1 Specialist Brain Injury Services Welcome to Blackheath Brain Injury Rehabilitation Centre
2 About Our Company The Huntercombe Group, the specialist division of Four Seasons Health Care*, is an independent provider of health and social care services who work in partnership with the NHS to deliver exceptional patient-centred treatment and care. We have 53 hospitals and specialist care centres throughout England and Scotland, providing a wide range of effective treatment and care programmes in the areas of: Adult Mental Health and Intellectual Disabilities, Specialist Brain Injuries and Child and Adolescent Mental Health Services (CAMHS). The Huntercombe Group and its centres are regulated by the Care Quality Commission (CQC), OFSTED, Health Improvement Scotland and the Care Inspectorate in Scotland. You can find out more about our company from our website which is * Four Seasons Healthcare is one of the largest independent health care providers of nursing homes, care homes and specialist units throughout the UK. Service Key Adult Mental Health Addiction Services Specialist Brain Injury Tier 4 CAMHS Eating Disorders Map not to scale 2
3 Specialist Brain Injury Services Welcome Every patient with a brain injury or complex neurological condition can, with the right person-centred interventions delivered by the right team at the right time on their treatment journey, have an improved quality of life irrespective of their neurological difficulty. We understand that you may be feeling worried about coming into our specialist centre. Being in an unfamiliar environment and leaving home, family and friends can be very difficult, that s why we have put this booklet together to share information and answer some of the questions you may have. Hopefully the following information will answer most of your questions about our centre but if not, please remember, we are all here to help you, so if you have any questions or concerns please feel free to speak with either myself or any member of staff. We have split this guide into three sections to help you locate the information you need at any given time: About Your Centre This section provides you with information about the facilities on offer and other important information you need to know to keep you safe, well and comfortable during your stay with us. About Your Rehabilitation This section covers all information relating to what you can expect regarding your rehabilitation and care whilst at our centre. Useful Contacts This section lists organisations and charities that offer advice, guidance and support to people with a brain injury or other neurological condition. We look forward to welcoming you to our centre. Best wishes Centre Manager For further information, you can check the noticeboards located around the centre or visit our website 3
4 Contents About Your Centre 5 Centre Features 6 Your Bedroom 7 Your Personal Belongings 7 Meals 9 Social Life 10 A Typical Day 11 Visitor Information 13 Security, Fire Procedure and Risk Management 14 Respecting Each Other 15 Complaints 16 About Your Rehabilitation 17 Your Rights 18 Moving in 19 Review Meetings 19 Person-Centred Rehabilitation 20 Rehabilitation Timeline 21 General Medical Care 22 Confidentiality, Safeguarding and Whistleblowing 23 What s included? 24 Our Team 25 4 Useful Contacts 27
5 About Your Centre Located in South East London, Blackheath Brain Injury Rehabilitation Centre provides person-centred inpatient rehabilitation and care for adults (aged 18+ years) with an acquired brain injury or other complex neurological condition. 5
6 Blackheath Brain Injury Rehabilitation Centre Centre Features 6 Our centre is situated close to Blackheath and Lewisham, home to numerous shops and restaurants with Blackheath Common and Greenwich Park also close by. There are two purpose-built units: The Thames Brain Injury Rehabilitation Unit (TBIRU) provides assessment and specialist rehabilitation for individuals with acquired brain injuries and other neurological conditions with a primary cognitive and behavioural need. This may include individuals who are currently held under Mental Health Act Section. The Heathside Unit provides specialist intensive rehabilitation for individuals who have complex physical and/or communicative impairments associated with either a brain injury or other neurological condition. We care for adults who are medically stable, with an acquired brain injury resulting from traumatic injury, for example, road traffic accident, anoxic brain injury, subarachnoid haemorrhage, encephalitis or meningitis, complex stroke or tumour. We are able to admit patients detained under the Mental Health Act (1983) or on a Deprivation of Liberty Safeguard Authorisation (DoLS). We also accept patients with Percutaneous Endoscopic Gastrostomy (PEGs) and patients in low states of arousal requiring SMART (Sensory Modality Assessment and Rehabilitation Technique). Thank you for all your help and support in helping me achieve my full potential. I don t think I could have made it without your help and support 35 beds in