the support package maximise potential and growth maximise potential and growth so we can help individuals be the with and we provide First Aid so clients must have abelieve solid wherever possible for the accordingly. We possible for the client they work accordingly. We believe theywork can manage medical risks and enjoyable relationship thehelp best they can be. bebe clients soinwe we can can individuals they with clients must havea asolid solid help individuals with client and we provide Firstand Aid so so must have the client’s home. We run with those who they are First Aid sorisks and enjoyable relationship they we canprovide manage medical in and enjoyable relationship the best they be. responsive, monthly seminars on brainbest and spinal comfortable their time. Our process is to the theycan can be. investing with they can manage medical with those whothey theyare are the client’s home. runsupervise SIRS monthly, monitor their those who injuries We and we match the client with the most appropriate SIRS to risks in the client’sseminars home.and, investingis to responsive, monthly onencourage brain andthem, spinal time. Our process recordings weekly nurture themcomfortable meet theirinvesting needs. ■ theircomfortable Weand run and responsive, monthly seminars monitor on brain and their time. process is tomost matchappropriate the client with theto usually keep them! injuries we supervise SIRS monthly, their match the Our client with the SIRS spinal injuries and we supervise SIRS monthly, monitor most appropriate SIRS to meet their needs. ■ recordings weekly and, encourage them, nurture them meet their needs. ■ their recordings weekly and, encourage them, nurture PRODUCING CLEAR EVIDENCE and usually keep them!

““

them and keepfee, them! Forusually a monthly we can produce court friendly electronic daily report sheets which provide clear PRODUCING PRODUCING CLEAR EVIDENCE detailsCLEAR for teamsEVIDENCE while producing clear evidence for For aFor monthly fee, we cancan produce instructing SIRS are court Personal Assistants a monthly fee, parties. we produce courtfriendly friendly electronic daily report sheets which provide trained to the highest standard of careclear in Brain and electronic daily report sheets which provide clear Spinal Injury Rehabilitation by our in-house Care details for teams while producing clear evidence details for teams while producing clear evidence for for instructing parties. SIRS areare Personal instructing parties. SIRS PersonalAssistants Assistants trained trained to the highest standard Brain and to the highest standard of careofincare Braininand Spinal Rehabilitation by our Care Experts, SpinalInjury Injury Rehabilitation by in-house our in-house Care

”

For further details please contact: Tel: (01234) 262863 Email: admin@maiarehab.com

www.maiarehab.com For detailsplease pleasecontact: contact: Forfurther further details Tel: (01234)262863 262863 Tel: (01234) Email: admin@maiarehab.com Email: admin@maiarehab.com

www.maiarehab.com www.maiarehab.com

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MAIA REHAB

Serious Injury Rehabilitation Specialists

Calling All Case Managers Are you an Independent Case Manager overwhelmed by CQC Registration? Are you concerned, that these regulations may begin to outweigh the benefits of being a Case Manager? We recognise that for small businesses, this could have enormous ramifications on time, infrastructure, expense and constraints on how you operate. Which is why we are offering any Independent Case Managers who do not wish to register themselves with CQC but would like to work under a CQC registered company, to join us and get in contact to see how we can help. We want to ensure that you can continue treating your clients without worry of losing work due to your registration status.

Please contact Maia Rehabilitation to speak with us on 01234 262863 or email on:

admin@maiarehab.com

The Maia Team are here to help.

CASE MANAGEMENT

A Person-Centred Approach TO REHABILITATION Unite Professionals Limited, put the client front and centre of their rehab journey, this is key to achieving a best possible outcome.

nite Professionals have been supporting individuals following catastrophic injury since 2010. With national coverage, our team of highly skilled Case Managers have specialist clinical knowledge and experience in working with clients who have sustained traumatic brain and spinal cord injury. Through early intervention (our InReach service) and Immediate Needs Assessment (INA) to understand the impact of the injuries sustained on the individual’s life, our case managers will ensure that rehabilitation goals are established early in collaboration with the client. In major trauma, rehabilitation is not one dimensional. It is a complex interplay of what makes us human including physical, emotional, cognitive, social, work and more. Understanding the bigger picture of what a truly holistic approach looks like is essential to give the individual the best possible opportunity to make the best possible recovery. Let’s look at traumatic brain injury (TBI) as an example: The individual might be working with a therapist on improving their functional performance within their daily activities using cognitive strategies, and engaging in brain injury education. At the same time another practitioner is arranging imaging to look for underlying pathology to explain the headaches or addressing mood related changes. Without a conductor assimilating this clinical information and bringing these practitioners together to agree the

optimum approach, the client can be left to navigate conflicting and confusing messages from multiple sources leading to disengagement or a tighter grasp on unhelpful, limiting beliefs.

WHY USE UNITE PROFESSIONALS? All at Unite Professionals are committed to providing a culture of collaborative case management service to advocate for and enable clients access to what they need to achieve best possible outcome. As an independently owned business we are able to make informed choices on specific rehabilitation intervention providers best suited to the client’s needs, not just treatment networks.

WHO ARE OUR CASE MANAGERS? All our case managers are registered Occupational Therapists who have been selected for their 6 years plus experience and skills in understanding the complexities of the rehabilitation process. They are skilled in brokering conversations across the board ensuring the commitment of all stakeholders for a successful outcome. Our Case Managers are registered with HCPC, CMSUK and BABICM.

WE ARE CQC REGISTERED We pride ourselves in keeping our clients front and centre in their rehabilitation journey and our recent CQC registration further underpins this objective. We are delighted that we have gained registered status under Personal Care with the Care Quality Commission. Our mission is to assist clients to optimise their functional restoration, resilience and independence within a safe framework.

For more information on how we can assist, please contact us at: tel: 01704 508777 email: admin@uniteprofessionals.co.uk web: www.uniteprofessionals.co.uk

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CASE MANAGEMENT

“Reflections on a year like no other – ADAPTING CASE MANAGEMENT DURING A PANDEMIC” Heidi Stanley and Nikki Smith, directors of StanleySmith Case Management (SSCM), reflect on a year like no other and how they have continued to develop their company through it all.

e are really mental health in a difficult situation. The same can be proud of said for valuing and supporting our care staff, who have how the worked tirelessly and selflessly throughout the pandemic, StanleySmith we have ensured that they have felt supported and safe Case Management team to continue their essential work. We were passionate to has responded to the keep things moving forward for our clients but as safely coronavirus pandemic. as possible. As the pandemic progressed, we have been Using our clinical able to follow the government and PHE guidance keeping Heidi Stanley – knowledge, thinking outside our clients, families, care teams and case managers Director, Adanced the box, being dynamic and safe through a regular supply of PPE, covid testing and BABICM Case innovative we were able to organising covid vaccinations in January 2021. Manager, MSc, BSc give guidance and advice to It’s amazing how much our practice has evolved and Hons OT our clients, care teams and the difference this will continue to have moving forward. professionals working with Video meetings have become an effective, efficient and our clients well before the cost effective tool to use as a case manager. government’s first lockdown We were under no illusion that facilitating support in March 2020. and rehabilitation during a pandemic would be easy, it This ensured that safety takes hard work and dedication of a highly skilled team was not that can work cohesively together. compromised Utilising each and everyone’s To ensure safe but rehabilitation data processing we set strengths, recognising challenges, Nikki Smith – and support supporting each other by being kind Director, Case up secure portals for and empathetic. was promoted. Manager, CQC Through quick, We are proud to have been able to video sharing of Registered Manager, BSc Physiotherapy decisive action grow and develop in our practice and therapy regimes and we managed to learn new skills, all whilst maintaining programmes. source PPE for our core values and company ethos of our care staff and had an emergency stock ensuring that the client and family is at if a client, family member or carer displayed coronavirus the centre of our work. symptoms, this was all prior to the Public Health England Please visit our website for more details on this, plus how guidance on PPE. We organised for rehabilitation to be our mentoring support has evolved and how we’ve expanded implemented indirectly where possible and monitored our team over the last 12 months including our registered by video calls. To ensure safe data processing we set nurse overseeing medication and complex care packages. up secure portals for video sharing of therapy regimes and programmes. We liaised with education settings and where possible set up remote teaching assistant and tutor support. SSCM’s highly skilled case management input with Web: www.sscasemanagement.co.uk our clients ensured that they progressed towards their 01752 891 930 rehabilitation and life goals and maintained optimum

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EMPOWERING YOUR QUALITY OF LIFE Our ethos is to tailor our work to our client’s individual needs, putting the client at the centre. At StanleySmith Case Management we:

Who we are, the team:

Î Have the experience, knowledge and skills to steer case management so that it is individual to the client’s needs.

Î We are a friendly team of highly experienced HCPC registered Therapists and Case Managers.

Î Listen to the client and their families promoting autonomy.

Î Members of CMSUK and BABICM.

Î Lead case management through adopting a collaborative approach with the client their family, professionals and services involved.

Î We each have over 10 years experience within our individual discipline.

Î Promote quality of life, rehabilitation, vocation and recreation which underpins our work. Î Value individual carers, ensuring that they are skilled and competent to manage the client’s individual needs. Î Are registered with the Care Quality Commission (CQC).

Î We are directed and supported by dynamic and experienced clinicians. Î We ensure Case Managers are appropriately trained, supported and valued to complete their role effectively. Î We have administration, finance, HR and office support to ensure swift and effective Case Management implementation.

www.sscasemanagement.co.uk

01752 891930

CASE MANAGEMENT

MAINTAINING CLIENT CARE STANDARDS How to Plan For a Transition During a Pandemic CASE: “Charlie” - Dual Diagnosis of Brain Injury and Paranoid Schizophrenia – Liz Drummy

t the beginning of the Pandemic, with the help and support of his team, Charlie was part way through a transition between a residential unit and his own flat in the community, with a Community Treatment Order. By February 2020, Charlie’s transition was well underway with overnight support 3 nights per week and daily visits to his flat, working on both rehabilitation and social goals towards semi-independent living. With the introduction of the National Lockdown and the need for vulnerable people to shield Charlie needed the full support of his team, especially his case manager and neuropsychologist in order to understand the importance of government guidelines, why he needed to consent to actively shield and unfortunately place his transition on hold. Therapeutic Intervention & Compliance: Through the guidance of Charlie’s case manager weekly remote

sessions with each clinician were maintained, reinforcing pre-existing themes, agreements and assurances while introducing new challenges to maintain progression. Through these focused sessions Charlie was able to continue moving forward and completing the transition when the time was right. Now: With the new property still available, and Charlie’s team maintaining the strategies and skills to ensure the successful transition previously denied due to the Pandemic, Charlie is looking forward to 1st April when face to face sessions can begin again and his ultimate goal comes ever closer to reality. ■ This is just one example of Browns case managements client-centric approach, to find out more contact:

Web: www.brownscasemanagement.com email: info@brownscm.com Tel: 01257 686070

Browns takes a client-centric goals based approach to managing your needs. Our team are here to provide support through: Assessment of your current and future needs Bespoke plan to help you achieve your goals Advocacy for access to education and community resources Liaising with your legal team / financial deputy through to settlement.

www.brownscasemanagement.com E. info@brownscm.com T. 01257 686070 66

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Brain Injury Case Management in Lincolnshire

Managing the ups and downs of the the climb from serious injury to a clear and optimistic future.

• Initial needs assessments • Case management To Young and older adults with complex needs resulting from brain injury, orthopaedic injuries and/or polytrauma

15 years as a specialist brain injury/serious injury case manager Based in Lincoln Set up, coordination and management of complex rehabilitation and support packages with person-centred SMART goals at the centre of service delivery......and a lot more.......

Contact Anne-Marie Burnett MCSP enquiries@headsmartrehab.co.uk 01522 581 781 www.headsmartrehab.co.uk

A brand leader in providing expert witness services for clinical negligence, personal injury litigation and professional regulation issues

Over 200 highly professional trained experts in a range of health disciplines, all of whom remain in clinical practice and maintain their CPD

Balanced portfolio of claimant and defendant instructions illustrating professionalism, objectivity, and understanding of legal principles and CPR

Well structured and robustly argued reports

Competitive fees and fee estimates upon request

01494 792711 admin@somek.com www.somek.com

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CASE MANAGEMENT For over 21 years Anglia Case Management (ACM) has worked with adults and children with brain and spinal injuries, and their families. Our case management and rehabilitation services enable clients to improve their quality of life, and achieve their goals; we also recruit, train and manage carers to provide outstanding care to our clients.

“Puts in a tremendous effort to meet the requirements of my and my family. We are extremely happy with her”, “W has made progress in a way we haven’t been able to for the last 5 years”.

Prior to Covid-19, all our services were delivered faceto-face, but since March 2020, Case Managers and OTs have found innovative and imaginative ways of working with our clients. We have been able to continue to provide high quality services despite social distancing lient choice is always at the centre of restrictions, and source new forms everything we do, and therapy. Recent lock-down we work closely with Her help and support has of successes have included on-line our clients to help been invaluable …. All of which yoga to reduce anxiety, drumming them devise, prioritise and work lessons, remote music therapy, towards their goals. Goals vary has given me freedom and and Zoom laundry and cooking according to an individual’s is helping give me a sense of lessons, together with face to abilities and needs, but can range normality in my life face volunteering sessions with from walking the dog, to shopping appropriate PPE to ensure the and completing tasks of daily safety of clients and staff. living, to returning to the workplace, volunteering, or The work of the ACM team is outstanding; clients and moving back into the family home. their families can be confident in our services because Recently, ACM enabled S to move back into the family we are registered with the Care Quality Commission and home from a residential care home; her husband said “Me, have been rated ‘Outstanding’ since 2017. ■ and the kids were able to spend time with S at home for the first time in over 10 years. That is absolutely priceless If you think that ACM could help you please contact us on especially for the kids.” 01359 271900, or info@angliacasemanagement.co.uk, Other comments we have recently received about our or visit our website www.angliacasemanagement.co.uk work include:

Specialist services for people with complex disabilities Expertise includes brain injury, cerebral palsy, spinal cord injury, stroke, amputation, orthopaedic injury, PTSD and dementia

Case Management

Rehabilitation

Care Experts

Support Services

Manual Handling Advice

Judged to be OUTSTANDING by the CQC

For more information, please visit www.angliacasemanagement.co.uk or call 01359 271900

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Psychology-Informed Case Management At SBK Case Management, we provide rehabilitative case management to a range of complex clients. Our team’s psychological insights add value by: Ensuring clients and families are supported well with evidence-based approaches Addressing emotional barriers that impair rehabilitation, such as trauma Facilitating relationship dynamics within the professional network Supporting difficult and diverse conversations to achieve goals Focusing on ways to maximise rehabilitation and settlement outcomes

Email: welcome@sbkcm.co.uk | Tel: 07942 691070

THE PSYCHOLOGICAL PERSONAL INJURY SERVICE Case Management-Informed Psychological Therapy At PsychWorks Associates, we use our knowledge about case management to run a psychology service solely for catastrophically injured clients that: Works on issues around adjustment, trauma, anxiety, depression, neurological needs and so much more Understands and works towards managing risk issues with the systems around the client and family Works collaboratively with individuals, family and professional networks Understands how to skillfully navigate litigation processes to provide meaningful therapy Offers proactive, timely and responsive input to Case Managers and legal referrers

Email: admin@psychworks.org.uk | Tel: 07942 691070

CASE MANAGEMENT

Expert Rehabilitation Case MANAGEMENT SERVICES Proclaim Care is the UK’s foremost independent provider of rehabilitation case management.

Therapy and Vocational services, with the consultant working hand in hand with the case manager to achieve the desired goals and outcomes. Resolve Health Treatment and Diagnostic Service offers a joined up approach to co-ordination of treatments, therapies and other required clinical services recommended by the case manager. The client is placed at the centre of everything we do, and this has been recognised by CMS UK, when we were chosen as Case Management Company of the Year 2019. We have highly experienced Rehabilitation Case Managers located throughout the UK, ready to support your clients. ■

e are recognised by solicitors and insurers as independent and expert in what we do. We employ a diverse range of health professionals with extensive clinical experience to allow us to match the case manager to the client’s specific needs. Our innovative approach to working with clients impacted by brain and/or spinal injuries include a dual case manager approach; this combines different health professionals, with differing skills and expertise aligned to the needs of a client throughout the duration of the case. Uniquely with Proclaim Care, rehabilitation services can be seamlessly co-ordinated for the client through our specialist sister services; Obair Associates and Resolve Health. Obair Associates provides a full range of Occupational

For further information please call on 01698 207 755, or email helpis@proclaim-care.co.uk or visit www.proclaim-care.co.uk

Rehabilitation Management Specialists

Occupational Therapy & Vocational Rehabilitation Specialists

Treatment & Diagnostic Specialists

Independent client-centred rehabilitation services Back to health • Back to work proclaim-care.co.uk

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CASE MANAGEMENT

Desktop, Multi-Trauma & Specialist Case Management Major Incident Response Service Treatment & Diagnostic Services Vocational Case Management

Award-winning Case Management With over 20 years’ experience, we are one of the UK’s largest impartial

and independent providers of award-winning rehabilitation case management, treatment and diagnostic services.

