Why our care homes are in Northampton

We have six specialist residential care homes: three for adults with learning disabilities and three for adults with acquired brain injuries, and all of our homes cater for people who present with behaviour that challenges and have complex needs. All of our homes are located within a few miles of each other in Northampton, and we are often asked why this is the case.

The answer is two-fold. Firstly, Northampton is our home town. My parents started the business back in 1989 when they looked after service users with learning disabilities in their own home, and it grew from there. Having all the homes in Northampton means that we can more be aware of what’s happening in each one. As the owners of the business, we need to ensure its long-term sustainability and that we remain true to our values and objectives. We also need to be confident that we are providing a high-quality service on a day-to-day basis. Being close by helps us to stay in touch with what’s happening in each home. Too many care companies are owned by private equity firms, who view success in terms of profit alone, and not by the welfare and achievements of the people in their care.

Belonging to a community

Having the homes located close together also means that they share resources more easily: members of our multi-disciplinary team of therapists work with service users in all of our homes, so they are much more accessible. In addition, we can provide greater opportunities to service users. They can get together for activities such as short-mat bowling, live music events or parties. It helps them to feel part of a bigger community, increasing social interaction and building confidence.

A hub for neuro specialists

Secondly, Northampton has evolved as a hub for the treatment and care of people with neurological conditions, particularly brain injuries. Consequently, there is a high concentration of specialist care providers for people with acquired brain injuries, learning disabilities or mental health needs. This means that there is a range of a care options to suit individual needs, and The Richardson Partnership for Care forms part of the care pathway. We can also work in partnership with other support services if crisis care is required, providing continuity for service users and improving outcomes.

This specialism in the neurosciences and related care draws neuro experts to Northampton, which also means that there is a larger pool of talented and experienced people in this area. This makes it easier to recruit the right people to deliver the high-quality support that we provide.

Maintaining family relationships

In addition, Northampton’s location in the centre of England, and at the heart of the motorway network, makes it easy to access from most parts of the country. However, we appreciate that many families may still find it difficult to visit their loved ones in our homes. We can therefore include supported home visits as part of the individual’s care plan. This helps them to maintain or rebuild their relationship with their family, which is important for their well-being.

Person-centred care

Although there are many benefits to being in Northampton, we believe that location is just one of a range of factors to consider. What is best for the individual is what counts – the care and therapy provided, the environment, the community and the opportunities for social inclusion and fulfilment. Placing the service user at the centre of the decision-making process is crucial.

Psychology services for adults with complex needs

The psychology team at The Richardson Partnership for Care plays a crucial role in the care and support of our service users, who have complex needs and acquired brain injuries or learning disabilities. Dr Pedro Areias Grilo, Consultant Clinical Neuropsychologist, heads up the team and is supported by three Assistant Psychologists: Julita Frackowska, Olivia Ferrie and Joseph Szablowski. The Assistant Psychologists are assigned to specific service users according to their needs and the homes in which they live.

Person-centred care
The ethos of the psychology team is the one that runs through the organisation as a whole: the service user is at the centre of everything we do. We are committed to providing individualised care to effectively support the nuanced needs of each service user. We take a person-centred approach and offer interventions to service users based on cognitive behavioural models, dialectical behaviour skills and operant conditioning. All of the interventions offered are evidence-based and follow NICE guidelines.

Psychological reviews
All service users receive an initial psychological review, which includes neuropsychological assessments, a review of clinical presentation, assessment of stability of mood and suggestions for future interventions. This review is then repeated on a regular basis to assess the effectiveness of the therapies and interventions delivered. In addition, we have an ‘open door’ policy at The Richardson Partnership for Care, so all members of the psychology team, and the Assistant Psychologists in particular, can develop close working relationships with the service users. This means that their well-being can be monitored closely on an informal basis and we have found that this helps to maintain their mental health, so any problems can be addressed early, preventing the need for crisis care.

Positive Behaviour Support
Positive Behaviour Support (PBS) is a key part of the psychological support that we provide and an emphasis on positivity is one of our main philosophies. PBS Plans are person-centred and designed with input from the service user to promote positive behaviour. They are supported to set their own goals and to achieve them.

In addition, Pedro and the team are working on an innovative Positive Behaviour Tool to more effectively monitor and encourage positive behaviour. This runs alongside the traditional techniques of reducing negative behaviour.

Multi-Disciplinary Team
The psychology team works closely with the other members of the multi-disciplinary team. (This comprises a consultant neuropsychiatrist, homes managers, service manager, physiotherapist, speech & language therapist and occupational therapist.) Pedro and Consultant Neuropsychiatrist, Dr Seth Mensah, work closely together to balance the use of drug therapies and psychosocial therapies. Where possible, we aim to focus on psychosocial approaches and gradually reduce the reliance on drug therapy to achieve better outcomes for service users over the longer term.

