Section 6 Legal issues

Transcription

1 Section 6 Legal issues Anyone who suffers a brain injury in an accident should seek preliminary advice from a specialist personal injury solicitor about the possibility of compensation as soon as they can. Compensation can be awarded for injuries received only if it can be demonstrated that another party was responsible for the accident, either wholly or partly. However, even if the injured party appears to be solely responsible, it is worth seeking advice in case limited negligence by another party can be identified. The initial interview is usually free of charge and will establish whether there is a case for claiming compensation. The solicitor will need to get a clear picture of the circumstances surrounding the accident and the nature of the injuries sustained. In the case of severe injury, the first assessment interview may take place in the hospital. The Brain Injury Handbook 87

2 Selection of the legal team Bill Braithwaite QC is a specialist in catastrophic personal injury cases and the author of Brain and Spine Injuries The Fight for Justice. Here he outlines the process of choosing legal representation where this is necessary. The following information applies to the legal systems in Scotland and England. In the event of a claim being considered, the selection of a legal team is extremely important. The process of making a legal claim is difficult and it can be made more so by lawyers who are not suited to either the individual or the type of claim. Catastrophic personal injury claims are now a specialised area of claim management and the legal team needs to be sufficiently experienced in this area of work. The key element in the team is the solicitor. They are the person who has the daily conduct of the claim and who communicates everything that matters to the person with a brain injury and their family. It is important for the individual who has sustained a brain injury to select an experienced solicitor, and to make sure that it is someone who will be able to carry out the claim from start to finish. In my opinion, it is important to make sure that you select an individual, not just a firm, as it is the individual who you will be dealing with, and who you must trust. It is beneficial for the team to be created at an early stage. It is almost universal that the solicitor would decide to use as a consultant a barrister who specialises in the preparation and presentation of this type of catastrophic claim. That would mean that the solicitor would select and instruct a barrister, and this should be done before the claim is too far advanced so that the individual with a brain injury, and their family if appropriate, can get to know the whole team early on, and the team can get to know them. The person with a brain injury, and their family, have the right to ask detailed questions about the solicitor and barrister before they commit themselves to instructing them. Appropriate questions 88

3 Legal issues Section 6 might include those set in the questionnaire opposite. Although it is important to meet the solicitor before deciding whether to instruct them, the questionnaire could be given (or sent) to more than one solicitor, so that some early impression can be gained of their experience. A good track record established by clear evidence is important, and should be explored in detail. It is not sufficient just to rely on a solicitor saying that they, or their firm, have done this type of claim before. You need to know much more: how many, at what value did they finalise, how long ago was it, what was the type of injury, and so on. The response of the solicitor may give some indication of their character; if they are embarrassed or offended by this questionnaire, or consider it impertinent or rude to be asked these questions, the reason may be based on lack of experience of this type of work. The individual and their family may also want to ask the solicitor how they intend to communicate with the client during the course of the case. Some people like to have frequent letters describing progress, some fear and dislike such constant reminders. Some prefer the phone, but others don t. Personal visits are an obvious possibility, but again not all people welcome the intrusion into their home. Personal contact is essential, however, because the relationship between the patient and the legal team, including the barristers, is so important. As the claim progresses, the injured person and family should build up complete confidence in the knowledge, experience, support and ability of the legal team. There is no right or wrong way, but there is likely to be a system that will suit the family in question. Sample questions to ask a solicitor Are you a member of any specialist organisation related to the conduct of brain injury litigation? If so, please give details. Have you been approved, franchised or accredited by any specialist organisation related to the conduct of brain injury litigation? If so, please give details. Have you received any training or education related to the conduct of brain injury litigation? If so, please give details. Have you ever conducted this type of claim before? If so, please give a brief description of each case, including the nature of the injury, the stage proceedings reached and the value of the claim as finalised. Do you have any system whereby the quality and efficiency of your work is audited by an independent body? If so, please give details. Do you expect to be in charge of the case throughout its duration? The Brain Injury Handbook 89

