Kerwin Court. A specialist neurobehavioural rehabilitation centre for people with acquired brain injury

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1 Kerwin Court A specialist neurobehavioural rehabilitation centre for people with acquired brain injury

2 Contents What is Kerwin Court?...1 Facilities and environment...2 Assessment and rehabilitation...3 Clinical practice and clinical team...4 Outcomes for service users...5 Continuum of care...6 Quality and value for money...7 Case study...8 Where we are...9 Contact information...10

3 What is Kerwin Court? Located near Horsham in West Sussex, Kerwin Court is a specialist neurobehavioural rehabilitation centre for people with acquired brain injury. Opened in 2007, it offers a modern, comfortable and superbly equipped environment for rehabilitation. It forms part of the nationwide network of rehabilitation support services provided by The Brain Injury Rehabilitation Trust (BIRT). What does it do? Kerwin Court provides specialist residential rehabilitation for people with an acquired brain injury who are medically stable and have the potential for increased independence and social re-integration. We work with adults who have to cope with a range of complex physical cognitive, behavioural and emotional difficulties. The rehabilitation model is based on a neurobehavioural approach and focuses on enabling service users to function as independently as possible and regain the skills required to participate in as many of their previous roles and activities as possible. Our aim We aim to provide the best quality neurobehavioural rehabilitation for people with complex and challenging needs after brain injury. Ultimately, we want to enable service users to participate in life as fully as possible, needing the least possible assistance. Professor Michael Oddy, Director of Clinical Services, BIRT Kerwin Court, Horsham 1

4 Facilities and environment Set in attractive landscaped grounds, Kerwin Court provides a calm, bright and modern environment for rehabilitation. The main building has 16 en-suite bedrooms and two selfcontained flats. There are also five separate bungalows where service users are able to further develop their independent living skills before moving into the community. All service users have their own comfortable en-suite bedrooms, complemented by spacious and well-appointed communal areas for dining and leisure. Depending on individual needs rehabilitation can involve a wide range of therapeutic and recreational activities including daily living skills (cooking/food preparation, laundry, money management) as well as memory groups, anger management skills, computer skills, arts and crafts, gardening and relaxation skills training. Access to the wider community forms an important part of rehabilitation. Its close proximity to Horsham, with its many shops and leisure facilities, makes Kerwin Court ideally situated for social integration and also offers opportunities for education and work placements. Family support Kerwin Court provides education and emotional support to individual families as required and has a wide range of family information and resources in its family support room. 2

5 Assessment and rehabilitation Assessment When a service user is admitted to Kerwin Court they undergo a 12 week neurobehavioural assessment to determine their potential for social reintegration and increased independence. This includes assessments of, for example, cognitive skills, the nature and frequency of any challenging behaviour and the service user s ability to engage with the community and complete functional daily tasks. Initial goals are identified with the service user and the first phase of the rehabilitation programme is established. During the assessment period, a meeting is held at which family, funders and other involved parties join our team to discuss the results and to plan the next steps in the individual s rehabilitation. This may involve a further period of residential rehabilitation or a planned transition to a community support package/longer term placement. This is discussed fully with the service user, family and funders, and enables the team to identify any barriers to recovery and link these with the proposed programme of rehabilitation and support. Rehabilitation If a further period of rehabilitation is recommended, the service user will work on their agreed goals within an individualised treatment programme. This may include individual or group learning and therapy sessions, behavioural management, personal, social and domestic skills training, support to structure leisure time, community access and vocational training and support. Rehabilitation goals take into account short, medium and long-term aims such as transfer to a more independent environment for ongoing rehabilitation. The average length of a residential placement varies, depending on individual need. Kerwin Court, Horsham 3

6 Clinical practice and clinical team The clinical team at Kerwin Court comprises professionals from a wide range of disciplines, all of whom are recognised in their field as having special expertise in the management of brain injury. The team is led by Dr Camilla Herbert, Consultant in Neuropsychology and Rehabilitation, and includes clinical psychologists, a speech and language therapist, physiotherapists, occupational therapists, a recreational and vocational coordinator and rehabilitation support workers. Clinical practice is based on a neurobehavioural approach and focuses on a combination of social and behavioural interventions to aid recovery of independence. The emphasis is on a systematic and structured observation of behaviour and skills in everyday situations and tasks. Clinical governance is promoted through BIRT s Clinical Executive, a national forum comprising consultants in neuropsychology and rehabilitation from across BIRT s services. Led by Professor Michael Oddy, the Clinical Executive is committed to promoting clinical governance, training and research, as well as developing and reviewing clinical policies and procedures. Accreditation Kerwin Court has been awarded full accreditation with the Commission for the Accreditation of Rehabilitation Facilities (CARF) and is registered with the Care Quality Commission (CQC), receiving consistently good reports. 4