Let’s be friends. Follow us on Social Media

@CorporeUK

Corporé

OCCUPATIONAL THERAPY ASSESSMENT AND TREATMENT FOLLOWING TRAUMATIC BRAIN INJURY

Community Case Management Services Ltd is a specialist provider of case management for the rehabilitation of severely injured adults and children throughout the UK and Worldwide. We provide quality-of-life solutions for catastrophic, complex and life-changing injuries such as brain injury, spinal cord injury or loss of limb. We ensure that the highest level and quality of care is provided and tailored to individual needs. Our dedicated and experienced Associate Case Managers have varying clinical backgrounds which we match to our clients. We work closely with treating professionals and the well trained care and support teams, to achieve positive and measurable outcomes. We are proudly known to go above and beyond to provide opportunities, therapeutic holidays and retreats for our clients. These activities assist re-engagement and gives our clients the opportunity to live their lives to the full.

www.ccmservices.co.uk

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Our aim is to improve a person’s quality of life by promoting an optimum level of recovery and independence in activities of daily living. A trusted, calm, and positive approach helps us support people who are unable to advocate for themselves or who may present with psychological, emotional, or cognitive needs. We provide a highly skilled service and maintain professional documentation which clearly identifies needs and records progress.

Based in Derbyshire Tel: 0778 68 23 655 www.headinjuryrehab.co.uk

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CASE MANAGEMENT

MSP CASE MANAGEMENT Specialists in case management support to children and young adults with brain injury and neurological conditions.

Case Managers come from varying professional backgrounds, so we have a wealth of combined experience to call on to ensure that our clients, and their families, have the strongest team behind them.

Case Management Ltd provides a case management service for children and young adults. It was started by Marylka Puchalska in 2015. She had previously been a Regional Case Manager for a leading brain injury company. Marylka has a son who, in his early teens, suffered a brain injury. At the time Marylka was working full time as a midwife. The traumatic event and the subsequent rehabilitation was a difficult time and Marylka found herself having many battles in her fight to gain the best support and care possible for her son. This experience inspired a career move into case management, as Marylka realised she had the personal qualities to help others in similar circumstances. Marylka has been a Case Manager for over 13 years and leads the company with a passion and drive to inspire those who work alongside her and ensure a bespoke service for our clients and their families. We currently have an established team of 5 Case Managers working throughout the Midlands and Northern England. Our

My son has been a client of Marylka’s for over ten years. She has the perfect balance of friendliness and professionalism and is one of the most important back-up support people in our lives. Marylka has the experience, knowledge and contacts to help and her passion for her work and lovely down-to-earth personality makes her a joy to work with CLIENT, DONCASTER

MSP

We recognise that client issues don’t only arise during office hours, so we are always there for them, at any time of the day or week. We have also built up an extensive network of therapists who work alongside us to provide therapeutic assessment and therapy input. ■

Contact: Marylka Puchalska Mobile: 07843 347128

Specialist Quality Case Management for Children & Young Adults with Brain Injury and Other Neurological Conditions.

We are a team of professionally qualified case managers who have a wealth of experience in working with families and legal teams. We offer a bespoke service, tailored to your needs which can include:

Immediate needs assessments Training in medical interventions such as PEG feeding, epilepsy, administration of medication and tracheostomy care Providing therapeutic input from our vast network of therapists Input with schools and colleges and support with Education, Health and Care Plans Setting up and management of support packages, including complex care

Please get in touch with Marylka Puchalska to learn more about our services: marylka@mspcm.co.uk 01673 885683, or visit our website www.mspcm.co.uk to find our what the people we work with say about us.

We are regulated by the Care Quality Commission and our case managers are registered with the British Association of Brain Injury Case Managers.

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MEDICO-LEGAL

Traumatic Brain Injury (TBI) AND THE HIDDEN LOSSES IN FAMILIES Following a TBI, many people experience physical and cognitive impairments, as well as psychological and behavioural changes. Sometimes the full extent of any residual impairments are not fully realised by the family until their loved one is discharged home. Inevitably, when discharged, the dynamics of the family can be irrevocably changed as family members frequently take on different roles, including that of carer.

he way that the family adapt to the changes in their loved one, as well as the interacts and relates to changes occurring to their life. Following TBI, it is evident the outside world may that psychological input for the family needs to be also change as time is considered as a crucial part of the rehabilitation process. spent on caring for the injured Furthermore, while there is some research on the family member rather than impact on parents and spouses/partners there is little engaging in premorbid social and research looking at the impact on siblings. Depending on Dr.Caz Lyall recreational activities. In some the age of the siblings when the TBI took place, it can have instances, this traumatic event may draw families a devastating impact on their psychological wellbeing. together while others may be torn apart. It is well This lack of consideration means that no therapeutic known that TBI increases intervention is provided the risk of marital and no financial award in The way that the family breakdown (Wood and the case of litigation for any Yurdakul,1997). It is arguably an under interacts and relates to the outside input. Injury to the frontal addressed area of need in world may also change as time is lobes, is one of the main litigation. features of TBI, causing To conclude, TBI is a spent on caring for the injured subtle personality changes, wide-reaching event and family member rather than which are mostly observed affects the wellbeing of the and experienced by parents, whole family. engaging in premorbid social and partners, and siblings. The person they knew, now Dr.Caz Lyall PhD, MA, MSc, recreational activities. behaves, sounds, and acts BSc (OT) is an independent differently and family Occupational Therapist members experience a loss for the person that they used specialising in complex neurology, PTSD and loss of service. to know before the TBI. It is, as if their loved one has died. She is also an Expert Witness with Somek & Associates. This can give rise to feelings of loss and guilt as loved ones grapple with their emotions and try to adjust to the changes. Unsurprisingly, the literature demonstrates that parents and partners experience high levels of depressed mood, anxiety, and carer burden (Ponsford et al 2003, Gillen et al 1998, Marsh et al 1998, Sander et al 1997, Brooks et al 1986, 1987, Ennis et al, 2013). Linn et al (1994) found that family carers who reported higher levels of social aggression in the person with the head injury also experienced higher levels of depression. Contact: Somek & Associates Ltd Research demonstrates that family members need Tel: 01494792711 | Email: admin@somek.com support to help them through the grief process and to Web: www.somek.com

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MEDICO-LEGAL

Jane James and Associates has been medico-legal reporting FOR OVER 35 YEARS We are an independent medico-legal reporting company who have been providing reports for the Court within the clinical negligence and personal injury arenas for more than 35 years.

e provide a highly respected expert witness service and our professional and friendly team are available to support all new and existing clients. We understand how important it is to build positive relationships with our clients, and to ensure a smooth process from the initial enquiry through to the settlement of the case. We have received repeat instructions over many years from both claimant and defendant legal representatives, and these are a testament to the high regard in which we are held by our clients. Our team of experts are carefully selected to provide the best combination of expertise, experience, and up-to-date knowledge in their field. We provide valued opinions in a range of specialities,

including general and paediatric nursing, occupational therapy, neuro physiotherapy and manual handling. Many of our care experts also work in case management, ensuring that their assessments and recommendations are robustly informed by first-hand clinical proficiency. Our quantum reports are clearly written, robust and succinct, easy to read and completely transparent on costs. We also provide liability reports in a wide range of disciplines, including general nursing, mental health nursing, practice nursing, accident and emergency nursing, manual handling, tissue viability, and care provision, including nursing and care homes. Lucinda Lloyd, our Head of Operations and Clinical Support, would be delighted to discuss the expertise that we have in our team or any of our reports. Please see our contact details below. ■

As an independent medico-legal reporting company we provide professional reports in the fields of clinical negligence and personal injury. We work with both claimant and defendant legal representatives EXPERT WITNESS SPECIALISTS

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01249 456 360

www.janejamesandassociates.co.uk

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Case Management, Case Management, Expert Expert Rehabilitation and Witness,Witness, Rehabilitation and Specialised Care Recruitment Specialised Care Recruitment Services. Services.

YOUR JOURNEY

over 20 TBL have Case Management, For over For 20 years TBLyears haveExpert Our Team of Specialists Witness, Rehabilitation provided Case Management, provided Case Management, and Specialised Care Recruitment 360 is a Team of Specialists working collaboratively and Rehabilitation and Specialist Rehabilitation and Specialist Services. cohesively together to offer the Client the support of Clinical Services for both adults every Specialist they need to assist in their journey. Clinical Services for both adults For over 20 years TBL have and children. and children. provided Case Management, The Directors’ extensive experience of working in the case management and care sector recognises that Rehabilitation and Specialist offer a nationwide service our consultantfamilies require more than just Case Management. We offerWe a nationwide service with our with consultant Clinical Services for both adults case managers located across the cliniciansclinicians and case and managers located across the and children. country (including all of whom are country (including Scotland),Scotland), all of whom are We offer a nationwide service with our consultant highly experienced with considerable skills to work highly experienced with skills to work clinicians and caseconsiderable managers located across alongside clients with complex cognitive, physical, the country (including Scotland), all of whom are alongside clients with complex cognitive, physical, highly experienced with considerable skills to emotional and behavioural 360 Case Management emotional and behavioural needs. needs. Expert Witness Case Management & Rehabilitation Services

work alongside clients with complex cognitive,

physical, moreemotional information at For moreFor information visitand usbehavioural atvisit us needs. For more information visitus us at www.taniabrown.com, email us www.taniabrown.com, email www.taniabrown.com, janettewynn@taniabrown.com call us 01257 janettewynn@taniabrown.com or call usor 01257 email us janettewynn@taniabrown.com 473967. 473967. or call us 01257 473967.

has an experienced range of Professionals including Occupational Therapists, Nurses & Physios.

WWW.360CASEMANAGEMENT.CO.UK 07745527051 INFO@360CM.CO.UK

JE JACKSON Brain Injury Case Management

Vikki Sturgess

Jane Jackson

Co Director

Managing Director

Our team possesses years of experience as brain injury case managers with specific skills in traumatic injury, rehabilitation and occupational therapy.

Lucy Allen Shirtcliffe

Associate Case Manager

Sue Harlow

Office Manager

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unlocking the potential

Helen Smart

Associate Case Manager

t: 01536 724485 / 07908 577861 e: jane@jejacksonltd.co.uk w: www.jejacksonltd.co.uk 37 Grosvenor Way, Barton Seagrave, Kettering NN15 6TG

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COMPLEX CARE

PROMOTING MENTAL HEALTH as well as physical wellbeing

aplewood Independent Living provides bespoke specialist case management, rehabilitation, care, support, expert witness and property and garden services to individuals (both adults and children) who have suffered from catastrophic and complex injuries such as:

Brain Injuries Spinal Injuries Cerebral Palsy Stroke

Amputations Orthopaedic Injuries Multiple Complex Injuries Clinical Negligence

We offer a holistic, bespoke and comprehensive case management service fully complemented by our experienced and dedicated team of care and support workers. We understand the requirements of the individual and operate on a person-centred basis ensuring the individual receives the best case management, care and support available throughout their rehabilitation and beyond, as we appreciate this may just be for a short while or lifelong. The case manager, care and support team will be matched to the individual’s needs who will be at the centre of everything we do enabling the individual to reach their full potential and independence. It is our belief that mental health is just as important as physical wellbeing and we recognise the important link between the two - always being mindful of the individual. A complete service is provided from initial assessment,

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management and planning through to the ongoing day to day care and support and encompassing all steps in between. We manage all aspects of the individual’s case management, care and support under cover of a case manager, CQC registered branch manager and the care and support team. Management, recruitment, training, supervision and compliance are all undertaken in house, so everything is in one place ensuring high standards and continuity of service are maintained. We are CQC registered and pride ourselves on the high standards we consistently deliver to those we support. Our case management team has over 25 years’ experience in dealing with acquired brain and spinal injuries as well as catastrophic trauma and injury. All staff are enhanced DBS checked and undergo regular and comprehensive training and assessments. We also provide expert care witness reports for use during the litigation process which cover both liability and quantum. We work for both Claimant and Defendant solicitors and insurers and our reports are comprehensive and fully CPR complaint. Our comprehensive service is completed by our garden and property maintenance and disability adaptations service, which enables us to modify any property or garden for the individual and maintain it thereafter. ■

Web: www.maplewoodhcs.co.uk Tel: 01371 877707

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CASE MANAGEMENT SERVICES

• Bespoke Specialist Case Management, Care & Support Services • Brain Injuries, Spinal Injuries, Cerebral Palsy, Stroke, Amputations, Orthopaedic Injuries, Multiple Complex Injuries & Clinical Negligence • Person Centred Support Tailored to Individual Requirements • Complete In House Service – Case Management, Care Management, Care & Support • Skilled, Dedicated & Reliable Management & Support Team • Promoting Independence • Basic Home Help through to Complex Care • Property & Garden Services & Adaptations • Complete Service including Tailored Reports • Consistently High Standards with Over 25 Years’ Experience • CQC Registered • All Staff Enhanced DBS Checked • Comprehensive Staff Training & Assessments • Annual Leave and Sickness Cover to maintain Continuity of Service

Tel: 01371 398118 Tel: 01279 295115 E-mail: info@maplewoodhcs.co.uk Web: www.maplewoodhcs.co.uk

COMPLEX CARE

Complete Care Amegreen EXCEPTIONAL CARE FOR EXCEPTIONAL PEOPLE Complete Care Amegreen is an innovative complex care provider, specialising in supporting children and adults with spinal and brain injuries to live full, independent lives at home, as active members of their families and local communities.

ear after year, clients continue to choose us over directly employing Health Care Assistants. They tell us it’s because they experience wider support and reassuring contingency. They ‘feel respected, listened to and treated as equals’. That they are ‘encouraged to direct their own care and achieve a great quality of life’. It all boils down to the values at the heart of our culture and the way we work. Our people are our greatest asset. Our respect for them is reflected in outstanding training pathways, career development opportunities, year-round recognition and their remuneration. As valued employees, they’re motivated to pay forward that respect to our clients. They encourage and embrace client individuality and life choices; communicate accessibly without patronising; Whilst celebrating and building clients’ capabilities to maximise independence. The result is a highly skilled workforce whose loyalty delivers excellent retention that translates into unmatched consistency and continuity; and powerful long-lasting relationships between our clients and their teams that deliver transformative outcomes. We empower our people to empower our clients. Enhanced clinical training, state-of-the-art technology and a culture of safe autonomy facilitates positive risk taking to challenge clients’ perceptions of what is possible for them. We’re determined advocates of client choice. Our knowledgeable team educates clients in areas including legislation and funding options, empowering them to make informed decisions about their care and take control of their future. Innovation has produced our water-tight delivery model. Client-dedicated teams and a mixed blend of nurse and Health Care Assistant delivered care provide outstanding consistency and excellent value. Additional enhanced Health Care Assistants, clinically trained to

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flexibly support a small group of clients, and our highly trained, versatile Rapid Response team enable us to deliver unmatched contingency without compromising client safety or personalisation. Partnership working with other stakeholders means we deliver high impact, streamlined and cohesive, multi-agency services that effectively target clients’ outcomes and make best use of their budget.

What delivers success for our clients is our commitment to partnership working throughout our organisation. We work as equals with case managers, health professionals, funders and, above all, our clients to ensure their voice is heard We are confident in our service delivery standards, but where issues do arise, we are open and take ownership to ensure immediate resolution. Our processes and systems facilitate total transparency that offers the utmost reassurance to clients and other stakeholders that they are in safe and honest hands. It’s foundation for the trust that results in long and successful working relationships. ■

To learn more about how Complete Care Amegreen could be the perfect solution for your clients, call us today. Tel: 03331215301

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Live your life your way Spinal and brain injury specialists 24-hour adult and paediatric care at home Health care assistant and nurse delivery models available Rapid hospital discharges Registered for services in England (CQC) and Wales (CIW)

0333 121 5301 enquiries@completecareamegreen.com

COMPLEX CARE

Better quality of care for A BETTER QUALITY OF LIFE Active Care Group is the UK’s leading national provider of complex care services, harnessing innovation to raise standards and deliver better outcomes for children, young people and adults. We have been at the forefront of working with those who have experienced spinal cord or brain injuries for over 25 years and our specialist care provides progressive, personalised pathways for all.

t Active Care Group, quality of life comes first. We understand the impact catastrophic injuries can cause on all areas of life; therefore, we have developed steering groups to maximise focus on both brain and spinal injury. The Spinal Excellence Steering Group has leaders from all divisions who have proven experience in working with people with SCI in a variety of settings. Our vision is to develop care and career pathways that are underpinned by clinical excellence standards across ACG. We offer neurogenic bowel management, respiratory care, skin and pressure care, and much more.

“

Prior to finding Active, there wasn’t a company who supported spinal injuries for people in their own homes. That’s why I love Active Care Group! I like to see my PA’s as friends. We often go out to interesting destinations, such as Kew Gardens and the Classic Car show at The Exxon Centre, near Greenwich. The Brain Injury Steering Group offers life-changing rehabilitation and care for people of all ages with complex neurological needs. Our clinical teams are experts in reenablement and our interdisciplinary teams develop personcentred rehabilitation programmed to promote cognitive skills, emotional and psychological wellbeing, communication, and independence. We are proud to be working with industry experts such as the Multidisciplinary Association for Spinal Cord Injury Professionals, as well as client support organisations such as Spinal Injuries Association, The Back Up Trust and Aspire who have provided back and forth fundraising and support throughout the years. ■

The care and support I receive from Active Care Group allows me to live the best life possible. I started off in a specialist rehab facility and eventually moved back home with a full-time live-in carer to help me with my daily needs. It’s the best support I could have possibly asked for! Graham Serivce User

01732 779353

Active Care Group is the UK’s leading national provider of complex care services with over 25 years experience in developing care and career pathways across the UK.

enquiries@activecaregroup.co.uk

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www.activecaregroup.co.uk

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COMPLEX CARE

EnViva COMPLEX CARE Our collaborative approach with Case Mangers means that our clients get the best co-ordinated care available.

wonderful feedback we receive is testament to the success of this approach.