4 Making a claim If you are happy with the initial advice received from a solicitor, you should instruct them to act. The solicitor will collect evidence from all concerned parties in order to establish a view on liability (the legal term for blame). This may include interviewing and obtaining evidence from witnesses and, in the case of a road accident, getting a police report. The time that this takes depends on the complexity of the case. Alleged medical negligence claims are particularly complex. If, after collecting the evidence, the solicitor thinks that liability can be established, they may apply to the court for what is called a Summary Judgement. This enables part of the claim to be dealt with quickly before going to trial. Alternatively, the issue of liability may need to go to trial before financial compensation is calculated. If you are worried about going to court, remember, the vast majority of cases are settled out of court. The solicitor will also need to collect evidence to establish the effects of the brain injury on all spheres of life: short-term, long-term, and future health and work prospects. This is necessary to calculate financial compensation (called Quantum ) and will involve arranging for specialist reports from a variety of professionals. These sources will vary depending on the nature of the injury but could include reports from any one of the following: Doctor (GP/specialist who may have been involved in early care), physician, surgeon (possibly a neurosurgeon), orthopaedic surgeon or plastic surgeon Neuropsychologist for an assessment of cognitive skills, personality and judgement regarding future prospects Consultant for an independent medical report to provide a medical overview Case manager (if one is involved) Reports may also be requested from an occupational therapist, psychiatrist, school or former employer and possibly an employment rehabilitation consultant to advise on occupational potential and earning capacity. In the case of severe brain injury, this part of the claim is likely to take a long time, not least because of the recovery time. 90

5 Legal issues Section 6 Time limits Where the injured person is an adult, the legal time limit for accident claims is normally 3 years. However, there are exceptions: There is no time limit for starting a case in serious head (brain) injury cases where the person is so seriously disabled that they are incapable of managing their own affairs. In some cases, particularly medical negligence cases, the injured person may not be aware that they have been injured as a result of someone else s mistake until after 3 years have passed. The solicitor will examine the circumstances surrounding the injury and then advise whether the injured person is still in time to bring a claim. If the victim is a child at the time of the accident, the 3-year time limit does not commence until the age of 18 years is reached. Calculating financial compensation Calculating a personal injury claim (PIC) is a highly specialised procedure. Both the person and their solicitor will need to ensure that every eventuality is accounted for and that records are kept so that claims can be made for every loss and expense. For example, PICs have two elements: special damages and general damages. Special damages are awarded to compensate for all direct financial loss incurred as a result of the accident, e.g. private medical fees, cost of equipment, travelling expenses, damage to vehicle and clothing, loss of wages, etc. General damages have three components: 1 Pain, suffering and loss of amenity (amenity refers to loss of capacity caused by physical or psychological problems). 2 Loss of earnings including future earnings or promotion prospects. 3 Care needs, e.g. cost of providing care, specialist rehabilitation/therapies, accommodation, special aids and adaptations, and transport. The Brain Injury Handbook 91

6 Interim payments You do not necessarily have to wait until the case is settled before receiving money. A solicitor can apply for an interim payment and should do so if at all possible. This involves applying to the defendant for some of the damages immediately or well before the case is settled. As detailed earlier, rehabilitation can make a tremendous difference to the quality of recovery and eventual independence. An interim payment will enable the injured person to obtain whatever is required to aid their recovery when it is needed, as opposed to waiting until the case is settled, which can take up to 4 years. Being awarded an interim payment involves the insurers of the defendant paying some of the damages before the case is finalised. PI Ad Aug 13:Layout 1 15/08/ :32 Page 1 We are here to provide the support you need Specialist Personal Injury Lawyers If you or someone you are close to has suffered from an injury this will be a difficult time for you. At Lester Aldridge, our specialist lawyers are here to support you through the crisis, protect your interests and ensure that you receive the compensation that you deserve. Call our Bournemouth office or visit our website