A diagram explaining the psychology services at The Richardson Partnership for Care
A summary of the psychology services offered at The Richardson Partnership for Care

Community participation and well-being

Activities for service users with learning disabilities and acquired brain injuries

With Spring in the air, we are looking forward to longer days and better weather. However, even in the winter, we have a varied range of activities for our service users. Community participation and presence are two of the key principles that underpin our organisation. We take positive steps to enable service users to integrate into the local community and build culturally-valued relationships, and we do this in a number of ways.

Our care home at 23 Duston Road, Northampton, accommodates ten adults with learning disabilities, acquired brain injuries or a dual diagnosis. In addition, service users have complex needs and may present with behaviour that challenges. Here is a brief list of some of the activities that they did, supported by their care workers, in January and February this year.

  • Walk into the village centre, visit local shops
  • Drive out and walk around garden centre
  • Visit local park, café and mini zoo
  • Singing in the music room, karaoke at Care with a Difference
  • In-house board games and movies
  • Trip to the cinema
  • Trampolining, swimming, working out at the gym
  • Ten-pin bowling, short-mat bowling
  • Card making at Headway
  • Dancing at the Rock Club disco
  • Shopping for clothes and toiletries
  • Visiting the library, visiting the museum
  • Meals out, pub lunches
  • Supported visit to see family in London

Many of these activities anyone would do at a weekend or part of their daily life: they are not particularly unusual. However, for someone who has previously been living in a hospital or institutional setting, they are a big step forward in their quality of life and an important part of their care plan.

For someone with learning disabilities and complex needs, managing their anxiety sufficiently for them go on a shopping trip and enjoy other people’s company has a very positive impact on their well-being. And for someone with an acquired brain injury, just being able to do some of the things that they did before their injury can be an important step. It is part of our focus on ‘normalisation’, enabling our service users to live as close to a normal life as possible and to improve their emotional well-being.

In addition, these activities benefit service users in several different ways:

  • Physical activity improves fitness as well as having a positive impact on mental health
  • Decision making – we respect each person’s individuality and support them in making their own choices
  • Skills development – craft activities improve dexterity and creativity, while developing skills in any area increases confidence
  • Reducing anxiety – gradually increasing the range of activities an individual undertakes, while helping them to develop their own awareness and coping strategies, reduces anxiety and improves their quality of life.

For more information about how our services improve the lives of service users with learning disabilities, acquired brain injuries and complex needs, see our case studies

Brain injury rehabilitation – Kay’s story

Kay - brain injury survivor

Kay has transformed her life with the help of the MDT and support staff at The Richardson Partnership for Care

When she was only 18 months old, Kay contracted Encephalitis and consequently experienced severe epilepsy. At the age of 13, she underwent surgery on her frontal lobe, which further exacerbated the brain damage. Kay also has a diagnosis of moderate learning disability.

Kay lived at home with her mother and grandmother before moving to specialist residential schools and other settings. At the age of 27, Kay moved to The Mews at The Richardson Partnership for Care. She had previously resided in a private hospital, but the placement broke down due to her risk behaviours and the inability to manage Kay in that environment.

Behaviour on Admission to The Richardson Partnership for Care
Kay’s challenging behaviour was thought to be underpinned by poor impulsivity control and a reactive approach to challenging situations due to her brain injury.

On admission, Kay presented with severe verbal and physical aggression towards herself and others. She also would make false allegations towards staff and other residents, disregarding staff prompts and instructions compromising her and others’ overall safety.

Kay was offered a holistic approach to help her to manage her challenging behaviour and become more self-aware. With the support of the multi-disciplinary team at The Richardson Partnership for Care and her care support workers, Kay has transformed her quality of life.

Read Kay’s brain injury rehabilitation case study in full here

Sad news and tribute to Brian Richardson

Brian Richardson

Brian Richardson

This month we pay tribute to my dad, Brian Richardson, who has died after a short illness: He was diagnosed with Lymphoma in his brain in April this year. Brian was the driving force behind The Richardson Partnership for Care, which he founded with my mum, Jackie, in 1989.

Brian was an amazing man who touched the lives and hearts of so many people. He was born on Christmas Eve 1949 and grew up in humble surroundings in Northampton with his parents and two brothers. His entrepreneurial spirit was evident from a young age when he would devise enterprising schemes, which included repairing motorbikes on the lawn in front of the family home.

