We are delighted to share our latest outcomes report for Murdostoun Brain Injury Rehabilitation Centre which shows that our patients make good progress with half our patients being discharged home to live independently. For the full report: Outcomes Murdostoun
Dialetical Behaviour Therapy (DBT) is now available to our young people at Huntercombe Hospital Edinburgh.
DBT is a structured therapy that includes a focus on a person’s thoughts, emotions, beliefs and behaviours.
At Huntercombe Hospital Edinburgh individual therapy sessions take place alongside a skills training group supported by access to DBT coaches between sessions if needed.
Leading our DBT programme we have a core team comprising eight clinical staff members headed by our Lead Clinical Psychologist and all our staff have been trained to have a good understanding of DBT language, better insight into how changes to a physical environment can promote helpful behaviours and most importantly knowledge of the skills our patients are actually learning in the skills group.
For more information about DBT, please look at our brochure:
Thursday 14th December saw a group of young people from Thorneycroft and Wedgwood take a trip into a decommissioned nuclear bunker nestled in the sleepy Cheshire countryside. The bunker was built in the 1950s and would have acted as a centre of regional government if ever a nuclear war broke out. So, in short, it’s where all the ‘important’ people would hide and protect themselves!
Our group had a great time looking around the eerily preserved rooms and spooky corridors, taking in sights such as radar equipment, a medical bay, decontamination room and an old BBC studio, intended to broadcast instructions and messages to those left in the radioactive wasteland above ground.
One of our young people documented our adventure by taking many photographs of this strange attraction.
The young people and staff from Thorneycroft also attended an Activities Trip to the Birmingham Art gallery and Museum in December. The museum has over 40 galleries to explore, including exhibits on the Staffordshire Hoard, Ancient Egypt, the Pre-Raphaelites, and Birmingham: its people and history. We enjoyed dressing up as Anglo Saxons!
The importance of technology in healthcare is unquestionable. Yet so often it can be difficult for healthcare providers to introduce new technologies because of numerous barriers. The Huntercombe Group strives to continually seek innovative solutions to improve care and are currently piloting a new software called Brain in Hand at Cedar House in Canterbury. Brain in Hand (www.braininhand.co.uk) is being used to help patients better self-manage in order to reduce anxiety and crisis incidents, especially when in the local community.
Brain in Hand gives patients easy access to their own personalised diary, reminders, and coping strategies through an app on their phone. An inbuilt anxiety monitor also allows users to report their emotional state on a regular basis using a simple traffic light system. This enables support staff to be able to see how patients are feeling, wherever they are, and intervene if needed.
If coping strategies aren’t working and a patient needs help, they can press the red traffic light button at any time and a text message is sent to the senior nurse on site. The senior nurse then then contacts a trained traffic light responder, who will get in touch with the patient to help to deescalate the problem. The system also provides a wealth of usage data, including anxiety tracking and problems faced, to help with reflection and planning.
Amie Drayner, Brain in Hand Lead at Cedar House explains: “Eighty staff have been trained on how to use Brain in Hand and ten patients now have been set up with the software; including patients with Learning Disabilities, Autism or Mental Health conditions. Each patient has weekly sessions with their supporter; together they look at the patient’s Brain in Hand usage tracker. This shows exactly when they have been feeling anxious and what coping strategies they have used. This informs discussion, helping to spot any new areas of concern or develop new coping strategies. They also take this time to add any upcoming events or reminders to their diary, such as a day trip.
“It’s only been a few weeks, but already the team are seeing results. Some patients are now getting up earlier in order to complete their morning routine, getting up at 11am compared to as late as 3pm sometimes. Others who do not communicate with staff when not feeling good are pressing red, enabling staff to provide help before their situation worsens.”
Chris Davis, Senior Support worker, adds: “It gives patients the chance to express themselves, even if there are unfamiliar staff, or the ward is unsettled. They’re not going to want to come and find help if the ward is unsettled, but now they can use their device for that.”
The software is designed to help people with a range of conditions including; mild or moderate mental illness, autism or recovering from brain injuries. It is based on well-established therapeutic principles such as CBT, solution focused therapy and recovery-based rehabilitation; the learning from these approaches are turned into a set of patient-centred coping strategies.
Feedback from patients has been extremely positive. When asked about Brain in Hand, patients have shared that: “It helps with communication’’ and “I like Brain in Hand because it helps me to stay calm.”
Going forward, it is planned that the software will contribute towards safer discharge planning.
By Lucy Berrisford – Occupational Therapist, Ashley House
Learning Disabilities Work Week is from 6th to 12th November 2017, when Mencap is celebrating what great employees people with a learning disability can make www.mencap.org.uk/get-involved/learning-disability-work-week #LDWorkWeek.
Mencap works to improve the lives of people with a learning disability, and with the theme of the week being making paid work a reality for more people with a learning disability, the charity will be exploring the difficulties of getting a job if you have a learning disability, as well as raising awareness of the benefits of employing people with a learning disability. Throughout the week, Mencap will be sharing stories from employers and employees on the benefits of employing people with a learning disability, aiming to help tackle the current low levels of employment of people with a learning disability in the UK.