7 Suffered a serious head injury? We can help brighten your future. At Harris Fowler, we support you every step of the way. We understand the complexities of your injury and how your life is affected by it. We look at the long term impacts of your injury and do our very best to achieve the highest level of compensation, rehabilitation, medical care and support services for you. Our friendly, experienced and specialist team will take the burden of making a claim away from you and provide a helping hand to guide you to a better future. We understand that it s not just about compensation. It s about rebuilding a life. Adverts To find out if you could claim compensation CALL FREE or VISIT us online harrisfowler.co.uk It s NO WIN, NO FEE. Harris Fowler is a trading name of Harris Fowler Ltd, authorised and regulated by the Solicitors Regulation Authority No You ve got nothing The to Brain lose Injury and perhaps Handbook a lot to gain

8 Brain injury and community care law Simon Garlick of Ben Hoare Bell LLP Solicitors, Newcastle upon Tyne, outlines how community care law affects people with brain injuries and their carers. The following information applies to the legal system in England. Individuals who have sustained brain injuries, their families and carers, must usually look to the state s statutory services in the form of the NHS or their local authority for the provision of appropriate care. In most cases, statutory services will be the only source of professional care and support in the longterm. For a minority of people, they may be used in the short-term only, until a private care package, funded from existing savings, insurance, or by a compensation payment, can be put in place. The NHS and local authorities are subject to many legal duties that oblige them to assess the needs of both the person with the injury and their carer(s). They are empowered, and often under a legal duty, to provide a range of services, which may include residential or nursing home care, nursing or social care at home, provision or adaptation of accommodation, short breaks (respite care), disability-related equipment, day centre services, assistance with travel, breaks and holidays, as well as counselling and befriending schemes. These services may be provided by the NHS or local government, using their own or agency staff. Alternatively, if certain conditions are met the services may be funded by handing over a budget to the individual, leaving them or their carer(s) to choose and to buy the necessary service this is called Direct Payments (also known as Personal or Individual Budgets). In many cases, statutory service provision is of a high standard, but sometimes assessments and services are not provided when they should be, whether because of a shortage of resources or staff, or due to a lack of understanding on the part of statutory services about what their powers and obligations are. In such cases, it is important that individuals with brain injuries and their families or carers have access to an advisor who knows about community care law, and who can ensure that statutory services fulfill their obligations, particularly in these times of cuts in local authority and NHS services. 94

9 Legal issues Section 6 Assessment Under Section 47 of the National Health Services and Community Care Act 1990, where it appears to a local authority that any person, including children, may be in need [ ] of community care services the authority must assess their needs and make a decision about what services are to be provided to meet those needs. This provision relates to the provision of social care for which local authorities are generally responsible, rather than nursing or medical care for which the NHS is responsible. Assessments must be carried out within a reasonable time, cannot be delayed or refused because of shortage of local authority funds, and will result in a person s needs being banded according to the level of risk to their independence that will result if services are not provided. Psychological, emotional and social needs are as relevant as physical needs. The four bands are critical, substantial, moderate and low. Most local authorities fund services to meet all critical and substantial risks, and a few meet some moderate band risks. Once a local authority has decided that a person s needs are serious enough to be funded, it must provide a service and is not entitled at that point to refuse or defer services on the grounds of shortage of resources. If there are alternative ways of meeting assessed needs, a local authority is entitled to take into account the relative costs in choosing which service to provide. Once a service has been assessed as necessary, the local authority is not entitled to withdraw or reduce the service without first carrying out a reassessment. The Department of Health s Guidance on the Provision of Adult Care (referred to as the Prioritising Need Guidance of 2010), which is binding on local authorities, sets out precisely how they must carry out the banding exercise. For example, needs for services will be banded as critical if in the absence of services the following (among other issues) would occur, or have already occurred: Significant health problems Inability to carry out vital personal care/ domestic routines Unsustainability of vital social support systems and relationships Unsustainability of vital involvement in work, education or learning Little choice/control over vital aspects of immediate environment Local authorities, like the NHS, must also take into account the rights of every individual under the European Convention of Human Rights (ECHR), which was incorporated into English law through the Human Rights Act Included are the right not to be subjected to inhuman or degrading treatment (Article 3) and the right to respect for private and family life (Article 8), which embraces many aspects of personal autonomy and independence. This last right is qualified, which means that it can be infringed if there is a lawful and proportionate justification, such as the genuine prioritising of limited resources. There are several other assessment provisions that are relevant to particular groups of people or types of services, including specific obligations on the NHS and local authority social services to carry out thorough assessments and put in place necessary services before the point of discharge from hospital. Assessment and provision of services to children (under 18), and in limited circumstances young adults, is generally carried out by local authorities in exercise of their functions under the Children Act Children with disabilities are Children in Need for the purposes of the Children Act, and so have the right to in depth assessments, and may (in many cases must) be provided with services (or Direct Payments in lieu) to meet their assessed needs. The Brain Injury Handbook 95