Our Case Management Partnership Ensures:

nViva Complex Care have over 20 years’ experience One point of contact supporting clients in the community with complex Transparent communication care conditions. Our strong reputation has Emphasis on partnership and co-ordination been built on our ability to deliver a fully Nurse concerning care and rehabilitation planning Managed service to Adults and Children who require Effective and efficient record keeping specialist support. and reporting in line with Case Managers Our emphasis is based on quality care, client enablement, requirements safe care delivery, staff training and consistency of staff, Case Management time saving which we believe are prerequisites to providing a consistent high quality complex care service. Many of the Case Managers who we EnViva is my go to care agency have worked with and continue to for clients. Their can do approach work with have full trust in our ability to work with them in partnership, really makes a difference to the coupled with the assurance that they quality of care that my clients will receive a service that meets the receive. In addition to EnViva’s needs of their ABI and SCI clients. We are here to help. Please contact excellent Nurse Management, This collaborative approach to care us on 020 4538 3228 or email there has also been a significant plans and rehabilitation goals ensures complexcare@envivacare.com to impact on reducing my case that both client and case managers talk to our experienced team. KT. management hours by 65% needs are always prioritised. The

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COMPLEX CARE

Superior Healthcare: THE ROAD ACCIDENT THAT CHANGED EVERYTHING Superior Healthcare was born out of personal experience. In 2001, our founders, Stewart Thorp and his father Charles, had their world turned upside down. Stewart’s brother and Charles’ son, Alex, was knocked from his bicycle whilst cycling along a country lane by a driver using his phone.

lex suffered a severe nurse educators and trainers. head trauma and In addition to classroom-based was placed on life learning, Superior Healthcare support. Upon ensures team members complete waking, he went through an shadow shifts while receiving intensive period of recovery support and mentorship from and rehabilitation before Nurse Managers and Field returning home. Stewart and Care Supervisors. Superior Charles gained first-hand Healthcare’s additional and experience in providing specialist courses are always CPD complex care at home as they accredited. had to adjust their lives to suit As we’ve been through the the needs of a family member unexpected and the unknown with an acquired brain injury. ourselves, we understand the Together with Sarah Richards challenges and uncertainty (the registered nurse assigned to that come with finding the Alex) they identified the need right complex care for a loved As we’ve been through for a specialised care service that one. It’s for this reason we would close the gap between provide a nurse-led service, with the unexpected and the independent care providers and experienced nurse managers unknown ourselves, we national organisations – soon overseeing our packages, after, Superior Healthcare was managing all areas of our clients’ understand the challenges brought into existence. care and giving support to both and uncertainty that come Having had personal clients and care teams. experience of delivering complex Knowing the right carers with finding the right care in a family home, we know and nurses are by our clients’ complex care for a loved what it’s like to find a care sides really does make all the team that’s a great match. We difference. For us, it’s personal. one. understand how significant the relationships between families and care teams are, and we focus on matching carers who don’t just have the relevant clinical skills - but who have the mindset and personality to fit seamlessly into the home too. When it comes to competency and experience, carers will vary. Therefore, it’s of utmost importance that our care teams are provided with correct, up-toContact: Superior Healthcare date training. Because of this, we ensure all our staff are Tel: 01227 774873 trained to the highest level with our courses mapped Email: care@superiorhealthcare.co.uk to the Care Certificate. We manage this by providing our own in-house training conducted by experienced Web: www.superiorhealthcare.co.uk

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Nurse Led Complex Care Service Superior Healthcare was founded in response to one family’s personal experience of sourcing the right care, and the right care team. With ﬁrst-hand experience of complex care in

the home, we work with Case Managers, Solicitors and Private Individuals to provide training, nurse management and fully managed care packages.

For us, it’s personal.

Tel: 01227 774873 Email: care@superiorhealthcare.co.uk www.superiorhealthcare.co.uk

COMPLEX CARE

Outstanding live-in care for clients WITH CLINICAL NEEDS Eximius Live-in Care Ltd is a nationwide company providing exceptional 24 hour live-in care. We are fully managed and rated “outstanding” by CQC. With our carers support, people recovering from a life changing accident or living with a long term condition can safely return to their own homes. Our dedicated live-in carers are led by our clinical team to ensure they have the right experience and training to care for the clients they are placed with.

ximius is a family run company with extensive experience in Spinal injury care and acquired brain injury care. Because we are a smaller company we are extremely flexible and able to be quicker and more innovative than many larger companies. We know all our clients and their families well and are able to give them the personal attention that they deserve. During the covid pandemic we were able to facilitate several clients needing to return home after long stays in hospital. One such client was a young lady with acquired brain injury following a horrific road traffic accident. We were approached by her case management team several months prior to her anticipated discharge. She had been in hospital for a year but due to having a young family all involved were keen to get her home. Her care requirements were extensive, including Peg feeding, person handling, support with special braces, repositioning every 4 hours (Including night), specialist diet and fluid support. The client was doubly incontinent and their communication was limited, mainly through gestures. We liaised with all health professionals and the discharge team over the following months to develop an appropriate person

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centred care plan for the clients return. As the client needed 2 carers during the day and one at night this would have been an excessive intrusion on their family life. We took the initiative and rented a 3 bedroom house 5 minutes away where the carers live when not working – this has worked brilliantly for all involved. We have an internal bespoke training programme that all our clinical carers go through. This includes but is not exclusive to, training on bowel management. Autonomic dysreflexia, tissue viability, neurological conditions and

respiratory care. We also liaise with external companies for specialised training if needed. So, Whether you are a Case manager, health professional, family member or anyone looking for clinical care, then talk to us about how we might help. We offer a no obligation assesment and an exceptional service.

Tel: 01494 424222 Web: www.eximiussupport.uk Email: info@eximiussupport.uk sevenstarmedia.co.uk

Rated Rated outstanding Rated outstanding outstanding for for caring caring forbycaring CQC by CQC by CQC

Supporting Supporting Supporting people people people with with with brain brain brain ororspinal or spinal spinal injury injury injury totolive to live live atathome at home home At Eximius At Eximius At Eximius we we provide provide we highly provide highly trained, highly trained, dedicated trained, dedicated dedicated live-in live-in carers live-in carers socarers someone so someone so someone who who is recovering is who recovering is recovering from from from a life a life changing achanging life changing accident accident accident or living or living or with living with a long-term awith long-term a long-term condition condition condition cancan return return cansafely return safely tosafely their to their own to their own homes homes own homes with with outstanding outstanding with outstanding carecare support support care support in place. in place. inWhether place. Whether Whether youyou areare you a Case aare Case manager, a Case manager, manager, health health professional, health professional, professional, family family member family member member or anyone or anyone or looking anyone looking for looking for clinical clinical forcare, clinical care, then care, then talktalk then to us totalk about us to about us how about how we we how might might we help. might help. help.

OurOur clinically clinically Our clinically ledled team team led can: team can: can: Liaise Liaise with Liaise with health health withprofessionals health professionals professionals andand discharge discharge and discharge teams teamsteams to ensure to ensure tocomprehensive ensure comprehensive comprehensive carecare planplan care in place in plan place prior in place prior to to prior to discharge. discharge. discharge. Work Work with Work with physios, physios, with OTs, physios, OTs, community community OTs, community nurses nurses tonurses ensure to ensure to ensure rehabilitation rehabilitation rehabilitation andand physical physical and development physical development development plans plans areplans are are adhered adhered adhered to. to. to. Manage Manage all Manage aspects all aspects allofaspects care of care needs ofneeds care including needs including including medication, medication, medication, personal personal personal care, care, pegpeg care, feeding, feeding, peg bowel feeding, bowel management. bowel management. management.

OurOur carers carers Ourare carers are fully fully are trained fully trained trained in all in all these inthese all areas: these areas: areas: Acquired Acquired Acquired brain brain injury brain injury and injury and neurological neurological and neurological conditions conditions conditions Autonomic Autonomic Autonomic dysreflexia dysreflexia dysreflexia Bowel Bowel management Bowel management management Continence Continence Continence carecare (including (including care (including catheter catheter catheter care) care) care) Emotional Emotional Emotional andand mental mental andhealth mental health changes health changes changes Medication Medication Medication administration administration administration Paraplegia Paraplegia Paraplegia andand tetraplegia tetraplegia and tetraplegia PEGPEG tubetube PEG or nasogastric or tube nasogastric or nasogastric feeding feeding feeding PainPain management management Pain management Respiratory Respiratory Respiratory carecare (including (including care (including tracheostomy tracheostomy tracheostomy andand ventilation) ventilation) and ventilation) Tissue Tissue viability Tissue viability viability WeWe create create We a bespoke create a bespoke a bespoke carecare planplan care based based plan onbased the on the actual on actual the needs actual needs of needs the of the individual, of individual, the individual, both both physical physical both and physical and emotional. emotional. and emotional. WeWe then then We identify identify thenaidentify suitable a suitable a carer, suitable carer, or itcarer, ormay it may or need itneed may a team, need a team, including a team, including including hoisting hoisting and hoisting and night night and care. night care. WeWe care. cancan even Weeven can even arrange arrange housing arrange housing for housing for thethe care forcare the team team care nearby team nearby tonearby atoclients a clients to ahome, clients home, tohome, ensure to ensure tothat ensure that thethe client thatclient the canclient can protect protect cantheir protect their their privacy privacy and privacy and family family and space, family space, while space, while stillwhile still receiving receiving still receiving safesafe andand safe exceptional exceptional and exceptional support. support. support.

Please Please call Please call us for us call for a confidential usa for confidential a confidential chat chat to see to chat see if to we’re ifsee we’re the if we’re the right right the company right company company for for you. you. for you.

01494 424 01494 424 222 424 222 222info@eximiussupport.uk info@eximiussupport.uk info@eximiussupport.uk Contact Contact Contact us today us today usfor today for a free a for freea free 01494 no no obligation obligation no obligation assessment assessment assessment 0203 0203 794 0203 794 9933 794 99339933www.eximiussupport.uk www.eximiussupport.uk www.eximiussupport.uk

COMPLEX CARE

HEALTH & SOCIAL CARE SERVICES LIMITED

Changing lives, one at a time

HASCS is a specialist nurse led high quality home provider for people with complex care needs.

e work in partnership with you to provide you with care, which is both bespoke and responsive to your needs, whilst in your own home. With the support of a dedicated, professional staff, who are employed by a company built on a foundation of extensive clinical care experience, we make sure that our services provide people with safe, compassionate, and effective care.

WHO DO WE PROVIDE FOR? HASCS provides care for people who have both complex health & social care needs. Some of our clients are recovering following surgery or illness, some require palliative care, and some require longer term continuing health care. With the expertise of our health care professionals, we can support a wide range of care needs, across a wide range of client groups. Whether it is general support, complex care, or meeting personal needs that you require, we are here to help.

YOUR CARE PACKAGE Your care package will be designed by our health professionals so that you or your loved one can get the very most out of life. Before we start work with you, we ensure that your needs are fully assessed, so that we provide the care which is right for you. We work in partnership with you to deliver your care package. Our skills, knowledge and experience allow us to provide a high-quality support service tailored to your needs. We can support a range of conditions including, but not limited to: Motor Neurone Disease Ventilation & Respiratory Cerebral Palsy Multiple Sclerosis Spinal Cord Injury

Brain Injury Epilepsy Multi-sensory impairment Post-traumatic stress disorder Children & Young Adults

We work with you when we set up your care provision, to create your care plan. Your care plan is the way we jointly plan and agree how your health, social needs and wellbeing will be met. It ensures we deliver consistency of care across your team. Each package of care is unique, built by you and designed to meet your individual needs. We work with you to

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choose your care team, and we look to match personalities as well as clinical skills. We also offer training to family members free of charge to ensure that they feel confident in the care being delivered.

WHAT KIND OF CARE DO YOU NEED? There are two crucial factors that never change: we provide different levels of support to suit each individual client, and we ensure that the most compatible staff are selected for each care package. Complex Home Care has become an increasingly viable option for those with complex care needs, who need a care package to help maintain their independence. Throughout the time that we have been operating in this care sector, our services have been constantly evolving to meet our client’s needs.

FINALLY We are looking forward to working alongside you and getting to know you and your family, so call, email or go online. If you have any questions about your care, please do not hesitate to contact us. ■

Contact: Chantelle Treacy | tel: 03300 020 773 email: businessdevelopment@hascs.co.uk web: www.hascs.co.uk

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HASCS changing lives

one at a time

We are a specialist provider of home care and clinical support for people with complex care needs. Providing our services nationwide, our continuing care and robust complex care packages enable our clients to live independent and fulfilling lives from the comfort of their own homes.

Motor Neurone Disease Ventilation & Respiratory Cerebral Palsy Multiple Sclerosis Spinal Cord Injury Brain Injury Epilepsy Multi-sensory Impairment Post-traumatic Stress Disorder

Health & Social Care Services Limited

Call us now on 03300 020 773 info@hascs.co.uk | www.hascs.co.uk

COMPLEX CARE

“We have worked with the Complex Care Team for a number of years, during this time we have built up excellent working relationships with the Team. We have found them incredibly helpful, professional and accommodating. We would not hesitate to approach them for any service they provide as their ‘can do’ attitude is refreshing.” Bristol CHC Commissioning OUR NURSE LED DEDICATED CARE TEAMS KEY AREAS OF EXPERTISE ARE:

OUR COMPLEX CARE TEAMS RECEIVE:

• Spinal cord injuries

• Specialist client specific training from our experienced

• Ventilator Dependent Client

nursing team

• Motor Neurone Disease

• 24/7 nurse support for clients and care teams

• Transitional care from children’s to adult services

• Guaranteed hours contracts with excellent rates of pay

• ABI/CBI

Our aim is to facilitate each service user to live as independently as possible through maximising their potential, empowering them to live the life they choose CQC registered – at our last inspection we received 4 goods with 1 outstanding for responsive

0117 301 5040

michael.kilpatrick@networkhsc.co.uk

Network Complex Care Team Andy’s Journey

Our aim is to facilitate each service user to live as independently as possible through maximising their potential, empowering them to live the life they choose Andy suffered a spinal cord and brain injury following spinal surgery to remove a tumour in 2013; his journey of recovery and reintegration has been a long and arduous one, which has necessitated fighting for, all of the way. Andy was transferred to a number of organisations, where his prognosis for recovery and an acceptable quality of life was deemed as bleak. Due to the active persistence and determination of his family, Andy was transferred to the Spinal Injury Unit at Stanmore, where he was actively rehabilitated and made progress.

Andy’s support team have assisted him to achieve milestones e.g. go on family holidays, including Disneyland Paris, be involved in family activities, return to the organisations he enjoyed prior to surgery, including church, snooker and father/son activities.

We met Andy in February of 2015, where we worked alongside Stanmore, Andy and his family to prepare for discharge back to his family home. With support from Stanmore, members of the multidisciplinary community teams and hard work from, Andy his family and his

Through positive risk assessment, a can-do attitude, developing a trusting, respectful rapport and person centred support plan, Andy’s journey continues to develop as do his goals and aspirations Network Health are honoured to facilitate.

0117 301 5040 88

support team; he has gone from being someone who was ventilator dependant, unable to verbally communicate and eat or drink, to a man who is able to talk, eat and drink, participate in family activities and only uses his ventilator overnight as needed.

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michael.kilpatrick@networkhsc.co.uk

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COMPLEX CARE

National Neurological Services A DIVISION OF THE NATIONAL CARE GROUP Providing slow-stream neurological rehabilitation services plus short and long term residential complex care for men and women with acquired brain injuries, conditions and disorders.

t National Neurological Services we are dedicated to rebuilding lives and helping people reach their full potential. We work in partnership with our NHS and local authority colleagues to deliver a progressive care service which fully realises the unique situation of every person, putting their individual needs at the heart of their care plan to achieve their desired outcomes. Our six residential care centres across Lancashire, Greater Manchester and South Yorkshire range between 6-8 en-suite bedrooms. Each service has a homely feel with fully equipped communal living areas and gardens. At each of the centres we employ a registered manager who is supported by a team trained in brain injury and the wide range of conditions we care for. Working across the six centres is a specialist Area Acquired Brain Injury Manager, with an impressive 12 yearsexperience and a BSC (Hons) in Personal Behavioural Support, who supervises each centre, and the care of the individuals we support. We can also provide physiotherapist input, speech and language and occupational therapy if required.

Our slow-stream rehabilitation is a nurse-led service, supported by a Neuro consultant, Neuro psychologist, physiotherapist, occupational therapist and speech and language therapist to ensure all needs are met for individual’s rehabilitation.

We are committed to finding the absolute potential in everyone we care for with the ultimate aim of transforming lives Now part of a larger organisation, National Neurological Services can also benefit from the support of the wide range of extra services offered by the National Care Group. Recently recognised by The Sunday Times as one of the top three fastest growing companies in the U.K., the wider group offers a broad network of care services. ■

Contact: Keeley Mitchell/Head of National Neurological Services | Tel: 07806 768381 Email: keeley.mitchell@nationalcaregroup.com

www.nationalcaregroup.com National Neurological Services

Aquired Brain Injury Services National Neurological Services is a specialist service supporting people with Acquired Brain Injuries, neurological conditions and disorders. We provide slow stream rehabilitation and both short and long term residential care for males and females over the age of 18. You can contact our central referrals team on:

0333 305 0880

Alternatively you can email neuro@nationalcaregroup.com

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Reque st a copy of our full ser vice brochu re

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LONG-TERM SUPPORT

Vibrations and Shocks DURING MANUAL WHEELCHAIR PROPULSION Every wheelchair user experiences shocks and vibrations transferred from the ground to the body multiple times throughout the day.

hresholds, doorways, curbs, uneven terrain, grass, gravel, random cracks and other obstacles affect the smoothness and effort requirements of wheelchair propulsion. Shock and vibrations experienced by Olga Fomina typical manual wheelchair users can decrease a rider’s comfort, increase the rate of fatigue, cause spasticity, decrease propulsion distance and momentum, and consequently limit endurance, mobility and independence. The vibration and shocks individuals encounter on a daily basis while propelling their wheelchair may be sufficient to cause injury. Therefore, knowledge of the forces and accelerations experienced by the rider is important for successful wheelchair design which reduces vibration and shocks.