At Ashley House, one of the Huntercombe Hospitals for adults with mental health problems and learning disabilities, we set up the Ash Tree Café in June 2017 to facilitate vocational rehabilitation and social inclusion. The project arose from the Occupational Therapy team reviewing the service and thinking of ways to incorporate more onsite vocational skills opportunities and social inclusion.
The café is run by patients with the support of OTED staff and it provides an opportunity for purposeful work experience and a place to develop interpersonal skills. The café currently provides five work role opportunities including chef, kitchen cleaner, drinks maker and money handler, food purchaser and waiter.
Patients took part in a recruitment process and were supported to apply for a job from the notice board, attend an interview and complete a six week preparing for work scheme before starting their job in the café. The ‘Preparing for Work’ scheme supports patients to reflect on their skills and develop areas such as teamwork, communication, health and safety and writing CVs.
We are now into the fifth month of the café project and our original recruits have finished their work placements and were taken out for a celebratory meal funded by the café and received certificates. We completed a second recruitment process and Preparing to Work scheme, employing five new café project members, with a further two patients re-applying for their jobs. All workers have a custom made café t-shirt and have started well in their new roles, offering ideas for the café and practicing the skills they have developed in the Preparing to Work course. All employees and patients at the hospital are invited to attend the café or order a takeaway from the takeaway service, which following on from a competition to name the café, was aptly named ‘Thanks a Latte.’
The hospital also has some external work placements and have had many in the past to support these skills and onsite opportunities such as the gardening and grounds maintenance patient teams. We currently have placements at a local farm to help with general farm work and animal care and offer a voluntary mowing service as part of the community team at the local church. We are hoping to broaden the opportunities we offer our patients with work experience in the community in the New Year.
Mencap has carried out research which shows that whilst most individuals express the desire to work, only 6% of people with a learning disability and 15% of people with autism, are in paid employment, which is often part-time and low paid. Other research shows that it is really important to provide opportunities for vocational rehabilitation and greater social inclusion for those with a learning disability. Engaging in vocational rehabilitation offers a key focus to developing life skills to obtain or remain in work, which has been proven to increase independence and participation in society, as well as improve mental and physical health and well-being (College of Occupational Therapists, 2016)1 . Smith et al (2010)2 also recognise the importance of facilitating opportunities for individuals in learning disability settings to engage in vocational training to learn skills and support improved motivation, self-esteem and confidence. The report by Mencap, “Good for Business, the benefits of employing people with a learning disability’3 cites many fantastic examples of really successful working.
1 Smith A, Petty M, Oughton I, Alexander RT (2010) Establishing a work-based learning programme: vocational rehabilitation in a forensic learning disability setting. British Journal of Occupational Therapy, 73(9), 431–436.
2 College of Occupational Therapists Limited (COT) 2016, Vocational Rehabilitation Factsheet.
Dr Stefania Bruno is one of our consultants at Huntercombe Blackheath Brain Injury Rehabilitation Centre, and is one of the authors of an innovative and important work Brain structural connectivity atrophy in Alzheimer’s Disease. Please click on the link to read the paper.
Much fun was had by all last weekend when our care home in Kilbirnie opened its doors to the public.
Set in the beautiful Garnock Valley countryside, Moorpark Place provides a comfortable home and residential care to 25 adults with autism. On Sunday, August 20, staff, residents, carers and family members came together to host an Fun Day at Moorpark to showcase our fantastic facility and strengthen links with our local community.
Local businesses, like Kilbirnie chocolate shop, The Lime Tree Larder, turned out to showcase their produce – the homemade ice-cream was definitely a big hit, as was Coco the goat from Hillhead Pets’ Corners! Local Fire and Police Services attended and many residents enjoyed exploring the Police van “under caution”.
Inside the “Hub” – where our specialist care staff normally provide sessions for residents in Speech and Language therapy, Occupational Therapy, Psychology , music and art – were information stalls on Autism, Communication, Sensory Awareness, Intensive Interaction, with representatives from Epilepsy Scotland also attending to celebrate Moorpark’s day and give information and advice. Enid McCracken, Speech and Language Therapist at Moorpark Place, said “really relaxed friendly day, it was a great opportunity to meet people with connections to Moorpark”
Outside the Hub became a focus of fun, with a giant bouncy castle, large games and face painting laid on for visitors.
The sunshine even made a rare appearance which gave Catherine Edwards, Occupational Therapy Assistant, the opportunity to demonstrate Rebound Therapy – a trampoline-based therapy – to visitors in Moorpark’s impressive walled garden.
After all the excitement, there was a chance to relax with a cuppa from the tea stall and for guests to treat themselves to a cake from the tasty home baking stall while the raffle prizes were announced. Staff are delighted to have raised around £250 on the day which will help to provide new and exciting activities for residents our to enjoy. Michael Sneddon, Registered Manager said “overall it was a fantastic day and great to see so many residents, carers and families having fun”.
Brain injury is complex and its consequences are frequently life-changing. We look at the potential and effectiveness of rehabilitation post brain injury and how it can help those affected in rebuilding their lives and reaching their maximum potential.