10 Carers There are thought to be over 5 million carers in the UK, of whom over 1 million provide more than 50 hours of care a week. The value of unpaid care is said to be about 118 billion per annum. Carers defined as those who provide a substantial amount of care on a regular basis have important statutory rights. Carers must normally be consulted by the local authority social services staff when they carry out an assessment. The assessor is under a duty to consider the ability and willingness of the carer to continue to provide care. However, carers rights are not confined to participating in the assessments of those for whom they are providing care. Carers and those intending to be carers have a right to request that a Carer s Assessment be carried out, either simultaneously with the assessment of the individual concerned or independently. Services that may be provided to carers may include physical help for example, with housework, shopping or collection of prescriptions or other forms of support such as training, counselling, a mobile telephone, travel assistance, driving lessons or provision of equipment. Services might include the provision of holidays or special trips and, often of great importance, the arrangement of respite or temporary care to give the carer a break. Although technically local authorities have a power, rather than being under a duty to provide services to carers, in practice they sometimes have no choice but to do so. Carers, like the person being cared for, have their needs assessed according to the level of risk that will apply in the event that services are not provided. The risk being measured is the risk to the sustainability of the carer s role. Local authorities not only have an obligation to inform carers of their rights to an assessment but, when assessing carers, must specifically take into account the effect of their caring role on their ability or wish to work or undertake education, their family and social responsibilities, their autonomy and their health. NHS or Social Services? Department of Health guidance states that when a person needs a certain intensity or level of nursing care, as opposed to social care, they should be assessed as being eligible for NHS Continuing Healthcare, the effect of which is that all care whether social or nursing and, in certain cases, accommodation is provided free under the NHS. This contrasts with the position of those people who remain the responsibility of local authorities, which are entitled to means test and charge for the provision of community care services, including accommodation. The borderline between social care and NHS care is a controversial area and is described in the Department of Health s National Framework for Continuing Healthcare (amended November 2012). In the past, the Health Commissioner (Ombudsman) has criticised Primary Care Trusts the NHS bodies responsible for assessing eligibility for NHS Continuing Healthcare for excluding many people who ought to have been assessed as eligible. When a person who has suffered a brain injury may need substantial nursing or medical care, it is important that advice about possible eligibility for NHS Continuing Healthcare is sought. On the other side of the coin, it is important to note that the NHS is not subject to the same individuallyenforceable duties as local authorities, as the legislation governing the NHS allows it far more discretion about how and when services are provided to patients. For example, once a local 96