After leaving school Brian attended the newly opened Nene College in Northampton and qualified as a teacher, however he didn’t quite fit into the teaching world. Instead he came home with a teenage student who desperately needed short-term foster care and that was the beginning of his career as a carer.

Brian and Jackie started The Richardson Partnership for Care in their own home, caring for people with learning disabilities. In fact, two of the people that they looked after then are still residents in our care homes now, almost thirty years later. They built up the business with love, sheer hard work, determination and dedication; qualities that Brian also displayed in his personal and social life.

Brian and Jackie grew the business by buying up properties in Northampton to enable them to care for more people. They also recognised there was a need for specialist residential care and rehabilitation for people with acquired brain injuries, so extended the services to care for them too. I grew up in the business and have worked full time for The Richardson Partnership for Care since leaving school. Around 15-20 years ago, I was appointed a Director, and Brian and Jackie gradually stepped down from the day to day running of the business, handing over to me and my husband Greg.

The Richardson Partnership for Care is very much Brian’s legacy. He and Jackie established it to feel more like a family than a business. Brian was more than a boss to his employees – he was a true friend and a gentleman. He was known for his generosity, often helping people out when they didn’t expect it and investing in their personal development. He gave them the skills and the freedom to move on, but many of the staff chose to stay. This is still the case today.

Part of Brian’s legacy is also the ethos of The Richardson Partnership for Care and its commitment to providing a warm, friendly and positive environment for people with learning disabilities and acquired brain injuries. They are treated with dignity and respect and we aim to support them to realise their potential and live a fulfilling life.
Brian was a man who lived life to the full. He had many friends and a wide range of interests. As a youngster he would go to the Salon ballroom with his parents where he achieved gold medals for Ballroom and Latin American Dancing, and in later years he would love to Rock and Roll and Salsa with Jackie and Laura. He also loved the outdoors: he enjoyed walking and fishing, but his great passion was stalking and shooting. He was also a confident and extremely competent diver, as well as fast and enthusiastic skier. He was a risk-taker and had a reputation for a having a dare-devil attitude, which is perhaps why he was so much fun.

Brian was a warm and generous host and loved cooking for friends and family. He has been described as kind, caring, friendly, funny, a life-long friend, supportive, great company, interesting, intelligent, daring, obstinate and even, eccentric. We will miss him dearly, but we endeavour to maintain the ethos and vision for The Richardson Partnership for Care that Brian and Jackie established.

Summer holidays and activities

The excitement has been building as the holiday season is now well underway and we’ve had weeks of glorious sunshine. Holidays are planned months in advance and our service users, who have acquired brain injuries, or learning disabilities and complex needs, are supported in choosing where they would like to go.

Wherever possible, we try to accommodate specific requests for holiday destinations and they are financed by accruing a certain amount each month then topped up if someone needs something extra. Service users go away in small groups or individually, depending on their needs and preferences. They are supported by their care workers and they are involved in the decisions on who accompanies them.

Our service users enjoy the activities, atmosphere and the change in environment that a holiday brings. Some people need familiarity and routine so we balance this with the opportunity for enjoying new experiences. This year, some of our service users have been on a boat or seen the sea for the first time. Going on holiday is paramount to their health and well-being and is instrumental in their social inclusion and positive feelings of self-worth. There are also physical benefits of being outside and taking part in new activities.

This year popular holiday destinations include the Isle of Wight, Hemsby in Norfolk and Skegness in Lincolnshire – which is also close enough for a day trip. Billing Aquadrome is a local holiday park with good facilities, which is popular as it combines a change of scene and a relaxed holiday environment with a very convenient location. In addition, one service user has enjoyed a weekend trip to Blackpool, and others have visited their respective families in Malta and Serbia. We’ve also enjoyed day trips to London, the coast, zoos and country parks. Summer activities have also included trampolining and swimming, and one of our service users went to a David Byrne concert in London. We support our service users to lead a fulfilling and active life as possible.

A boat moored off the Norfolk Coast

Importance of location when placing someone in residential care

The front of 2 Kingsthorpe Grove

Location is often one of the first considerations when placing someone in residential care – so that they can be close to friends and family – but it’s not necessarily the most important. It’s usually a combination of factors that contribute to the quality of the care provided that takes precedent over the location. This is especially true of specialist residential care and rehabilitation for adults with acquired brain injuries, learning disabilities, complex needs and behaviour that challenges – there simply aren’t the facilities available across the country to meet local needs.

