Brain & Spinal Injury Handbook - 22/23

Page 1

2022 /2023 EDITION

Brain & Spinal Injury Handbook COMPLEX CARE

CALLUM’S STORY: Returning home with live-in care FINANCIAL & LEGAL


Opening up the law after serious spinal or brain injury

Innovations in wheelchair vibration dampening CASE MANAGEMENT

Is HR an integral part of your MDT as a case manager? RECOVERY & REHABILITATION

MANAGING SLEEP in long-covid An indispensable publication for occupational therapists, lawyers & other healthcare professionals

Focused on LIFE after life-changing events Frenkel Topping Group is a long-established family of businesses who are tried, tested and trusted. With such a wide range of services available from our expert teams across the Group, we’re confident that we can support you with anything you may need throughout the litigation journey. From professional services and independent financial advisers to investment management and Client support services, we’re able to offer a full concierge-style service that supports you and your Clients’ needs at every stage of settlement and beyond.

Service across the Group include:














Expert witness reports

Expert fund management

Welfare benefits advice

Accountancy Advice

Personal injury trusts advice

Care & case management

Legal costs

Talent planning

Holistic financial planning

Free training with the Knowledge Hub Expert training for expert practitioners. The Knowledge Hub, Frenkel Topping Group’s training academy, delivers free virtual and face-to-face training to our professional clients. Helping you stay up to speed and informed, all our courses are APIL accredited and count towards CPD hours.

We provide the support you need Our expert team of Business Development specialists are your first point of contact and will work closely with you to ensure you’re getting the most out of the Group and its many products and services. The team will listen attentively to your requirements and develop strategies and solutions that make your work more streamlined and efficient.



0161 886 8000

Part of the Frenkel Topping Group

Frenkel Topping Group PLC registered in England No: 04726826 Registered Office Address: Frenkel House, 15 Carolina Way, Salford, M50 2ZY

WELCOME Dear Reader, Welcome to the 2022/2023 edition of this essential publication for case managers, legal professionals, neuro rehab providers, patients, families, friends, healthcare professionals, and all those affected by brain or spinal injury. The Brain & Spinal Injury Handbook is an indispensable publication for occupational therapists, lawyers and other healthcare professionals, who will no doubt agree that this annual handbook creates an important platform for sharing knowledge and experiences, as well as raising awareness around this field of medicine, related law, recovery and rehabilitation. We would like to thank all of our contributors to this issue. If you have something to share about brain and/or spinal injury, please email the editor: Until next year. The B&SI Handbook Team

202 2 /23



How Hydrotherapy CAN ‘SUPPORT’ YOUR RECOVERY Using the properties of water, hydrotherapy and water-based activity can revolutionise what an otherwise fit but disabled person can achieve.


eing able to bring truly remarkable enhancements to quality of life is what gives the PLG team the greatest reward. And we want to make the client the centre of any hydrotherapy pool we create. Whilst it may provide important social interaction with other family members, depending on the client’s cognitive ability, its prime purpose is therapeutic and there are many considerations to be made when planning for the pool to ensure the therapy is the most effective. Getting a hydrotherapy pool right at the start of any programme of adaptations in a property is absolutely essential. We know that a poorly planned and designed pool means that it is difficult and uncomfortable to access, or it is the wrong depth and size. And this just leads to the client not bothering to access it at all. The client will lose the therapeutic value of the pool simply because they don’t use it and that is down to the design not being right. We know that each client’s needs are very different from the next. So, we know that each pool that we include in one of our adapted properties must be bespoke to our client’s needs. The questions that need to be asked are multiple and we seek to always ensure that we get the right pool and facilities for each of our clients. But we know that getting it right is the most rewarding achievement.

However, at PLG we take a more simplistic view of things and we have yet to find a single client who has not gained huge benefit from their own form of hydrotherapy and gains huge enjoyment from it. In addition to this it invariably an additional way of giving families precious time together as a unit. Our aim is to ensure each pool we design is as right as it possibly can be for the client and for all those around them. If you are considering hydrotherapy as an option or would like to talk to us about how we create bespoke pools please get in touch on the contact information below.

tel: 0333 577 0809 | email: web:

That first time she was in the pool… it melted my heart to see her so happy and to feel free in the water. VJ

There are numerous other professionals, who can discuss the therapeutic and additional benefits of hydrotherapy and it is well known that for some time it has been a contentious issue when considered as part of a litigation claim.


202 2 /23


a place to call home Inclusive. Inspiring. Honest. PLG approaches every new client and every new project with these values in mind which is why we are a multi award winning market leader in finding, acquiring, project managing and architecturally adapting disability property. We design to suit every client’s individual needs winning several regional LABC ‘Best Inclusive Building’ awards.

Proactive. Innovative. Thoughtful. And we love what we do. We pride ourselves in providing excellent service and supporting our clients every step of the way. We create inspirational new homes for our clients and their families in a uniquely supportive and flexible way always putting our clients’ needs and aspirations at the centre of what we do. We work as a team with our clients, their legal and clinical teams to address and solve all of their property related needs.




2022 /2023 EDITION

RECOVERY & REHABILITATION 14 16 18 20 22 24 26 29 30 32 36 37 38 40 43 44 45 46 48 52 54

What advice do you wish you could have given family and friends after your stroke? Specialist behavioural support following a brain or spinal injury Design for Independence celebrates 10th anniversary Sex, relationships, consent and capacity: Can the arts therapies help? The impact of poor mental health services on a child’s developing brain Delivering life changing rehab at Askham It’s only Child’s Play or is it? Rehab, Respite & Rock’n’Roll Supporting clients to achieve their goals Managing sleep - in long Covid B&SI BIS Services Recognising the complex needs of families living with brain injury How Calvert Reconnections’ new approach to brain injury rehabilitation is transforming lives Dedicated rehabilitation creating happiness daily Meet the team and take a tour of QEF’s new care and rehabilitation centre Renovo Care Group: Helping people reconnect Never give up So you think you know what OT is? We’re not so sure… Delicious, nutritious meals to aid your recovery All your rehabilitation needs under one roof Adapting for the future: The importance of the occupational therapist when designing a home

CASE MANAGEMENT 58 60 62 64 65 66 68 70 74 76


BABICM looks to the future Collaboration & the elephant in the room (substance misuse) Innovation and quality are at the forefront of case management provision at StanleySmith ABI Case Management Ltd Regulated HR services for court of protection teams balancing sensitivity & compliance Expert rehabilitation case management services Breakthrough case management ‘case management with care’ Traumatic births - What do we know and how can we support families as case managers? Taking the holistic approach to rehabilitation and case management Is HR an integral part of your MDT as a case manager?

202 2 /23

94 78 79 80 82 86 88 89

Are you looking for a case manager in the South of England? MCCM – Mary Campbell case management A care sector in turmoil - Is direct recruitment a solution? MAIA Rehabilitation assistants transforming the care of clients with brain or spinal injury A case manager’s perspective: Building relationships with clients and families Working with diversity - The psychological personal injury service Registration, registration, registration

COMPLEX CARE 90 93 94 98 99 100

102 104 105 106

Callum’s story: Returning home with live-in care JAM Complex Care - Helping you live a rich, independent & full life at home Maplewood Independent Living - Bespoke case management, specialist care & support Helping to improve lives Empowering U Complete Care Amegreen... Connecting healthcare and wellbeing with our trusted partner, the Spinal Injuries Association (SIA) Consumer lead healthcare that positions Advantage Healthcare as your provider of choice There’s nothing like the comfort of your own home Newcross Healthcare helping Britain get the care service it deserves Prestige Nursing & Care - Benefits of a fully managed service when sourcing brain and spinal injury care






116 107 108

Resolution Care Services - Providing specialist & personalised complex care solutions in Wales Eximius Live-in care Ltd – Personalised live-in care in your own home


116 118 120 122 124 128 130

A simple solution to independent living after brain or spinal injury Introducing CareFlex & the benefits of specialist seating Brotherwood Electric Wav is the perfect fit for Sussex charity Innovations in wheelchair vibration dampening Why manage posture? Historical merged with contemporary moving accessibly between the centuries Functional electrical stimulation (FES) for correction of dropped foot Living with a spinal cord injury

FINANCIAL & LEGAL 132 135 138 140 142 146

148 150 152

Somek and Associates’ Brain and spinal injury reports



From strength to strength How we help seriously injured people Opening up the law after a serious spinal or brain injury After the Event Insurance – More than a promise The hidden victims of Covid-19 and how we can help them MORR & Co

Leading experts - Specialists acting for a multitude of clients in all forms of personal injury What are the effects of the care crisis on compensation claims? Release the cash tied up in your ongoing cases I am his deputy so why is the official Solicitor acting as his litigation friend?


Personal Profiles


Brain & spinal injury contact information A very special thank-you to all our contributors

Executive Editor Lee Gatland Art Director Richard Hejsak Sales Team Claire Hollingdale & Joanne Lewis 01959 543 659 All other enquiries

202 2 /23



Secure Healthcare SOLUTIONS: Specialising in Person Centred care for complex needs clients.


ecure Healthcare solutions provides in home care. Clinically, we support service users varying from Spinal Injury to clients with acquired brain injury.

We specify in brain and spinal injury care; we provide in house training with our spinal and brain injury specialist nurse weekly to keep all of our field staff updated and refreshed on their skills, to ensure safety for the service users. We provide nurse led packages of care which are all nurse led starting from 6 hours all the way to 24 hours, 1:1 and 2:1 care around the west midlands and east midlands. We have a dedicated robust work force who are clinically skilled in a variety of complex care techniques, these can vary from acquired brain injury, Spinal Injury to medication administration.

Professional Agency, well trained brilliant staff. Since Secure Healthcare has supporter me, I can do tasks more independently. QUOTE FROM SERVICE USER TH WHO HAS AN ACQUIRED BRAIN INJURY

INDIVIDUAL CARE PLANS: Secure Healthcare Solutions creates personalised care plans to meet the needs for the service user and their family. We create meet and greets which are planned with the family to make sure they are in safe hands and to make sure they feel that they get the right carer or nurse.

Let our Family take care of yours!

Tel: 01212 859449 Email: Web:

WE SUPPORT CLIENTS WHO HAVE: Motor Neurone disease Spinal Injury Acquired Bain Injuries Palliative care Tracheostomy care Stoma care And many more

THE 4 PRINCIPLES OF PERSON-CENTRED CARE THAT SECURE HEALTHCARE SOLUTIONS FOLLOW: Treat People with dignity, compassion and respect Provide Coordinated Care, support and treatment Offer personalised care Enable service users to recognise and develop their strengths and abilities


202 2 /23

6 - 7 July 2022 | NEC, BIRMINGHAM



Our Key Focus Areas for 2022: Rehabilitation Mental health

Brain & Spine injury Diagnostics

A few of our highlighted speakers this year: JAMES CRACKNELL OBE

CLAIRE MACLAINE Specialist Rehabilitation Case Manager & Speech & Language Therapist Dr Anita Rose Director of Clinical Development & Consultant Clinical Neuropsychologist

CPD CPD accredited content programme Gain up to 12 CPD points

Free tickets to join over 1000 neuro professionals for 2 days of collaboration and education. NEUROCONVENTION.COM Neuro Convention also provides free access to:

Placements available We provide rehabilitation and specialist education to children and young people aged 0-19 with brain injury, neurodisabilities and complex health needs. Located just south of London and set in 24-acres of beautiful woodland, our national specialist centre is the UK’s largest paediatric rehabilitation centre of its kind. With our children and family services rated ‘Outstanding’ by CQC and our school rated ‘Good’ with ‘excellent management and leadership’ by Ofsted, we are currently accepting placements across all areas of our service.

Key services •

Brain injury rehabilitation.

Specialist education at The Children’s Trust School (residential and non-residential).

Short breaks, camps and clubs.

Step-down medical and nursing care from hospital to home.

Specialist assessment and clinical support in the community.

Online information and support via

Find out more 01737 365 810

The Children’s Trust is inspected and rated ‘Outstanding’ by Care Quality Commission and rated a ‘Good Provider’ by Ofsted Care (for residential houses). The Children’s Trust School is rated a ‘Good Provider’ by Ofsted Education. The Children’s Trust, Tadworth Court, Tadworth, Surrey KT20 5RU Registered charity number 288018. TCT_1359 04/22


What advice do you wish you could have given family AND FRIENDS AFTER YOUR STROKE? Life after stroke can be daunting and the support and understanding of family and friends is crucial. But it can be a challenge to communicate how you feel, and to know what the future will look like.