7 Outcomes for service users In our 2010 satisfaction survey, referrers were satisfied, more than satisfied or extremely satisfied on all 12 key performance indicators for the services provided at Kerwin Court. In 2010, at the time of admission to Kerwin Court over 80% of service users required either direct or indirect full-time supervision. Upon discharge 60% of people were able to manage with no supervision and a further 10% with only part-time supervision. This reflects a highly significant reduction in support needs. On admission, 58% of service users had no productive activity; by the time of discharge this had been reduced to just 5%. At discharge 20% of service users went on to vocational training, supported employment, volunteer roles or back to their roles as homemakers and 75% had a structured recreational or day activity programme. Ongoing monitoring of the severity of neurobehavioural symptoms following brain injury is vital to the rehabilitation process. BIRT uses a series of standardised rating scales to assess cognitive, emotional and behavioural changes over time. Each service user is assessed during their first month of admission. These results are then compared with the same measurements sampled during the last month prior to discharge. This includes monitoring of mood, behaviour and motivation, together with any demonstration of verbal or physical aggression. As well as enabling us to measure service users progress, the outcome measurement system also acts as a valuable tool for individual goal setting during the rehabilitation programme and informs the ongoing care pathway. Satisfaction ratings Feedback is very important to us as it enables us to continuously improve our standards of practice. Each year we ask service users, families and referrers to offer feedback on their satisfaction with our service. The majority of service users who completed our 2010 questionnaire were very happy with the services provided at Kerwin Court, giving special praise for being treated with dignity and courtesy by staff. Of the family members who responded, the majority were satisfied, more than satisfied or extremely satisfied across all 12 key performance indicators. All referrers/funders surveyed also reported the same satisfaction levels. Kerwin Court, Horsham 5

8 6 Continuum of Care BIRT offers a nationwide continuum of services for people with acquired brain injury including post-acute hospital based rehabilitation, assessment and rehabilitation, continuing rehabilitation and community support services. Duration of placements at Kerwin Court vary, depending on the service users level of need and their potential for rehabilitation. A service for those with longer term rehabilitation needs is also available.

9 Quality and value for money BIRT s continuum of care ensures that in most cases a reduction in costs occurs as a service user moves towards greater independence. On average, the lifetime cost savings are between 800,000 and 1 million, if a service user is admitted within one year of brain injury.* Reducing costs through the BIRT continuum - a case study: When Steven came to BIRT, any attempt to engage with him resulted in outbursts of violence and aggression. After moving through BIRT s continuum of services, costs were reduced as follows: Challenging Behaviour Assessment and Rehabilitation Centre move to Challenging Behaviour Continuing Rehabilitation Centre = reduction of 750 per week (equating to 39k per year) Challenging Behaviour Continuing Rehabilitation Centre move to Assessment and Rehabilitation Centre = reduction of a further 438 per week (equating to 22K per year) Assessment and Rehabilitation Centre move to Community Supported Housing scheme = reduction of a further 712 per week (equating to 37K per year) The savings shown are the costs that would have been incurred had Steven not moved through the BIRT continuum. Coupled with the high satisfaction ratings from service users, families and referring agencies, research data confirms that BIRT delivers quality and value for money from admission to discharge. * Peer-reviewed research data references are available at Fees correct at time of print Kerwin Court, Horsham 7

10 In November 2008, Kerry Ellis, 26, collapsed at work and was rushed to hospital where she suffered a series of seizures. Following tests, she was diagnosed with encephalitis, a rare virus that causes swelling in the brain, damaging brain cells and resulting in a lack of muscle coordination. It is fatal in two-thirds of all cases. Although Kerry felt normal on the inside, she had lost her ability to move or speak normally. She was advised by doctors that she may never fully recover. Kerry was admitted to Kerwin Court for a period of rehabilitation. With the help of the clinical team, her family and a good deal of self determination, she began her difficult journey to recovery. Even the simplest tasks such as washing and dressing had become a challenge. She had to relearn how to read, write and even eat. After seven months, she was well enough to return to her family home where she was cared for by her mother. Four months later, she returned to work and living independently in her own home. People can barely believe how far I ve come. Strangely so much good has come out of what happened. I m now closer to my family and friends and appreciate what I have so much more. But most of all, I m thrilled that I m finally back to the person I used to be. I m myself at last and have never felt better. Kerry Ellis 8

11 Where we are Located near Horsham in West Sussex, Kerwin Court has excellent road and rail communications. Service Manager, Kerwin Court Five Oaks Road, Nr Horsham, West Sussex RH13 0TP Tel: Fax: For more information on Kerwin Court, please contact the Service Manager at the address above Google - Map data 2011 Tele Atlas Referrals Referrals should be made directly to the Service Manager at Kerwin Court. We accept referrals from a wide range of agencies including health, social services, medico-legal and other specialist providers. Kerwin Court, Horsham 9

12 The Brain Injury Rehabilitation Trust The Brain Injury Rehabilitation Trust (BIRT) provides a continuum of care for people with acquired brain injury, from post-acute hospital based rehabilitation, assessment and rehabilitation, continuing rehabilitation and supported housing and home support. Through our range of specialist services, we aim to enable people to function more independently in the wider community and develop their lives in ways they choose. For more information about our work please contact: The Brain Injury Rehabilitation Trust 60 Queen Street, Normanton, Wakefield, WF6 2BU Tel: Fax: The Brain Injury Rehabilitation Trust is a division of The Disabilities Trust and the means by which it provides its brain injury services. Founded in 1979, The Disabilities Trust is now established as one of the UK s leading charities, offering imaginative, progressive services to people with autism, brain injury, physical disability and learning disability. The Disabilities Trust First Floor, 32 Market Place, Burgess Hill, West Sussex RH15 9NP Tel: Fax: If you would like to help us by fundraising for The Disabilities Trust, BIRT or this service, please call us on , or visit our website for more information.

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