total, split across two units On-site multi-disciplinary team NHS England registered On-site hydrotherapy pool Wheelchair accessible therapy kitchen Gymnasium Other dedicated therapy rooms Accessible garden areas Good transport links by bus, road (directly on the A2), rail (Greenwich, Lewisham and Blackheath stations all close by) and air (London City Airport 7 miles away) Close to wide range of local amenities Large communal living spaces with flat screen televisions, Wii, DVD player Leisure and recreational equipment Patient accessible computer and internet Patient laundry service On-site chefs, who provide patients with choices for their meals within the dining room Extensive therapeutic activities programme Optional recreational programme available Minibus for outings / appointments 17
7 Your Bedroom On moving into our centre you will be given your own bedroom. To help you feel more at home, we are more than happy for you to bring in items from home such as pictures, soft furnishings and any other belongings provided they meet our fire and safety regulations. All our bedrooms have locks and we will happily provide you with a key to your bedroom once we are confident that managing the door lock poses no problem for you. No member of staff is allowed to enter your room without first knocking and receiving a response. The only exception to this is if a member of staff thinks you may be in difficulty or if it is identified in your personal care plan. If this does not happen, please let us know. Most patients like to bring in their own TV and, in addition to the furniture we provide, often purchase items to personalise their room. All rooms are cleaned on a daily basis by our housekeeping team. Tell us if there is anything we can do to make your stay more comfortable, for example, if you need extra blankets or if you are being bothered by noise in the night. Your Personal Belongings Laundry We provide a central laundry service that can cater for all your laundry needs. Due to the number of patients that we care for, we do ask that your clothing is labelled to prevent items being misplaced or lost. However, if you prefer, your family or friends can organise your laundry for you. Valuables If you bring any valuables into our centre, we would always advise you to carry these with you, if at all possible. We can, however, provide you with a lockable bedside cabinet or safe, if required. You can also give your valuables or money to the nurses to put in our safe. You will be given a receipt for any items handed over to our safekeeping. We would recommend that you consider your own separate insurance cover, particularly if you have any high value items such as ipads and laptops. However, we would strongly advise that you leave any expensive or valuable items at home. 7
8 Personal Monies Whilst we cannot accept responsibility for your personal finances, we can offer you some support. In some circumstances we are able to hold small amounts of personal monies to meet your immediate needs if requested. The amount you ask us to look after should be kept to a minimum but can be regularly topped up as required. All such monies are kept secure in one bank account with separate records for each patient recording the amount held on their behalf, and details of deposits and withdrawals made. The bank account is a non-interest bearing account, so no interest is earned on any monies you ask us to look after. We also undertake to provide easy and flexible access to your monies. However, it must be noted that we are unable to subsidise expenditure from monies held if you have insufficient money within the account. All expenditure must be authorised by you or, where applicable, by your representative before payment is made. We would suggest that you don t bring into the centre more money than is necessary for your day-to-day living. Electrical Items To make you feel comfortable, we are happy for you to bring in electrical appliances from home, for example, hairdryers, laptops etc. In order to comply with health and safety legislation, our maintenance officer will need to undertake an initial electrical safety check which will be repeated on an annual basis. If your electrical appliance has been risk assessed as unsafe, you will not be able to use it. 8 Mobile Phones and Cameras Most patients like to bring their mobile phones into the centre for ease of contact with friends and family. Families and friends are at liberty to take photographs of their relative but it is not permitted to take photographs of any other patient or staff member. Members of staff are not allowed to use mobile phones or take photographs of any patient or other staff member without consent. There is also a payphone located in the reception area for outgoing telephone calls. There is a computer available if you wish to use the internet. The login details are: Username: blackheath.patient.1 Password: bl4ckheath If you wish to use your own computer to access the internet, you will need to purchase your own mobile network device, for example, USB or pocket WiFi.