S Kate Allatt

troke survivor and GripAble ambassador, Kate Allatt shares 10 key things fellow stroke survivors wish they could have told their friends and family following their stoke.

Post-stroke recovery looks different to everyone. The effects of stroke can vary considerably, and can include memory loss, cognitive impairment, emotional difficulties, balance problems, sight loss, weakness, and much more. Whilst wrestling with concerns such as getting back to work, finances, and looking after the family, survivors are often having to remember how to carry out everyday tasks such as showering or making a cup of tea.

family and friends in those first few days, weeks, and months after our stroke, knowing what we know now.

Here are 10 things fellow stroke survivors wish they’d told their family and friends after their stroke:

1. 2. 3. 4. 5. 6.


8. 9. 10.

Rehab can feel like a daily challenge and requires much determination and motivation. But with the right support and understanding from loved ones, progress is possible.

ADVICE FOR FAMILY AND FRIENDS OF A STROKE SURVIVOR At a recent GripAble peer-support discussion for stroke survivors, we discussed what we wish we could have told our


202 2 /23

Be patient and give me time – my recovery is a marathon, not a sprint Focus on what I can do, not what I can’t do Just because I look ok, it does not mean I am better My journey won’t be a smooth continuum – I will make small gains over a long stretch of time Don’t look back or forward, focus on the present and take each day as it comes I won’t ever be my former self again, and that’s ok – for those of us that have experienced strokes brought on by stress, carrying on as we were would not be possible nor helpful Don’t underestimate my abilities – stand up for my right to continue working if I want to, or support me in finding a new role that suits my needs There is more to me now than there ever was There will be good days and bad days – never give up hope Everyone’s experience of stroke recovery is different – stroke survivors are all on the same journey, but in different vehicles, and on different roads.

We hope that these advice points prove a useful source of information and guidance for stroke survivors and their families. To find out about future stroke survivor peer support sessions, visit www. or contact Kate Allatt at



TO HOME Struggling with putty and pegs? GripAble can support you along your journey, with engaging and measurable hand and arm activities designed with brain and spinal injury survivors in mind. Connecting to an app on a tablet, GripAble empowers you through your training - face-to-face or remotely. BUY OR TRY NOW +44 (0) 207 661 4018 YOUTUBE.COM/GRIPABLE




Specialist behavioural support following a BRAIN OR SPINAL INJURY Specialist nursing care provider, Exemplar Health Care, has the in-house skills and expertise to support those who display complex behaviours of concern arising from a brain or spinal injury.


xemplar Health Care is a specialist nursing care provider that supports adults living with complex and high acuity needs. They specialise in supporting those who display complex behaviours of Julie Booth concern. Serious injuries, such as those to the brain or spinal cord, may result in people experiencing changes in their physical and cognitive functions, behaviour and personality. In this article, Julie Booth, Head of Quality, talks about how Exemplar Health Care support people who display behaviours of concern following a brain or spinal injury.


As part of the assessment process, we do a ‘community fit’ assessment which looks at whether our home is the right ‘fit’ for the individual, and if they’d be a good ‘fit’ for the home and the people who already live there. We carefully plan our care to minimise risk to everyone, and have stringent safeguarding procedures in place. Our high staffing levels, often 1:1 or 2:1, enable us to build trust and work at people’s own pace. Our homes in-house Life Skills Teams empower people to take part in everyday activities that are meaningful to them and to be meaningfully occupied. This helps to reduce feelings of frustration for people who display behaviours of concern. Alongside many of our homes we have OneCare services, There are many reasons why which offer specialist nursing people display behaviours of care in a single or dual concern, which is why our approach occupancy domestic living environment, that’s separate is personalised to the individuals to the main care home. They’re that we support. ideal for adults who have complex needs that cannot be JULIE BOOTH, HEAD OF QUALITY met in a group setting.

Many of the people we support have been deemed to display ‘behaviours’ that are considered ‘too complex’ for mainstream nursing and care services. There are many reasons why people display behaviours of concern, which is why our approach is personalised to the individuals that we support. We work with them, their loved ones and professionals to design a care plan that’s tailored to their needs and goals, and that’s enhanced through meaningful activities. Our approach to behaviour support focuses on how we can prevent the need for restrictive practices and reduce the frequency and intensity of behaviours of concern, so that people can live a fulfilling life and integrate with society without their ‘behaviour’ restricting what they can do. Our trained teams work with individuals to understand the reasons for their behaviour, to learn the skills to manage their own behaviour, to identify, remove and reduce any trigger factors, and to implement strategies to reduce the frequency, duration and impact of incidents of behaviours of concern.


202 2 /23


COLLEAGUE SAFETY AND WELLBEING Our care and nursing colleagues complete Exemplar Positive Behaviour Support (EPBS) training that’s been certificated by the British Institute for Learning Disabilities Association of Certified Trainers (Bild ACT). We also have a central team of Mental Health and Behaviour Support Specialists who support colleagues and service users, including crisis or rapid intervention when a person’s behaviour is escalating. The team is supported by a Consultant Psychiatrist. ■

Tel: 01709 565777 | Web:


Design for Independence CELEBRATES 10TH ANNIVERSARY A decade of finding, designing and adapting homes for the less able.

DfI have a bespoke property search service which is led by an OT and their in-house sales and lettings manager, with 15 years’ experience working within estate agency. This super-efficient service has no finder’s fees and is exempt from VAT as this work is completed by an OT. Once the OT understands an individual’s unique requirements, they create a proposed detailed design and support the client with sourcing all equipment, fixtures and fittings. If the project does not require a planning application the project can be managed in-house as they have experience in tendering and monitoring the work. The team can also provide manual handling training for family members During the last 10 and the care team when a client moves years DfI have created a in. DfI design the property to enhance the trusted team of client’s abilities and empower them to construction function effectively in a house they are professionals. proud of.


rivate housing occupational therapy (OT) company Design for Independence is celebrating the 10th anniversary of its unique approach to bespoke, costeffective property searches and adaptations for the people who have suffered catastrophic injuries. The company was founded by Anava Baruch, a housing OT, it specialises in the most challenging and complex cases of physical, sensory and emotional disability. Each design is as unique as the individual client, their care needs and rehabilitation goals. The company takes pride in coming up with creative solutions for even the toughest challenges, even when space is tight, and budget is restricted. During the last 10 years DfI have created a trusted team of construction professionals. They provide support for small adaptations as well as large refurbishments and rebuilds. In the last 10 years the team has developed and grown, the OT team includes practitioners from a variety of backgrounds. This includes OTs with a paediatric background with specialisms in sensory integration and seating as well as end of life with a focus on pain management. The team as a whole has extensive knowledge in acute musculoskeletal injuries such as amputations as well as rehabilitation of neurological conditions such as brain and spinal cord injuries. They also specialise in designing homes for people who have severe visual and hearing impairments. This knowledge and expertise enables the OTs to understand the rehabilitation and care involved along with the manual handling needs to support the client. With the experience of working with people who have suffered life changing injuries, the design takes into consideration the loss of privacy and the impact this has on the entire family. As well as the required space for substantial storage for medical supplies and equipment. The team provides bespoke layouts to enable their client’s independence when completing personal care activities. The recommended design is tailored to meet the client’s unique needs and style.



202 2 /23


Anava Baruch

Managing director Anava Baruch acts as an accommodation expert under part 35 of civil law. Her background in occupational therapy gives her a holistic view of a client’s accommodation needs.

Tel: 01799 588056 Email: Web:

The housing occupational therapy specialists

Design for Independence is a private housing occupational therapy company, searching, designing and adapting homes for the less able. We cover all areas of physical, sensory and cognitive disability, and work both nationally and internationally. These are just some of the services we offer:

Property search for suitable accommodation

Creating specifications for the building work required

Sourcing all equipment fixtures and fittings for the client

Sourcing and liaising with building professionals

Working closely with the contractors during the adaptation work

Sourcing contractors for internal work

Visit to find out more


Sex, relationships, consent and capacity: CAN THE ARTS THERAPIES HELP? An insight into how the arts therapies can help support vulnerable people when dealing with issues surrounding consent & capacity


onsent and capacity have become the topic of conversation following recent cases brought to the Supreme Court.. Daniel Thomas, managing director at Chroma explains how the arts therapies may be able be used to support vulnerable Dan Thomas people when dealing with issues surrounding consent & capacity. ‘Capacity and consent’ has become the subject of debate since December 2021 following a Supreme Court case involving a client living with a brain injury, who wanted to access a sex worker. The ruling stated the client must be able to demonstrate the ability to understand, and be able to provide on-going consent and must have the capacity to do so. This raised many questions as to the implications for the client, the sex worker, his care workers and case managers.

Key questions to arise following the ruling were - can a care team be lawfully involved in facilitating contact with a sex worker for a vulnerable person; and does the client have the capacity to provide consent as well as the capacity for ongoing consent – understanding the needs of another person?

THE ROLE OF THE ARTS THERAPIES IN DEMONSTRATING AN UNDERSTANDING OF CONSENT Consent means giving permission to do something, and in these cases, refers to an agreement between participants to engage in sexual activity. Capacity is the ability to understand information and make decisions about one’s own life. It can be difficult for traditional therapies to reveal such abilities in someone with impaired cognitive function, but the arts therapies may lend themselves well to creatively unlocking the capabilities of the brain. Music Therapy (MT), Art Therapy (AT) and Dramatherapy (DT) are all capable of finding out and demonstrating if someone has the ability to make decisions and choices, and, to work with cognitive abilities e.g. holding information in mind, looking at issues around memory, organisational/ problem solving skills, and sense of self. Dramatherapists, for instance, may implement role-play to help clients understand the feelings of others as well as how their actions may affect those around them. Role-play also provides a means to embody what it may feel like to start a relationship with someone. Art Therapy can help a client to understand how the world may see them, and how they may see themselves, helping the client understand themselves. This can be in the context of their personal safety and their possible vulnerability in the world around relationships. Music Therapy uses techniques such as song writing to help determine if someone has the cognitive abilities required to understand what consent and capacity entails. If a client can create, plan, execute a song, and then replicate the entire process the following session, it shows the ability to hold information in mind and supports the possibility that the client may be capable of giving and understanding ‘consent’, at least in the context of song-writing.

WHAT IS CONSENT AND CAPACITY IN TERMS OF SEX? Capacity means the ability to understand information and make decisions about one’s own life. If one cannot show one understands and retains the information, one is said to ‘lack capacity’ and deemed unable to make decisions about one’s own treatment or relationships, for example.


202 2 /23

RECOVERY & REHABILITATION As recent judgements show, it can be difficult to make clinical and care decisions in someone’s best interests in the context of the law, but consent in this context, refers to an agreement between participants to engage in sexual activity. In this situation, consent must be communicated clearly and freely and this should be verbal and affirmative, and on-going. It can be challenging for case managers, care workers or clinicians to determine whether the individual they are supporting can give consent and understand their sexual partner must also give consent.

Creativity helps support clients in demonstrating whether they have the ability to provide consent. Findings gathered during arts therapies sessions can provide indications that individuals are able to make choices and decisions in therapy and therefore may be able to apply this to other areas of their lives. Creativity helps support clients in demonstrating whether they have the ability to provide consent.

THE IMPACT OF SUCH RULINGS In cases such as these, creative arts therapists must prepare for the client’s high level of emotional need as well as from those who support them. When clients are deemed to not have capacity and are prevented from starting a relationship or using a sex worker - it is of course impactful, not only for the client, but for the network of people, whose role it is to enable that person to live with the best quality of life. The creativity of arts therapies lends itself to helping the client, and their network, think through the emotional impact of the ruling.

