Inpatient

NR Times learns more about the centre, its service expansion, and ongoing investment and development work to ensure its team can deliver the best possible care to patients.
A long-established neuro-rehabilitation service is broadening its specialism even further through the addition of dedicated spinal cord injury and tracheostomy care. 
Hunters Moor has a strong reputation for its support of people with brain injury and neurological conditions, with intensive neuro-rehab programmes devised by the in-house multi-disciplinary team helping to deliver outcomes for patients well beyond expectations. 
And now, as the Level 2 neuro-rehab centre in Birmingham - owned by Active Care Group - continues to invest in its facilities and staff to ensure it offers the best possible service to clients, it is delivering the required training to enable it to provide support to patients with SCI and with tracheostomy needs. 
Since the appointment of Dr Khuram Waheed last year, an in-house specialist doctor with a background in rehabilitation medicine, Hunters Moor has seen strong progress, with new levels of development and support available to staff and a host of new procedures around best practice introduced. 
Statistics show that, in the past year, the work of the centre and its team has helped to reduce hospital admissions by 76 per cent. 
And with the demand-led addition of dedicated SCI and tracheostomy services - and beds currently available to accommodate these patients - Hunters Moor is also looking at the potential to use existing unoccupied space as a care setting, further supporting the NHS in taking patients out of frontline care and into a specialist neuro-rehab environment. 
“The patients are the cornerstone of Hunters Moor and we are all dedicated to providing them with the best possible levels of care,” said Dr Waheed. 

“Since I have come here, we have made many changes to help make that the best it can be, our staff are more able to communicate and work together and there is a very good set up for our patients. We want to make Hunters Moor the best it can be and we are all working to achieve that.”
Growing levels of specialist neuro-rehab support Hunters Moor has built a reputation over many years as a key site in delivering neuro-rehab, with patients from a wide geographical radius across the midlands and surrounding areas - moving to the 42-bed centre for its specialist support. 
With a specialism in brain injury work, Hunters Moor’s MDT also cover the full spectrum of neurological conditions and illnesses, achieving often life-changing outcomes for patients during their time at the centre, which is usually for a minimum of 12 weeks. 
Now, with the addition of dedicated SCI and tracheostomy care, it can support even more people.
“We are known for our work in acquired brain injury and traumatic brain injuries, as well as progressive neurological conditions. But through the extensive training we have undertaken to broaden our offering, we are now advancing into spinal and tracheostomy patients,” said Dr Waheed. 
“Our nursing teams have undergone extensive training and we are now ready to accept new patients who need our specialist care.”
Lisa Mullineux, business development manager at Active Care Group, said: “Our development of the spinal and tracheostomy care pathways at Hunters Moor are as a direct result of referral demand. 
“We are pleased to have been able to harness the expertise we have within our wider group, and well-established care in the home division, to support all of our staff in specialist training for spinal and tracheostomy care to enable us to offer our services to these patient groups.  

“It’s a really exciting time for us at Hunters Moor, our hope is this offering will allow for more local people to remain as close to home as possible having their specialist care needs met  in an expert therapeutic environment .
“We are working with our commissioning partners to explore opportunities to develop additional   residential step down provision for those patients who have ongoing needs requiring  skilled clinical oversight and transitional living settings before they can safely be supported in the community.
“Such an approach will enable cost savings to the public purse, progressive pathways and partnership working, which we are looking forward to exploring further.”
The developments at  Hunters Moor come after years of successfully supporting patients to achieve and surpass their outcome expectations.
“Each of the patients we are privileged to work with at Hunters Moor is individual and their rehab journey is their own for some, their needs will be met within three weeks, for others that may take 12 weeks, and for others that road will be longer. This is an intense period of neuro-rehabilitation, and as we work towards discharge, it is the responsibility of us all to ensure this is safe,” said Dr Waheed. 
“The two things we focus on from the outset are maximising  quality of life and reducing the care burden, while promoting  independence
as much as possible. 
“We work very closely with everyone involved in discharge planning and what that is going to look like, to ensure our support goes right
up until  the point of discharge. We are absolutely committed to doing the best at every point whilst our patients are with us, we are proud to have assisted our patients to have achieved some really, really good outcomes.”