11 Legal issues Section 6 authority has assessed a person as needing a community care service, it must provide that service. By contrast, even if a patient needs an operation, the NHS is quite entitled (subject only to European Court of Human Rights considerations) to put an individual on what may be a long waiting list. There is now scope for the provision of Direct Payments to those who are Continuing Healthcare patients. These are available by virtue of the NHS (Direct Payment) Regulations Capacity and consent Individuals who have sustained serious brain injuries, with enduring effects, often have impaired abilities to take certain decisions. These decisions may relate to the most important choices in life: where to live, whether or not to undergo serious medical treatment, how to spend income and savings, which people to have contact with, etc. If the injured person is an adult (or in most cases aged 16 or over), no other adult, however closely tied to the injured person, has the legal right to make these decisions on their behalf, unless specifically authorised to do so by the Court of Protection, or validly appointed to do so under a Lasting Power of Attorney. It may sometimes be difficult to decide whether a person does, or does not, have capacity to take decisions themselves. These issues are governed by the Mental Capacity Act 2005, which sets out that capacity is issuespecific (a person may have capacity to take certain decisions, but not others) as well as timespecific (capacity to take a particular decision may vary at different periods). There is a presumption that a person has capacity. who may be empowered to take certain decisions on behalf of patients, and independent mental capacity advocates, who assist in particularly vital decisions about where a person should be cared for and whether he/she should undergo serious medical treatment. If a person is assessed as lacking capacity in relation to a particular issue, any decision taken must be in their best interests. Best interests must always include consideration of the wishes of the person concerned (although if they lack capacity, their wishes will not be decisive) and should always include consultation with anyone engaged in caring for the person or interested in his/her welfare. Conclusion Community care law is a fragmented and technical area. As a glance at the government website will reveal, it is also an area that develops and changes with great speed. Many victims of accident or assault who suffer brain injuries with significant effects do not receive the statutory services to which they may be entitled. Often they, or those who care for them, are too worn down to question whether they are entitled to more than is offered. Many people are not aware that there are detailed laws and binding guidance that spell out the powers and duties of local authorities and the NHS towards those with disabilities. Lack of appropriate services can have serious consequences for a person with a brain injury and their carers and family. In contrast, provision of appropriate services can bring about substantial improvement in the quality of life for all concerned. The Act sets out how capacity should be assessed. It goes on to provide mechanisms for decisions to be taken for those who are assessed as not having capacity, including the appointment of Deputies, The Brain Injury Handbook 97

12 Social service provision and case managers in Scotland Robert Swanney, senior partner at Digby Brown Solicitors, outlines the financial issues that may arise in the case of litigation. The value of compensation When someone suffers a brain injury due to the fault of another party, it is reasonable for that person to seek fair and prompt compensation. While compensation cannot turn the clock back, it can pay for rehabilitation and proper care, which are often not available through NHS or social work services. In order to establish just what is needed, and to show the court that it will work well, it is good to set up a care regime as early as possible, so that the court can see that it is appropriate and effective. Funding the care regime Like the Claimant in England, the Pursuer in Scotland is able to seek interim damages and to use these to set up and manage a care regime. The law in Scotland does require that the Pursuer is certain of success and a full valuation of the case has to be placed before the court. If satisfied that interim damages should be awarded, then a reasonable proportion (perhaps up to 60%) can be given. It is, therefore, necessary for a written defence to be lodged, which inevitably means that the case will have had to proceed to an advanced stage. If the insurers accept liability at an early stage then as in England voluntary interim payments are often made. Alternatively, social work departments can provide support, possibly through Direct Payments. Lord Carloway in the case of Fletcher v Lunan did indicate that judicial thinking was moving in the same direction as England, with the court simply asking whether the claims in respect of 98

13 Legal issues Section 6 care are reasonable and awarding damages to pay for it if so found. Many insurers, however, continue to argue that, if the local authority will pay for a care regime, then the Pursuer has suffered no loss and the insurer should not be required to pay damages in respect of care. Will the State provide funding? The position in Scotland has been similar to that in England since the National Health Service and Community Care Act 1990 came into being. The statutory authorities (through social work departments) are required to carry out an assessment of need, and to try to meet that need from their resources. Certain sections of the Act do not apply in Scotland and the different legislative framework set out in the Social Work (Scotland) Act 1968 and the Community Care and Health (Scotland) Act 2002 leads to a different and less certain position in relation to financial assessment by the local authority for the provision of nonresidential care. In other words, when it comes to providing care in a person s own home, rather than nursing home care, there is a good deal of variation between one local authority and another. The Brain Injury Handbook 99