SCIENTIFIC EVIDENCE FOR THE ARTS THERAPIES EMOTIONAL AND FUNCTIONAL SUPPORT Art Therapists may use clinical interventions such as clay as a means to support emotional expression and communication in a creative and non-threatening way. According to Elbrecht C & Antcliff L, (2014) “Neuroscientific research provides increasing evidence of the intimate relationship between physiological and psychological dimensions of human experience. Haptic perception allows non-verbal access to psychological and sensorimotor processes thwarted by trauma.” Dramatherapists may implement clinical Interventions such as Embodiment, Projection, Role (EPR), which enables clients to start adding layers of meaning and expand their reflective capacities in a playful non-threatening way (Jennings, 1990). Dramatherapy supports psychological adjustment and through stories, clients can access material not easily spoken about through language. Stories provide “distance” from the challenge or issue, which enables clients to work with the areas of their lives that are important to them, in a non-confrontational manner. And stories can help clients to understand the dynamics of difficult life events which helps them to come to terms with their experiences. Music therapists use musical training to enhance brain plasticity. Evidence shows that musical training is associated with improved

perceptual, motor and cognitive skills, including executive functions (Criscuolo et al 2019, Thaut, 2014, Galinska, 2015). It also emerged as a useful framework for training-related plasticity in the human brain, which results in behavioural, structural, and functional changes on time scales ranging from days to years (Arkin et al, 2019. Herholz 2012, Vaquero et al, 2018). In essence, Music Therapy, especially Neurologic Music Therapy techniques, can improve brain function and help clients demonstrate their capacity for understanding and providing consent.

HOW CAN THE ARTS THERAPIES HELP CLIENTS LIVING WITH COGNITIVE IMPAIRMENT IN TERMS OF RELATIONSHIPS? Everybody craves intimacy. Those living with cognitive impairment are no different – they are still human beings with natural urges and feelings. To be told you are unable to fulfil those needs would be devastating. Creative arts therapists may offer an effective means to help case managers determine if their clients have the capacity for consent around aspects of creativity which could be transferred to other areas of their lives, and could help care staff have conversations about the impact of these judgements. An arts therapist’s finding may not change the capacity assessment, but could assist the multidisciplinary team and the clinician performing the capacity assessment, as it provides them with evidence to see what the clients’ capable of. Arts therapists can also present information on behalf of the client, for example via melody which research suggests is a very useful “information-scaffold”. What sets the creative arts therapies apart from other therapies is that they are able to help a client improve cognitive function whilst engaging in a fun, creative activity. They provide a nonthreatening, safe environment for the client to process their thoughts and feelings, whilst gaining a better understanding of their situation. The Arts Therapies are able to highlight everyday abilities through creativity. Dramatherapists and art therapists can use their medium to help clients understand the sequence of setting up a date for instance; starting a conversation with someone, through role-play, or through creating art using a learned sequence. Both means have the ability to discover if the client has the capacity to learn and if they do, the use of Arts Therapies in this context gives hope to the clients who need it, in that intimacy may be a possibility for them in their future. ■

For more information about Chroma Neurologic Arts Therapies within neurorehabilitation settings, please contact Daniel Thomas, Chroma via or 0330 440 1838

202 2 /23



The impact of poor mental health services ON A CHILD’S DEVELOPING BRAIN Are the mental health support needs of children with ABI being ignored? by Gerard Anderson, Head of Brain Injury Services at the Child Brain Injury Trust.


urrent research indicates that those who have sustained an acquired brain injury are more likely to have suffered from poor mental health than those of the general population, especially those with Gerard Anderson neuropsychiatric disorders. As a child’s brain develops and grows, the experiences a child has go on to shape who they are and lays the foundations for sound mental health and happiness. All of the cells in our body communicate with each other by sending messages using a form of electricity. The nerve cell releases chemical signals called neurotransmitters which travel across the synapse to another neuron to create a new electrical wave in that cell. When we have more experiences, we send more messages, and this contributes to the increase of synapses. Synapses are like muscles; they are strengthened by use. If we use our synapses a lot, it can create new, strong synapses that remain in place for many years, even decades. When chemicals are released connected to the negative environmental changes that are occurring around us, those interactions between genetic predispositions and sustained, stress-inducing experiences can lay an unstable foundation for mental health that endures well into the adult years. If these chemicals are released in a sustained and persistent way because of prolonged negative environmental stimulus, we’re then in a situation where a child may be subject to toxic stress, further impacting brain development. Because of the long-term effects of toxic stress, this can impact school or academic success, peer relationships and impair physical and mental health throughout a child’s lifespan. When a child sustains an acquired brain injury, the mechanism of injury can at times predict the outcomes associated with it, especially if the cause was related to risk taking behaviour. This is not to say that the injury itself


202 2 /23

doesn’t predict outcomes, as we know that there are poorer outcomes associated with global acquired brain injuries than there are focal injuries. When we are referring to outcomes associated with how the brain injury was sustained, we are specifically referring to those risk factors that are associated with previous behavioural difficulties; being a male in any age group; social factors and lower socio-economic status. All of these can increase the risk of acquired brain injury, but they can also impact recovery post injury.

REHABILITATION AND SCAFFOLDING AFTER BRAIN INJURY When rehabilitating a child’s brain after an injury or illness, it is essential to scaffold the child in the context of the environment around them, which includes siblings, care givers and wider community. We know that the emotional development and health of a developing brain is directly tied to the interactions they have with the stimulus around them. When this stimulus is less than ideal, it can then lead to the development of poor mental health. Therefore, reducing the negative stimulus connected to the networks around the child requires appropriate and well-trained services able to cope with the support needs of a child with ABI. When accessing emotional, psychological or mental health services after childhood acquired brain injury, most children will initially receive input from clinical psychology services, however these tend to be assessment focussed and not always intervention led. Stress after a traumatic event is not abnormal and when we are exposed to intermittent periods of stress, it allows our brain to develop appropriate coping skills which then allows us to recover psychologically. When a child is discharged from an acute environment, the hope is that they will develop those healthy and natural coping mechanisms that will contribute to physical and mental rehabilitation after ABI. When this doesn’t happen, intervention is then required; both physical and


RECOVERY & REHABILITATION ACCESSING CAMHS AFTER ACQUIRED BRAIN INJURY Many children after acquired brain injury are referred to Child & Adult Mental Health Services (CAMHS). Once a CAMHS referral is received, a judgement is made to determine if support from mental health services is needed. If so, the child or young person will then be offered a choice of appointment during which an assessment will be completed. For many children with a brain injury, CAMHS is a last chance of accessing specialist intervention. For many families these referrals are refused when a diagnosis of acquired brain injury is provided. It is true that a brain injury can impact the production of chemicals in the brain and can be directly connected to change in mood, however more often than not, the development of poor mental health after brain injury is connected to the psychological trauma, not the biological change.

PSYCHOLOGICAL INTERVENTION AFTER BRAIN INJURY In 2019 the Child Brain Injury Trust launched the first of its kind; a national counselling programme for children, siblings and family members affected by childhood acquired brain injury (conditions apply). To date, 211 referrals have been made to the service. Individuals are offered six to eight, fifty-minute counselling sessions via telephone or video-call – these can be extended if needed. This is with a qualified counsellors trained on understanding childhood acquired brain injury (ABI) and serious emotional trauma. Although the impact this service has had is remarkable, it is not a replacement for specialist CAMHS services. Some recent feedback includes

Soon after my first session, I was nervous, apprehensive and doubtful that just talking to someone would help in anyway. I remember my counsellor telling me that our sessions were a “safe space” to talk and it was okay to feel sad. Fast forward 10 weeks and I am in a much better place – my counsellor has helped me put in place a range of strategies to cope with how much life has changed.

to access timely and appropriate support.” The report includes feedback and experiences of those who have accessed or work with CAMHS services and summarises the current state of national CAMHS provision. When addressing the need of children affected by acquired brain injury, CAMHS is an essential service that can impact recovery and rehabilitation.

CONCLUSION To effectively support rehabilitation after acquired brain injury, both physical and psychological rehabilitation needs to occur and should be delivered by specialist, qualified practitioners trained in supporting people affected by brain injury. Currently, there are many gaps in mental health provision. Training needs to occur to understand the link between brain injury and the development and onset of poor mental health and the impact services can have in reducing poor mental health. Counselling is standard within many UK schools and a lifeline to many children with neurodiverse conditions, but this is not universal. With the current review of neurology services in Scotland and Northern Ireland and the development of the ABI Strategy from the UK Government as well as the national #MyNeuroSurvey from The Neurological Alliance, it will be important to include mental health of people affected by neurological conditions and ensure that appropriate mental health services are provided.

Visit our website: Call us on 01869 341 075

In a recent Care Quality Report from the independent regulator of health and social care in England, it was found that “The [CAMHS] system as a whole is complex and fragmented. Mental health care … is provided by many different organisations that do not always work together in a joined-up way. As a result, too many children and young people have a poor experience of care and some are unable

202 2 /23



Delivering life changing REHAB AT ASKHAM From meeting people at their most vulnerable and facing an uncertain future after significant injury or illness, Askham Rehab has a stellar track record in supporting its care users to achieve positive, life-changing outcomes.


t the very start of their rehabilitation journey, the Askham team unite behind each resident, helping them to achieve their personal goals and look to a more positive future than the one they believed lay ahead when they arrived. Such is the reputation of Askham, based near Doddington, Cambridgeshire, that residents come from across the nation, with the compelling combination of person-centred rehabilitation which includes hydrotherapy and the latest in robotic innovation helping to deliver significant results, often within a 12-week placement. And at the heart of the service Askham delivers is its team. From the care, nursing and therapy teams, through to the housekeepers and facilities support, everyone has a role in ensuring the Askham journey is the best it can be for each and every resident. “The team we have here is incredible and we couldn’t achieve what we do without them,” says Luke Cook, Head of Rehab and Nursing at Askham Rehab. “The role of a carer is impossible to define as they do one million roles rolled into one. They support with; personal care, mobilisation, therapy, personal issues, and holistically support our residents with absolutely everything. “While our nursing team, with the support they provide with pain management, corresponding with MDTs and enhanced levels of care, alongside our therapy team - so the SLTs, OTs, physios and neuropsychologist - are crucial in the support, leadership and expertise they give our residents.”


202 2 /23

Upon transition to Askham, each resident is assessed by its in-house therapy team - comprising speech and language therapy, physiotherapy, occupational therapy, and neuropsychiatry - to set out the goals during their time there, with support given on a daily basis in making them possible. “Residents have a finite amount of time here so it’s important we commence their plan at the earliest opportunity, which is then reviewed after eight weeks,” said Luke. “It’s very personalised and there is no set timeframe for recovery. You could have two people of the same age with a brain injury, but it could impact them very differently. It’s all about the individual and how they progress during their time with us.” To increase its support for residents nearing their time at Askham, and in preparation for their return to home, four on site apartments help with the transition and offer the opportunity for residents to be joined by loved ones. Luke concluded: “Delivering a high-quality service is essential and we feel a moral obligation to take steps to ensure the best for our residents. After all, we put the individual at the heart of our offering.”. ■

For more information about our services or working at Askham Rehab please visit:


It’s only Child’s Play OR IS IT?


s an experienced Chartered Physiotherapist Jayne Hallford knows the importance in engaging patients in meaningful movement to enable them to achieve their goals. When working with children it is Jayne Hallford important to understand how what and why movement is important to a child and to be able to integrate this into their rehabilitation goals. Movement teaches a child so much, it defines depth and perception, left and right, up and down, strong and light, fast and slow. Play is a child’s work, their occupation, their interaction with the world and cannot be seen as separate from physiotherapy. Reaching for a brick or kicking a ball is more likely to engage a child in their rehabilitation than physio stretches that are abstract and meaningless to a child. Knowing how to incorporate movement into physiotherapy to achieve rehabilitation goals is a key skill but knowing how to engage a child in movement through play is the real skill.

ITS ONLY CHILD’S PLAY OR IS IT? Is Play important? Why even consider it? How do children with a brain or spinal cord injury access play? Do they need to?

ever considered what if anything the child is learning during this time when they are playing? The Oxford Dictionary defines play as –

Engage in activity for enjoyment and recreation rather than a serious or practical purpose. The above definition leads us to think that play is frivolous and has no real life benefit, but is this true? Take a moment– what words/phrases come into your mind when you think about children playing?

running, loud, happy, being with friends, falling out, sharing, throwing, catching, being imaginative, climbing, fun, loud, spontaneous, inquisitive, constructive, making friends, laughter, shouting, burning off energy, calm, physical.

Do physiotherapist’s working with children need to consider play as part of their rehabilitation goals? What role does play have within rehabilitation? So you’ve paused and thought, and some of those words in the cloud above you may have considered and thought about. Does this have any benefit? Let’s break this down even further by looking at one activity. Take for example the play opportunity of making a white house from a selection of brightly coloured plastic bricks.