The Richardson Partnership for Care is located in Northampton – we’re in the centre of the country and have good road and rail links, so easily accessible for families to visit. We welcome visits to our care homes but these are not always practical, especially if family members work full-time, have children to look after or are elderly. Or they may have a long way to travel – our service users come from all over the UK as well Ireland and Eastern Europe.

Supported home visits
We believe that family contact is very important for our service users’ well-being so we include regular supported home visits when devising each individual’s care plan. Our care support staff arrange their transport and accompany them on their journey (overseas if necessary) and often continue to support them in their family home during their stay. If it’s not practical for individuals to stay with their relatives, then we arrange accommodation for them. This provides valuable assistance to the families too, helping them to enjoy the time spent with their loved one.

Video calls
As well as phone calls, we also use online applications and video calls to help service users and their families keep in touch – this can enhance communication for people with speech and language difficulties, making them easier to understand. It also means that their families get to see them and become more involved and reassured about their care.

We also use video calls to enable family members to participate in the review process. Our service users have an external review every 12 months where their care team and case workers review their care plan and discuss their progress. The service user can choose whether or not they take part in the review, but under The Care Act 2014, reviews must be attended by a family member or advocate.

A video call enables family members to take part in a review when they may have otherwise been unable to perhaps due to other family or work commitments. They can contribute fully to all areas discussed, see and hear the review team and ask questions as well as providing their thoughts and feelings on the care package.

If the service user declines to take part in the review, they can still have a video call with their family afterwards and speak with their care manager and review coordinator about what happened in the review.

Local environment
The immediate local environment can have a greater impact on someone’s day to day wellbeing than where they are located in the country. For example, all of our homes are situated in areas within easy reach of the town centre, but with their own communities. This means that we can visit local shops, pubs, cafes and leisure facilities and benefit from the friendly and personal service that they provide. We have found that some service users with acquired brain injuries and/or complex needs, on arrival at The Richardson Partnership for Care, have not accessed local communities for years. We facilitate and actively encourage service users to access local facilities as it is an important part of their well-being, rehabilitation and progress towards independence.

Centre of excellence
Due to historical factors, Northampton has evolved to become a centre of excellence in brain injury rehabilitation. This draws neurological experts to Northampton, which means that we have a larger pool of talented and experienced professionals in the area enabling us to deliver high quality rehabilitation care and support. We work in partnership with other support services if crisis care is required, providing continuity and orientation for service users and improving outcomes.

So, although location may be a starting point when placing someone in residential care or for residential rehabilitation, geographical distances can be overcome. It’s the quality of care, well-being and outcomes for service users that should take priority. We also find that in some cases, after a period of specialist rehabilitation, service users require less intensive support and are therefore able to go and live closer to their families.

Bowls sessions provide a range of benefits

One of the most popular activities that we arrange in-house for our service users is the weekly bowling sessions that we hold in the main hall at The Mews each Monday.

We are fortunate to have Duggie Mitchell on our team, who is an experienced bowling instructor and has played competitive bowls for 35 years with success at Club, County and National levels. Duggie joined the board of Disability Bowls England in 2016 and continues to be inspired by the achievements of people with disabilities. His experience, skill and enthusiasm for the game as well as his empathy with the service users have contributed to the success of the sessions. Duggie is assisted by Lisa Hutchins, the Administrator at 144 Boughton Green Road, who helps with the organisation and keeps the score.

Bowling adapted to suit the players
The format of the game is Short Mat Bowling, which is very similar to Carpet Bowling. A mat 45 feet long and 6 feet wide is laid out in the main hall with guards at either end to stop the bowls running too far. A jack is placed at one end of the mat and each player uses weighted bowls to try and hit the jack. We have adapted the rules to meet the cognition needs and suit the various abilities of the players. They bowl eight balls each and Lisa records the number of ‘strikes’. People from all of our homes join in and we have a league in which around 20 players take part. One of our service users who is blind has mastered bowling very successfully. Other service users come along to watch and support, and it’s a lively, social occasion with lots of cheering.

Key benefits to individuals
What may just look like a leisure activity is actually an important element of our service users’ care. As well as being very enjoyable, the bowling sessions also help to improve:

Physical strength and dexterity
Co-ordination
Cognition and communication
Motivation and self-esteem
Social Skills

Duggie has been running the sessions for around two years and new players can join in at any time. He has noticed significant improvements in some of the participants and says: “I have seen so much change in many of the group since we started: going from little or no eye contact or verbal communication in the early days to total interaction and response. My partner and I went along to the Christmas party recently and it was lovely to have them recognise us and want us to join them dancing.”

Thank you to Duggie and Lisa for their help and commitment to these sessions. They have contributed to some significant improvement and much enjoyment for our service users.

