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

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

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.

 

Structured skills development for adults with learning difficulties

In May 2012, The Richardson Partnership for Care became an officially-recognised accreditation centre with ASDAN – the Awards Scheme Development Accreditation Network. The organisation provides courses to thousands of training providers, which offer flexible ways to accredit skills development and enrichment activities.

For service users with learning difficulties, ASDAN offers the flexibility to complete modules in different ways according to each individual’s abilities, preferences and concentration levels. It also means that service users can gain accredited qualifications in a familiar environment, working with people that they know and trust.  Receiving a certificate for their efforts also provides a sense of achievement and fulfilment, which often encourages them to progress to further learning and qualifications.

As Arts & Crafts is a popular activity within our homes for adults with learning difficulties, we started the ASDAN programme with the Creativity module. This has led onto modules in Independent Living (Introduction and Progression levels) and Numeracy Skills (Introduction and Progression levels). Sallie Maris, our ASDAN Co-ordinator finds creative ways to encourage the service users to participate in the modules and gain new skills. For example, learning numeracy skills may involve baking a cake, dividing it into segments and sharing it with others. We are now starting modules called ‘Myself and Others’ and ‘Personal Care Routines’.

Evidence must be provided for each task and assessments for each module are independently verified. Each individual is awarded a ‘grade’ for their module as follows: Experience recorded, Sensory experience, Physical help, Spoken help, No help. These ‘grades’ ensure that people with disabilities can still be treated fairly and their qualifications properly accredited.

The scatter diagram below shows the ASDAN qualifications obtained by service users with learning difficulties in Creativity and Independent Living, where 1 represents ‘Experience Recorded’ and 5 represents ‘No Help’.

ASDAN awards for adults with learning difficulties

John enjoys his first ever holiday

We’ll soon be holding a birthday party at a local pub for John, one of our service users. That may not sound unusual, but on this occasion it is. John has been in our care for over 20 years and has rarely chosen to go out. He has learning disabilities and complex needs and he presented with very challenging and aggressive behaviour when he first came to us.

John has also achieved another major milestone – taking his first ever holiday when he went to the seaside town of Skegness in Lincolnshire for four days. He was supported by Selina, a review co-ordinator at The Richardson Partnership for Care, with whom he has a great rapport.

Skegness beachIt has taken years of hard work and consistent support from our trans-disciplinary team of therapists and our care support workers to enable John to develop his confidence and control his behaviour in order to take this huge step. To help him experience and enjoy the holiday as much as possible, it was booked at short notice. He chose where he went and who he wanted to accompany and support him. During the holiday he was in full control of what he did.

Dr Mick Clarke, a close family member of John said: “John is having the best care he has ever received and your professional and devoted work with him has enabled him to grow in confidence and become a happy man.”

“Selina’s total commitment to him has supported him to the extent that he has finally been able to go on holiday. Your team at the Richardson Partnership for Care has allowed him to blossom into the lovely caring man that was always there.”

“Your plans for him over the years to withdraw drug therapy and support John through specialist behaviour plans has meant he is becoming more socially skilled and a joy to be with. Going on holiday has meant John’s confidence has moved to another level.”

The holiday was such a success that he has requested to go back again next year as well as choosing to celebrate his birthday with a party at an external venue. This story demonstrates that consistent care and support, while providing opportunities for social integration and decision-making can lead to increasing fulfilment and autonomy.  Sometimes this is a very gradual process.

A seal in a pool at Skegness

National Learning Disability & Autism Awards 2016

We are delighted to have been shortlisted as finalists in the National Learning Disability and Autism Awards 2016 in the Employer Award category.

In order for us to provide a consistently high quality of service to the people in our care, we recognise that we need to have skilled, caring and hard-working employees who are dedicated to their work. It is only fair that we support them as best we can and help them to gain the skills that they need to progress in their roles, and this is what we always aim to do.

What makes us different?
Dr Pedro Areias Grilo, a Consultant Clinical Psychologist has worked at The Richardson Partnership for Care since 2014 and has a substantial array of clinical experience, both in the private and public healthcare sectors. This allows him to have significant insight and awareness about the services that we offer to meet effectively the needs of individuals we cater for. He has highlighted what makes The Richardson Partnership for Care stand out against other care homes.