Play - When we think about play – what comes into our minds? Does anything come into your mind? Have you actually ever thought about why children play? Afterall isn’t it just what children do and what we as adults either expect them to occupy their time with or offer as a break from learning to blow off steam e.g. play times at school. Have you


202 2 /23

RECOVERY & REHABILITATION Have you ever considered those coloured bricks may actually have value other than being the pesky toy that gets everywhere and really hurts when you stand on them!

can’t? And what role if any would playing with bricks bring to a child’s rehabilitation and therapy input? Answer - The skills a child develops when playing with building bricks are often precisely the skills a child with a brain or spinal cord injury need to experience to ensure they are developing and reach their maximum potential. A brain or spinal cord injured child may have significant areas of difficulty within their physical and cognitive skills – so as adults how do we ensure this child gains the benefit of building a house with bricks? For example They may not be able to sit unaided.

Again, a person without clinical experience might think of skills such as creativity and problem solving, or maybe patience and concentration. This is all true - but there is so much more! Below is a list of some of the skills and abilities a child needs, which can be developed just by playing with bricks.

A stable posture that allows them to take their hands away from their body Muscular strength to maintain the posture Head control to allow improved efficiency of eye control scanning for the white bricks Hand eye coordination – looking at the bricks and picking up the right ones Dexterity to manipulate the bricks Muscular strength to push the bricks together / pull them apart Handling the bricks gives experiences of different textures The ability to know what a house is and how to replicate the construction. The ability to know what ‘white’ is and be able to pick the white bricks out from the other colours; being able to scan with their eyes. Imagination- what do they want their house to look like? Perseverance, repetition, practice and motivation to keep trying so the project is successfully achieved. Concentration- not being distracted or bored. The ability to interact with other people and gain recognition and reward The list goes on.

Question - Why play with building bricks with a child with cognitive and physical difficulties? Does it matter if they

They may need to stabilise by propping with their hands. Their ability to scan and look for objects may be affected, or they might have a visual impairment. They may have poor head control. They may not understand what white is, or even what a house is.

SO, - How might a physiotherapist address some of these problems and still make the task of building a white brick house fun!

STARTING POSITION Before we can consider actually playing with the toy, as the physiotherapist the first thing to consider is the physical capabilities a child needs just to be able to start the task. In this case, the child must have the physical ability to get into and maintain a posture where they can access the bricks sitting, standing, on the floor. They then must have the stability within that posture to hold their head up and be able to take their arms away from their body to be able to see and pick up the bricks and manipulate them. This is so important for the child to be able to explore movement. Giving a disabled child the opportunity to explore other positions for play introduces activities which support muscle stretching, strengthening and functional practice. Remember Most young children play on the floor, not in sitting at a table! If a child is a wheelchair user so often the toy is taken to the child and so the movement options are limited by the constraints of the wheelchair. Being facilitated by a physiotherapist to roll to reach for a brick, is fun for the child, a learning opportunity and challenges the motor systems. Moving the brick further and further away with each roll increases the range of movement that is challenged and builds the core components for a child to be able to turn in bed. Being supported for example by the physiotherapist to sit or stand in a way that allows the child to move within and outside of their base of support challenges their balance and postural control to reach for the brick. If a child only plays in sitting then their movement experience will be limited to sitting in a wheelchair!

202 2 /23


RECOVERY & REHABILITATION LEARNING THROUGH MOVEMENT Once the child has the brick in their hands, they need to use their sensation recognise its shape and dimensions of the brick. Sensation and movement are integrally linked therefore supporting the child to manipulate the brick and learn from the experience rather than doing it for them is key. Next the child needs the finger and hand dexterity alongside upper limb mobility and postural stability and head control to orientate the bricks into place. A physiotherapist will provide enough guidance and support, in the right places to the right muscle groups to enable this to be more successful, than if they did it on their own, providing errorless learning.

ACHIEVING THE GOAL But how to make a house? The child needs to understand how to manipulate the bricks together how much pressure to apply to make the construction stable and know what shape they are trying to achieve and so they need to know what size and colour bricks they require. The child needs to be able to scan the pile of bricks and locate and separate the white ones out and ensure they have enough to complete the project, which then dictates how big is the house going to be. Playing with building bricks - it might have surprised you what skills a child is using and developing in order to build that white brick house!

PLAY AS A MEASURABLE OUTCOME? So, if play is so important to a child’s development why can it be overlooked as a part of their rehabilitation? Despite the complex nature of working specifically with a child, in my experience and those of my colleagues here at SP Therapy Services, there is very little to no time on a physiotherapy course designated to specifically looking at how to engage children in the rehabilitation process. Specific conditions that


202 2 /23

affect children and alter the physical and cognitive presentation of a child may be on the curriculum, but the specific principles of how to use the power of play to engage children in meaningful therapy that they will adhere to is still an overlooked aspect of the training. Added to that problem is that often as adults we ‘forget’ how to play with the children, getting frustrated with the repetitive nature how often children want to play, or feeling they should be doing ‘something more important’. Hence, our focus as physiotherapists is on improving range of movement or preventing skeletal deformity, whilst the child’s focus is building a house! The skill is in manipulating the environment and the opportunities to achieve the physiotherapist’s goals whilst the child learns through the experience. Play is the work of all children including those with a brain or spinal cord injury, that enriches their development as they grow and is not a frivolous activity that holds no real benefit. Teaching support staff and family members how to engage in play that is physically meaningful and functionally challenging benefits the whole family. Understanding the benefits of play and its role in rehabilitation is central to our ethos at SP Therapy Services when treating children with a brain and spinal cord injury. We pride ourselves on having the high level of skills to problem solve how to involve and engage a child in play that achieves their rehabilitation goals.

If you wish to know more contact us on web:


Rehab, Respite & Rock’n’Roll Supporting clients to achieve their goals Since 2009, Steps Ahead Care & Support have supported clients who have sustained life changing injuries to achieve their goals and aspirations, regardless of how big or small they may seem.


e understand that for a lot of clients, it may be more difficult to access staycations, holidays abroad or gigs and festivals. In more recent years, we have developed our service to enable us to support clients on these trips, which includes extensive research, planning and preparation. Recently, a case manager approached us to arrange the trip of a lifetime for one of her clients, something she had struggled to do for over a decade. An incredible amount of planning behind the scenes went into this trip, from booking an accessible hotel (not as easy as it sounds!), to renting and organising the delivery of mobility equipment and drawing up countless risk assessments. Through sheer determination,

we made this happen for our client and we enjoyed every second of making his dream come true! In his words, he said

I’d just like to thank all those involved in this dream come true to visit my beloved team, Liverpool FC. Thank you from the very bottom of my heart! Over the years, we have had people who don’t receive support from us approach us to deliver this service. Making sure that we inject fun into any client’s rehab journey is central to what we do at Steps Ahead - we believe this is what keeps clients engaged and aids motivation to make every journey a success. Whether a client or not, we will work tirelessly to make anyone’s goal a reality. ■

HQ: 01752 547257 Email: Web:

202 2 /23



Managing Sleep IN LONG-COVID Experiencing sleeping difficulties is very common after sustaining a brain injury, with at least 50% of people who have had a brain injury reporting disturbed sleep as a result of the trauma they have sustained.


he situation is often very complex, as described below in figure one, there can be multiple sources of sleep disturbances in this group of clients, which can originate from a range of experiences over a broad time-course. When we are asked to treat a sleep problem for a client who has had a brain injury then a detailed assessment is essential. One which probes for all the factors shown in Figure One below, and one that, preferably, uses objective outcome measurements such as actigraphy. Firstly, and most importantly is the quality of sleep that the client experienced before their injury. The actual location of the injury, and areas of the brain which have been specifically damaged may also have significant effects on a clients’ sleep, as are current and previous medication prescription, psychosocial lifestyle factors (such as activities of daily living, alcohol, nicotine, and caffeine consumption), and the presence of pain and mood disturbances (both of which are very commonly experienced by people who have had such injuries). All of these factors have been important to consider for people living with a brain injury, but with the recent advance of the Coronavirus variants across the globe

the impact of symptoms of covid-19 in the short-term and long-covid in the medium-term have brought additional challenges for the sleep of this group of clients. Fatigue is a very common symptom of long-covid and this can often lead to people sleeping for long periods, socalled “hypersomnia.” Paradoxically, common symptoms of hypersomnia are feelings of tiredness and fatigue. As a result, some of the fatigue experienced by people living with long covid may be driven by their oversleeping (hypersomnia) as much as by the condition itself. There is a potentially useful intervention which may be of significant benefit to those experiencing these negative symptoms, and so potentially promote a faster and more full recovery.

And that is: exposure to natural daylight.



Exposure to natural daylight during the day promotes the production of melatonin in the pineal gland within our brains. Melatonin aids with sleep onset and sleep maintenance.

Figure One. Factors which can impact on the sleep of someone who has had a brain injury.


202 2 /23



With an excess of melatonin the body can break this down and convert it into serotonin. Serotonergic depletion is associated with depression, so if we have excess amounts of melatonin in our systems due to an additional exposure to natural daylight, we can convert this into serotonin and this can lead to improvements in mood.


Being exposed to natural daylight also promotes the production of Vitamin D in our skin which has proven immune boosting benefits, but you do need to let your skin see the sun and not be too covered up. Please be careful with sunburn at the same time

EXPOSURE TO LIGHT SHOULD BE Natural light, i.e. daylight, outside and not through a glass window for example. Best in the morning or early afternoon as light at this time of day is in the best frequency range for promoting the production of melatonin. For at least one hour, but as much as possible beyond this will likely add additional benefit. This intervention is free of charge and easily accessible.

This intervention only requires some simple lifestyle changes (not sleeping for too long and going out of doors more often) and as a result should be easy for most people to engage and comply with. Critically important in the design and delivery of effective interventions for this client group is a sensitive assessment

process alongside close liaison with the client, their family and other carers, as well as with other treating professionals within the client’s multi-disciplinary team. Being “on the same page” and working in a client-centred way is essential to ensure compliance and so deliver effective and durable outcomes for the client and their family. Excellent results can be achieved with regard to improving sleep in this group of vulnerable clients when these factors are taken into consideration. If you, your family members, colleagues or friends are struggling with symptoms of long covid then trying this for a few weeks should show benefits for many.

If you are still struggling with your sleep, mood and / or levels of fatigue after trying this for a few weeks, then it may mean that you require some more help. In which case please do contact our offices for an informal and confidential discussion about additional options for further treatment or onward referral as may be required. ■

Read More about sleep management in Lee DR. 2017. Teaching the World to Sleep: Psychological and Behavioural Assessment and Treatment Strategies for People with Sleeping Problems and Insomnia. Routledge, London.

For further information, please visit

Sleep Unlimited Ltd – the largest private company of sleep experts in the UK - specialise in the assessment of people who have sustained a life changing injury – and our reports have been used by many legal practitioners in successful litigation. We also offer highly acclaimed training in CBT for insomnia to healthcare professionals, corporate training and consultation, both apnoea testing and assessments for insomnia disorders, and Bond Solon trained expert witness testimony. Please see our website for further details, or contact our friendly team - we look forward to hearing from you. |

202 2 /23



B & SI

Flex Health was established in 2015 by two physiotherapists who had a passion to change the face of physiotherapy on a national scale.


lex Health was established in 2015 by two physiotherapists who had a passion to change the face of physiotherapy on a national scale. Rehabilitation and physiotherapy have evolved and changed dramatically over the last ten years due to advances in understanding complex conditions, seeing incredible examples of patients making significant recoveries. To date, innovation within Physiotherapy has never been better. Using leading processes developed in elite and professional sport, Flex Health, led by Alex and Matt, have developed their own assessment and treatment process resulting in a cutting-edge philosophy which has led to the success of countless rehabilitation outcomes. Below are a handful of Flex Health case studies:

CASE STUDY ONE – LIAM CRITCHETT: Liam from Scarborough, UK, searched nationally for a provider of physiotherapy to support his ambition of walking again. Liam suffered a spinal tumour aged 14 which left him reliant on a wheelchair due to significantly reduced strength in his lower back and legs plus reduced sensation from the knees to the feet. Over the last three years, Liam has worked tirelessly with the Flex team to regain his independence. Liam now mobilises with the use of a stick for balance and support and walks comfortably indoors with no support. Through his determined efforts he gained support from the RST foundation who are supporting Liam in his journey. “Before starting at Flex, I toured the country to try and find the most suitable rehabilitation centre for myself. After my first assessment I knew Flex was the place for me. I started at Flex in a wheelchair and needed a lot of assistance, couldn’t walk and had extremely poor posture. I am now able to walk unaided; this is something that I was unsure would ever be possible. I would highly recommend Flex to any spinal patient who is wanting to enhance their lives.”