One recent example is from a man who arrived with a hypoxic brain injury after an insulin overdose. He arrived in a prolonged disorder of consciousness (PDoc) with minimal expectations for his progress. 
“This gentleman  was with us for several months and we were seeing glimmers of change in his presentation. We worked with his responsible commissioner to extend his stay as we were seeing the progress and wanted to maximise his opportunity for that,” recalls Dr Waheed. 
“He arrived here with a need for one-to-one care 24 hours a day, to being discharged to a nursing home with a reduced care burden and
no longer needing one-to-one support. 
“You can imagine the cost saving to the NHS  when funding a placement for a patient in a nursing home with the needs this gentleman  arrived with, compared with when he left us. 
“Aside from the financial benefit and most importantly the positive impact this has on the patient is enormous We were all very pleased with the outcome for him, and the progress he made during his time at Hunters Moor.”
‘We want to be the best we can be’. 
Keen to continue to build and develop the reputation it has for the quality of its neuro-rehab, Hunters Moor is always looking for opportunities to improve its ways of operating to maximise the care it can deliver to patients. 
In the past year in particular, since the arrival of Dr Waheed, a raft of major changes have been made in the centre, supporting its staff
with new processes and training to enable them to deliver the highest standards of care. 
The closer working between the therapy teams and nursing teams, with Dr Waheed at the centre of the link, has given rise to a number of other measures. 
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“We have weekly electronic ward rounds, each plan for patients is updated for our nursing and therapy staff to follow.
We have a new admissions policy, which can be done electronically too, so everything can be found digitally,” says Dr Waheed. 
“I am in charge of heading up the MDT meetings, and we also have new levels of medicines management training and emergency drills. We’ve had specific training in a range of areas and I give educational lectures on staff training as well. Maintaining patient safety is the absolute priority.”
Dr Waheed provides a consistent point of contact and support, working with colleagues around the clock to deliver the best possible service to clients. 
“Because we know our patients so well, we can identify issues and intervene at the earliest opportunities. If I or one of my clinical colleagues are contacted at any time of night or day, as well as providing reassurance to the team, our patients and family members, this can very often avoid long delays in sourcing external support, whether that be through NHS 111 or a GP service,” he says. 
“Because we have very complex patients with brain injury or progressive neurological conditions, any change in them can have a massive change on their outcome. Unless we pick up the signs early, it could potentially have life-threatening complications. 
“There is that security for our staff of knowing they will always be speaking to someone who knows the patients and their specific circumstances and needs. That reassurance can make them feel more confident in their roles, and that is a theme which has run throughout our regular staff and also our agency nurses.
“There was one gentleman who had a cranioplasty and came to us from hospital after having that done. Within two days he developed a swelling and if no-one was there to recognise it, he could even have died. But within two hours, our staff had recognised the problem, spoken to me, and organised a transfer to hospital under his neurosurgeon, who I spoke to on the phone, and the patient was stated on antibiotics. 
“That probably did save his life, and that is why I and the team invest the time we do in getting to know our patients, their conditions, their history and their needs.” 

Through a combination of regular physiotherapy, occupational therapy and wellness sessions, Askham Rehab, which forms part of Askham Village Community near Doddington, has been working closely with Isabel to restore her motor functionality and improve her mental wellbeing following what she describes as “one of the most challenging times of my life”.
Isabel, who was very active before her stroke, was referred to Askham Rehab for an initial eight weeks and since discharge, now attends its outpatient service to fulfil her ongoing rehab goals. 
Since joining the progressive and personable community, she has come on leaps and bounds — overcoming the challenges of being restricted to full use in just one arm and leg.
Upon arrival, she required assistance to sit, stand and maintain balance due to a right-sided weakness, which was more pronounced in her upper limb. The priority was to centre her treatment around active movement, focussing on things like wrist flexion — using state-of-the-art robotic equipment, such as the Pablo system — an interactive therapy device.
The mental hardship of this restricted movement was one of the most challenging components of Isabel’s rehabilitation and occasionally left her feeling unmotivated and daunted by the process. 
Commenting on her rehabilitation journey, Isabel said: “When you have a stroke, it can be a very consuming time of your life and without the guidance and continued support of a community like Askham, I’m not sure how I would have got through it. 
“I am fortunate to have three amazing children and a loving husband of 39 years, who have supported and motivated me throughout this whole process. I think I owed it to them and to myself to give this everything I've got, even on the days when it feels like an impossible task.
Despite this, the consistent ‘can do’ attitude of her specialist care team, coupled with her continued resilience, has amounted to significant progress and positive steps towards independence.

