Quality requirement 4: Early and specialist rehabilitation

People with long-term neurological conditions who would benefit from rehabilitation are to receive timely, ongoing, high quality rehabilitation services in hospital or other specialist settings to meet their continuing and changing needs. When ready, they receive the help they need to return home for ongoing community rehabilitation and support (‘home’ in this context means the place where the individual chooses to live, which may be their own accommodation or may be a residential or care home).

The service specialises in assessment, disability management and rehabilitation for adults with severe to profound acquired neurological impairment, presenting with complex neuro-disability. The multidisciplinary team specialises in assessing, treating and managing complex neuro-disability using an integrated goal setting approach. They have developed a clinical tool called SMART (sensory modality and rehabilitation technique) to assess and rehabilitate people in low-awareness states.

The Trust runs a rehabilitation unit for adults with acquired brain injury. They have developed an induction programme in line with the TOPSS (Training Organisation for Personal Social Services) standards and an ‘at a glance’ training record to identify staff training needs. They also have a training booklet, which contains a list of everything a new employee should be shown, that works as a checklist

The Eastern Head Injury Group Study (EHIS) was set up in 2000 to assess the current provision of HI services in the Eastern Region, and to facilitate strategic planning and development of high quality acute and rehabilitation services in line with national guidance. They have developed a number of useful resources including Head Injury Standards for Acute Hospitals, a set of rehabilitation codes which map patient pathways through the rehabilitation stages, and a template for HI coordination.

The unit specialises in assessment, rehabilitation and long-term disability management of adults who present with neuro-disability compounded by challenging behaviour as a consequence of acquired brain injury. The unit admits individuals whose behaviour prevents them from participating in rehabilitation or onward placement. It follows a philosophy of 24 hour behaviour management using positive programming. A variety of approaches to rehabilitation have been developed which the service is willing to share.

The centre is an accredited practice development unit, which delivers a comprehensive range of rehabilitation services. It has developed a number of policies and procedures, including the use of taped handovers and the covert administration of medication.

Redford Court was established in partnership with Riverside Housing Association in July 1997. It provides a rehabilitation service for people with cognitive and behavioural difficulties following acquired brain injury who may require longer-term care. It has developed a ‘move on’ bungalow to help people prepare for living back in the community. Residents are involved in both planning services and recruiting staff.

The unit is a supra-regional specialist rehabilitation service for younger adults with severe complex neurological disabilities. The service has developed a number of innovative approaches including:, outcome measures, interdisciplinary goal-setting and goal attainment and a number of integrated care pathways.

The service provides link workers for people from ethnic minority groups undergoing neurological rehabilitation. The link workers receive additional training about brain injury rehabilitation. They have helped individuals and their carers to have a better understanding of the rehabilitation process and to make individuals’ rehabilitation more culturally appropriate.