CASE STUDY TWO – MOSE MASOE: Mose, from New Zealand, suffered a career-ending injury during a professional Rugby League match for Hull KR, defending his try line. Mose tackled an opposing player and his neck moved from cervical extension into cervical flexion, resulting in a severe spinal injury. Mose was transferred to Pinderfields Spinal Injury unit, Wakefield, for intensive rehabilitation. During his rehabilitation period at Pinderfields, Mose reached out to Flex Health to continue his recovery


202 2 /23

after seeing excellent news stories of similar spinal injury successes. Mose arrived at Flex in a wheelchair and his first goal was to independently stand from sitting. Mose achieved this goal within two weeks and progressed to independently walking within 4 months. During his successful rehabilitation period, Mose gained international news coverage for his life changing results. “I always thought maybe after 12 months I’ll probably be walking with one stick, and that’s what I had in my head. But I just attacked it like any other injury I’ve ever had. You have to put in the time in rehab, and the small steps will get you there. One of the biggest things I wanted to do was just to hold my son and nurture him like any other dad, and I’m able to do that now. I’m just happy I can be that dad for him. Flex Health has given me this opportunity again”.

CASE STUDY THREE - JAKE GAMMOND: Jake suffered a severe traumatic brain injury whilst living abroad. His frontal lobe injury resulted in an inability to walk, affecting his fatigue levels, co-ordination and balance, and motivation. To date, Jake has worked incredibly hard on his motivation and fatigue levels. As a result of his injury, Jake struggles to keep himself motivated, therefore we have had to keep his sessions engaging, fun and creative using technology and developing one to one personal relationships with his team. Not only does Jake struggle with fatigue and motivation when trying to walk, he has difficulty identifying foot placement due to his inability to co-ordinate his lower limbs. Jake has battled to give himself the best opportunity to walk and has transitioned from being in a wheelchair to taking his first independent steps with a frame.

PAEDIATRIC AND YOUNG ADULT CLIENTS We established a dedicated paediatric and young adult service at Flex Health in September 2020 and it has gone from strength to strength. We are passionate about providing the very best assessments and treatments for these clients either at our purpose-built facilities or in their own homes or school settings, focussing on producing the best outcomes possible for the child’s short- and long-term needs. We have clinicians who are highly trained in paediatrics and have extensive experience working with children, using a reassuring, fun, enthusiastic and confidence building approach. We treat a wide variety of paediatric musculoskeletal, neurological and developmental conditions including cerebral palsy, Down’s syndrome, adolescent spinal conditions, torticollis, autism, and recovery following brain tumours. Many of our clients attend following recommendations from other parents, but we also treat a growing number through case management companies. “Lisa has been working with my client, a 15-year-old young lady with Cerebral Palsy, for the past 4 months, and in that time she has built a positive therapeutic relationship with her, making the sessions fun whilst being able to carry out much needed physiotherapy intervention […] We have been incredibly impressed with her level of engagement and the changes that have been noted to the client.” Nicola Ewell, Senior Case Manager, Tania Brown

CASE STUDY FOUR – ROUX OWEN: Roux initially attended Flex Health just after his first birthday.

RECOVERY & REHABILITATION He had been diagnosed with a brain tumour (the size of two oranges) at four weeks of age after attending various medical appointments and A&E with swelling in his left eye. He eventually underwent six long surgeries at Leeds General Infirmary to remove the tumour then six further surgeries to help control the hydrocephalus. By his first birthday, Roux had only spent half his life at home due to long stints in hospital where he was often wired up to various monitors or laid avoiding his incision sites, preventing many changes of position. Roux therefore first presented at Flex with developmental delay. After an initial thorough assessment with the lead paediatric physiotherapist, followed by discussing and agreeing on Roux’s short- and long-term goals, Roux’s parents Amy and Antony decided to bring Roux to Flex twice a week, with a treatment plan designed to produce the best possible outcome for him. Following a few sessions of physiotherapy, Roux started to show excellent signs of progress. He continues to take huge steps in his recovery. As soon has he comes through the door he stretches his arms out for his physio to take him into the paediatric room where he adores throwing balls all around the room whilst giggling loudly and saying all his favourite words. He happily has his stretches performed for the tightness in his left lower limb before he’s desperate to walk with slight assistance into the gym where he takes great delight in going ‘on a bear hunt’, jumping on the crash mat and completing dinosaur-themed obstacle courses.

a gradual decline in the twins’ flexibility and mobility. They decided to bring them for an assessment at Flex to see if we could offer them any extra help. Louie presented at his initial appointment with severe contractures of his upper and lower limb muscle groups. He was extremely nervous, had very limited transitions, was unable to sit unassisted plus had very poor mobility and function. Ava was very anxious and showed a big lack of confidence. She had much reduced flexibility of her calves and achilles tendons plus poor lower limb strength, balance and walking ability. Louie and Ava have both made amazing progress at Flex and their parents are over the moon. Louie adores going in the Flex gym and has all the team laughing and joking with him. He can now sit unaided for long periods whilst doing upper limb activities and walks well between two therapists or independently in his adapted walker. Ava has shown improvement week after week and smashed all of her goals so far. She can now stand unassisted whilst throwing and catching balls plus walks confidently with two sticks or increasingly more competent with no aids or assistance. All clients in the above case studies have given permission to share their stories.

CASE STUDY FIVE – LOUIE AND AVA: Louie and Ava are nine-year-old twins who have been attending Flex Health for the past 16 months. Louie has quadriplegic cerebral palsy and Ava diplegic cerebral palsy. Following lockdown in 2020 where NHS treatment and time spent in school reduced, Louie and Ava’s parents noticed

Tel: 01482 966 006 Email: Web:

202 2 /23



BIS Services BIS Services provide high calibre, quality rehabilitation assistants who work collaboratively to increase function and develop independence.


ur award winning team are raising the standards in cognitive rehabilitation provision throughout the UK, enabling clients to reach their own goals and develop their skills.

We are committed to providing a person centered quality service to individuals living with cognitive deficits acquired through brain injury and neurological illness, with an innovative and practical approach to cognitive rehabilitation. Our interventions enable reintegration into the community, work or vocational environment and promote independence in activities of daily living. Specialised cognitive rehabilitation assistants provide education and compensatory strategies for clients and their families, allowing for immediate feedback and metacognitive skill building, in a variety of settings. Our high level training to all RAs ensures that clients and teams are assured of a highly specialised service, with exceptional feedback and report writing skill.


202 2 /23

Goal setting and attainment is key to our input and is a collaborative process with the client, their families and treating therapists. We work closely with case managers, solicitors, and therapists to ensure dovetailing and a coordinated approach to client rehabilitation and support programmes. Building on our expertise in delivering packages for independent living trials, BIS Services have developed The Link. This pioneering project is designed to bridge the gap between acute medical settings and return home, allowing for a 12 week period of independent living assessment, providing detailed feedback of support need for future support requirements. ■

Tel 01622 584 456 or email: Web:


Recognising the complex needs of FAMILIES LIVING WITH BRAIN INJURY Jo Throp considers the role of the neurological occupational therapist in supporting brain injured survivors and their families.


aving and belonging to a family is something we all share. The meaning of family, the ‘form and shape’ of our family, and the experience of being part of our own family, are unique to each of us. Brain injury is a catastrophic event that impacts a family unit’s stability and everyday roles and routines. Brain injury survivors require substantial emotional, physical, and practical support and this is often given by a parent or spouse. The consequences of a brain injury are far-reaching, often having a significant impact on the individual’s family relationships. The support provided by family members to a relative affected by brain injury is often unconditional; however, it

does come at a price. Family members will find themselves wrestling with overwhelming feelings of grief, loss, and guilt. The adjustment to a new way of living can be painful. The consequence is a complex mixture of emotions.

Family members find themselves living with the complexities of brain injury often with no prior experience. Acknowledging and recognising the needs of each unique family is an essential part of the rehabilitation process. Neuro occupational therapists at Krysalis work hard to create a therapeutic environment where both the brain injury survivor and their family feel ‘listened to’ and ‘safe’, enabling them to express their inner thoughts and feelings. We help survivors to realise their potential and families to adapt to a new way of living. Assisting them with their new routines and roles and helping them to facilitate positive relationships and regain hope. ■

Contact Krysalis Consultancy tel: 01722 466117 | web: twitter: @KrysalisNeuroOT

Krysalis’s approach is totally centred around the individual and their needs, giving them the support and encouragement to move in the right direction. The result is that they are left with an empowering sense of achievement. ‘Onwards and upwards’ is often declared when the small thing becomes part of the big picture. Mother of ABI Survivor

202 2 /23



HOW CALVERT RECONNECTIONS’ new approach to brain injury rehabilitation is transforming lives In one of the most innovative developments in the ABI field for decades, a groundbreaking new rehabilitation service in the Lake District is delivering life-changing outcomes for participants.


alvert Reconnections is a unique residential neuro-rehabilitation centre for people with post-acute ABI. The centre delivers cognitive and physical rehabilitation strategies alongside daily living and vocational skills within the local community. Since Calvert Reconnections opened in June 2021, individual client results have been quite remarkable in terms of physical improvement, personal sense of wellbeing and a return to independent living. “We deliver individualised rehabilitation opportunities enabling each person to reach their potential while having a different rehabilitation experience,” explained Claire Appleton, Head of Service at Calvert Reconnections. “Our programme aims to maximise the participant’s cognitive, social, emotional, physical and psychological


202 2 /23

well-being facilitating recovery and independence. “With a view towards life back in the community for each participant we also provide aspects of the rehabilitation programme where needed around self-care and work, with opportunities for increasing self-care skills and work-based placements.”

WIDE RANGE OF ACTIVITIES Calvert Reconnections, which is part of the Lake District Calvert Trust, actively seeks to incorporate a wide range of outdoor activities into each participant’s rehabilitation programme. This may range from reflective activities such as fishing, bird watching or a nature walk to higher adventure activities such as horse riding, canoeing, rock-climbing and abseiling - all closely assessed and graded to a person’s interests and functional abilities.

RECOVERY & REHABILITATION Importantly, participants are involved in every aspect of the activities they undertake. They complete meaningful tasks, from concept to completion, in a real-world setting. Amongst the abundance of facilities available to participants is the Lake District Calvert Trust Riding Centre, a British Horse Society approved riding school which offers riding and carriage driving for people of all abilities. Equine activities are tailored to the participant’s individual rehabilitation programme and delivered by qualified instructors working closely with the centre’s clinicians. The same principles apply at the centre’s indoor pool where significant investment has seen an underwater treadmill and underwater balance obstacle course installed as part of a wide-ranging aquatic therapy programme. At a more sedate pace, Reconnections also has a dedicated therapy garden, providing a wide-range of horticulture therapeutic benefits.

Neuro-psychologists assessing and treating across all areas of cognitive function and behavioural changes. Speech and language therapist supporting our participants with a variety of speech, language and communication difficulties to maximise all forms of communication.

PARTICIPANT FEEDBACK AND OUTCOMES In recent months, participants at Calvert Reconnections have talked about the transformational impact of the programme. Referrals from brain injury case managers and solicitors have also continued apace. Talking about the life-changing impact of his stay at Reconnections, Scott said:

EVIDENCE-BASED CLINICAL OUTCOMES Evidence-based clinical outcome measures are used to assess and monitor the participant’s progress. Clinicians also use their own objective and standardised professional assessments to inform clinical decision making and any other assessments relevant to the individual’s needs. It is well-known that that physical exercise reinforces the adaptive processes of the brain post injury: helping the brain ‘scaffold’ to compensate for damage. It also improves people’s mental health, outlook and wellbeing. Outdoor activities have also been demonstrated to improve people’s understanding of themselves and their abilities, post brain injury, with long-lasting benefits. Additionally, group work and a social environment have been identified as key factors in recovery after an ABI.