Supporting staff
The Richardson Partnership for Care (RPC) is on the forefront of care offered in the UK and is currently able to offer, meet and surpass the needs of all individuals they cater for. They strive to go the extra mile to effectively support people. How? They empower staff to strive and accomplish. They develop their staff through in-house weekly training sessions, weekly reflective practice facilitated by Consultant Clinical Psychologists, effective supervision and open-door practice. Likewise, staff feel skilled, supported, cared, involved and motivated to deliver outstanding care and to strive on their roles. The professional satisfaction, sense of belonging and ability to acknowledge what needs to be done to support individuals in need is immense. This impacts positively on the care being delivered. The individuals’ lives change immensely and they feel they are part of a family, rather than people just “living” in a place. They have a home, a family, a social network and happiness. This is what care is about: Enhancement of life quality. The Richardson Partnership for Care without any doubts, offers this and much more.

Multi-disciplinary team
RPC also employs a Multidisciplinary team (MDT), currently offering to the individuals they support an in-house Consultant Neuropsychiatrist, two Consultants Clinical Psychologists, one part-time and one full-time Assistant Psychologist, one Occupational Therapist, one Physiotherapist and one Speech and Language Therapist. I must say, this is extraordinary. As evidenced, RPC has the ability to offer in-house clinicians to immediately and efficiently meet all the needs of the individuals they support.

Innovations
There are also constant innovations. The MDT and Registered Home Managers meet frequently to evaluate the best treatment and intervention plans to support the individuals they cater for. In-house treatment directories were developed, based on NICE guidelines and clinical evidence, to effectively meet and support individuals’ needs. This makes a substantial difference in terms of care being delivered.

I believe RPC could offer what the majority of other organizations do. But no. They have decided to take the hard route. The route that requires an outstanding commitment, the route that might bring discussions, challenges, the route that brings changes, the route that takes people out of their comfort zone. However, this is the route to excellence, which RPC is and will continue to follow.

Greg and Laura are far ahead of their time. They have a clear understanding of the service they offer and where it must go. They have the individuals’ care on the centre of their hearts and the awareness and rationality to observe, analyze, discuss and establish action plans to meet individuals’ needs. This makes the difference and impacts substantially on the service being delivered. This brings innovation and positive changes to care services in the UK.

Dr Pedro Areias Grilo
Consultant Clinical Psychologist
Birmingham University Honorary Tutor

What makes RPC different?

ASDAN achievements recognised

Congratulations to the service users at The Richardson Partnership for Care who were presented with their ASDAN certificates at a special awards ceremony at The Mews.

ASDAN stands for the Award Scheme Development & Accreditation Network. It offers educational programmes and qualifications with flexible ways of accrediting skills for learning, employment and life.

The Richardson Partnership for Care is an ASDAN-accredited centre, which means that we can provide ASDAN programmes in-house for our service users.  They help them to develop skills, achieve accredited qualifications and increase their independence and self-confidence.

ASDAN certificates on mantelpiece

The ASDAN certificates on display on the mantelpiece

Sallie Maris, our Arts & Crafts lady, manages the programme in which around 30 service users with learning difficulties or an acquired brain injury are currently participating. The Independent Living and Creativity modules are our main focus as they help to bring back skills that have been lost as well as providing enjoyment, engagement and a sense of achievement.

Each service user completes a portfolio to show what they have achieved and there are various pass levels: experience recorded, spoken help and no help. These enable progress to be recorded and achievements acknowledged with accredited qualifications.

More information about ASDAN

Residential care in the heart of the community

There is much debate on whether community-based support is better than ‘institutional care’ but of course, it depends on the individual. It also depends on the type of care and support. One of the best ways to describe our specialist residential care homes is ‘a place that feels like home’. Yes, we deliver effective intensive short-term rehabilitation and long-term rehabilitation for adults with acquired brain injury. We also provide care and support for adults with learning difficulties and behaviour that challenges. And we have a high support worker to service user ratio, but we strive to provide an environment that feels like a home, not an institution. It’s safe, comfortable and homely. Our homes provide companionship, and protect vulnerable people from social isolation, loneliness and hate crime.

Community engagement
We also enable service users to be part of the local community. All of our care homes in Northampton are situated close to local shops and facilities, as well as within easy access to the town centre. For service users who are able to, popping out to the local shops means that they feel part of the local community and ‘normal’, especially when they see people they know. It’s also part of our focus on ‘normalisation’ for service users with an acquired brain injury. Enabling them to live as close to a normal life as possible is an important part of their rehabilitation.