INTRODUCING THE ETHOS FROM KI MOBILITY In 2019, a new innovative frame concept (Ki Mobility Ethos) was introduced to eliminate or significantly reduce spasticity by reducing vibration. Being a new design, this requires in-depth research and observation to understand to which degree spasticity and low back pain (LBP) can be reduced. The frame is separated, and four ISO tech polymers are added in between the seat frame and the base frame of the wheelchair. A case study was conducted involving Ki Mobility’s Ethos rigid wheelchair. Highlighted below is an evaluation of whole-

body vibration exposure on manual wheelchair users in their communities in an effort to determine if use of this new frame design reduces vibration and subsequent user impact.

PUT TO THE TEST Three active manual wheelchair users with a SCI diagnosis agreed to participate in the case study. The research was conducted under typical propulsion conditions, including urban streets, parks, apartments and work environments. Participants performed curb descents of various heights and propelled across various terrains in three different manual wheelchairs.

Participants reported an over 18.3% decrease in spasticity and musculoskeletal pain triggered by whole-body vibration while propelling the Ethos The three optimally configured chairs included a titanium rigid chair with Frog Legs caster forks, a Ki Mobility Ethos rigid wheelchair without suspension forks, and participants’ own rigid wheelchair (1 was titanium without suspension forks and 2 and 3 were aluminum with suspension forks). Questionnaires were administered after each wheelchair trial, and time measurements were taken during each obstacle course wheelchair trial. They hypothesized that the wheelchair design would reduce vibration experienced by individuals during propulsion. Based on the results of the questionnaires and observations, the researchers excluded the titanium rigid wheelchair with Frog Legs from the case study, as participants rated them virtually the same as their own chairs. Because of this, they simply compared the results of the users’ own optimally configured wheelchair trial against the trial in the Ethos wheelchair. Participants reported an over 18.3% decrease in spasticity and musculoskeletal pain triggered by whole-body vibration while propelling the Ethos frame design. This study demonstrates the significance and importance of vibration damping in pain and spasticity reduction. ■ Written by: Olga Fomina, EMT, ATP, CRTS®

To find out more visit www.kimobility.com or contact sales@kimobility.com

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@kimobilityuk

5.26 kg transport weight

THE ROAD IS ROUGH. THE RIDE DOESN’T HAVE TO BE.

Navigate city streets, cruise the backroads or tackle cobblestones with the Ethos. Ki Mobility’s patent pending Isolation Technology separates the user from the road, reducing the amount of vibration felt. Vibration that published research has linked to pain and fatigue.

“In my old wheelchair my back and hips were so sore, and my feet were always bouncing off my footplate. Ethos has reduced my spasticity and improved how I feel during the day.” Karah S. Working Professional and wheelchair user since 2009.

Find out more by visiting www.kimobility.com or email sales@kimobility.com

LONG-TERM SUPPORT

WHY MANAGE POSTURE? A wheelchair users very independence can hinge on effective postural management within the wheelchair. Postural management can and does influence:Systemic function (i.e the effect of posture on all the bodily systems including the cardiovascular system, respiratory system and digestive system). Ease of propulsion in a manual wheelchair. Ease of access to driving controls in a powered wheelchair. Management of the interface between the wheelchair and other equipment of daily living. Access to and completion of all activities of daily living inclusive of personal care, work/ education and leisure activities. Access to communication and other assistive technology devices such as environmental controls.

ucy Weech is the Clinical Director leading the Wheel of Health team based throughout the UK and Ireland. The team consists of 17 Clinical Associates who all have extensive post graduate experience in the postural management of complex clients. Presentations range from physical disability following trauma to those with profound and multiple learning difficulties. These clients frequently present either during the litigation process or post settlement. All Clinical Associates manage a highly complex caseload of children and adults. Within this role, clincians complete 24hour postural management assessments (including medico-legal reports); assessment, prescription and provision of specialist equipment; assessment for provision of wheelchair accessible vehicles; personal care and manual handling assessments.

WHY IS POSTURAL MANAGEMENT SO CRITICAL FOR WHEELCHAIR USERS? Posture is often seen as static, with the posture presented at assessment identified as being the clients permanent posture, likely to stay that way. But consider how our own posture changes as we age, and our lifestyle changes. How much more so, then, will the postural requirements of wheelchair users change under the influence of rehabilitation, variable and changeable muscle tone, spasticity patterns, behavioural changes and so forth.

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HOW DOES A POSTURAL MANAGEMENT SPECIALIST/EXPERT EVALUATE A CLIENT’S NEEDS WHEN ASSESSING? The first step in an assessment process is to carefully evaluate the client’s physical presentation taking account of deformity, altered muscle tone, spasticity patterns, impaired sensation, effects of trauma and so forth. These findings should be clinically recorded to give a baseline to subsequent problem solving. It is important to evaluate how much correction is achievable for that which is obviously seen. For example, where there is a pelvic asymmetry that is correctable, then any seating solution should seek to correct it. If it is not correctable, then a posture management solution should seek to accommodate it, to reduce the risk of the deformity becoming worse.

HOW DO THE FINDINGS OF THAT EVALUATION INFLUENCE THE SELECTION OF THE MOST APPROPRIATE EQUIPMENT? Having completed postural analysis and recorded clinical findings in detail, the professional clinician’s responsibility lies in the selection of equipment that is clinically appropriate and addresses issues identified during the assessment process. Features of wheelchairs and posture management equipment informs this process. The professional is therefore responsible for ensuring that they have a good grasp of the features of the equipment and how they affect posture. It is rare to find a single product that will effectively manage sevenstarmedia.co.uk

LONG-TERM SUPPORT client’s postural needs but rather a range of products used together to reach an effective clinical solution. We consider it of the utmost importance to actively work in direct collaboration with the client, their carers and stakeholders and take a multidisciplinary and holistic approach.

WHICH COMES FIRST; THE WHEELCHAIR OR THE VEHICLE, AND WHY? It is of paramount importance to “work from the inside, out”. That is to say, that during the process, it is imperative to start with the client and their presenting postural needs, then work “outwards” in the selection of clinically appropriate products. Therefore, posture management products interface into wheelchairs which then interface into vehicles. We are then able to select a suitable vehicle to fit the wheelchair, rather than trying, usually unsuccessfully, to find a clinically appropriate wheelchair to fit the already purchased vehicle. Retrospective adaptations to previously purchased wheelchair accessible vehicles can cost tens of thousands of pounds.

HOW CAN YOU ENSURE THAT EQUIPMENT SELECTED MEETS BOTH THE NEEDS OF THE PRESENT AS WELL AS BEING ABLE TO FUTUREPROOF ONGOING CLINICAL NEEDS? Competent clinicians need to work with equally competent technical teams and mutual collaboration

Wheel of Health “Opening doors to maximise independence...”

is of the utmost importance. Equipment suppliers have variable strengths and for wheelchair users who have a full-time dependency on all their equipment require both clinical and technical input that can address those complex needs. Additionally, it is true to say that the clinician needs to be able to crystal ball gaze as much as is possible with regard to the presenting condition (be that positive rehabilitative progress or degenerative progression). Our ethos is to work in direct collaboration with competent equipment suppliers who can provide, maintain and assist in the adjustment of equipment to meet the ongoing clinical changes of our clients. ■ Do you have a client in mind, (or are you the client) that would benefit from a postural management assessment?

Please contact myself or Wheel of Health HQ to discuss further: Email: info@wheelofhealth.co.uk Tel: +44 (0) 23 8076 8583 Mob: +44 (0) 78300 72700 Web: www.wheelofhealth.co.uk

UK & IRELAND Specialists in Wheelchair, Seating & 24hr Posture Management Solutions... » Specialist wheechair, seating and 24hr posture management clinical practice. » Specialist provider of wheelchair, posture management and allied equipment solutions for adults and children with complex needs. » Highly specialist and skilled professionals with specialist postgraduate training and expertise.

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Email: info@wheelofhealth.co.uk Web: www.wheelofhealth.co.uk

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LONG-TERM SUPPORT

DIETZ Power MASTERPIECE OF EMPATHY Passion combined with many years of experience provides the force behind the DIETZ Power team as they work to optimise the quality of life for people with reduced mobility.

OPTIONS

IETZ Power is highly successful in combining functionality with modularity. This means they can supply wheelchairs for any type of user and any environment, and that each one is fully adjustable Darren Legg in terms of both functionality and comfort, right down to the last detail. At the same time, the wheelchair’s design is always in perfect balance.

SANGO POWERED WHEELCHAIRS Every individual is different. And that is why every powered wheelchair needs to be different too. DIETZ Power succeeds in combining the uniformity required for keeping production speed low and service levels high with the modularity and adaptability the market needs. After first building a sturdy base version, DIETZ Power then set to work on developing different models of wheelchairs. This means that there is a suitable DIETZ Power wheelchair for most types of user – for anyone of light and average build, and for heavier users and children too. The wheelchairs can be adjusted to the user and to the particular environment, right down to the very last detail and, when needed, can be tailor made.

excellent support for the whole body. The SEGO seating systems and support elements provide the very best comfort under any conditions. And it goes without saying that the materials used are of the highest quality. As the seating system is so easy to adjust to size, it can also easily be readjusted when needed. This also makes it ideal for mounting segmented, foam carve and other specialist seating solutions. There are numerous options for the SANGO including a selection of different chassis, colours, wheel types, powered adjustments, seat and backrest cushions, legrests, armrests, headrests, trays and accessories.

SPECIALS As DIETZ Power wheelchairs are modular in design and offer a whole range of options, standard components go a long way towards meeting needs in most cases. If, however, an individual user still requires any additional adaptations, wheelchairs can be customised to order. In the 35 years the DIETZ Power developers have been working in this field, they have received numerous special requests. These often come from users who, due to their particular disability, require special controls or need unusual functionality or adaptations to be made to their wheelchair. Each day, a separate department within the company works on such special adaptations. The people in the adaptations team are all experts who know the standard products through and through, and therefore also know where space makes an adaptation possible. These ‘inventors’ do not give up until they find a safe and practicable solution.

We had one very clear goal in mind: to develop powered wheelchairs that are adaptable right down to the last detail

Contact: Darren Legg Tel: 07539 732 718 | Email: darrenlegg@dietz-power.com Web: www.dietz-power.com

SEGO SEATING SYSTEM Comfort is incredibly important! That is why the SANGO is fitted with the SEGO seating system, which provides

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DIETZ Power offers high quality, innovative powered wheelchairs that are adjustable to each individual need with quick and reliable delivery of products and spare parts. Customers beneﬁt from ﬁrst class sales and after sales support as well as being able to have features on their chairs often only found on much more expensive products.

Contact Darren Legg on 07539 732 718 to discuss the beneﬁts of the SANGO powered wheelchairs, arrange a product review and assessment visit.

LONG-TERM SUPPORT

Assistive technology provision: MATCHING THE USER WITH THE RIGHT TECHNOLOGY When being confronted with a diagnose or condition affecting your independent mobility, the choice for a wheelchair seems to be an obvious way forward. The wheelchairs available on the market come with different types of functionality and design features. How do you select the right wheelchair for you or your patient?

study* on 70 wheelchair users with spinal All questions that need to be thought of before deciding cord injury showed that these individuals on the type of wheelchair. perceive their wheelchair as their most These insights, in combination with the right common factor limiting participation, expectations from a product perspective is the followed by their physical impairment and physical foundation of a high quality wheelchair provision leading environment. It’s the to the best possible match wheelchair that confronts the between the user and the users with barriers, limits them suggested solution. to participate in activities and Permobil designs technology prevent them from doing what and products with the user in matters. This study underlines mind. User needs and functional the importance of a thorough solutions are the starting point assistive technology selection for product innovation. We process. are convinced that every user A good wheelchair provision has the right to have access to process starts with an in-depth products to compensate for assessment of user needs. Where their disability. Those products is the wheelchair going to be should have the same technical used? What are the requirements standards as those we all use for the seated position? Are in our everyday lives. With this there additional needs to mission statement we ensure to improve postural stability? optimize user outcomes on a It’s crucial to ensure a good functional, clinical and psychomatch between the suggested social level. ■ assistive technology and the Having access to the right person intended to use this *Chaves, E.S., Boninger, M.L., Cooper, R., mobility equipment can help Fitzgerald, S.G., Gray, D.B., Cooper, R.A. technology. Having access to the Assessing the influence of wheelchair right mobility equipment can the individual to improve technology on perception of help the individual to improve independence, participation participation in spinal cord injury. Arch independence, participation and and quality of life Phys Med Rehabil 2004;85:1854-1858 quality of life. The right solution should not only be an enabler for activities, it should also protect individuals from developing secondary complications associated with prolonged sitting. How high is the risk for the development of pressure injuries or contractures? What strategies will the individual use to prevent Tel: 01484 722888 secondary complications? How can the asssistive Email: customer_support_uk@permobil.com technology support the prevention? Is the person capable Web: www.permobil.com/en-gb of implementing these strategies in an independent way?

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Innovating for individuals

permobil.com How to mindfully move with a brain or spinal injury With the right wheelchair, people’s lives improve immeasurably. Individualising a wheelchair to suit a person’s lifestyle and identity makes an enormous difference to a user’s life. It can give them the confidence and energy to socially interact, express themselves and take a more active role in society.

For more information on Permobil Power and TiLite Manual wheelchairs please contact: 01484 722 888 info@permobil.co.uk

LONG-TERM SUPPORT

How to find the PERFECT CHAIR? My name is Mark Babb, and I work for Electric Mobility, the leading supplier of Powered Wheelchairs, Mobility Scooters, Riser Recline, and Fireside Chairs.

s Head of Rascal Rehab, my job is to support Rehab Dealers and customers to ensure everybody gets the best out of these lifechanging products. Mark Babb Having gained nearly 30 years’ experience working within the Rehabilitation sector, I am proud to have been instrumental in aligning rehab products within the mobility business, driving company growth, and developing products in line with everchanging market demands. But, most importantly, by working with key stakeholders to develop and improve specialist rehab products, we can improve the lives of the people who use them. There is a wider choice of chairs available now than ever before, which is great, but it can make the selection process daunting. It’s easy to get overwhelmed by the reams of features and unique selling points promised by each chair, especially with

glossy adverts and social media posts promoting products, but I prefer to take a different approach in finding the perfect chair for the individual. The first step should be the clinical evaluation of the patient. What are their individual goals? The chair should always fit the person, not the other way round. Quality of life is always the most important factor. The best chair is the one that provides the greatest level of freedom and independence. When the end goal is that important, it comes ahead of any business needs. I have always prided myself in being happy to recommend a competitor’s product if the company I am working for cannot provide a solution that’s the best fit for the individual in question. Users are increasingly keen to be able to enjoy life outdoors, never more so than during the global pandemic.

Optimus 2 RS Powerchair rugged for active outdoor use

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LONG-TERM SUPPORT Depending on the level of spinal cord injury, some patients can maintain an active life in a lightweight wheelchair, but challenges often occur when they need to go off-road. Even country park walks on fire road trails can become iChair Sky a problem. Stand-up multi-functional Disabled access ingenious new design has seen great improvements over the years but there will always be challenges, particularly on hills. With this in mind, the Optimus 2 RS powerchair is ideal. It looks good, and its ability to cover terrain is much better than a standard chair. Standard chairs have previously been given different tyres and suspension for indoor and outdoor use, but the Optimus 2 RS takes this further with larger, balloon-style wider tyres that are perfect for country use. It matches this with a larger, more powerful motor, and batteries that can cover longer distances. It’s ideal for rough terrain due to its independent suspension and excellent climbing ability. All Meyra chairs can adapt to seating and positioning requirements thanks to electric backs and seat tilt. I’ve been mountain biking in the great outdoors for over 30 years and it’s a joy to see chair users being able to explore the wilds thanks to these advances in technology. It brings me great pleasure to support Rehab Specialists with demo models that show what can be achieved in this area. I came into the industry from a sporting background as an International Gymnast and British Champion, before training in Sports Injuries and working with Rehab Therapies. The experience I gained as a gymnast, with the biomechanics of performing in the sport to achieve success, relates closely to the seating, positioning, and ergonomics of a chair. I further deepened this understanding during 25 years working for the two largest manufacturers, Invacare and Sunrise, including 10 years specialising in seating, positioning, and pressure care. Today, with Electric Mobility, the UK’s exclusive supplier for Meyra, the highly reputable German manufacturer with 80 years’ industry expertise, I work closely with them to distribute state-of-the-art mobility aids that are individually responsive to the diversity of demands of the user. I am delighted that recent developments have taken another huge leap into the future to help assist rehabilitation with the advancement of the multifunctional stand-up chairs. The iChair Sky, an ingenious

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new design with smart memory, is a multi-functional chair that can offer a wide variety of benefits:

MEDICAL/THERAPEUTICAL BENEFITS Improved circulatory activity Deeper respiration Pressure relief Better digestive passage Improved bladder function Reduced spasticity Prevention of contractures Reduction of bone mineral loss

FUNCTIONAL BENEFITS Undertaking single and multiple tasks Carrying out daily routine Improved mobility Self-care; toileting, washing Dressing Housework/cooking Interpersonal interaction

PSYCHOLOGICAL BENEFITS Community life Recreation and leisure Hobbies Socialising Human rights

ECONOMICAL BENEFITS Potential cost savings by minimising pressure sores Pain control without costly drugs Cost savings of a kitchen modification The ability to work jobs requiring standing, e.g. dentist, surgeon

A stand-up powerchair gives us the ability to integrate standing training into daily life activities. For SCI patients facing a life in a chair, I believe these benefits go beyond the initial financial costs of a chair. Electric Mobility and our partners succeed when we help our customers succeed. That starts with finding the right chair and continues with ongoing support, which is more important than ever with the advent of increasingly technologically advanced chairs. We believe that buying a chair isn’t merely a transaction; it’s the beginning of a meaningful partnership between us, the specialist dealer, and the user.