“Noticing progress in your rehabilitation journey is difficult as you are experiencing it every single day. However, my friends, family and care team are constantly reminding me how far I’ve come and when I think about my situation now compared with when I first had the stroke, it’s truly amazing. 
“When I first came to Askham, I couldn’t do half the things I can do now — and I can’t put into words how grateful I am for their support. Being from Turves in Cambridgeshire, I was so lucky to have such an amazing care community right on my doorstep and I couldn’t recommend them more to anyone unfortunate enough to find themselves in my position.”
Askham Village is a family-run community with a rehabilitation service that has transformed the lives of many individuals, and its remote setting and person-centred approach is the perfect place to address any personal challenge — big or small. With the latest robotic equipment and state-of-the-art gym and hydrotherapy facilities, it is leading the way in the local area for rehabilitation services.
Sara Neaves, Clinical Lead and Outpatients Service Manager at Askham Rehab, said: “When we first met Isabel, aside from her terrific sense of humour and caring personality, there was a strong sense of determination to face her situation head on — and throw herself into the rehabilitation programme. It's a real privilege to see how far she has come, and to see her engaging in activities she loved to do prior to her injury is just amazing. A key part of Askham’s ethos is empowerment and Isabel's journey really encaptivated this.”

For more information on Askham Rehab,
please visit askhamrehab.com

Askham is always welcoming new residents and staff into its growing community.
For further information,
please contact 01354 740269

Richardson Care Continues to Impress in Family Surveys

Richardson Care is a specialist provider of rehabilitation and residential care for adults with acquired brain injury, or learning disabilities, and complex needs. Each year it conducts a survey of the family members of its service users about the quality of care that it delivers.

The results of the survey completed at the end of 2022 show that:

> 100% of respondents were happy with the care provided

> 100% felt that their relative was treated
with dignity and respect

> 100% felt that staff were friendly
and approachable

> 89% said that their loved one’s quality of life had improved since admission to the service

> 94% would recommend Richardson Care,
if appropriate.

In addition, one respondent, who’s son has an acquired brain injury summarised her thoughts as:
“I agree 110% that his quality of life has improved since he arrived at Richardson Care.
[They provide]:
Professional care - kindness with
knowledge applied
Happy faces - staff and, more importantly, residents
Clinical knowledge - access to expert advice, attention to detail of personal care plans.”
Laura Richardson-Cheater, Director at Richardson Care comments: “We are delighted with the survey results again this year but we’re never complacent. We welcome all feedback and are always looking at ways to provide better outcomes. Our service users have complex needs and we are entrusted with their care. We take that responsibility very seriously.”
The Northampton-based care provider has six residential care homes and a long proven track record of delivering successful outcomes for service users. It provides a flexible care pathway, which allows individuals to progress within a stable home environment.

The services are:
1. ABI assessment & complex diagnosis unit, The Coach House
2. ABI rehabilitation & transitional service, The Richardson Mews
3. Long-term community neuro-rehabilitation service for men,
144 Boughton Green Road
4. Transitional & long-term LD & complex needs service,
23 Duston Road
5. Long-term community LD & complex needs service,
2 & 8 Kingsthorpe Grove

Graph Key
Families were asked if they strongly agreed, agreed, didn’t know or disagreed with the following statements:

Q1. I am happy with the care provided for my relative
Q2. The home has a warm, non-institutionalised feeling
Q3. The home provides an inclusive or ‘family’ environment
Q4. The staff are friendly and approachable
Q5. I am regularly updated with information
Q6. I feel that my relative is treated with dignity and respect
Q7. I feel that their quality of life has improved since they arrived at
Richardson Care
Q8. I feel that my relative takes part in meaningful and/or enjoyable
activities
Q9. Would you recommend our service to others? Yes/No