We are fortunate that we have some great local pubs where the staff understand the needs of our service users and are very welcoming and helpful. In December we held a 60th birthday party for a service user at the local pub. Donald enjoyed a lovely meal with his sister, all his fellow service users from his home and members of staff. He’s been living in our care home for over 20 years and it was a really lovely occasion. And the pub staff even sang ‘Happy Birthday’ to him!

Donald's birthday cakeCompany ethos
As well as everyday trips to the shops and special occasions, there are also trips to the cinema, sports centres and cafés. They help every service user to become familiar with their local environment and make them feel at home. It’s all part of the ethos of The Richardson Partnership for Care, ensuring that service users are treated with dignity and respect, actively supported to make their own choices and given the opportunity to participate in community activities.

Donald and his sister

Donald with his sister at his birthday party

Holidays form important part of brain injury rehabilitation

During the summer, service users with acquired brain injuries went to a range of different holiday destinations including Norfolk, Lincolnshire, Shropshire and Wales, as well as supported home visits to all parts of the UK and further afield.

The choice of holiday destination is a decision made by each service user – we respect each person’s individuality and actively support them in making decisions, with the aim of increasing their autonomy. Not only is an annual summer holiday an enjoyable experience, for service users with acquired brain injuries it is also an important part of their rehabilitation programme and helps them in many ways. For example, a holiday is part of our focus on ‘normalisation’, enabling our service users to live as close to a normal life as possible and to enjoy things that they may have done before their brain injury, such as having a picnic or fish and chips by the seaside.

Novel experiences
Although some of our service users need to keep to a routine, they all enjoyed the opportunity to see and experience new things and especially meeting and chatting to new people. Novel experiences enhance learning and when they are put into a functional context, such as preparing for and taking part in a holiday, they can provide an important source of practice and maintenance for skills.

Short term memory
The holidays also provide a focus for orientation for service users experiencing short term memory loss. For instance, preparing for a holiday and buying new clothes provide cognitive stimulation and enable service users to be excited about going away.

There are benefits to be gained after the holiday too – putting all of the photographs into an album also aids cognitive stimulation and the album provides a novel reference point for discussions about the trip and assists in a service users’ ongoing rehabilitation.

Quality of life
Quality of life is important to everyone and a relaxed and leisurely week by the sea provides some fresh air and a much welcome change of routine. Supported home visits helped service users to reconnect with family members and gave them all a real boost. All of these activities form part of individual rehabilitation programmes to increase skills and independence and to improve service users’ physical and emotional well-being.

The Norfolk Coast

The Norfolk Coast is a favourite holiday destination for some of our service users

144 Boughton Green Road regains Headway Accreditation

No two brain injuries are the same, as no two individuals are the same, so our specialist residential care homes need to cater for people with different needs. Service users may come to us several years after they have sustained a brain injury and after they have already had a period of acute rehabilitation. We continue their rehabilitation, working steadily and patiently with them to help them achieve their goals, recognising that it may take longer for them to reach their maximum potential.

Many of the service users at our home at 144 Boughton Green Road receive slow stream rehabilitation and long-term support. In 2013, the home received Headway Approved Provider status, following an assessment against a range of standards that reflect the specific needs of people with acquired brain injury. In June this year, Headway reassessed 144 Boughton Green Road and the home passed with flying colours. The accreditation has been extended by a further two years, subject to passing unannounced visits from Headway assessors.

Headway Approved Provider logoThe assessment process requires the home to demonstrate the provision of appropriate specialist care for people with complex, physical and/or cognitive impairment due to acquired brain injury. Headway has identified six key themes, or domains, against which it assesses the level of care provided as well as issues such choice and dignity of service users.

The domains are; Communication, Culture, Development, Governance, Quality, Environment (psychological/emotional) and Environment (physical).

144 Boughton Green Road received a rating of Good-Excellent in six of the domains, and a rating of Good in the seventh. Well done to all the staff who work very hard to continuously improve the service and support that we provide to our service users. They help them to maintain their existing abilities and to progress towards more independence, and acceptance, in a positive environment. The whole team at 144 Boughton Green Road contributes to providing long-term rehabilitation in a supportive and homely environment.

A living room at 144 Boughton Green Road

One of the living rooms at 144 Boughton Green Road