Contact Electric Mobility | tel: 0800 252 614 web: www.electricmobility.co.uk

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LONG-TERM SUPPORT

Historical merged with contemporary MOVING ACCESSIBLY BETWEEN THE CENTURIES

he combination of old and new architecture provides unusual views and insights. When an old English farmhouse with a building structure dating back to the 15th century meets a creative team of architects from the 21st century, special moments are created. This was certainly the case with the extension of the Batelease Farm in the county of Devon. The original Batelease Farm was built back in the 15th century and the building has been changed and extended over the centuries. A large barn for cattle adjoining the main house was destroyed by a bomb during the Second World War. An empty site was left in its place until 2017.

literally. Because the goal wasn’t merely to create a new build - it also had to be accessible and enable access between the old and new building. This will allow the client, a wheelchair user, to navigate between the buildings independently and to move between the centuries, so-to-speak. A glass structure connects the main house and the new build and covers two floors, including a lift. Access has been created between the buildings on both the ground floor and the first floor. There is also an entrance and exit here, which enables the client to enter or leave the building independently at any time. When designing the residential building with larch woodsteel element construction and the plain zinc roof, the creative designers at New British Design used style elements common in earlier agricultural barn designs and revived and re-interpreted the original technical-agricultural design. The interior design is modern and linear. The residential area is 145 square metres per floor. The building is dominated by generous and bright rooms. Exposed beams in the interior spaces also add technical-agricultural style elements whilst also being extremely useful. A Guldmann GH1 ceiling hoist system, installed by Direct Healthcare Solutions Ltd, is used in the client’s bedroom with the rail system integrated subtly into an exposed timber beam, so that the practical aid is almost invisible.. ■ +44 (0) 1793 611892

www.dhslimited.co.uk

The Devon-based “New British Design” architecture and design company took over the planning and execution of a new build to be built on the site of the former barn. Because the Batelease Farm is a Grade II listed building everything had to be approved by the responsible heritage officials. The modern extension to the old farmhouse creates a contrast between old and new and combines the two - quite

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For further details please contact: Tel: +44 (0) 1793 611892 www.dhslimited.co.uk

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T: +44 (0) 1793 611892 | W: WWW.DHSLIMITED.CO.UK

LONG-TERM SUPPORT

The health & wellbeing benefits OF A HOMELIFT Improving neuro rehab can lead to meaningful living through safer access between floors.

wheelchair-accessible Trio+ Homelift from Stiltz which hose with chronic travels between the ground floor dining room and her disability who wish to first-floor bedroom. continue living with their families, often find the OCCUPATIONAL THERAPISTS ENDORSE THE existing home layout can impede CLINICAL BENEFITS rehabilitation and condition management. The inability to Stuart Barrow, respected Occupational Therapist, Stuart Barrow move - or be moved - freely in a comments: “Stiltz Homelifts provide positive outcomes wheelchair creates challenges, particularly if upstairs for people who need adaptations to make their home bathrooms and bedrooms are out of reach. Faced safe and accessible. A homelift is especially beneficial for with expensive building wheelchair users and those conversions, cost of carers experiencing issues with balance or even having to move to and mobility, which would make a more suitable property, stairs unsafe to use. First floors the prospect of a simple often become no-go areas due adaptation is an attractive to access limitations, which has option. One such solution is a negative effects on wellbeing. installation of the increasingly Through client referrals, I know popular homelift. Stiltz Homelifts can be assessed Stiltz Homelifts are at the for and installed quickly. This forefront of helping transform product prescription ensures in-home access for people meaningful occupation and living with ABI, SCI and inclusion is achieved for a client. neurological conditions such It also benefits family members as degenerative Parkinson’s. and carers through safer moving The company’s homelifts and handling provision.” provide safe, easy transfer Stiltz Homelifts combine between floors for those who style with advanced safety can’t safely use stairs. Through and can be installed without clinically-led client assessments, complex construction Stiltz Trusted Assessors or bespoke electrical work alongside healthcare requirements. A cost-effective Dani says: Before we had the professionals, case managers solution, they are available to Stiltz Homelift, my partner used to and expert witnesses, so the purchase privately or through a carry me upstairs. Not only was this correct product is specified. Disabled Facilities Grant. ■

TRANSFORMING LIFE WITH A SCI At the age of 27, mother-oftwo Dani Watts sustained spinal injury playing rugby and now uses a manual wheelchair. Supported by financial donations, Dani and her family purchased and adapted their home to support rehabilitation and enable independence. This included installation of a

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bad for his health, but it was extremely undignified for me. But now the Stiltz Homelift has transformed the way I live. I can help my children more, easily pop upstairs on my own if I’ve forgotten something, and go to bed independently when I want to … I’ve always been fiercely independent and my Stiltz Homelift has enabled me to continue living this way.

Contact the Stiltz specialist advisors for free on: 0808 163 7909 or email: enquiries@stiltz.co.uk sevenstarmedia.co.uk

Stiltz Homelifts. Supporting in-home accessibility. Returning home after long periods of recovery and rehabilitation is an important milestone. And once home, being able to move around safely and with confidence will help to boost over mental wellbeing.

• Stiltz work directly with the user or via an OT

Stiltz Homelifts are committed to designing accessibility products which are affordable, attractive and look as if they belong in a private home rather than a clinic.

• ThruCar option perfect for wheelchair users

A Stiltz Homelift will help reduce the difficulties of living with limited mobility, leading to positive outcomes and less need for ongoing intervention.

• Nationwide coverage for assessment visits • Homelift tailored to customer need • Ambulant and wheelchair options available • Option of automatic door • Fitted with comprehensive safety sensors • Extremely flexible fitting options • Minimal structural work required • 12 months’ parts and labour cover • Extended warranty available on all products

For more information or to arrange a meeting, contact Stiltz on enquiries@stiltz.co.uk or call 0808 163 7909

LONG-TERM SUPPORT

Brotherwood case study FORD TOURNEO CONNECT Tracy Penney is an experienced WAV user - having recently taken delivery of her third Wheelchair Accessible Vehicle for son Harry. Tracy took some time to give insight into her process of selecting a new WAV, and why the new Ford Tourneo Connect is the perfect vehicle for Harry. and taking in the surroundings. By choosing the Titanium model we have the panoramic roof – you will usually find Harry starring up watching the clouds go by! The Titanium model also gave us pretty much everything we needed to make the journey comfortable for Harry and as he can require medical interventions whilst we are out, having the privacy glass means we can do this discreetly. The Hook-i-PAWRS restraint system will assist with pulling him into the car and while it may not be used all the time we were looking to future proof our needs should he get bigger and heavier. We were super impressed by the STORQ system which self-tensioned the rear restraints – no more catching knuckles when tightening or worrying you haven’t quite turned them enough!

his is our 3rd WAV, for my son Harry who has just turned 18. Our previous vehicle which we had had for 7 years had BROTHERWOOD CASE served us well, but our STUDY - FORD TOURNEO needs had changed with CONNECT Harry’s brothers having Having a level floor in the We chose and viewed the car now grown up along with during the COVID pandemic and vehicle was important to us to give Harry getting much bigger. were reassured by the additional Harry a more comfortable ride and Harry had moved into a procedures put in place to ensure larger wheelchair and it was minimise the rocking and tilting you everything was done safely. Both immediately apparent that Hayden and Rachael helped to can get from a wheelchair being we need a vehicle that had a make the process as simple and positioned on an incline generous entry level height straight forward as possible.” ■ so that we didn’t need to keep tilting Harry up and down as we were doing in the old vehicle, at the same time we wanted to downsize to a smaller WAV whilst increasing interior space for the wheelchair. From searching through the different vehicles available on the Motability website we found the Ford Tourneo Connect with a 59-inch entry height, and Brotherwood.” “Having a level floor in the vehicle was important to us to give Harry a more comfortable ride and minimise the Tel: 0808 274 5888 rocking and tilting you can get from a wheelchair being Web: www.brotherwood.com positioned on an incline. Harry loves being out in the car

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LONG-TERM SUPPORT

One more step on the road to INDEPENDENCE GowringsVersa Mobility is one of the UK’s leading manufacturer of wheelchair accessible vehicles that enable people with mobility difficulties to lead independent, active lives.

s a wheelchair user, you and your family’s lives can be changed forever when you own a GowringsVersa converted wheelchair accessible vehicle (WAV). We manufacture multi-purpose WAVs focused on the specific requirements of the wheelchair users. All of our models make easy access into the rear of the vehicle while ensuring greater visibility for the wheelchair user. Our largest vehicles accommodate multiple wheelchair users. Perfect solutions for patient transport, care homes, and wheelchair user support organisations. GowringsVersa Mobility have an extensive vehicle range. Our highly engineered vehicle conversions meet a variety of disability needs and deliver an exceptional

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wheelchair-passenger experience. View our website to see our complete fleet range.

Gowrings were an obvious choice for us, after looking at a wide range of WAVs. They offer a conversion that places the wheelchair user in the heart of the vehicle, enabling them to feel part of the family Whether you need a New or Used wheelchair accessible vehicle for your own personal use or are a business requiring specialist transport we can assist. GowringsVersa Mobility also operate an extensive hire fleet, so you can try a vehicle for a specific event or holiday, we can help! ■ Call our expert advisors to discuss your specific wheelchair accessible vehicle requirements.

Tel: 0345 608 8020 (quote LF4X) Web: gowringsversamobility.co.uk

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The Closomat Palma Vita The Closomat Palma Vita Wash and Dry toilet. Wash and Dry toilet.

“I am so grateful I have it. It is brilliant.” Dave Dave Ralph, Ralph, a a former former garage garage owner, owner, suffered suffered a a prolapsed prolapsed disc disc at work, but carried on working, and unfortunately he severely at work, but carried on working, and unfortunately he severely damaged damaged his his spinal spinal cord cord as as a a result. result. Dave Dave realised realised that that he he needed needed extra extra help help when when going going to to the the toilet. toilet. “It was was getting getting more more and and more more difficult difficult to to clean clean myself, myself, as as II “It couldn’t couldn’t get get my my hands hands behind behind my my back. back. II wouldn’t wouldn’t expect expect my my wife wife to wipe my bottom: it’s embarrassing!” explains Dave. to wipe my bottom: it’s embarrassing!” explains Dave. A A friend friend told told him him about about Closomat Closomat Wash Wash and and Dry Dry toilets, toilets, so so spoke to his Occupational Therapist; and under a Disabled spoke to his Occupational Therapist; and under a Disabled

he he Facilities Facilities

Grant, a a Closomat Closomat Palma Palma Vita Vita was was installed. installed. Dave Dave says, says, “I “I am am so so Grant, grateful grateful II have have it. it. It It is is brilliant. brilliant. II just just push push the the pad pad with with my my elbow, elbow, and and the the toilet toilet does does the the rest.” rest.” To To find find out out more more about about how how life-changing life-changing a a Wash Wash and and Dry Dry Toilet Toilet from Closomat can be, visit closomat.co.uk. from Closomat can be, visit closomat.co.uk.

LONG-TERM SUPPORT

Home Semen Retrieval: FERTICARE 2.0 IS BACK The long awaited NEW version of Ferticare – the 2.0 in blue, is now available from Pelvic Health Specialist Distributor – iMEDicare Ltd (www.MyPelvicHealth.co.uk) Author: Darren Breen, MD, iMEDicare Ltd

enile Vibratory Stimulation or PVS is considered the method of first choice for semen retrieval in men who are anejaculatory due to spinal cord injury applicable when the level of injury is above T10 which means local ejaculatory reflex arcs are likely to be intact – at S2-S4 and T10-L2 .

DEVICE FEATURES - Ferticare 2.0 features a built in lithium-ion battery, Applicator pad Frequency Range : 70-110 Hz and Amplitude Range (peak to peak): 0.5 – 4.0 mm Variable. The applicator pad should be placed to the dorsum (top) or frenulum (bottom) of the glans penis (head). The amplitude and frequency

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of pad oscillation can be increased or decreased to determine the extent of stimulatory vibrational energy delivered to the penile glans.

RISKS: Autonomic Dysreflexia (AD) is a risk if the level of injury is above T6. Seek advice from your physician before use of Ferticare if you have any concerns at all. Compared to electro-ejaculation, PVS results in better semen quality, is preferred more by patients and can be used at home. There is also good evidence that spasticity can be reduced from 2-24hrs after each PVS application EVIDENCE - Whilst there were a gamete of published studies

relating to the efficacy of Ferticare 1.0, as yet there is only one Unpublished study for Ferticare 2.0 from The Miami Centre to cure paralysis (University of Miami Miller School of Medicine – Nancy Brackett). This study established efficacy in 13 of 15 subjects with level of injury above T10 ie 86.6% (some patients did use a TWO device approach). ■

ACQUISITION - Ferticare 2.0 costs £708 including VAT plus delivery (not returnable or refundable when used). Order from www.MyPelvicHealth. co.uk or call iMEDicare Customer services M-Fri 8am to 5pm on 01923237795.

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LONG-TERM SUPPORT

ALLIANZ LEGAL PROTECTION We’re one of the longest established providers of After the Event (ATE) insurance in the UK and part of the Allianz group. Our fully underwritten solutions are designed and priced to recognise the expertise and success of progressive law firms.

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Have you suffered a brain injury following an accident? Brain Injuries can be life-changing. Which is why Brian Barr Solicitors work tirelessly to secure our clients the compensation they deserve. Traumatic Brain Injury and Subtle Brain Injury can occur as a result of a car accident, a fall or an accident at work and if you are looking to claim compensation for a brain injury, you will need to be able to prove that the injury was caused by another’s negligence. The compensation amounts for brain injuries can vary depending on the severity of the injury and the impact it has had on both your working capabilities and your needs for care. As experienced brain injury solicitors we will go out of our way to ensure you receive the compensation you deserve. and we can also provide access to medical experts, rehabilitation services and therapies to ensure you have all the aids, equipment and assistance to help you to recover from your brain injury.

Brain injury solicitors specialising in both traumatic and subtle brain injury claims To start your claim get in touch: call us on 0161 737 9248

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Accessible and Inclusive Environments Removing barriers by design

BUILDING SURVEYING ARCHITECTURE & DESIGN CONTRACT ADMINISTRATION PRINCIPAL DESIGNER / CDM COST CONSULTANTS EXPERT WITNESS PROPERTY FINDING SUITABILITY REPORTS

William Martin’s specialist personal injury division comprises senior, experienced accommodation experts who lead a team of architects and designers to provide a service to those requiring a home intended to promote their independence, mobility and rehabilitation. We have undertaken many successful new build and adaptation schemes including adaptations to temporary accommodation. We are accustomed to working closely with the injured party often in conjunction with their Case Manager, Occupational Therapists and legal team. We are able to offer innovative and bespoke solutions to meet the needs of each client.

Julian Rendall: jrendall@william-martin.co.uk James Nocker: jpn@william-martin.co.uk London: +44 (0)207 378 5800 Manchester: +44 (0)161 457 0336 32 Threadneedle Street, London, EC2R 8AY 3 Hardman Square, Spinningfields Manchester M3 3EB www.william-martin.co.uk

FINANCIAL & LEGAL

Release the cash you have tied up IN YOUR ONGOING CASES Cash flow is the lifeblood for all firms and the timescales to receiving costs for serious brain injury and medical negligence claims present a challenge for even the best law firms. For multi-track or high- value cases creates a financial burden on the firm.

FLEXIBLE TAILOR-MADE SOLUTION ALIGNED TO A CLINICAL NEGLIGENCE FIRM’S CASH FLOW VFS assists by releasing the WIP and cash tied up in existing cases. By proving simple competitive cashflow solutions we increase your financial muscle. Disbursement Funding Facility (DCF) can be used to fund disbursements and issue fees on an individual file basis including releasing cash tied up in disbursements already incurred releasing up 100% of the external disbursements incurred on each case. Costs Advance Funding (CAF) This is our most popular product and comparable to invoice discounting and can be used when a law firm has won a case and the bill of costs has been served. VFS will advance funds against the settlement of the expected costs. This enables the firm to negotiate the right settlement and accept a lower offer just to get the case settled. High Costs Case Funding (HCF) For higher-value cases hird parties ‘dragging their feet on complex where there is an admission of liability, VFS can release part claims means payment is often received many of the WIP already incurred years from the start disbursements to date. of the case. The uncertainty that surrounds and This aids cashflow and is Don’t let cash flow restrict repaid upon the natural the funding required for such the growth of your firm or of the case. affect the service to your complex cases often leaves firms in conclusion VFS takes care of the funding clients. a difficult position when and cash flow enabling the VFS has been providing law firm to do what it does forecasting cash required to run a funding facilities to Law firms best and focus on the case for over a decade specialising in case or how they compensate for and achieving the right high-value, complex litigation. outcome. ■ the cases that lose. The uncertainty that

surrounds the funding required for such complex cases makes forecasting cashflow difficult for firms. Our Disbursement, Cost Advance and High-Cost case funding have made us the funder of choice for legal firms providing over £150 million of funds to over 90 firms. Funds can be used for any purpose and our regulatory compliant documentation, low interest-only payments and repayment aligned to the individual case all ensure a smooth cash flow. Our core products are specifically designed with Personal Injury and clinical negligence cases in mind.