9 Meals Our menus are specifically designed to ensure you receive a healthy balanced and varied diet. We usually operate a four week rotational menu and offer both meat and vegetarian dishes on a daily basis. We also cater for any cultural or specialist dietary requirement on an individual basis. There is a full range of modified texture menus for people with swallowing difficulties. We do encourage meals to be taken in the dining room but you may eat by choice in your own room if you prefer. Meals can be provided for family and friends who are visiting you. Our centre will request a small fee for these and individual tickets can be purchased from reception. Visitor orders for lunch and dinner should be placed before 10am and 3pm respectively. The daily menu is on show on the noticeboard in the dining room. From patients choice, our meal times have been set as follows: 9.00am am Breakfast 12.30pm pm Lunch 5.30pm pm Dinner Snacks and Drinks Drinks such as tea and coffee and snacks are routinely served mid morning, early afternoon and in the evening but are also available throughout the day to suit you. You are more than welcome to make a drink or snack during the day for yourself or your visitors in our independent living skills kitchen as long as we have assessed your ability to use the kitchen and its equipment safely. Sample Menu Breakfast Porridge or choice of cereal Bacon and cheese turnover Fruit juice Tea /Coffee with toast/ rolls and preserves Lunch Lamb or roast vegetable moussaka with sautéed potatoes and mixed vegetables or Salad with pitta bread, cheese, roast pepper and red onion or Egg and cress sandwich Apple flan or fresh fruit *** Dinner Leek and potato soup Turkey meatballs and pasta Mince quorn and pasta Roast beef and horseradish potato salad Tuna and sweetcorn sandwich Peach slices with cream Chantilly or fresh fruit 9
10 Social Life Thank you so much for looking after my mum. She has done so well since she arrived. Never thought she would make such good progress. Mum has made friends here and she is sad to be leaving. She is having a cry while I m writing this card We have a dedicated Activity Co-ordinator who, with the involvement of our patients, organises a varied structured programme of recreational activities. Our activities programmes are tailored not only to meet both the needs and choices of individuals, but also to enable individuals to be independent in a variety of everyday situations. We encourage our patients to make choices about which activities they wish to join in with and which activities they prefer to avoid. Activities for each week are shown on your weekly timetable. Some examples of popular activities and trips include: Regular On-site Activities Quizzes Board games Cinema evenings/afternoons Gardening Annual Sports Day Basketball Table Tennis Summer BBQs Pamper Sessions (eg: nail painting) National celebration days e.g, Burns Night, St George's Day Art and craft Karaoke Birthday celebrations Visiting performers Typical Trips and Outings Visits to beach / countryside Ten pin bowling Theatre/ Pantomime trips Picnics Visits to museums Cinema visits Visits to cafes / restaurants Supermarket shopping trips Other shopping trips, eg: local markets Visits to local town / city Visits to local attractions Swimming Please see the A Typical Day section on the following page to get a feel for how a day at Blackheath is structured
11 A Typical Day To give you a feel for what life is like at Blackheath, we asked an existing patient to describe a typical day in her words: My day begins around 8am or soon after, with a knock at the door and a carer saying Good morning. I m here to assist you. Then depending on your individual requirements you are washed, showered and dressed and set for the day in a wheelchair or on your feet. Next is the most important meal of the day, so we make our way to the dining room for breakfast. If you are able, you have the opportunity to join a group to make our own breakfast and get some practice in cooking scrambled eggs and toast! On Monday mornings we are given a timetable of our activities for that week and each day will be different. There will be some free time, maybe an hour or perhaps the whole afternoon. So it could be you are free after breakfast until say 10.30am when you have physiotherapy. This will be tailored to your needs to ensure you develop and improve. After that, at 11.30am there is GRASP Group where several patients join together for exercises. These are mainly upper limb exercises to encourage us to use limbs that have been affected by our illness or stroke. Part of this time is also taken up by activities tailored to your injury using your thinking skills as well as physical ones. The morning has flown by because 12.30pm means lunch and once more we make our way to the dining room. Each day we are given the menu for the following day so we can choose our preferences. Breakfasts are generally the same with cereal and toast with the hot section varied each day. Lunch and supper we have a hot meal with vegetarian option or salad or sandwich. If we do not like these there is an alternative menu from which to choose. Some days we may have an outing booked whereby we are taken out to Greenwich Park, or for a cup of coffee, or the shops depending on the weather. According to your risk assessment you may have the opportunity to go boating. Upon your return you may choose to take a rest. When you don t have therapy sessions you can do what you like; perhaps to read, watch television or do crosswords for example, in your room or join with others in the lounge. 5.30pm arrives and supper is served so again we are in the dining room for food and perhaps converse with fellow patients. Thus we come to the end of the day and the therapy staff team have gone home. This also means time to unwind, watch television or read before bedtime and sleep. I would mention that therapy sessions can be in the afternoon, and some other group sessions available are: Current Affairs (a time of looking at the newspapers and discussing the topics reported); Reading Group (topical articles are read aloud and discussed); Book Group (each group decides on a book to read and discuss chapters read); Craft Skills (participating in paintings, card making and origami). There are also one to one sessions for Pampering etc. 11