Duggie Mitchell demonstrating short mat bowls

Duggie Mitchell demonstrating short mat bowls

Christmas activities in our care homes

Throughout the year we have a wide range of activities for our service users with acquired brain injuries or learning disabilities to enjoy, but at Christmas this is especially important. While many service users go and stay with their families at Christmas, we want to make the day special for those who remain with us over the festive period.

Christmas activities are discussed and planned with service users in their regular house meetings, so they can decide (with support as required) what they would like to do.

This year, Sallie Maris, our Arts & Crafts lady will be ‘chief elf’ when it comes to making Christmas decorations. She will be supporting her helpers to make Christmas bunting and mobiles. Not only is this very enjoyable, it is an important part of our ongoing support and rehabilitation programme, helping people to improve their concentration and dexterity, learn new skills, give them a sense of achievement and satisfaction and increase their self-esteem. We will be using the decorations in each home, as well as for the joint Christmas party on 20th December.

Making a Christmas star

Having a large hall in The Mews enables us to provide opportunities for service users and staff from all of the homes to get together for social events. We hold short-mat bowls sessions in the hall, usually once a week, and monthly music sessions with Simon the Sax. It’s also a great place to hold the joint Christmas party and we have a travelling theatre group coming to perform The Wizard of Oz here for us.

There are lots of trips to see Aladdin at the theatre in Northampton as well as various Christmas dinners taking place – going out to the local pub for lunch, plus Rock Club (service users get together for social activities from three different organisations) and the Headway Christmas lunch. Also, the staff in each home will be coming in on Christmas Day to cook lunch and a former service user from one of our homes has been invited back to spend the day with some of his old friends.

We’ve also been baking gingerbread and other tasty treats. And our home at 23 Duston Road has a new karaoke machine, so there will plenty of singing, as well as various games to play, watching Christmas films and DVDs and going out for a Christmas Day walk, weather permitting.

From all of us at The Richardson Partnership for Care, we would like to wish you a happy and peaceful Christmas and all the best for 2018.

 

Satisfaction survey: our care home residents

Adults with acquired brain injuries, learning disabilities and complex needs

In addition to surveying the families of service users in our care on an annual basis, we also complete a questionnaire with the individuals themselves, which asks specific questions about different aspects of their lives within the care home. They are asked to respond using a satisfaction rating of 0 – 4 where 4 is the most satisfied. All of our service users have complex needs and some are unable to answer the questions, so staff either help them to answer the questions or observe their behaviours to ascertain their needs.

The results from each individual are combined to give average scores, which are shown below. There are up to five questions in each section, so the totals show an indication of satisfaction in each area.

However, as every person is different, and has different needs, our approach is always individualised, person-centred care.

bar chart showing satisfaction survey results

Service user satisfaction survey results 2017

The following gives you more information about the specific areas covered in the satisfaction survey.

Know how to complain
This question assesses how well the individual knows what to do if they have a complaint. The average overall score across the homes was 3.63 out of 4. It excludes the individuals who were unable to understand the question.

People you live with
This is very important to all of our service users, and satisfaction ratings can vary according to the type of care home as stable populations with long term residents tend to have a higher satisfaction rating. The Mews, which focuses on short-term intensive rehabilitation for adults with acquired brain injuries, naturally has more of a changing population. This can affect the dynamics of relationships between the residents. We work hard to ensure that any incoming service users will not upset the balance in any care home and we continually review our admissions policy to ensure that we receive sufficient information in advance of a full assessment of any potential new residents.

There is very much a family environment within our care homes, and many strong friendships develop between individuals. However, like a family, it doesn’t mean that everyone gets on well with everyone else all the time. Therefore it is important that we focus on relationships between individuals and use mediation and psychology to manage any disagreements. As a last resort, we can move individuals into another of our homes but this is rarely necessary.

Decision making
These questions covered how involved people feel in decisions relating to their care plan and risk assessments as well as making choices in their everyday lives.

Staffing
These questions ascertain how well service users know the support staff in their home and how they feel that they are treated by them: whether the staff are approachable, as well as whether they would like to be involved in the interview process. Many service users said that they would not want to be involved, which has reduced the average score.

Food and drink
As well as being asked about their choice of food and their cultural needs, individuals were also asked about how involved they wanted to be in menu planning and food preparation.

Activities
Many of these questions were qualitative: describing current activities undertaken or potential new ones, so a numerical score was not given. The activities that we provide are very much tailored to the individual and if something is requested but not achievable or affordable then we explore alternatives.

Environment
These questions simply asked how satisfied service users are with the communal areas of the home, the garden and their room.