For more information call 01604 791266 or visit www.richardsoncares.co.uk

Identifying and maximising potential
Through supporting service users to rediscover the levels of ability and independence many feared may have been lost forever, the therapists at Tyne Grange - typical of the approach taken throughout the Exemplar Health Care portfolio - are able to really maximise their skills and push the boundaries of supposed limitations.  
The specialist care home is home to people across the spectrum of neurodisabilities, from brain and spinal cord injury through to neurodegenerative disease and complex mental illness. 
But through the bespoke approach of the team, achieving the full potential of each and every one of the 22 service users at Tyne Grange is the priority - often enabling them to live a life far beyond what they and their families may have imagined possible.
“Everything we do is person-centred, so we will ask the service user and their family right at the outset where they want to be, what are their goals,” says Helen. 
“Every single person has a different goal here.
It could be something very physio specific, like ‘I want to be able to get from my bed to my chair without support’. Or it could be that they want to engage more in the community, to go to church, to be able to go out for a coffee, to be able to prepare their own food or do their own shopping. It could even be something like the prevention of secondary problems, where we will find ways to reduce things like skin breakdown, chest infections and recurring illnesses through education, better positioning and postural support.
“We will break these up into smaller goals, and then we spent time considering how we can work together to achieve them. We’ll get
the family involved, plan out what it might look like for them. The most important thing for us is that the service user takes ownership of their rehab and what they want the outcomes to be.”
And what their ambitions may be - and how that is achieved - is entirely dependent on the individual. 

“For our service user who was said to have no further rehab potential and is now walking along corridors and standing independently, that has been absolutely life-changing for him. What might take many people a few days to achieve has taken him six to nine months, but the focus from us was on him achieving his ambitions,” says Helen. 
“We will do absolutely everything we can to help them get there. We have one service user who has had a stroke, and the goal for her was to improve her communication, as sadly she has lost the ability to communicate verbally,” says Helen. 
“She began her rehab journey in a minimally conscious state, but she can now communicate with gestures, so we’ve been working on dexterity of hand movements so she can tell us what she wants by gestures. Then we work with the staff to train them in what the gestures mean, what she is referring to, and we have opened up a new channel by which she can tell us what she wants and wants to say. This has given her a level of independence that she wouldn’t otherwise have had.”
But what is constant with every service user is the Tyne Grange team’s commitment to doing everything they can to support them in achieving their goals - even when others may not see the potential. In this environment, the ability to integrate our rehabilitation through the culture of the home is the key to our success.
“We’re always looking at how we can make improvements for our service users, how we can empower them to live better lives, in whatever way shape or form. Our whole team will persevere and persevere until we absolutely know we’ve done all we can,” says Helen. 
“Finding those little wins, so there are things that absolutely everyone can achieve, is really important to all of us - and really brilliant we can spend the time in supporting our service users to do this day in and day out, providing consistent and continuous therapy alongside their day-to-day care.”

Relationships at the heart of rehab
For all therapists, the ambition is to support people in every way possible, investing the time and building the relationship to enable them to unlock their full rehabilitation potential. 
However, the challenges in the healthcare sector currently are well-documented, and being able to work in the way that therapists trained to do - and badly want to do - is not always possible, particularly in under-pressure NHS environments. 
For Helen, she is grateful that she and the multidisciplinary team have the “unique” opportunity to enjoy a very different situation, which she believes is absolutely fundamental to the outcomes Tyne Grange regularly achieve for service users. 
“You can support people in every aspect of their rehabilitation – physical, emotional, social and mental - and for a physio, you don’t have the luxury to do that in many other settings,” she says.
“If you’re in a hospital setting, for example, you will likely see people for a very small portion of their life, or maybe for 20 minutes at a time, or appointments a couple of weeks apart. But in what we do, you’ll see them day in day out, for the duration of their time here, which is brilliant because you get to know them, and they and their family get to know you. 
“By getting to know people, you can put plans together based on what you know about them, their personalities, their preferences, their wishes, their capabilities and their potential, and then work on them together. 
“Sometimes it can take a long time for them to achieve what they want, but it’s fantastic to be able to build the trust and develop the relationship that can really support them in doing that. Just the process of working towards something that they’ve been involved in decision is motivating enough in itself to engage consistently.
“The beauty of it is that we can try things, change things, and consistently adapt to the changes in conditions and presentation.
We can make things more intensive or less intensive, and increase or decrease other therapies or activities around that to meet a service user’s needs.”
As a physiotherapist, Helen is also able to tailor her activities according to people’s needs, and invest the time in delivering that. 

“My role is quite diverse in terms of the physio work, working across such a wide range of conditions, and being there all the time to see the progress our service users are making” says Helen. 
“I can be doing anything from postural support or positioning through to functional rehabilitation. We do a lot of strength and conditioning, functional practice of activities of daily living, and supporting balance and coordination for those who have conditions like Parkinson’s or Huntington’s. We have service users who are physically independent and want to keep fit, so we do exercise sessions to help with maintaining their fitness. 
“Just one day could cover almost the full spectrum of physiotherapy intervention, and it’s great to be able to have the chance to do
such a range of work.”