12 12 Cultural, Religious and Social Needs We will discuss with you your cultural, social and religious needs during your settling in period and we will ensure that these needs are catered for. We will facilitate meetings with a representative of your chosen religion at any time Smoking In line with current legislation, we do have a designated smoking area outside our centre. Smoking in any other area is strictly prohibited. For patients who choose to smoke, we complete a detailed risk assessment to agree on matters such as whether you need assistance or supervision. We would request that matches and lighters are handed to our nurses for fire prevention and safety. We are more than happy to facilitate smoking cessation if you request help with this. Outside Appointments Part of normal everyday life involves going to the hairdressers and/or beauticians and other therapists, for example, reflexologists. We are happy to organise these appointments for you but these are not included within the cost for our service. Patients Meetings Our patients hold regular meetings, which act as a forum for them to raise any concerns they might have with our service or care and to discuss any suggestions to improve life at the centre. Dates of meetings are posted on our noticeboards. Transport Our centre owns a minibus which is used to take individuals out for trips or for appointments. It is only driven by approved drivers. Other transport services, such as taxis, can be arranged as required, although the cost for these will have to be met by the patient or their family. We can explore entitlement and other options for financial support for transport if necessary. Newspapers, Magazines and Mail Any mail that is addressed to you will be handed to you promptly and unopened. If you need any help with opening or reading your correspondence, a member of staff will, of course, be happy to help you. We are also happy to post letters on your behalf. We can also organise regular delivery to the centre of newspapers and magazines but you will be expected to cover the cost of these.
13 Visitor Information Visiting hours are between 10am and 8pm. We do ask though, that if possible, visitors avoid mealtimes and therapy times unless arrangements have been made for the visitor to be involved. Visiting pets and children are also welcome but we do ask that they are supervised at all times and that you advise the Ward Manager in advance. You can either entertain your visitors in the privacy of your own room or in one of the lounge areas or garden areas. Unfortunately, there is limited car parking on site. For the safety of our visitors, we ask all visitors to sign our visitors book on arrival and to sign out again on leaving. In the event of a fire, staff will instruct visitors on our building evacuation policy. To ensure that all our patients remain safe at all times, all external doors are keypad protected. This may mean that visitors sometimes have to wait at the door until a member of staff is available to let the visitor in. We do apologise for the inconvenience that this may cause but this simple rule enables us to keep our patients safe. We also ask that if any visitor to the centre sees anything or anyone suspicious, that they alert staff immediately. With regards to smoking, it is not permissible for visitors to smoke at our centre. Meals can be provided for visiting family and friends but our centre will request a small fee for these. To ensure that we have ordered enough food for the day, please can orders for visitors lunch and dinner be placed before 10am and 3pm respectively. We are unable to allow visitors to bring in home-cooked meals for food safety and hygiene reasons. There is some further information that may be useful to visitors in other sections of this guide. 13
14 Security Your security whilst staying with us is of the utmost importance. We have a number of security systems on doors throughout the building. Our staff will advise you how to access these. The entrance to our centre has a keypad entry system and whilst it would seem appropriate to give the code to frequent visitors, it becomes meaningless as a security measure if the code becomes widely known. For this reason, we do not give out entry codes even to our frequent visitors. Fire Procedure Our centre is equipped with a modern fire alarm system and we have taken the advice of our local fire department about signage for fire exits and instructions as to what to do in case of a fire. Our furniture and fixtures and fittings are made from fire-resistant or fire-retardant fabrics and materials. When you move into our centre, both you and your relatives will be informed of the fire evacuation procedure and the congregation points. We will always ask your visitors to sign in so we can account for every person present in the building in case we need to evacuate. We would also draw your attention to the fact that bedroom doors should not be propped or wedged open at any time. Some rooms are fitted with portable devices which hold the door open, but release when the fire alarm sounds to prevent the spread of fire. The fire alarm is a very loud continuous siren, quite different to the sound for nurse call or door bells. If the alarm sounds, staff will follow our fire evacuation procedure. A fire alarm test is carried out routinely every week to ensure that the system is working properly. We also run an unannounced actual fire drill on a monthly basis. If you wish to know more about our fire procedures, please ask to see a copy of our Health and Safety manual. Risk Management We have policies in place to manage risks. Choices should not always be ruled out simply because it involves risk, as responsible risk-taking is part of normal life. We can complete a risk assessment before you leave the centre for either a home visit or planned outing. 14