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To find out more about how we can assist www.vfslegal.com or for an informal chat telephone 0203 747 9333 or email enquiries@vfslegal.com

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Release the cash tied up in your high value clinical negligence cases Disbursement Funding ALL third party costs incurred in running the case as covered by your ATE.

High Cost Case Funding When the case reaches a stage where liability has been admitted but there is still much more work to do to finalise, VFS can release the WIP incurred to that point.

Cost Advance You have won the case and the draft bill issued, VFS can release the cash tied up in the bill.

Simple, Innovative and Proven VFS provides an effective funding solution for these long tail cases.

To find out more visit www.vfslegal.com or for an informal chat telephone 020 3747 9333 or email enquiries@vfslegal.com VFS Legal funding is a trading name of VFS Legal Ltd, Kingfisher House, 21-23 Elmfield Rd, Bromley, Kent, BR1 1LT

FINANCIAL & LEGAL

BEWARE AND BEHAVE! Those who fail to take Alternative Dispute Resolution (ADR) seriously must expect the worst, says Professor Dominic Regan, Frenkel Topping Group’s Director of Training & Insight

n 2013 Briggs LJ, now a member of the Supreme Court, held in PGF that a defendant who had merely ignored an invitation to engage in ADR had acted unreasonably. Accordingly, the defendant was Dom Regan denied tens of thousands of pounds in costs to which it was otherwise entitled. High Court Judges in 2020 ordered recalcitrant defendants to pay indemnity costs solely because they had rejected ADR outright. In January this year, Sir Geoffrey Vos became the new Master of the Rolls, the most powerful Judicial position in the world of Civil Procedure. He is a dynamic character and has a reputation for getting things done. Take it from me that he thinks the Courts got it wrong back in 2004 when it was decided in HALSEY that the Court had no power to order parties to engage in mediation. The time is ripe for a fundamental rethink. This issue shot to the top of the reform agenda after a case Whilst there are various There will be cases where a party or called LOMAX V LOMAX in 2019. parties will refuse to engage. What The Appeal Court held that a modes of ADR, the firm happens in a mediation is protected Judge could order parties to judicial favourite is by the shroud of Privilege. The engage in another process, Early process can only be opened up with mediation. A mediator is a Neutral Evaluation, even if they the consent of both parties. Those did not want to. The reformers neutral - a go between. They misbehaving are never going to agree. pounced and asked why then cannot be partisan nor I suspect that things may move can’t the Court equally order parties to get together through judgmental. Their function is quickly on the reform front. It is imperative that any suggestion of Court managed mediation? to find common ground ADR is always acknowledged. It I worked for 7 years with between the parties may be that the suggestion is made Sir Rupert Jackson, advising on prematurely. If so, explain your aspects of reform. He had not position. Outright rejection is a suicide note. You have a scintilla of doubt that ADR was a fundamental part of been warned. dispute resolution. A successful outcome would mean big savings in costs. The anxiety and uncertainty of trial would be avoided. HHJ Simon Brown QC described going to trial as akin to a visit to a casino. Those entering always believe they will be successful but one party will leave disappointed. Whilst there are various modes of ADR, the firm judicial favourite is mediation. A mediator is a neutral - a go Tel: 0161 886 8000 between. They cannot be partisan nor judgmental. Their Web: www.frenkeltopping.co.uk function is to find common ground between the parties. Email: contactus@frenkeltopping.co.uk It would be naive to pretend ADR is a universal panacea.

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FREE

Expert Training for Expert Practitioners from Frenkel Topping knowledge Hub The knowledge Hub – from Frenkel Topping Training academy delivers FREE virtual and face-to-face training to our professional clients - helping you stay up to speed and informed. Courses available from knowledge Hub. 1.

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Personal Injury Trusts

Application of Periodical Payment Orders

Trusts for Minors

Financial Implications for Vulnerable Clients

Loss of Earnings Self Employed Claimants

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GROUP

FINANCIAL & LEGAL

Can the Court of Protection SAVE MY MEANS TESTED BENEFITS AFTER I INHERIT? LMS, a 21-year-old with Sotos Syndrome and significant autism lacked the capacity to manage her own finances. LMS’s grandfather died in January 2018. His Will left 30% of his estate to LMS when she reached 25 (approximately £170,000).

oncerned about her benefits, LMS’s mother applied to the Court of Protection to allow the money to be placed into a disabled person’s trust. The Official Solicitor was concerned that putting the money into trust would not protect LMS’s means tested provision because it would be treated as a deprivation of capital. Under those rules, if somebody gives something away, including into trust, with the aim of preserving means tested provisions, they can be treated as still owning it. The Court looked at the case law around deprivation. The preservation of means testing did not have to be the sole purpose for deprivation to apply. The arguments from the mother were based on there

There is no guarantee of how the Department for Work and Pensions and the local authority will treat the transfer into trust. being other reasons for the setting up of the trust, LMS not understanding the capital rules therefore not being able to try to get round them, and that this would not be an act by LMS herself. The Court looked at a Northern Irish decision in the matter of ‘McCullogh’ where a variation to Will Trust was allowed to protect means tested benefits. In that case, which is not binding in England and Wales, the Court felt that the significant operative purpose was to give a better effect to McCullogh’s intention that her son should benefit from his inheritance. The Court did not believe that amounted to deprivation.

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The Court authorised the transfer into trust. The Judge made it clear that the Court of Protection did not have jurisdiction to determine whether LMS would be entitled to means tested benefits and funding but can record the Court’s intention in authorising the deed. It is very important to remember that this is a decision made by the Court of Protection in LMS’s best interests and not one that is binding on any benefits authorities. The Court took the view that it would be in LMS’s best interests for the inheritance she had received from her grandfather to be placed into trust as they believed it gave a chance of her Employment and Support Allowance and care funding being preserved. There is no guarantee of how the Department for Work and Pensions and the local authority will treat the transfer into trust. The Court revisited the choice between trust and deputyship. Of course, a deputyship would not have protected LMS’s means tested benefits, so the only option was a trust. Unlike when a deputy looks after money somebody has received as a result of an injury. Those assets being looked after by a deputy would be disregarded for means testing purposes. As always in these situations, it is far better to set up an appropriate trust in your Will if any of your beneficiaries might be receiving means tested provision. ■

Tel: 0114 267 5621 or Email: jane.netting@wrigleys.co.uk sevenstarmedia.co.uk

Court of Protection Specialist Solicitors We have extensive experience of working with injured or disabled people with matters concerning the Court of Protection. We are uniquely placed to assist you in this specialist area as we are not part of a litigation firm and are independent.

Why Wrigleys? •

We are well known and respected nationally in this area of expertise and work with you to achieve the best outcomes for you.

•

We have experience in driving negotiations with the CICA meaning we are often able to redraft clauses of the trust deed with your interests in mind.

Our team of specialists deal with various matters that arise following catastrophic injury, such as: • Court of Protection applications • professional deputyship • professional trustee • property purchases and adaptations • issues concerning community care • statutory wills and liaison with the CICA • direct employment •

We have one of the largest trust and Court of Protection administration teams of any national law firm; this team includes tax specialists, trust specialists and legal experts

•

We believe a strong, long-standing professional working relationship is key and we pride ourselves in that we care. We build relationships that last a lifetime.

FINANCIAL & LEGAL

Expert pre settlement IFA SERVICES We offer a suite of services for law firms and barristers to apply over the course of a client’s case. Covering key financial aspects of a claim, our expertise can assist you and your client throughout the litigation process.

e have built a strong reputation acting for both claimants and defendants in high value claims. Our level of knowledge in such cases is second to none and we have invested in systems that allow us to provide up-todate advice on whether Periodical Payments are appropriate.

OUR EXPERT WITNESS PERIODICAL PAYMENT SERVICE INCLUDES: Periodical Payments versus lump sum analysis Format of the award Appropriate indexation Case conference attendance Advice on settlement strategies and negotiations Expert evidence at trial

PERSONAL INJURY TRUSTS Many Personal Injury claimants are in receipt of welfare benefits, or may become entitled to state support over the course of their lifetime. If claimants do not receive appropriate advice about the use of Personal Injury Trusts, their benefits may be affected upon receipt of a damages award. We can advise in plain, straightforward terms how best to manage payments and how to set up a structure that protects the best interests of claimants. Legal advisers have a duty to inform claimants of the option to set up a Trust in order to protect entitlement to means-tested state benefits. We can assist by providing a free written assessment for all clients, and then, if a Trust is viable, arrange a suitably worded Trust Deed, establish a Trustee bank account and deal with the local Benefits Agency, both now and in years to come. Moving forward, we can also offer cash and investment advice to suit the client’s needs.

WELFARE BENEFITS ADVICE Personal Injury can have profound and often devastating effects, not just on the injured party, but also on their family, friends and work. The impacts of the aftermath of an injury can be complex, and may include medical needs, litigation, rehabilitation and financial affairs. Families often find themselves under financial pressure as a result of Personal Injury and have to navigate the complex welfare benefits system. We can smooth the process of dealing with multiple benefits from several agencies.

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We offer a benefits health check service to make sure that clients are receiving all the payments to which they are entitled. We offer assistance with claiming the correct benefits and managing application processes. We provide representation at appeals and tribunal hearings and assist in overturning unjust decisions by applying expert knowledge of welfare benefit law we will stand by clients from the very beginning of the process and be there at every stage as required. We aim to ensure the best results possible, with peace of mind and confidence in our skills and experience.

LOSS OF EARNINGS Claims for loss of earnings in Personal Injury cases can be complex and challenging, particularly when they involve the self-employed, family businesses or employments with variable components such as bonuses or commission. To help with negotiations and settlement of cases, we provide thorough calculations and reports from the financial evidence. We aim to provide this as clearly as possible and at any stage of the claim process. We have considerable experience and expertise in advising on evidence and disclosure, providing alternative calculations for different scenarios, letters or reports for disclosure, advising in conference and giving expert evidence.

LOSS OF PENSION Depending on the age of the claimant or their employment, pension calculations may be an important part of the losses to be quantified. There has been, and continues to be, many changes to state and private pensions, including changes to the way pensions based on final salary are calculated, lifetime allowances and the rising state pension retirement age. Again, to help with negotiations and settlement, we provide thorough calculations and reports from the financial evidence, set out as clearly as possible. We have considerable experience and expertise in all types of pensions. At Chase de Vere Personal Injury & Court of Protection, we are aware of budgeting requirements and the need to control costs. We are happy to discuss cases and review papers in order to provide a fee estimate before we are instructed. ■

Tel: 0800 082 1216 | Email: PiCop@chasedevere.co.uk Web: www.chasedeverepicop.co.uk sevenstarmedia.co.uk

Truly independent, specialist advice for damages awards As specialist independent financial advisers, Chase de Vere Personal Injury and Court of Protection can help you get the most out of your personal injury settlement. We provide post-settlement investment and welfare benefits advice, personal injury trust and periodical payment and pension loss reports for personal injury claimants and their families.

To arrange an initial discussion, call 0800 082 1216 or email PiCop@chasedevere.co.uk

Chase de Vere Personal Injury & Court of Protection is a trading name of Chase de Vere Independent Financial Advisers Limited, which is authorised and regulated by the Financial Conduct Authority. Head office: 60 New Broad Street, London, EC2M 1JJ.

FINANCIAL & LEGAL

Strength in DEPTH The Serious Injury Team at No5 Barristers’ Chambers prides itself on its strength in depth, with experienced counsel at all levels offering an exceptional understanding of complex clinical, causation and quantum issues.

e are regularly instructed in cases involving issues around capacity, provisional damages, PPOs and statutory funding. Members work nationally and internationally, with leading provincial and London solicitors and national defendant insurer firms. Most importantly, we pride ourselves on being accessible and responsive, working closely with those who instruct us to provide a proactive and strategic approach in order to secure outstanding results. Members are noted for their empathy and approachability. We are keenly aware of the need to see a claimant as an individual, not just as another ‘case’ and of the concept of facilitation i.e. by care and support, mobility aids and equipment, to support aspiration and maximise quality of life.

BRAIN INJURIES Our experience includes accidents at work and RTAs, from significant structural brain damage to more subtle brain injuries and post-concussional syndrome, cases of hypoxic brain injury, brain haemorrhage and delay in diagnosis of brain tumours.

Case examples include: Claim involving a moderate brain injury sustained by a young man in a road traffic collision. Issues involved failure to wear a seatbelt, but principally mental capacity and the long-term projections for case management and care. Case settled in seven figures shortly after a joint settlement meeting.

SPINAL INJURIES In addition to spinal injuries arising from trauma, our work includes clinical/ surgical mismanagement and spinal cord injury, including cauda equina, hip replacement, spinal and epidural anaesthesia and surgery.

We are regularly instructed in cases involving issues around capacity, provisional damages, PPOs and statutory funding.. Case examples include: Representing a T5 ASIA B spinally injured Claimant where, due to her age and urgent accommodation needs, the RCJ has agreed to expedite the case management of it, akin to a mesothelioma claim, and to proceed to £1 million+ interim payment application within weeks of the issue of proceedings. Working with specialist instructing solicitors to coordinate the instruction of a raft of Part 35 experts in the case of young man, aged only just 20 years at the date of his scaffolding accident, who unfortunately suffered a life changing T6 ASIA A spinal injury as a result. He is sadly partially dependent in all activities of daily living, requires extensive care and therapeutic input and is at ongoing risk of autonomic dysreflexia and syringomyelia with, realistically, no residual earning capacity.

Delay in diagnosis of mastoiditis leading to brain empyema causing brain damage and uncontrollable generalised epilepsy. Liability initially in dispute. Settled following a roundtable settlement conference for £6.5m. Wrongful birth claim arising out of negligent failure to diagnose microcephaly (a genetic brain malformation) during antenatal scanning. Settled at roundtable conference for £6m.

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Contact the Serious Injury clerking team: Tel: 0845 241 7006 | Email: MT@no5.com

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SERIOUS INJURY TEAM

Expertise & Excellence in all aspects of serious injury litigation: – Acquired brain injury – Spinal cord injury – Amputation – Pain disorders – Fatal accidents

For more information please contact: Tel: 0845 241 7006 Email: MT@no5.com

No5 Barristers’ Chambers provides services on an equal opportunities basis

Birmingham London Bristol Leicester

No5.com/seriousinjury

FINANCIAL & LEGAL

Specialist KNOWLEDGE Morrisons Solicitors is a Surrey, Hampshire and South-West London based law firm.

ur Personal Injury and Clinical Negligence department work exclusively for Claimants who have suffered catastrophic and life changing injuries, including brain and spinal injury.

long-term health, well-being and lifestyle by facilitating the provision of privately funded treatment and equipment. We have a strong network of experts who we work longside to explore and provide bespoke rehabilitation plans such as Medical Experts, Case Managers, Pain Management experts, Prosthetic experts and home adaption and The Personal Injury team at Morrisons Solicitors are technology experts. specialists in catastrophic, life changing We pride ourselves on Our approach is to deal with cases injury cases. We understand how compassionately and robustly, working traumatic and debilitating a life taking a rehabilitation to achieve the best all round results for changing injury can be for an injured focussed approach our clients. We also maximise damages client and their family. for our clients and are very confident We pride ourselves on taking a in our ability to understand the impact that the injuries have rehabilitation focussed approach. This means we pro-actively on them personally, to get their life back on track. ■ work within and encourage agreement of The Rehabilitation Code 2015. This protocol encourages parties to a claim to use the Code to identify the needs of any injured client and address the cost of providing for their needs on a private basis. This approach ensures that our clients make the best and quickest recovery. Acting in the best interests of our clients goes beyond just securing reasonable financial Tel: 020 8971 1020 compensation. We work with our clients, their families and Web: www.morrlaw.com/personal-injury/ independent experts, to improve their present and / or

PERSONAL INJURY & CLINICAL NEGLIGENCE Free initial consultation No win, no fee funding options available

We work hard to help you get your life back on track.

Brain and spinal injury specialists

Just when life seems to be going along smoothly, something can happen that turns your world upside down. At Morrisons we will support you through the claims process and help you move positively into your future.