UNIQUE INTERDISCIPLINARY TEAM Calvert Reconnections is located at Old Windebrowe in Keswick, a Grade II listed Tithebarn and one-time home of Lakeland’s most famous poets, William Wordsworth. The centre has undergone a £1.4 million transformation but retains its character and real-life setting. Delivering 24-hour rehabilitation programmes, the Reconnections team includes: Neuro rehab coaches delivering individualised rehabilitation programmes. Neuro-occupational therapists empowering people to overcome barriers and maximising recovery and adaptation. Neuro-physiotherapist using a variety of treatment techniques to promote mobility, function, and quality of life.

“I had a serious motorcycle accident involving my bike and a fire engine - and I lost. “I suffered a serious bleed on the brain, but I’m fighting back. “I didn’t expect to be able to take part in all the activities but I’ve proved myself wrong. “Calvert Reconnections has turned my life around. I feel fitter both mentally and physically. It’s helping me to live a better life.”

202 2 /23



DEDICATED REHABILITATION Creating Happiness Daily CHD Rehabilitation operates two specialist rehabilitation centres, Bagshot Park Neurorehabilitation Centre and Kingston Rehabilitation Centre.


ach of the CHD Rehabilitation Centres are overseen by skilled clinical multidisciplinary teams, who are supported by GP’s and specialist consultants. The services are specialised in delivering neurorehabilitation, complex nursing, tracheostomy care and long-term disability management and are committed to providing the very highest levels of rehabilitation through individually tailored goal driven treatment programmes. Together our teams work to provide excellent treatment and rehabilitation for those in our care. CHD Rehabilitation centres are located in Kingston-upon-Thames and Bagshot, Surrey and are purpose built to provide exceptional care and rehabilitation in comfortable surroundings whilst maintaining personal wellbeing. Therapy facilities at CHD Rehabilitation include fully equipped gyms and treatment rooms, a hydrotherapy pool and occupational therapy kitchen.

OUR AIMS ARE SIMPLE To establish a care pathway that includes patient specific treatment programmes to facilitate the best possible recovery of those in our care. To enable our patients to live as independently as possible, within the scope of their rehabilitation, to enhance their quality of life in a stimulating and caring environment. Personalised rehabilitation pathways are delivered through our expert multidisciplinary teams consisting of psychologists, nurses, occupational therapists, physiotherapists, speech and language therapists and rehabilitation assistants.

AWARD WINNING CARE CHD Rehabilitation is part of CHD Living, an award winning, family-owned group of care services with more than 35 years of experience in providing the best quality


202 2 /23

care and home care services to individuals across Surrey and South London. This coupled with the superior care delivered by our team of carefully selected registered nurses, health care assistants and specialist neuro therapists who work alongside doctors and consultants, help to ensure the best quality of life for our residents whilst enabling them to reach their full potential through individualised rehabilitation programmes. Through the provision of personalised 24-hour care and support we look to maintain privacy, choice and dignity whilst maximising independence.

SPECIALIST SERVICES Specialist neurological rehabilitation Our in-house MDT can offer a full rehabilitation package to optimise independence and facilitate safe discharge to the community

Complex nursing care Our nurses are highly skilled in the management of symptoms arising from neurological conditions and spinal cord injuries Specialist tracheostomy care Our therapy and nursing team are all trained in tracheostomy care Post-COVID rehabilitation We can offer rehabilitation following hospital admissions and COVID treatments to provide ongoing physical, neurological and respiratory support as well as discharge planning for individuals prior to returning home

RECOVERY & REHABILITATION PATIENT SUCCESS STORIES: MRS R In October 2021, Mrs R had an unwitnessed fall at work. CT head showed a subarachnoid haemorrhage, but with no aneurysm identified it was unclear if this was of traumatic or spontaneous nature. Mrs R was initially admitted to her local NHS Hospital for a short period of acute stroke rehabilitation. During this time Mrs R was showing some signs of progress and so after 8 weeks was transferred to Kingston Rehabilitation Centre (KRC) for a further period of specialist neurorehabilitation input. On admission to KRC, her baseline presentation included:

Full hoist for all transfers Dependent upon assistance of two for all activities of daily living Not orientated to person, place or time Evident cognitive impairment Doubly incontinent Global Aphasia Communicating at 1-to-2word level Left sided weakness

Prior to her accident, Mrs R was fully independent, working as a domestic assistant in a hospital and lived in a first floor flat with her partner. A full neurological therapy assessment

was completed by the KRC therapy team who then discussed their assessment findings with Mrs R and set goals for placement together with a view to returning home and maximising her independence. Goals identified included being able to mobilise using and aid with assistance, completing personal care tasks with minimal assistance, to communicate in full sentences and utilising cognitive strategies to support attention and memory n function. Mrs R’s rehabilitation programme included functional task practice, upper limb rehabilitation using a forced use approach and repetitive task training, and daily cognitive rehabilitation including use of the O-log, process training, strategy training and functional retraining with the occupational therapists. She also engaged in lower limb strengthening through targeted gym-based exercise and gait re-education with the physiotherapists, as well as aphasia therapy conversation practice and word copying interventions with the speech and language therapist to support communication. Over just a 12-week period, Mrs R made significant functional improvements in all areas of her rehabilitation and overall, there was a significant reduction in care dependency and a significant improvement in functional independence and quality of life. At the time of discharge, Mrs R was able to mobilise with assistance and complete the stairs which enabled her to return home to living in her first floor flat with her partner and was able to have

all care needs met with assistance of one, without the need for any specialist equipment in the community.

OUTCOMES: MEASURING PROGRESS During a patient’s rehabilitation stay we collect information about care needs, mobility, cognition, communication, and engagement in daily living tasks on admission. This is reviewed regularly and again on discharge to identify and monitor progress and change as a result of rehabilitation. One such tool that we use is the Functional Independence and Functional Assessment Measure (FIM+FIM) and the FIM+FAM chart below depicts the progress made by Mrs R during her neurorehabilitation placement at KRC.

If you would like any further information on the services available at or Bagshot Park or Kingston Rehabilitation Centres, or to make a referral:

Visit our website: Call us on 01483 413 120 Email us at

202 2 /23


01483 413 120


CHD Rehabilitation operates two specialist rehabilitation centres, Bagshot Park Neurorehabilitation Centre and Kingston Rehabilitation Centre.

Bagshot Park Neurorehabilitation Centre Bagshot, Surrey, GU19 5HN

Kingston-upon-Thames Rehabilitation Centre Kingston-upon Thames, KT1 2TQ

Each of the CHD Rehabilitation Centres are overseen by skilled clinical multidisciplinary teams, who are supported by GP’s and specialist consultants. The services are specialised in delivering neurorehabilitation, complex nursing, tracheostomy care and long-term disability management and are committed to providing the very highest levels of rehabilitation through individually tailored goal driven treatment programmes. Together our teams work to provide excellent treatment and rehabilitation for those in our care.



• Fully equipped physiotherapy suites

• Specialist neurological rehabilitation

• Hydrotherapy pool

• Complex nursing care

• Occupational Therapy assessment kitchen

• Specialist tracheostomy care

• Accessible, en-suite bedrooms • Choice of lounge & dining areas • Beautiful, maintained gardens

“At Kingston Rehabilitation Centre, you really can achieve – Mr C, former resident, Kingston Rehabilitation Centre whatever you want!”

• Post-COVID rehabilitation

Make a referral or arrange a viewing: 01483 413 120


FIND OUT MORE: For further information regarding all CHD Rehabilitation services, or to register your interest in attending one of our CPD training days, please get in touch: E: T: 01483 413 120 W:

Family Business 2021 – WINNER –

Care Home Awards 2020 – FINALIST –

Outstanding Response to COVID-19 – WINNER –

Regulated by Preferred provider of care for Acquired Brain Injury & Neurorehabilitation

Quality Management – REGISTERED –

Lifetime Achievement – AWARDS –

Best Regeneration Project – FINALIST –


Meet the team and take a tour of QEF’s NEW CARE AND REHABILITATION CENTRE


UPPORTING people after an acquired brain injury, incomplete spinal injury, stroke or other neurological condition; the expert team at QEF provide person centred, holistic neuro rehabilitation and care. Physiotherapists, clinical psychologists, speech and language and occupational therapists work closely with nursing and care staff, to support each person to rebuild their lives. People like David, who came to QEF after a stroke left him unable to move or communicate. He’d spent 100+ days in intensive care, requiring a tracheostomy for much of that time. David says “The therapies I’ve received at QEF have been amazing. When I arrived I was unable to sit unsupported and quickly became fatigued. The physios helped me become more stable and I can now stand unsupported for short periods. At first standing was terrifying as I’d lost my spacial awareness. Speech and language sessions have been terrific, from only

being able to say single words my speech now is more intelligible. And in occupational therapy I’ve been getting proficient using a powered wheelchair and had cooking sessions using tools adapted for just one functional hand. I’ve made amazing progress whilst at QEF and can’t praise them highly enough.” The modern facilities include a large therapy gym, interactive room, dining and activity rooms as well as en-suite bedrooms with tracking hoists. Each bedroom also features award winning accessible technology to give clients greater control over their personal space. ■

Watch a virtual tour and meet the QEF team: Contact or call 01372 84 11 11

Rebuilding lives and

creating futures Expert neuro rehabilitation and nursing care in a modern, spacious centre

“The neuro rehabilitation package that QEF delivers is so comprehensive and holistic, and in my view a real leader in this speciality.” NHS neuro rehab placement manager

Find out more: Tel: 01372 84 11 11 Email: Web:

Registered Charity No 251051

202 2 /23



Renovo Care Group:

HELPING PEOPLE RECONNECT Dr Anita Rose, Consultant Clinical Neuropsychologist and Director of Clinical Development, Renovo Care Group


t the Renovo Care Group we recognise the importance of providing a goal directed multi-disciplinary approach to work collaboratively with those who enter our Dr Anita Rose rehabilitation pathways by supporting them to re-engage in meaningful activities and to find meaning in their life following their brain or spinal injury. In other words, we are trying to re-establish the “bridge” across the gap between old and new. We support them along the journey leading to the “new me” after brain injury and look at how a comprehensive IDT evaluation and treatment of the “damaged sense of self” can lead to increased self-esteem, self-efficacy, and self-empowerment.


202 2 /23

All this leads to an improved quality of life for both our service users and their families. A recent individual, after going through this journey, spontaneously said in his last session with the Neuropsychologist, whilst leaving the therapy room, “I have re-found myself”. He may still be profoundly disabled as a result of his brain injury and not met his original goal to walk again, but he has found an identity, a new sense of self that has emerged and reformed as he has found reconciliation between his self “before” and his “new me”. A bridge has been built across the gap. We celebrate with everyone who has completed their journey with us however short or long. We celebrate as they learn to be self-compassionate, move towards reconciliation and acceptance of the “new me”, regardless of whether or not their original goals have been met, the end of their rehabilitation process has been positive as they leave feeling empowered and able to believe they have a world of “teeming provisional possibilities” (Kenneth Gergen ,1991). ■

Tel 01732 833 924 or email: Web:


NEVER GIVE UP Lynda has gone from being withdrawn, unable to walk and with limited speech to a confident, happy and physically-active woman.


ynda was admitted to Richardson Care four years after sustaining a brain injury. She was wheelchairbound and had been told that it was very unlikely that she would be able to walk again. Because of her brain injury, Lynda had little insight into her own limitations and needed frequent prompting and encouragement in all aspects of daily living. She also presented with behaviour that challenges. However, she had been an independent young woman with a job, family and friends prior to her brain injury and wanted to be as independent as possible and was determined to walk again. Lynda’s care plan included psychology input combined with Positive Behaviour Support to aid her emotional wellbeing and develop coping strategies to reduce incidents of challenging behaviour. She had regular physiotherapy sessions to increase her strength, balance, co-ordination and

flexibility. In addition, social and community activities helped to build Lynda’s confidence, develop positive relationships and increase independence. After four years at Richardson Care, Lynda was able to walk independently with no aids. She continues to get fitter and stronger and can now walk easily and enjoy an active life. Her physical ability has also helped her mental well-being and her cognitive abilities continue to improve.

Lynda is the prime example of how someone with a brain injury can still make considerable improvements given the right environment and therapy approach Richardson Care has a portfolio of six specialist residential care homes in Northampton. It caters for adults with complex needs and offers a range of services including shortterm and long-term rehabilitation and a home for life. ■

Call Richardson Care on 01604 791071 to find out more or Email: Web:

Respect & Restore Specialist residential care and rehabilitation for adults with acquired brain injuries. • Portfolio of services to meet a variety of needs • Innovative person-centred care • Unique ‘family’ environment • Focus on social integration • 30-year proven track record Proud to be an independent family business.