14 Financial assessment by local authorities in Scotland As in England, these arguments have necessitated a review of the law on financial assessment provisions for both residential and non-residential care. It is generally accepted in Scotland that for residential care these provisions are the same, with Charging for Residential Accommodation Guidance (CRAG) applying. Money derived from a personal injury held in a personal injury trust or to the order of the court, is excluded from the means-testing process in relation to capital and income. The position in relation to charging for non-residential care is entirely different, with local authorities maintaining that they have discretion as to whether to charge and the level of the charge. This is important because after a brain injury most people are living at home, rather than in a nursing home, and it means that in these cases the local authorities have discretion each can decide for itself and can change policy from time to time. In Scotland, the UK s Fairer Charging Guidelines issued under Section 7 of the Local Authority Social Services Act 1970 do not apply. The Convention of Scottish Local Authorities issued a voluntary guideline in January 2006, which makes no mention of money derived from a personal injury and specifies those items of income and capital that can be excluded. This guidance is not binding on the local authorities and, as a consequence, the financial assessment approach differs from area to area. However, the prevailing practical approach by many local authorities is to include capital and income derived from a personal injury this means that, if a person has received an award of damages, they will have to pay the maximum charge for any care received. While this may seem beneficial to those having to counter the insurer s place that the local authority will pay for the care regime, it does leave the Pursuer in a difficult position if the settlement is a compromise one in relation to care. This will frequently happen in cases where the Claimant is partly responsible for the accident, e.g. for not wearing a seatbelt. The result for the Claimant is that damages awarded for pain and suffering are used to pay for care. The solution It is clear that all Pursuers with brain injury should seek to set up and manage their care regime privately and that the appointment of a case manager will invariably be necessary. For that reason, expert legal advice will give access to the needed rehabilitation services in the form of an experienced rehabilitation provider, with case managers who are members of BABICM or CMSUK and who have proven experience in managing nonresidential care regimes for those with a brain injury. It is important that the Pursuer gets advice from experienced specialist personal injury lawyers. 100

15 Legal issues Section 6 The Court of Protection and the Office of the Public Guardian The Court of Protection and the Office of the Public Guardian make decisions about property and welfare for those who lack capacity to do so. The Court of Protection and the Office of the Public Guardian were created under the Mental Health Capacity Act (the Act), which came into effect in England and Wales on 1 October 2007 (separate arrangements exist for Scotland and Northern Ireland). The Court of Protection The Court of Protection makes decisions in relation to the property, affairs, healthcare and personal welfare of adults (and children in a few cases), who lack capacity. The court also has the power to make declarations about whether someone has the capacity to make a particular decision. The Office of the Public Guardian The Office of the Public Guardian (OPG) is an agency of the Ministry of Justice. The OPG supports and promotes decision-making for those who lack capacity or who would like to plan for their future within the framework of the Act. The head of the OPG is the Public Guardian. The Public Guardian is responsible for: supervising deputies appointed by the court keeping registers of deputies, lasting power of attorneys (LPAs) and enduring power of attorneys (EPAs) investigating representations, including complaints about deputies and attorneys acting under registered LPAs or EPAs The Mental Health Act The Act provides a basis to empower people to make decisions for themself as far as is possible, and to protect vulnerable people who are not able to make their own decisions because of the way their brain is affected: for instance, from illness, injury, disability or substance misuse. The Brain Injury Handbook 101