15 Respecting Each Other Whilst we try our best to provide a home-from-home and happy environment for all our patients, you can help us achieve this by showing respect to your fellow patients and members of staff and by adhering to a few guidelines: Please do not enter other peoples bedrooms as this is someone s private space. Only smoke in the designated areas and do not share your cigarettes or tobacco with a fellow patient as there may be a clinical reason a particular patient is unable to smoke. For safety reasons and to adhere to fire regulations, we ask that all lighters and matches are handed in to the nurse on duty. Do not take photographs or video other people within the centre. If using your mobile phone in a communal area, please have consideration for those around you by keeping the duration of the call to a minimum. Do not bring drugs, alcohol, sharp objects or glass into the centre. Discuss any vitamins or alternative treatments with the medical team before use as they may interact negatively with other treatments. Please inform the nursing team if any food or drink is brought into the centre. Follow the individual guidelines put in place by the team as they are for patient safety Do not use abusive language or threatening behaviour towards a fellow patient or a member of staff. Remember that some of our patients, due to their condition, may behave in ways you may consider inappropriate. 15
16 Complaints How to make a complaint: We want to resolve any problems as quickly and as informally as possible. In many cases discussing it with your named therapist or named nurse is all that is needed to put things right. If you do not want to speak to a member of staff directly responsible for your care, you can take your complaint directly to the Centre Manager who is responsible for dealing with complaints. Any member of staff will be able to advise you how to do this. The Centre Manager will then log the complaint in the Complaints Register and assign someone to investigate your complaint. If you would prefer independent help in addressing an issue, we can facilitate advocacy arrangements. If you are not happy that your complaint has been handled to your satisfaction by your Centre Manager, you are at liberty to contact our Clinical Compliance team who deal with complaints. You can do this by writing to the following address: 1. Clinical Compliance Feedback and Complaints The Huntercombe Group Tulip House Craven Court Willie Snaith Road Newmarket Suffolk CB8 7FA T: E: We aim to handle all complaints within 20 days of the complaint being raised. Where this is not possible we will advise you and give you an alternative timescale. 2. If you have reached the end of the complaints process and are still not happy, or if your complaint hasn t been resolved after six months, you can complain to the Parliamentary and Health Service Ombudsman: Millbank Tower Millbank London SW1P 4QP Enquiries: Fax: You should normally refer your complaint to the Parliamentary and Health Service Ombudsman within 12 months of becoming aware of the problem. 16
17 About Your Rehabilitation Our philosophy is to provide our patients with a safe and comfortable environment in which to achieve their own personal rehabilitation goals, whatever their physical, psychological, emotional, cultural and spiritual needs. 17
18 Your Rights When you go into hospital or a specialist centre, you have certain rights and there are things that should always happen. These are listed below: Your best interest must always be taken into account. You should always be kept as fully informed as possible, and receive clear and detailed information concerning your care. Your views, wishes and feelings should always be considered. You should always be treated with dignity and respect. You must be informed of the type or nature of treatment that is being proposed; the reason for it and how it is likely to affect you. You have a right to withdraw your consent to treatment at any time, and must be told how and when treatment can be given to you without your consent. Your progress and possible changes in your care plan should be reviewed at regular intervals. You have a right to appeal against a decision to section you under the Mental Health Act. Any intervention in your life (like how long you are kept in hospital) should be as unrestrictive as possible, and mean the least possible separation from your family, friends and community. You have the right to have contact with family and friends either through visits or on the phone (except under exceptional circumstances). Any intervention in your life should result in the least amount of stigma. You should be able to have as much access to education that is suitable and right for you, if applicable. You have a basic right to food, shelter, water, warmth, a comfortable environment, confidentiality or reasonable privacy (both physical privacy and privacy in regard to your personal thoughts and feelings). Rights of relatives/ carers Your family and carers have a very important role in your life and in supporting your care. Your admission to a specialist centre can be a difficult time for your family too and it is important that they are kept involved in your care. At the same time, you have a right to confidentiality (as long as this does not present a significant risk). We work closely with families throughout your time with us. Parents and carers can contribute to the review of the care plans, either by using feedback forms, or attending the review meetings or discussing plans on the telephone with senior members of the team. Sometimes family and/or carers have to consider making hard decisions in your best interest, such as consenting to your treatment, or discussing the use of the Mental Health Act if no other alternatives are available. 18 Independent advocacy service An independent advocate is a person who is not employed by or linked to the centre and is there solely to help, advise and represent you. Ask a member of staff if you require this service.