Call us on 01604 791071 to find out more or email The Richardson Mews, Kingsland Gardens, Northampton NN2 7PW

202 2 /23



So You Think You Know What OT Is? WE’RE NOT SO SURE… “This week I’ve gone swimming, been to the stables, played chess and squeezed in some retail therapy! All in a day’s work for an OT. We’re trained in so much more than issuing bath boards and wheelchairs!” Natasha Bruce-Jones, Clinical Director and Specialist Rehabilitation Occupational Therapist.


fter a serious or catastrophic injury, life is suddenly re-evaluated. Your very existence is questioned, everything you thought was certain, everything that identified you can now be in question. An OT deals with the whole person, their REAL life and uses Natasha Bruce-Jones LIFE ITSELF Clinical Director to return the individual to as independent a life as possible.


and anxiety management. Take a look at our ‘Functional Management with…’ programmes. Our OTs have developed a programme that stops pain stopping life, taking pain management to another level, challenging clients whilst teaching them! Doing the tasks that cause the issue, wherever that may be! Whether adult or child, whether physically or psychologically in need, our OTs can coordinate MDTs and streamline services to enable clients to stay focussed on their recovery.


We all know that prescribing home We train clients to be their own life exercises is beneficial, but being manager, to re-establish their life with that person, actually doing the balance. We value leisure, fun and exercises with them yields better hobbies as much as work, self-care results. and education, and that’s how we Our OTs do the rehab with the deliver rehab. Everyone is different, client, lycra on and in the park, circumstances are different, cycling through muddy tracks, experiences and expectations are rebuilding a shed - all great ways different! That’s why 1:1, face to face our OTs have helped and inspired rehab gets the best results. OTs their clients to push though tailor unique rehab plans to client’s barriers. interests and hobbies. People often know the right Rehab should not be forever, but choices, the right strategies, but part of a client’s journey, a stepping doing it is far harder than knowing stone to their future. That’s where OTs it. Our OTs focus rehab on getting pride themselves, training clients to do clients “walking the walk” rather than our job and stepping away when they All photos are our clients doing their Occupational Therapy with purpose and great outcomes! “talking the talk”. are confident to live their life again. We get stuck cases moving and Web: make complex cases seem simple. We see clients throughout email: the week - regular face to face contact to help make the Contact us via email or refer to our website for our changes needed to start and commit to their rehab goals. latest information. Cognitive, Behavioural, Memory concerns - we address them all! OTs can help clients pass driving tests, pass maths exams, address client’s benefits, providing rehab in REAL time with REAL issues. Weighted squats in the gym? - great! But it’s only the foundations for going back to work and lifting scaffolding boards all day. OTs rehab clients in the workplace, with REAL work tasks - all standard within our OT programmes. Tired and anxious? OTs address sleep hygiene, fatigue


202 2 /23

Think Therapy 1st is 1astRehabilita�on Think Therapy is a Occupa�onal Therapy led company Rehabilita�on Occupa�onal using home community Therapy ledand company usingbased approach! home andMDT community based

Empowering and suppor�ng clients from the very beginning to live their best lives following serious and catastrophic injuries. �

Voca�onal Rehabilita�on

Holis�c Educa�on for Anxiety Libera�on

We provide a Mul�disciplinary approach to rehabilita�on. Whether in hospital or at home, with voca�onal or leisure goals, our MDT rehabilita�on programmes can help anyone at any point in their journey.

Children and Young Adult Services

Our MDT specialists treat in the workplace, in the community and in the home for a bespoke, personalised rehabilita�on experience.

Fa�gue Educa�on & Explora�on for Living

‘Return-to’ Programmes

overy TT1st Road to Rec Specialist Rehabilita�on Occupa�onal Therapy

Holis�c Educa�on for Living with Pain www.�


Delicious, Nutritious Meals TO AID YOUR RECOVERY Creating appetising meals for yourself or a loved one following a brain or spinal injury can be a real challenge - blending meals at home yourself can often lack visual appeal and impact the level of nutrition that helps to aid recovery. NUTRITIOUS AND SAFE For those relying on a texture modified diet during rehab, Wiltshire Farm Foods has developed a Softer Foods range, specifically designed to meet the needs of those living with swallowing difficulties, also known as dysphagia. This can be a result of injuries that affect the brain following a stroke or from complications which arise from spinal cord injuries. The Softer Foods range offers meals to suit every Level of the IDDSI (International Dysphagia Diet Standardisation Initiative) Framework, which provides a common terminology to describe food textures and drink thickness. Your Speech and Language Therapist will recommend the most appropriate Level for your swallowing ability, following the rehabilitation journey from hospital to home. Sometimes a texture modified diet is only required for a matter of weeks, or for others this could be a longer journey so finding a tasty, safe way to enjoy mealtimes again will help in the recovery process.


Josephine Bailey started using the company’s meals after she was diagnosed with oesophageal cancer: “It makes life a lot easier for me to have the meals delivered and popped straight in the freezer. It takes the stress out of constantly thinking what I could eat and gives me time to focus on other things.”


As we eat with our eyes, it’s important that as well as being rich in flavour, whatever you’re eating looks appetising too

Making meals that are a manageable consistency or texture at home can be a real challenge, often taking much longer to prepare than a solid meal as well as often losing some of the nutritional value if water or thickeners are used. Wiltshire Farm Foods provides meals to cater for all specialist diets, including a menu of over 85 delicious Softer Food dishes for those that require texture modified food. They can also be simply warmed up in the microwave or oven directly from the freezer, making mealtime preparation quick and convenient.


202 2 /23

For many people living with swallowing difficulties, the enjoyment of mealtimes can be greatly impacted, particularly the social side of the dining experience. Wiltshire Farm Foods’ Softer Foods menu has been specifically created with the ethos that everyone should enjoy greattasting nutritious food, no matter their dietary needs. As we eat with our eyes, it’s important that as well as being rich in flavour, whatever you’re eating looks appetising too. The puréed meals from Wiltshire Farm Foods have been moulded to resemble solid food, with snacks including toasties, that appear gently grilled, so that anyone with a swallowing difficulty can bring a meal to the table without any social embarrassment. ■

To view the full range of Level 4, Level 5 and Level 6 meals visit

Meals for swallowing difficulties

FLAVOURS YOU LOVE IN A TEXTURE YOU NEED Enjoy good food every day in a texture that’s right for you with the Softer Foods range by Wiltshire Farm Foods. Carefully created meals for those experiencing swallowing difficulties. Made by award-winning chefs from quality ingredients, we have something for every meal of the day. Each dish is nutritionally balanced and made in line with IDDSI guidelines, so that you can eat with confidence. Just simply cook from frozen and serve it’s that easy.

Available in three textures,

Puréed, Minced and Soft & Bite-Sized.

Over 85 delicious dishes in flavours you know and love.

Delivered straight to your door by friendly local drivers.

Easy to order

by phone, online or with your driver.

No contract. No commitment.

For your FREE brochure call 0800

680 0655

or visit us at:

Caring for someone with complex needs?

The Children’s Trust School is a non-maintained special school for pupils aged 2-19, dedicated to their education, health, therapy and care needs.

Find out more 01737 365 810

The Children’s Trust is inspected and rated ‘Outstanding’ by Care Quality Commission and rated an ‘Good Provider’ by Ofsted Care (for residential houses). The Children’s Trust School is rated a ‘Good Provider’ by Ofsted Education. The Children’s Trust, Tadworth Court, Tadworth, Surrey KT20 5RU Registered charity number 288018. TCT_1359 04/22

Josiah’s story Josiah was diagnosed with four limb involvement cerebral palsy, causing a mixed pattern of spasticity and dystonia. As a result of his diagnosis, Josiah has multiple barriers to learning, requiring 1-1 support and monitoring at all times. Now 14 years old, Josiah has been a residential pupil at The Children’s Trust School since September 2020. He is very sociable and enjoys being in environments providing consistency, with familiar people he recognises and who can interpret his communications through facial expressions and eye pointing. A typical week at school for Josiah involves a variety of learning opportunities through a specialist curriculum. Josiah is given specialist support from colleagues in education, health, therapy and care to develop and acquire skills in communication, and work towards cognitive, personal, social and physical goals. He is also supported to gain control through technology. The broad curriculum with specialist music, movement, yoga, access to aquatic therapy and multi-sensory environments helps to support continuous learning in the unique ways that each pupil needs. Josiah takes real pleasure in acquiring skills through physical activities. All therapies are integrated into the daily lives and learning of the pupils. Specialist interventions such as

frequent position changes and access to specialist services such as orthotics clinics are available on-site, as is aquatic therapy and rebound therapy. Josiah’s Physiotherapist explained that, for Josiah, an aquatic therapy session “encourages him to relax and participate in a sensory experience with different lights, sounds and sensations, in the water” and that “this has a positive impact on reducing his dystonic episodes.” For Josiah, his access to learning in water is therefore taken advantage of by the class teams who plan for this. In partnership with families, professionals from across education, health, therapy and care are involved in assessments and agreeing goals. They take account of the aspirations and outcomes in a child’s EHCP and are jointly owned and worked upon across all contexts that young people are in. We can evidence that having an integrated approach has resulted in Josiah having an increased tolerance of supported sitting on a therapy bench with adult support and that he can now independently maintain head control for short periods and correct this position with verbal and occasionally physical prompts. This has also resulted in him starting to demonstrate an interest in participating in group activities with peers. Josiah’s learning, access and equipment needs are reviewed regularly by staff from across the professions with therapies, care and medical and nursing colleagues

integrated both in classrooms and on residential houses. Staff are active in identification of progress and collaboratively plan and train colleagues to promote optimal opportunities for learning and skill acquisition. Now in his second academic year at The Children’s Trust School, Josiah continues to make good progress towards his intended outcomes. Josiah’s mum, Sylvia believes that The Children’s Trust School is the best place for him. “You have specialist, professional staff members that really put the children at the heart of everything that they do,” she explained.

“When we arrived in Tadworth I entrusted a very happy and contented child, and what I see at the moment is that same happy contented child – in fact he’s probably even happier!”


All your rehabilitation needs UNDER ONE ROOF Founding Director and Head of Business Development, Jules Leahy, explains what makes STEPS Rehabilitation so unique, and why their rehabilitation pathway is second to none.


TEPS Rehabilitation in Sheffield has recently celebrated its 5th birthday. Opened in 2017 by sisters Jules Leahy and Toria Chan, the company is devoted to developing human potential and exemplifies Jules Leahy the very best in pioneering rehabilitation. The facility delivers intensive and ongoing rehabilitation for people recovering from brain injury, spinal cord injury, traumatic amputation, stroke, and complex trauma injuries, enabling them to reach their full potential and to rebuild their lives. “STEPS blossomed from a seedling of an idea” explains Jules. “We wanted to offer a service that we felt didn’t exist in the UK for individuals with life changing serious injuries and introduce a 24-hour rehabilitation approach. What we’ve done is reimagine rehabilitation by combining a wide range of specialist therapies and nursing care with medical consultant expertise to create a truly interdisciplinary approach. We believe this unique and sophisticated rehabilitation model, where the very best in rehabilitation methodology and care is all delivered under one roof, can achieve the best possible outcomes for our clients.”

REIMAGINING REHABILITATION Motivated by a vision to create a facility that would be a temporary home as well as a place that people could receive specialist and intensive rehabilitation, STEPS is widely regarded as one of the leading serious injury rehabilitation facilities in the UK. Alongside traditional rehabilitation therapies, STEPS offers clients access to pioneering robotic and VR technology, enabling them to receive truly individualised rehabilitation programmes that optimise their recovery. Last year STEPS opened the first UK Fourier Intelligence ‘RehabHub’, a suite of cutting-edge rehabilitation technology invented by a Singapore-based technology company that develops pioneering exoskeleton and rehabilitation robotics. It focuses on both upper and lower limb robotic therapy, as well as cognitive training, providing a unique solution for neurorehabilitation. STEPS is home to one of only three UK facilities offering clients access to the MindPod as part of the range of pioneering digital neurotherapeutics from MindMaze,


202 2 /23

developed in Switzerland. The MindMotion GO and MindPod Dolphin are part of a neurorehabilitation therapy system that comes with a large variety of animated gamified engaging activities covering motor and task functions. “A very natural development for us was to establish a Training School at STEPS, which we launched last year” says Jules. “The school enables us to work closely with external professionals to help with the appointment of care teams which makes the transition home for a client and their family as smooth as possible. It came about as a result of us being frequently asked to deliver training by NHS commissioners and case managers for the care teams they had recruited, so that they could be sure of meeting each clients’ unique rehab and care needs. With our Clinical Nurse Educator working alongside our Transition of Care Lead, we’ve been able to develop this into a more formal offering via our Training School. “

CLIENT CENTRED REHABILITATION FACILITY “We were all very motivated to ensure that STEPS is a place that we would choose for our loved ones. There have undoubtedly been many goosebump moments over the past few years. There are few things more satisfying than seeing clients who came into STEPS with serious and life changing injuries leave us after achieving a very significant improvement in the quality of their life, which of course also improves the quality of life for their partner and family.” ■

Our clients inspire us every day with their determination and positive attitude despite their serious injuries. Life is very precious, and we are reminded of this every day in our building.