The range of symptoms and disabilities a person with brain injury may experience vary greatly, depending on the type of injury and its location. There are two types of brain injury, which are mainly distinguished by their cause. Acquired brain injury (ABI) is caused by any brain injury since birth such as a tumour, stroke or infection and is typically considered as non-traumatic. Whereas Traumatic Brain Injury (TBI) is caused by a trauma to the head such as a fall, road traffic accident or assault.
The impact of brain injury depends on many factors including whether the damage is local to one specific part of the brain or more wide-spread. Not surprisingly, treatment for brain injury varies in type and duration and rehabilitation. Many people experience complex and longer-term physical, cognitive and behavioural problems where longer term support from rehabilitation is beneficial.
Whilst some organs can regenerate following injury, individual parts of the brain cannot. But following damage, the brain has an extraordinary ability, whereby it can try to modify its own structure to regain lost function. This is known as brain plasticity, and it occurs during the recovery period when new connections between neurons (brain cells) and nerve pathways establish themselves to try to compensate for the damaged brain areas. Specifically designed occupational activities enable the patient’s brain to use this plasticity to develop and learn alternative pathways of working.
In a rehabilitation setting, a multi-disciplinary team of professionals collaboratively work to assess the limitations caused by the brain injury and the potential for recovery. Their combined actions then work to encourage brain plasticity and greater function. In a multi-disciplinary environment, the team will work with the patient to develop a plan which aims to optimise the potential to reach the patient’s chosen goals. The goal might be as simple as ensuring a patient can eat (which is hugely important on a number of levels for patients) and this will involve the entire team – from physiotherapists who develop muscle function and range of movement in the limbs used for eating, to occupational therapists who will aid in the re-learning of how to get food onto utensils and bring this to the mouth, speech and language therapists who will assess the risk of aspiration and develop techniques to strengthen the swallow, and so on. Medical Director, Dr John Holloway from the Frenchay Brain Injury Unit in Bristol, comments: “Multidisciplinary working is at the centre of it all – it is the key to high level rehabilitation”.
Specialist rehabilitation is generally considered to be for those people with a brain injury or another complex neurological condition who would benefit from an intensive period of neurological rehabilitation. Such people might face difficulties talking, thinking, moving around, eating or interacting with others. Most patients using these types of specialist services are in the very early stages of recovery from their brain injury and often see the fastest results in recovery.
However, slower stream rehabilitation can be equally as important and beneficial. For some patients, an intensive period of rehabilitation can be overwhelming and they are better suited to rehabilitation that takes place over a longer period of time. This rehabilitation can still be multi-disciplinary, but spreading it out enables the patient to continue to recover at a pace that is more suited to their needs. Though recovery results are slower, there is increasing evidence that for these individuals, when given effective rehabilitation, they still have significant potential in recovery, even several years post-injury.
Frenchay Brain Injury Rehabilitation Centre in Bristol has a dynamic medical team with an outstanding depth of expertise including Consultant Neuropsychiatrists, Rehabilitation Consultants, Psychologists, Speech and Language Therapists, Occupational Therapists, Physiotherapists, Nurses and Support Workers. Through collaborative assessments and holistic treatments for patients, they deliver appropriately timed and individually-tailored rehabilitation. The UK Rehabilitation Outcomes Collaborative (UKROC) is an independent research project that benchmarks specialist brain injury rehabilitation services against similar services and Frenchay performs extremely well in these measures.
The latest UKROC report showed that patients treated at Frenchay made motor and cognitive gains that were significantly above the national average. Dr John Holloway comments: “We get good results for our patients because we have a high-functioning team at Frenchay. The members of the team are highly qualified at what they do and have been working together for a long time.”
Not surprisingly, the better a patient’s recovery following rehabilitation, the less their care is likely to cost the Health and Social Care system in the long run. UKROC measures the cost of care for patients before they begin rehabilitation, and again at discharge, and calculate the savings. On average, ongoing weekly care costs £711 less per week after treatment at Frenchay.
Ultimately, brain injury can have severe consequences on the affected person’s life and their family, so helping people reach their maximum potential through rehabilitation and reducing overall impact is vital. The gains people can make post injury have the potential to be both significant and cumulative. Therefore the role of rehabilitation and the length of time needed to fulfil potential, should not be underestimated.
Residents and staff at the Huntercombe Centre, Sherwood celebrated outstanding inspection results with a Mexican themed day.
The specialist care home for men with mental health problems and learning disabilities was inspected by Nottingham CCG and scored 97% for the second year running.
Inspectors for the commissioning authority looked at care standards as well as the home’s success in supporting men to move on with their lives and step back into supported living in the community.
“The staff work very hard to give the residents the best possible chance of returning home needing less support,” said Manager Michelle Rope. “I am really proud of what the staff and residents achieve together every day and we hope to beat 97% next year.”
The centre in Sherwood Rise, Nottingham is a home for men with really challenging mental health issues. They are helped to stabilise and rehabilitate by learning everyday life skills. Some attend college and various courses with the support of staff in an effort to manage their mental health more effectively.
For more information about Huntercombe Sherwood, click here