Access to rehabilitation treatment

morrlaw.com

Court of protection specialists

0208 971 1055

Offices across South West London, Surrey and Hampshire brain and spinal injury handbook .indd 2

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FINANCIAL & LEGAL

“The ‘impressive’ Old Square Chambers is an ‘excellent choice’ In the personal injury market. The set has a longstanding reputation in

for claimants but has recently significantinjury defendant presence.” Legal 500 2020 “The ‘impressive’successfully Old Squareacting Chambers is an ‘excellent choice’ built In thea personal market. The set –has a longstanding reputation in successfully acting for claimants but has recently built a significant defendant presence.” – Legal 500 “Old Square Chambers is well regarded for its expert representation of both claimants and defendants in complex personal injury matters. Areas of particular expertise for the set include catastrophic and fatal accident claims, and its members are often instructed in “Old Square Chambers is well regarded for its expert representation of both claimants and defendants in complex personal injury cases involving injuries sustained in RTAs and workplace accidents.” – Chambers & Partners 2020

matters. Areas of particular expertise for the set include catastrophic and fatal accident claims, and its members are often instructed in cases injuries sustained RTAs workplace accidents.” Chambers & Partners Our clients choose Oldinvolving Square Chambers because ofinour firstand class reputation, because of– our experience and knowledge, and because we listen. We put our clients at the heart of all we do. We will fight tirelessly for your interests and to achieve the best

Our clients choose Old Square Chambers because of our first class reputation, because of our experience and knowledge, and because results. we listen. We put our clients at the heart of all we do. We will fight tirelessly for your interests and to achieve the best results. For more information, please call one of our clerks on 0207 269 0300 or email clerks@oldsquare.co.uk LONDON

BRISTOL For more information, please call one of our clerks on 0207 269 0300 or email clerks@oldsquare.co.uk 9 Queen Square

10-11 Bedford Row

BRISTOL Bristol

LONDON London

BS1 4JE

WC1R 4BU

9 Queen Square

10-11 Bedford Row

T +44 (0) 117 930 5100

T +44 (0) 20 7269 0300

Bristol

London

F +44 (0) 117 927 3478

BS1 4JE

WC1R 4BU

DX 78229 Bristol 1

DX 1046 Chancery Lane

T +44 (0) 117 930 5100

T +44 (0) 20 7269 0300

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DX 78229 Bristol 1

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Leading EXPERTS Leading EXPERTS A A “ Specialists of clients in allinforms of personal injury.injury. Specialistsacting actingfor fora multitude a multitude of clients all forms of personal

rebuild their lives and cope with these life-changing specialist set with 79 members, including injuries with expert rehabilitation, medical 17 specialist Queen’s Counsel, Old Square Chambers set with 79 members, including to get the compensation our clients and familiescare needand to provides advocacy, advice and drafting of support. Our team’s experience in other associated help rebuild their lives and cope with these life-changing 17 Queen’s Counsel, Old Square Chambers such as medical clinical negligence, the highest quality, at trialadvice and and drafting of injuries expertareas, rehabilitation, care and provides advocacy, Recognised forwith their appellatethe level. Ourquality, exceptional costs work, product liability and highest support. Our team’s experience regulatory clerking team are also recognised experience in high value professional at trial and appellate level. Our in other associated areas,disputes, such allow us to provide a fully and provideclerking friendly and exceptional team are also as clinical negligence, costs work, Recognised for their and complex claims professional comprehensive recognised andsupport. provide friendly product liabilityservice. and professional experience regulatory disputes, allow to We and professional support. has proven expertise, Old Square Chambers at all in high We value put our clients at the heart of all weusdo. Old Square Chambers has provide fully comprehensive levels of seniority, encompassing the full will fight tirelessly for youra interests and to achieve andspectrum complex claims service. proven expertise, at matters. all levels of of personal injury Our members are the best interests. ■ seniority, encompassing We put our clients at the heart of particularly recognisedthe forfull their experience in high all we do. We will fight tirelessly for your interests and to spectrum personalclaims, injury matters. Our members value andofcomplex frequently acting forare particularly recognised for their experience high value achieve the best interests. ■ both claimants and defendants in casesininvolving and complex claims, frequently actingand for traumatic both claimants catastrophic and fatal accidents, For more information, and defendants in cases involving catastrophic and fatal For more information, brain, spinal and life-altering injuries. We service a please call one of our clerks on 0207 269 0300 accidents, and traumatic brain, spinal and life-altering please call one of our clerks on 0207 269 0300 wide range of work across the UK to get the or email clerks@oldsquare.co.uk injuries. We service a wide range of work across the UK or email clerks@oldsquare.co.uk compensation our clients and families need to help

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FINANCIAL & LEGAL

Stress points in catastrophic INJURY LITIGATION Litigation is stressful for claimants. Professionals working with people going through the court process should understand the stress points so that they can support the claimant as these arise.

art of the role of a solicitor conducting litigation on behalf of an injured person is to minimise the stress they experience. The solicitor needs to progress the case continually and have a clear Ben Townsend strategy to bring it to a conclusion. Many brain injury survivors will be unable to make decisions on their case personally because they lack capacity. While some will welcome this, others will find the lack of control frustrating.

EARLY STAGES OF LITIGATION

The defendant’s response can be a source of stress for the claimant, particularly if the defendant fails to provide a proper response and states that their investigations haven’t concluded. Potentially even worse for the claimant, the defendant may allege that the accident was partially or even entirely the claimant’s fault. This is an understandable point of stress for the claimant.

CRIMINAL PROCESS If there is a criminal process running alongside the claim, this can be a major source of stress. That process will be entirely outside the claimant’s control but may be central to the claimant feeling that there has been proper recognition of the wrong done to them. A decision not to prosecute or a failed prosecution can leave the claimant consumed by feelings that their suffering has not been acknowledged. Any criminal trial will carry similar stresses to those in a civil trial, as set out below.

The injured person should be kept well informed about the case and where it is going. If they have capacity to make decisions on the case, they should have the information they need to make those decisions. They need to be reassured that the litigation is being conducted in accordance with their needs and priorities, COURT PROCEEDINGS rather than what is convenient for their lawyer or the Cases become more serious once court proceedings are case. There will be several occasions when the injured person commenced (which must generally be within three years of the accident date). There are also court deadlines that has to recount what happened to them to the extent they can remember it. Some have to be met. These should claimants will not remember be primarily the concern of Many brain injury survivors will the accident, which can the instructed lawyer, but the be unable to make decisions on avoid the stress of flashbacks claimant will be involved in and having to relive what evidential decisions required to their case personally because they happened. For others, a meet those deadlines. This can lack capacity. While some will lack of memories can be be stressful for the claimant welcome this, others will find the frustrating. For claimants as the solicitor may need who can remember the documents to be provided and lack of control frustrating. accident in which they were reviewed, and decisions made at injured, it can be traumatic relatively short notice. having to recount what happened to strangers during the After the court papers have been sent to the case. defendant, it will explain its case in a document called the defence. It may be difficult for the claimant to read in a LETTER OF CLAIM formal document why the defendant is alleging that the At a relatively early stage of the case, the claimant’s claimant was partly or entirely at fault. solicitor will send a letter of claim to the defendant and Some claimants will never waiver in their belief that the case is going to succeed. Other claimants will be their insurer, explaining what is alleged to have happened worried by the defendant’s denials and may need regular and why it was the defendant’s fault. The defendant reassurance about the strength of their case and the should respond to the letter of claim within three months of acknowledging it. likelihood of it succeeding.

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FINANCIAL & LEGAL WITNESS EVIDENCE As part of the court timetable, the parties will need to exchange witness statements. The claimant may need to provide a witness statement covering the circumstances of the accident and the effect the catastrophic injuries have had on them. For some people, reliving the accident can be very difficult. It can be daunting to see laid out in one place the vast extent to which their lives have changed. For others, it can be cathartic to have the opportunity to set out for people how much their injuries have affected them. The claimant will also hear accounts from witnesses close to them, setting out how they perceive that the claimant has been changed by the accident. This may be tough for a brain injury survivor who doesn’t have good insight into the extent of their injuries and the effect their symptoms have on other people. The claimant will need to see the other side’s witness statements. Again, if liability remains in issue, then it may be hard for the claimant to read potentially radically different accounts of what happened.

EXPERT EVIDENCE The injured person will need to undergo a significant number of medico-legal expert assessments during the case. The more serious the claimant’s injuries are, the more experts they are going to see. The experts on the claimant’s side may be more sympathetic towards the claimant, but they’re still strangers to whom the claimant has to describe intimate and potentially embarrassing symptoms. Their stress may be increased when reading the resulting reports, knowing they are going to be sent to yet more strangers working on behalf of the defendant. The injured person will need to approve the expert evidence in relation to both liability and the value of the claim before it is released to the other side. This can be difficult for people and somewhat daunting. Once that evidence is exchanged with the other side, it may

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be stressful to see experts for the defendant potentially downplaying the claimant’s symptoms.

SETTLEMENT Settlement before trial can be stressful for the claimant. However, it is generally better for both sides to settle before trial. While that means the stress of negotiation is not spread out over a long period, the day of a settlement meeting can be stressful as the claimant knows they are making decisions that will affect them for the rest of their lives. If the claimant feels they have secured a good settlement, it will make it all worthwhile.

TRIAL Trials, although rare, are always stressful for claimants. This is partly down to the extremely formal nature of the trial, which will almost certainly be alien to the injured person and their families. This is partly because there is so much riding on the trial and its outcome, which will not be certain. Again, talking in public about painful memories and intimate details of injuries can be extremely stressful for claimants. Hearing the defendant’s witnesses and experts give evidence can also be difficult. Unfortunately, in many cases, the judge will not provide their judgment immediately at the end of the trial, and it may be some weeks until it is received. That wait can be difficult, but hopefully, the stress of the process will at that point prove to have been worthwhile. Hopefully, this article gives a flavour of the difficulties and stresses that affect seriously injured claimants. It is important that all of us working with such claimants bear in mind the stress points and plan to minimise them.

Contact Stewarts | tel: 020 7822 8000 web: www.stewartslaw.com

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We know you will be worried and have questions and concerns... Our specialist trauma lawyers can help

9 Complex & multiple fractures 9 Fatal accidents & nerve damage 9 Psychological injuries such as PTSD & depression

2021

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Brain & Spinal Cord Injury:

Brain & Spinal Cord Injury: Fighting For What’s Right Brain & Spinal Cord Injury:

Fighting What’s Right Right Fighting For What’s

odge Jones & Allen is one of the UK’s leading specialist law firmisis odgeJones Jones Allen odge &&Allen one of theUK’s UK’sspinal leading dealing with brain and one of the leading specialistsupporting law firm firm cord injuries, specialist law dealing with brain and spinal dealing with brain and spinal clients throughout the cord injuries, injuries, supporting cord personal injury claimssupporting process clients throughout the throughout the for clients over 40 years. Whatever personal injury claims process personal injury claims process you’re ourWhatever team fordealing over 40with, years. for over 40 years. Whatever is onyou’re hand, every hour of dealing with, our team you’re dealing with, our team the day, understand your of is onto hand, every hour is the on day, hand, every hour your of to understand personal situation. If you’ve thepersonal day, to situation. understand your you’ve been injured and don’tIfknow personal situation. If you’ve been injured and don’t know what to do next, we can help.

Specialist brain and spinal cord injury solicitors

Specialist brain Specialist brain and and Our major trauma team, includes spinal cord injury spinal injury solicitors Riffat Yaqub, Ken solicitors Brough and Our major trauma team, includes Anne Sanders, whoteam, workincludes with the Our major trauma Riffat Yaqub,case Ken Brough Riffat Yaqub, Ken Brough and and UK’s leading managers, care Anne Sanders, Sanders, who with Anne whowork work withthe the providers and support groups. We UK’s leading case managers, care UK’s leading case managers, care have a strong track record of providers and support groups. We providershigh and support groups. We securing value have a strong tracksettlements, record of have a compensation strong track payments record of interim securing high value settlements, securing high value settlements, and early access to top-tier interim compensation payments interim compensation and early access to payments top-tier rehabilitation experts, ensuring and early access to top-tier rehabilitation experts, that you are able to getensuring your life rehabilitation experts, ensuring that on youtrack, are able to get your life back as soon as possible. been injured and don’t know what to do next, we can help. that are able to as getpossible. your life backyou on track, as soon to do next, we can help. At what Hodge Jones & Allen we back onchoose track, as soon as possible. Hodge Jones & At Hodge Jones & Allen we People People choose Hodge Jones & understand that suffering a At understand Hodge Jones Allen wea Allen that & suffering because we’re in tune with Allen because in tune with People choosewe’re Hodge Jones & catastrophic brain or spinal cord catastrophic brain or spinal cord understand that suffering a their needs and wellbeing. Care their needs andwe’re wellbeing. Allen because in tuneCare with injury can be andand lifelife always being our primary focus. We injury candevastating be devastating catastrophic brain or spinal cord always being andprimary focus.Care We their needs wellbeing. changing not only for the injured changing notbe only for the injured injury can devastating and life understand understand every and everyinjury injury and always beingthat our primary focus. We party, but for their family situation is unique, so our advice party, but also for for their family changing not also only the injured situation is unique, so our advice understand that every injury and and but friends. Itfor can be difficult also their family situation andparty, friends. It can be difficult andtreatment treatment will onon is unique, sotailored our advice and will be be tailored know where to turn for help. a case by case basis. We will be andto friends. to know where It to can turn be for difficult help. aand treatment be tailored case by casewill basis. We willon be Our team of specialist solicitors on hand to support, guide and knowofwhere to turn for help. a case Ourtoteam specialist solicitors by case basis. We will be hand to support, guide and have a real depth and diversity onrepresent throughout the entire Oura team of specialist solicitors on hand you have depth and diversity to throughout support, guide and of real knowledge, offering personal represent you the entire claims process. have a real depth and diversity of knowledge, offering personal represent you throughout the entire support, guidance and a helping claims process. of knowledge, offering personal claims process. support, guidance and athe helping hand throughout claims Our specialist Deputyship & support, guidance and a helping Mental Capacity team can help & specialist Deputyship hand process. throughout the claims Our specialist Deputyship & hand throughout the claims Our too. They regularlyteam support Mental Capacity canbrain help process. We have always been committed Mental Capacity team can help process. injured the support elderly with Theypatients, regularly brain to fighting for what’s right to too. too. They and regularly brain dementia peoplesupport with learning We have always been committed injured patients, the elderly with Weachieve have always been committed the best possible result injured patients, thetheir elderly with disabilities. They use skills and to fighting for what’s right to dementia and people with learning to for fighting for what’s right to dementia and people with learning you and your loved ones. expertise to manage the affairs achieve best possible result Wethe place our clients at the heart disabilities. achieve the best possible result They use their skillsand and of individuals lacking the capacity disabilities. They use their skills for for you andand your ofyou everything we loved do.lovedones. your ones. expertise to manage the affairs to maketise decisions for themselves experto manage the affairs WeWe place ourour clients atat the place clients theheart heart ofof individuals lacking the capacity capacity and protect their interests. individuals lacking the of everything wewe do.do. of everything totomake for themselves themselves make decisions decisions for and andprotect protect their their interests. interests.

Riffat Yaqub Partner Riffat Yaqub

Riffat Yaqub Partner Partner

Anne Sanders Anne Sanders Partner Anne Sanders

Partner

We’ll help getPartner your life We’ll help get your life back on track

We’ll get your life backhelp on track

We always feel privileged to be back on track We feel privileged part of always an individuals’ personal to be We always feel privileged to be journey want to help make part and of an individuals’ personal part of an individuals’ personal a real difference. The to majority journey and want help make andarewant towith help make ofjourney our cases dealt a a real difference. Theonmajority a real difference. The majority No Win No Fee basis, so there of our cases are dealt with on a our cases are dealtrisk withoron a isofnever any financial No Win No Fee basis, so there No Win No Fee basis, so there burden to you.

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We’ll help you get burden you.the justice you burden totoyou. deserve and make the most of your life. We’ll helpyou you justice We’ll help getget thethe justice youyou

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deserveand andmake make most deserve thethe most of of your life. your life.

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FINANCIAL & LEGAL

What Rehabilitation Can Help BRAIN INJURED PEOPLE LIVE INDEPENDENTLY? Many people with brain injuries live with symptoms that aren’t visible, but need just as much support as those with severe injuries to live independently.

f a person has sustained a brain injury in an accident, many of the lasting consequences, such as behavioural changes and memory loss, can be incurable. So it’s essential they get the help they need to live with these issues as early as possible, so they can enjoy an independent and fulfilling life. But unfortunately, people who often appear to have made a full recovery don’t always manage to get the care they need.

HELPING THE WALKING WOUNDED People with the most severe brain injuries will often be referred to specialist units by their hospital or GP, but the so-called walking wounded may not. These are people who suffered a brain injury and, on the surface, appear to have fully recovered. To help understand if a client is displaying any symptoms of a subtle brain injury, we speak to their partner, loved ones, close family members and friends to fully understand the impact the injury has had upon them and any changes they may have witnessed. It’s an important part of our role as Serious Injury Solicitors to ensure issues such as behavioural changes are identified and addressed, and we’ll work with a case manager, such as a former nurse or occupational therapist, to make this happen. They can visit the injured person and their family, work out their immediate needs and set out what these would cost. This could include replacing work with meaningful activities, such as voluntary work if they’re unable to return to their job. Trained specialists referred to as buddies or enablers may also be brought in, helping them develop interests to fill their time and regain their independence.

with brain injuries are put at the heart of any care plan. A brain injury can have a huge impact even in very stable and loving relationships, so we want to help injured people maintain these connections, and make sure their immediate support network can return to being partners, family members or friends, rather than carers, and rebuild their lives too.

It’s important that the families and loved ones of people with brain injuries are put at the heart of any care plan

HOW SIMPSON MILLAR CAN HELP Our expert Serious Injury Solicitors have a strong network of case managers, who can arrange access to the care, equipment and support needed while a compensation claim is ongoing. We have a strong track record of securing substantial compensation payouts for brain injured people, and helping them access the rehabilitation they need for as long as they need it, which may mean for life. Ultimately, our aim is to help people with brain injuries get back into the position they were in before the accident happened, as much as possible. Matthew Clayton is a Partner and Serious Injury Solicitor, who specialises in helping people who have suffered life changing injuries.