19 Moving in An individual nursing and therapy assessment will be undertaken in your current setting e.g. hospital. This is to ensure that we are able to provide the exact service you need to help you achieve your individual goals. We encourage anyone considering moving into our centre to visit before making the final decision. A member of staff will be happy to show you and your relatives our facilities and to introduce you to key members of staff. This will give you the opportunity to sample the atmosphere and to see at first hand the quality of service we offer. On admission, you will be allocated your own named therapist and named nurse. Your named therapist and named nurse are members of our team assigned to oversee your care and treatment during your time at our centre. The names of both your named therapist and named nurse are written on the back page of this guide. Following your admission, our team will undertake a period of assessment, following which a goal-orientated and personcentred care plan will be developed. This care plan details your individual needs and tells you who will provide the services you need. It will be a document given to you by a member of staff. If you need to access a copy of your care plan at any time, please ask. Your care plan and goals will be regularly reviewed and documented to make sure your needs continue to be met and we will always involve you and your family, if appropriate, in any decisions regarding your care. All changes to your care plan will be documented within your care plan. We actively encourage your and your family s involvement, if appropriate, in all aspects of your care. This includes participation in: the planning of your care and in the setting of your goals the planning of and involvement in social activities menu planning and service development If, at any time, you wish to discuss your care plan, you can speak to your named therapist, named nurse or any other member of the team. Review Meetings Case review meetings will be held at regular intervals to discuss your progress, your future care and rehabilitation needs. These case review meetings will be attended by the members of our team directly involved in your care, you, your relatives and may also include your funder, your care manager or representative, if applicable. At the review meeting, plans for discharge may be made with you and your family and a date for discharge may be set. Alternatively, you may actually require further time with us to reach your rehabilitation goals. Your general health will also be regularly monitored by our clinical team and we will organise routine appointments with opticians and dentists. We also organise regular reviews with social workers and continuing care nurses. We can also arrange input from other specialists, for example, chiropodists and tissue viability nurses. 19
20 Person-Centred Rehabilitation The focus of this service is on increasing participation in everyday activities, wherever possible, and encouraging autonomy for the individual despite mobility and other physical or cognitive restrictions. Depending on your needs, there are individual and group therapy sessions available to help assess your needs and strengths, and to work towards your goals. We routinely use a range of outcome measures and patient-centred goals to obtain an objective measure of progress and change. You, our patients, are at the heart of person-centred care. Goal Setting Involvement/Inclusion We will involve our patients in all decisions relating to their care and rehabilitation We will involve family members as partners in goal setting and care planning We will encourage our patients to be part of life at the centre and the wider community of their choosing. Our Patients will Be kept safe Be treated with dignity and respect Have their privacy respected Be able to make their own choices about how they live their life whilst staying in one of our centres Be empowered to be as independent as possible wherever possible Have their rights to confidentiality respected We will assess each patient s capabilities on admission and on a regular basis and together agree individual goals We will identify the support required by each individual to achieve their goals and enable access to the right support at the right time. The care plan and goals will remain live - we will be flexible and modify the care plan according to the patient s changing wishes and needs by listening to our patients and putting into action what they want for their lives. 20 Tell us if you are not sure about any aspect of your rehabilitation or care plan or how to access a copy.