16 It sets out options for people who want to plan ahead, enabling them to appoint someone they trust to make decisions if they should lack capacity at some time in the future, and it clearly sets out the law on advance decisions to refuse treatment. The Act also gives further protection to vulnerable people by making a criminal offence the ill-treatment or willful neglect of someone who lacks capacity. In addition, it provides protection for carers and professionals working with people who lack capacity, who comply with its provisions. The Code of Practice The Code of Practice (the Code) provides guidance on how the Act works on a day-today basis. It has case studies and explains in more detail the key features of the law. Certain categories of people have a legal duty to have regard to the Code, they include: professionals and anyone who is paid for the work they do in relation to people who lack capacity, e.g. doctors, nurses, social workers, case managers, solicitors, police officers, paramedics, carers and attorneys appointed under the LPA or an EPA deputies appointed by the Court of Protection Family, friends and unpaid carers do not have a duty to have regard to the Code but will find the guidance helpful. Deputies Some people may feel that an LPA is not for them. If this is the case, and the person then loses the capacity to make important decisions in the future because of the way their brain is affected, then a relative, friend or a professional may need to apply to the court to be given authority to make decisions on behalf of this person. The court can appoint someone to make a single decision, or it may appoint someone known as a deputy to make a series of decisions. In this instance, whoever the court appoints might not be someone who the person would have chosen themselves. What is an LPA? An LPA is a legal document that allows a person (the donor) to choose someone now (the attorney) that they trust to make decisions about things such as property and affairs, or personal welfare, for them at a time in the future when they lack the capacity to make those decisions. An LPA must be registered with the Office of the Public Guardian (OPG) before it can be used. LPAs replace the previous system of enduring power of attorneys (EPAs). An EPA made before October 2007 is still valid, and must also be registered with the OPG should the donor lose capacity in the future. However, an EPA allows a chosen attorney to only make decisions regarding financial affairs. If a donor would like to appoint someone to make decisions about their personal welfare should they lose capacity, they would need to make a personal welfare LPA. 102

17 Legal issues Section 6 For more information about the court or the OPG, including the type of applications that may be made and the forms required, please either: Visit the OPG section of or Call the OPG on (Monday, Tuesday, Thursday, Friday, 9am 5pm, Wednesday, 10am 5pm) customerservices@publicguardian.gsi.gov.uk It is recommended that individuals consider seeking their own independent legal advice OPG staff will not be able to provide this. Call Jon Nicholson on or visit When you need a solicitor who will see you as an individual Anthony Gold specialises in helping those who ve been wrongfully braininjured to claim compensation. Our partners are experts in this field. We respect our clients individuality; they value ours because it s focused on winning their cause. We ll come to see you wherever you need at home, at hospital or at one of our three London locations. We will fully explain how your case can be funded, being transparent from the outset. The Brain Injury Handbook 103

18 3L Care Nursing Community Interest Company A not for profit organisation providing Respite, Residential and Day Care to people with Acquired Brain Injury and complex health needs. We provide a warm, cheerful & homely environment for young people & adults aged 16 and over. Our nurses & carers can deliver specialised care, including, tracheostomy & gastrostomy care, seizure management & oxygen therapy. 24 hour waking nursing staff ensure round the clock care. As a small, seven bed home, our staff are able to spend more time with each person to ensure that we meet their individual care and social needs. Modern in house facilities such as hydrotherapy pool, cinema & sensory chill out room. A very big thank you to all the staff at 3L who looked after our son. He seems to have been extremely happy with you and we couldn't ask for more. Call Allison Murphy on at 3L Care Chapel Rd,Winsford, Cheshire, CW7 3AD. AKA Case management are leaders in enabling those with brain injury, spinal cord injury and cerebral palsy to put meaning into their lives and live life to the full. We also provide expert evidence in support of any compensation claim. To find out what we can do for you call us now or visit our website. Call us on info@akacasemanagement.co.uk Helping you live life to the full after injury Supporting independence in acquired brain injury. Advantage Healthcare Group has extensive experience in providing support to individuals with an acquired brain injury. Our Support Workers can provide assistance with; Morning and night time routines Transitioning to more independent living Cognitive re-ablement exercises Motivation and social integration Providing assistance with financial management, diary and appointment planning. Personal care Accessing sport, community activities and holidays Domestic support Our specialist team coordinate every element of our care packages and work with our clients, their families and multidisciplinary teams to deliver an exceptional support service.