LIVING SAFELY AT HOME An occupational therapist may also be brought in to determine if someone with a brain injury can live safely at home. For instance, if they have memory problems, they may accidentally leave the front door open or the oven turned on, and therefore pose a risk to themselves. The right training and therapy can then be arranged to help them manage any continuing issues. It’s important that the families and loved ones of people

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Our Ourspecialist specialistBrain Brainand andSpinal Spinal Injury InjurySolicitors Solicitorscan canhelp helpyou you get getthe thesupport supportyou youneed. need. This This is is a picture a picture ofof our our client client Lee Lee when when hehe finally finally got got home home toto hishis family family after after spending spending 4 years 4 years in in a brain a brain injury injury unit. unit. HeHe was was seriously seriously injured injured in in a motorcycle a motorcycle accident accident and and could could only only communicate communicate byby squeezing squeezing hishis mother’s mother’s thumb, thumb, but but wewe helped helped him him get get private private treatment, treatment, and and hehe can can now now talk, talk, use use a wheelchair a wheelchair and and walk walk with with a mobility a mobility aid. aid.

“From “From within within days days ofof Lee’s Lee’s accident, accident, Rose Rose Gibson, Gibson, Lee’s Lee’s lawyer, lawyer, said said toto me me ‘I will ‘I will bebe byby your your side side for for this this whole whole journey”. journey”. “She “She certainly certainly has has been. been. OnOn behalf behalf ofof Lee Lee and and allall the the family, family, thank thank you you toto Rose Rose Gibson Gibson and and her her team team atat Simpson Simpson Millar.” Millar.” Lee’s Lee’s Mum Mum Sheila Sheila

Meet Meetour ourexpert expertBrain Brainand andSpinal SpinalInjury InjurySolicitors Solicitors

Rose Rose Gibson Gibson

Matthew Matthew Clayton Clayton

Caroline Caroline Fox Fox

Geoffrey Geoffrey Simpson-Scott Simpson-Scott

0345 0345 357 357 9382 9382

0345 0345 357 357 9350 9350

0345 0345 357 357 9384 9384

0345 0345 357 357 9546 9546

rose.gibson@ rose.gibson@

matthew.clayton@ matthew.clayton@

caroline.fox@ caroline.fox@

Geoffrey.simpson-scott@ Geoffrey.simpson-scott@

simpsonmillar.co.uk simpsonmillar.co.uk

Get Get inin touch touch with with our our specialist specialist team team forfor a free a free claims claims assessment assessment 0808 0808 239 239 1655 1655

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Adam, Liverpool

“My lawyers handled my case brilliantly. I cannot speak highly enough of the services they offer.” + Specialist brain injury, spinal injury and Court of Protection lawyers + Proven track record of high value settlements + Access to top quality rehabilitation + National UK coverage with home and hospital visits

Offices throughout the UK.

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Authorised and Regulated by the Solicitors Regulation Authority.

Managing finances following a brain injury It’s important that the finances and welfare of the most vulnerable members of our society are protected; that’s the job of the Court of Protection. When someone suffers a serious head or brain injury, their mental capacity can be affected and they may no longer be capable of making decisions for themselves. In such cases, a Court can appoint someone to make or help make decisions on their behalf and act in their best interests.

Q: What is a deputy? If someone becomes mentally incapable of handling their welfare and/or their property and financial affairs, and a Lasting Power of Attorney isn’t already in place, it’s necessary for the Court of Protection to appoint a deputy to manage those affairs on their behalf. A deputy looks after the best interests of the person who lacks capacity. The deputy’s responsibilities will include: • Budgeting • Arranging payments • Completing annual reports, accounts and tax returns • Liaising with healthcare and medical professionals • Buying, selling or adapting property • Applying for welfare benefits • Investing damages awards A deputy works closely with the client and, where appropriate, their family. They help them to make as many decisions as possible for themselves, empowering them to manage their own finances where possible.

Q: What do professional deputies do?

Q: What are Personal Injury Trusts?

A professional deputy is an independent and regulated alternative to appointing a family member or a friend. This would usually be a lawyer with specialist expertise in the Court of Protection process, mental capacity law, finances and investments. The professional deputy must act in accordance with the Mental Capacity Act 2005 and their role is very extensive. They’re responsible for liaising with the litigation solicitor during personal injury and clinical negligence claims. They’re also responsible for the budgeting and management of interim payments, agreeing the implementation and recommendations for care, therapies, accommodation, specialist equipment and associated work.

If someone has capacity to manage their finances, they should consider sheltering their award in a Personal Injury Trust (PIT).

Q: What happens when a claim settles?

A PIT provides a way of ensuring that individuals retain their entitlement to means tested benefits after receiving compensation for a personal injury.

Once a claim settles, any compensation award will need to be properly managed and budgeted – and wisely invested. This will require the deputy to advise on investment strategy and to appoint investment advisers. The deputy will review their performance and meet annually with an investment managers to oversee investment and risk strategy of the investments. The deputy will meet at least annually with the client (usually more) and/or his/her family and work closely with all individuals concerned to enable the client to make as many of their own financial decisions as possible.

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If someone claims means-tested benefits, any compensation money they receive may affect their entitlement to benefits and other statutory services. If their compensation, when added to the value of their own capital, exceeds fixed limit (such as money in a bank account, savings or investments), their means-tested benefits will reduce or may stop altogether. The law provides that personal injury compensation money which is held in trust for an individual’s benefit will normally be disregarded when assessing their entitlement to benefits such as Income Support, Tax Credits, Housing Benefit or Council Tax Benefit.

A well-drafted trust deed with supporting advice is a must in these circumstances.

Offices throughout the UK.

0330 912 2306 slatergordon.co.uk

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OUR SERVICES Home Rehab Therapists is a leading rehabilitation provider specialising in outreach packages that include Physiotherapy, Occupational Therapy, Speech and Language Therapy, Neuropsychology and Medical Services. We offer an evidencebased approach to rehabilitation. Our priority is to respect your needs and collaboratively identify your goals and rehabilitation objectives to ensure a successful and realistic outcome.

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Founder, Director & Case Manager Specialist Quality Case Management for Children & Young Adults with Brain Injury and Other Neurological Conditions. Regulated by the Care Quality Commission and registered with the British Association of Brain Injury Case Managers.

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Supporting people with brain or spinal injury to live at home

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AtWe Eximius provide highly trained, dedicated carers so someone workwewith case managers, healthlive-in professionals and who is recovering from afamilies life changing livingall with a long-term condition return safely to their own homes to accident ensureorthat aspects of care andcan clinical with outstanding care support in place. Whether you are a Case manager, health professional, support areormanaged to create a care, bespoke care family member anyone looking for clinical then talk to usplan. about All how we might help.

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Pain management Siobhan McSweeney Respiratory care (including tracheostomy and ventilation) TissueRM. viability RGN, We createManager a bespoke care plan based on the actual needs of the individual, both physical and emotional. Case We then identify a suitable carer, or it may need a team, including hoisting and night care. We can even Nursing Consultant arrange housing for the care team nearby to a clients home, to ensure that the client can protect their privacy and family space, while still receiving safe and exceptional support.

We have established antoexcellent foryou. Please call us for a confidential chat see if we’re thereputation right company for successfully helping our clients with acquired brain injuries, cerebral palsy and spinal injuries.

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PERSONAL PROFILES

Specialists in Court of Protection and professional deputyships

Specialists in personal injury and medical negligence

Offices throughout the UK

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Authorised and Regulated by the Solicitors Regulation Authority.

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PHYSIOCARE REHAB Ltd PHYSIOCARE REHAB Ltd Helping toreach reachyour full potential Helpingyou you grow to your full potential Physiocare Rehab specialises in the assessment and Physiocare Rehab specialises in the assessment and rehabilitation of rehabilitation of traumatic brain injury, vestibular and traumatic brain vestibular and balance disorders and complex balance disorders andinjury, complex neurological conditions.

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We have a specialist concussion clinic delivering We have a specialist concussion clinic delivering the internationally the internationally acclaimed Complete Concussion acclaimed Complete Concussion Management Programme (CCMI), concussion Management Programme (CCMI), concussion education and training. education and training. T: 07814 823602 07814 823602 E: info@physiocarerehab.co.uk W: www.physiocarerehab.co.uk

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PERSONAL PROFILES

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We are a team of Community Physiotherapists and Occupational Therapists. Led by Susan Pattison, we specialise in Acquired Brain Injury, Spinal Cord Injury and other Complex Injuries in local regions such as Greater Manchester/Lancashire, Cheshire, and South and West Yorkshire. +44 (0) 161 764 3799 info@sptherapyservices.co.uk www.sptherapyservices.co.uk @SPTherapySvcs @SPTherapySvcs

Norman Kenvyn Founder & CEO

VFS can provide immediate funding against your issued bill of costs or when you have a case with admitted liability. +44 (0) 20 3747 9333 +44 (0) 7748 963 965 enquiries@vfslegal.com vfslegal.com

Veronika Thompson BSc Hons Occupational Therapy

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USEFUL CONTACTS

Brain & Spinal Injury CONTACT INFORMATION Support groups, charities and other useful contacts and organisations across the UK. Vocational Rehabilitation Association UK

The VRA represents all those involved in delivering vocational rehabilitation services. A number of professional groups are involved from both health (NHS and private) and other government agencies e.g. the Department for Work and Pensions. www.vrassociationuk.com

Brain Injury Rehabilitation Trust (BIRT)

BIRT is a division of The Disabilities Trust, a leading charity that provides services to people with physical and learning disabilities, autism and brain injury. The Brain Injury Rehabilitation Trust (BIRT) aims to provide the best quality neurobehavioural rehabilitation for people with complex and challenging needs after brain injury. www.thedtgroup.org/braininjury

Brain Injury Hub

Online support centre for the families of children affected by acquired brain injury created by The Children’s Trust. www.braininjuryhub.co.uk

Brain & Spine Foundation

Provides support and quality information to people affected by brain and spine conditions, in order to reduce anxiety and help inform their choices. A free helpline is staffed by neuroscience nurses to answer questions about all neurological conditions and offer information and support on any medical and emotional issues. Helpline Number 0808 808 1000 www.brainandspine.org.uk

Carers UK

An excellent source of information, advice and support, this charity is at the forefront of campaigning for carers. www.carersuk.org

The Children’s Trust

A national charity, The Children’s Trust provides care, education, therapy and rehabilitation to children with acquired brain injury, multiple disabilities and complex health needs. It runs the UK’s largest paediatric brain injury rehabilitation centre at Tadworth (Surrey), and services include nationwide support in the community for children and young people with acquired brain injury. www.thechildrenstrust.org.uk

Child Brain Injury Trust (CBIT)

A leading charity providing non-medical services and support, including a telephone helpline, for families. CBIT also provides training for health and social care professionals working with families. Helpline Number 0303 303 2248. www.childbraininjurytrust.org.uk

Headway

A national brain injury charity that promotes understanding of all aspects of brain injury and provides information, support and services to brain injured people, their families and carers. Headway also operates a regional network of branches and support groups. www.headway.org.uk

The United Kingdom Acquired Brain Injury Forum (UKABIF)

The United Kingdom Acquired Brain Injury Forum (UKABIF) is a membership organisation and charity which aims to promote the understanding of all aspects of acquired brain injury. There are also regional groups throughout the UK, and UKABIF works with these groups to set common aims, encourage sharing of information and practice and co-ordinate group work. www.ukabif.org.uk

Spinal Injuries Association (SIA)

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Spinal Injuries Association (SIA) are a charity that provides information and support to spinal cord injured people, their families and health care professionals. www.spinal.co.uk sevenstarmedia.co.uk

USEFUL CONTACTS

Association of Personal

Injury Lawyers (APIL) Association of Personal Injury Lawyers (APIL) is an independent, not for profit organisation providing accreditation to lawyers specialising in the area of personal injury law. Website includes a directory of accredited solicitors. www.apil.org.uk

British Association of Brain Injury Case Managers (BABICM)

British Association of Brain Injury Case Managers (BABICM) is a professional association that was established in 1996 to promote the development of case management in the field of acquired brain injury. www.babicm.org

Law Society

Law Society is the professional association that represents and governs solicitors for the jurisdiction of England and Wales. It provides services and support to practising and training solicitors, as well as serving as a sounding board for law reform. www.lawsociety.org.uk

The Case Management Society UK (CMSUK)

The Backup Trust

The Backup Trust provides support services for people of all ages with spinal cord injury. Services include wheelchair skills training, activity courses, mentoring and support to get back to work or school after an injury. www.backuptrust.org.uk

Aspire

Aspire works with people with a spinal cord injury to create opportunity, choice and independence. They aim to support people to lead a fulfilled and independent life from the moment of their injury throughout their life. They are also committed to research in the field of technology to find cost effective solutions to improve the quality of disabled people’s lives. www.aspire.org.uk sevenstarmedia.co.uk

The Case Management Society UK (CMSUK) is a non-profit association of Case Managers, committed to the delivery of quality case management through standards of best practice while promoting the individual and collective development of case management throughout the United Kingdom. www.cmsuk.org

The Neurological Alliance

The Neurological Alliance is a wide range of neurological charities which have come together to make life better for people in the UK with a neurological condition. Their aim is to raise awareness of neurological conditions and their impact; inform and influence policy makers about the needs of people with neurological conditions; secure the highest standards of service and improved care for people with neurological conditions; promote research and the dissemination of information about neurological conditions. www.neural.org.uk

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RAISING AWARENESS IN SCHOOLS Tyler was diagnosed with a brain tumour at the age of eight. Following surgery, chemotherapy and radiotherapy, Tyler was doing well and had returned to school.

A VERY SPECIAL THANK-’YOU’

As Tyler transitioned to secondary school, her difficulties with memory, fatigue, concentration, and balance became more apparent. She felt increasingly isolated and was quickly losing confidence.

to all our contributors The Children’s Trust online awareness course helps to ensure teachers know what to look out for, and what assistance children might need in class to help them to continue to develop and learn.

Disclaimer: Brain & Spinal Injury Handbook is published annually (once per annum) by Seven Star Media Ltd. No part of Brain & Spinal Injury Handbook may be reproduced, stored in a retrieval system or transmitted to any form without permission. Views expressed in the publication are not necessarily those of Seven Star Media Ltd, and are included to provide advice only. No content is a substitute for professional medical advice. During printing, images may be subject to a 15% variation. © Copyright of content belongs to individual contributors with the publication copyright belonging to Seven Star Media Ltd. All rights reserved. Please either keep this magazine for future reference, pass it on for somebody else to read, or recycle it.

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Brain & Spinal Injury Handbook- 21/22

Articles inside

A very special thank-you to all our contributors

Brain & spinal injury contact information

Personal Profiles

Managing finances following a brain injury

What rehabilitation can help brain injured people live independently?

Brain & spinal cord injury: Fighting for what’s right

Stress points in catastrophic injury litigation

Expert pre settlement - IFA services

A rehab-focused approach to damages

Why the Serious Injury Team at No5 Barristers’ Chambers prides itself on strength in depth

Get 79 leading experts working for you

Reject Alternative Dispute Resolution at your peril

Can the Court of Protection save my means-tested benefits after I inherit?

Release the cash you have tied up in your ongoing cases

Home Semen Retrieval: Ferticare 2.0 is back

One more step on the road to independence

Brotherwood case study - Ford Tourneo Connect

How to find the perfect chair?

Historical merged with contemporary - Moving accessibly between the centuries

The health & wellbeing benefits of a homelift

DIETZ Power – A masterpiece of empathy

Assistive technology provision: Matching the user with the right technology

Why manage posture?

Outstanding live-in care for clients with clinical needs

Vibrations and shocks during manual wheelchair propulsion

Superior Healthcare: The road accident that changed everything

National Nuerological Services - A division of the National Care Group

Health And Social Care Services - Changing lives, one at a time

EnViva complex care

Better quality of care for a better quality of life

Complete Care Amegreen - Exceptional care for exceptional people

Promoting mental health as well as physical wellbeing

Jane James and Associates has been medico-legal reporting for over 35 years

MSP Case Management

Traumatic brain injury (TBI) and the hidden losses in families

Expert rehabilitation case management services

Anglia Case Management (ACM

Maintaining client care standards - How to plan for a transition during a pandemic

“Reflections on a year like no other – Adapting case management during a pandemic”

A person-centred approach to rehabilitation

Struggling to find trained, rehabilitation assistants who have something special?

Be more child-like to remove the barriers

BABICM celebrates its 25th anniversary

As a specialist case management service, what makes Emma Way Associates different?

“I’m so dizzy – My head is spinning”

What makes LDCM different

Family Focused Interventions - What happens when we bolster family resilience?

A unique approach to finding and adapting a home

Richardson Care’s unique brain injury care and rehabilitation

Getting a grip on making rehab fun

Complete Neuro Rehab - Helping you feel like... you

Think Therapy 1st - A brain injury case study

The Mental Capacity Act, deputyship and empowerment - The impact on occupational engagement

Improving rehabilitation outcomes… Is food and nutrition the missing link?

How to eat well with swallowing difficulties

New brain injury awareness programme to support teachers and school staff

Dedicated rehabilitation creating happiness daily

The benefits of using hydro/aquatic therapy to treat neurological conditions

UKABIF continues to drive change

The Spinal Injuries Association leads the way in supporting people with spinal cord injuries

How arts therapies can support the mental health of brain injury survivors

STEPS has just got even better! New world-leading rehabilitation technology now available

Specialist rehabilitation after a brain or spinal injury