Tel: 0114 258 7769

No matter how severe your injury, there is still a life to be had. All your rehabilitation needs under one roof.

STEPS Rehabilitation is a specialist residential facility for neurological and complex trauma injuries. Contact us today to arrange your residential rehabilitation:

 0114 258 7769 

Our purpose built, family-run facility in Sheffield is home to the very latest in rehabilitation technology from around the world. We combine technology with clinical expertise and therapeutic treatments to enable clients to reach their full potential.


Adapting for the future: THE IMPORTANCE OF THE OCCUPATIONAL THERAPIST WHEN DESIGNING A HOME Lucy Leonard is an occupational therapist and Clinical Director of The OT Service with a background in adaptations & housing design


Other members of the rehabilitation team may also participate in decision making. For example, a physiotherapist will be able to assist with the decision to provide hydrotherapy at home and the specification required for this. A psychologist can assist with decision making about where a person would feel safest to sleep. The architect, skilled in building design will be given a brief, often guided by an expert witness and draw up a design to meet the needs of that person. However, there is so much more to a functional home than a set of designs. At the heart of the process is the client. The occupational therapist will ensure any plans agreed will reflect the identified occupational needs of the person. Indeed, the Professional Standards for Occupational Therapy Practice, Conduct and Ethics (the behaviours and practices all occupational therapists must abide by) states:

ome’ is an important concept for humans. It is a place where we feel safety, comfort, and familiarity. Some people say home is not a place, but a feeling. This further emphasises the importance of the physiological and psychological Lucy Leonard aspects of home. Following an injury, it can be difficult to feel that sense of ‘home’ when the usually safe, secure environment is placing barriers to daily life. Moreover, the home environment The ultimate rationale for your intervention… is the should not only support a person’s safety and comfort enhancement of health and wellbeing thorough the promotion but promote independence and support the rehabilitation of occupational performance, engagement and participation process; however, the impact of assistive equipment can in life roles and change the environment, sometimes creating a ‘clinical’ 4.5.2. You develop…recommendations based on the feeling to the home. The importance of this should never be occupational performance needs, choices and aspirations of those who access the service as identified through your overlooked or underestimated. assessments (RCOT 2021). An occupational therapist as part of the assessment and intervention they provide, will take time to get to know and understand the occupational needs of a person. This Therefore, the role of the occupational therapist in the involves understanding a person as an occupational being design of home adaptations is key in not only facilitating and supporting them to achieve access to all areas of the home the things they need to do, want and promoting independence but to do, or are expected to do, as An occupational therapist listening to and taking account of part of their life role. Catastrophic the aspirations of the person and as part of the assessment and injuries causing issues with their life roles. intervention they provide, will cognitive functioning can present The important question an challenges such as the person not occupational therapist will ask take time to get to know and being able to express their goals, is: ‘what matters to you?’ This understand the occupational or their needs. In such cases, it often guides recommendations may be appropriate to work with needs of a person. This involves and allows partnership working to the family, friends, and carers to reach an agreed set of plans. understanding a person as an understand the makeup of the The process and decision occupational being and person prior to their injuries. Their making around adaptations can hopes, dreams, personality quirks be complex and the occupational supporting them to achieve the and what was important to them; therapist’s clinical reasoning things they need to do, want to this can help shape changes to should be robust. their home that reflect them and do, or are expected to do, as For example, a teenager with their makeup. a spinal injury had plans drawn

part of their life role


202 2 /23

RECOVERY & REHABILITATION up showing a ground floor bedroom and bathroom in her 2-storey family home. Following discussions with parents and the young person, the ability to be on the first floor with her siblings, to play, listen to music (and to avoid the fear of missing out!) was a priority. Her role as ‘big sister’ to her siblings was of the upmost importance. Her sisters went upstairs to bed which was normal for the family and was therefore a goal for the client too. Consequently, the treating occupational therapist discussed the provision of a lift in the property to allow the young person access to all areas of the property, supporting wellbeing and promoting life roles. The deputy and architect accepted the occupational therapist’s evaluation and clinical reasoning and funding to provide a lift was agreed. The architect was then able to identify a suitable position for this within the plans. Another example is that of a young adult male with a brain injury, again who had a ground floor bedroom recommended based on a very long-term prognosis of his mobility. The client struggled with paranoia around safety and security which was worsened by the thought of being on the ground floor, alone at night. After lengthy discussions with the occupational therapist, the client and his mother, the thought of being on the ground floor, although convenient and close to support workers, was negatively affecting his wellbeing. To further support the clinical reasoning for a first-floor bedroom, the clinical psychologist on the rehabilitation team was consulted. He was able to support the recommendation, as despite working on the issues around paranoia, no progress had been made. The deputy evaluated the clinical reasoning and agreed to re-evaluate the accommodation needs of the client. There can sometimes be an expectation to follow guidance from an initial assessment, or medico-legal reports, recommendations from which can often be based

The importance of the multidisciplinary team

on observable facts. As a treating occupational therapist, working under the Rehabilitation Code, their overriding duty is to the client, the relationship is therapeutic and they act independently of the instructing party. Despite the content of medico-legal reports, the treating occupational therapist assesses independently and provides clinical justification. The Professional Standards further support this approach:

4.3.6. You have the right to refused to provide any intervention that you believe…would not be clinically justified, even if requested by another professional (RCOT 2021).

It is the role of the occupational therapist to advocate for the client’s needs when considering changes to support them at home. The unique contribution of the occupational therapist to the adaptations process, ensures that the client’s physical, psychological and wellbeing needs are being met. In addition, the understanding of a person as an occupational being ensures the home not only facilitates daily life, but is a true reflection of their aspirations.

Contact Lucy Leonard, Clinical Director Tel: 0333 444 0062 Web:

Ar ch ite ct

Cl ien t O. T.

apy r e h T am Te

Reference: RCOT (2021) Professional standards for occupational therapy practice, conduct and ethics. London:RCOT.

202 2 /23





202 2 /23


Without Active Care Group I wouldn’t have made the remarkable recovery I have. They have supported me every step of the way, helping me to recover and get better until I was ready to return home. I honestly can’t thank them enough.

We're specialists in care and believers in people. We make sure people requiring rehabilitation are surrounded by the collaborative, holistic and expert care and therapy they need to achieve maximum recovery potential and a brighter future.

01732 779353

Robert Service User

Peartree Community Service Our service offers a personalised approach, building bespoke packages of care and therapy around the individual in community settings. With over 25 years inpatient experience providing rehabilitation to clients with neurological conditions, we have extended this experience to train our community staff to develop excellent skills in supporting individuals with acquired brain injury.

Neurological Rehabilitation Service

Our care team can support clients in the following areas: • Personal care • Continence care • Nutrition including PEG feeding • Behaviour management • Cognition and communication support • Community access and leisure • Household chores • Personal Assistant services • Therapist led rehabilitation goals

Call us to arrange an assessment or discuss your client 07514 500216 or

202 2 /23



BABICM looks TO THE FUTURE BABICM is the leading membership organisation for professionals working in brain injury and complex case management. The organisation works collaboratively, sharing knowledge and experience, and provides best-practice guidance on case management for people with brain injury and other complex medical conditions. BABICM provides high quality, evidence-based training, initiates and disseminates case management research, and maintains and expects high professional standards from its members.


s the British Association of Brain Injury and Complex Case Management (BABICM) moves on from celebrating its 25th Anniversary in 2021, the organisation is looking forwards to an exciting future. With a 20% increase in its membership in the last year, BABICM, the leading organisation for professionals in brain injury and complex case management, is delighted with the increased interest in case management as a profession. However, with that increased interest comes a responsibility for the organisation to provide all members with access to high quality guidance, information, and support to assist in the delivery of best-practice services to their clients.

with the ICRM working towards the implementation of this new regulatory body. And we will ensure that BABICM continues to provide high quality, evidence-based training which will support registration by the IRCM.”

BABICM’s mission: To ensure that the needs of people with brain injury and complex medical conditions are recognised and met through excellent case management.

MEETING TOMORROW’S CHALLENGES Four Working Groups facilitate and support BABICM’s work, with a focus on meeting the challenges and issues ahead.

Vicki Gilman, BABICM Chair said: “BABICM maintains and expects high professional standards from its members. Going forwards the organisation will continue to focus on the support of its members in the delivery of best practice services by providing high quality, evidence-based guidance, initiating and disseminating case management research”.

The future for case managers will involve the Institute of Registered Case Managers (IRCM), a new independent regulatory body. The IRCM was established following discussions involving BABICM, the Case Management Society of the UK, and the Vocational Rehabilitation Association about the need for a nationally recognised but independent register of case managers who can demonstrate their competence and that they meet specific standards for case managers. The IRCM is currently progressing along the path towards gaining the accreditation necessary to enable it to uphold standards for registered case managers. Vicki said: “It’s important that case managers are regulated and registered by an independent body; we’re actively involved


202 2 /23

BABICM’S AIMS To share knowledge and excellence in brain injury and complex case management To lead the way in related research and evidencebased practice To influence and shape national policy through collaborative working To maintain the highest professional and ethical standards

BABICM’s Professional Practice and Membership Group (PPMG) champions best practice, promotes professional standards and oversees membership of the organisation. The PPMG will continue to provide professional guidance to support case managers with clients who have brain injuries or complex conditions implement best practice, maintain all the expected professional standards, and have all the necessary competencies for IRCM registration. Going forwards the PPMG is developing documents to illustrate examples of

CASE MANAGEMENT good case management practice and improve the skill base of new case managers. ‘What does good case management practice look like?’ will soon appear as a series in the BABICM magazine and on its website. The PPMG is continually writing and updating guidance for its members, clients and families about case management and best-practice service delivery, and the group provides the tools necessary to support case managers applying for Advanced Membership. Research is a key aspect of case management and best practice evidence is crucial for steering BABICM’s future work and the delivery of optimal service for clients. Research is crucial for building the knowledge base, facilitating learning, understanding the issues that affect clients and providing the information required to drive change. Through the work of BABICM’s Research Group, the organisation plays a significant role in improving and enabling progress for its clients as it continues to promote the dissemination of, and encourages research into, brain injury and complex case management. At an early stage in its history BABICM recognised that training was critical in driving standards and competencies. Consequently, the Training Events Group is producing an extensive programme of training events throughout 2022 and beyond to support the professional development of members and other professional organisations working with people with brain injuries and complex conditions. The training courses relate to the BABICM Competencies and Standards and help to ensure members can respond to challenges, changes, and developments within the appropriate legal, statutory, medical, social, and scientific case management practice. The events are UK-wide, face-to-face and include webinars. In the future members will have access to all past and future webinars on the BABICM website. The Company Strategy Group (CSG) is responsible for BABICM’s strategic planning and promotes the organisation’s identity within the industry sector. CSG also supports and develops the organisation’s collaboration projects, marketing and communications activities as well as championing the membership.

MAINTAINING ITS INFLUENTIAL AND POWERFUL VOICE BABICM is now recognised as an influential and powerful organisation raising awareness of issues such as improved care and service delivery that impact on its clients. The organisation’s opinion is frequently sought on national policy. A recent survey was conducted amongst members to gather objective statistics alongside subjective narratives about their experiences recruiting and retaining support workers for clients. The questions addressed the range and frequency for higher rate payments for support workers and the impact of mandatory vaccination for case managers, support workers and clients. The results will be used to highlight the issues being experienced by clients with particularly complex disabilities, their families, and the support sector. BABICM communicates, lobbies, and collaborates with many organisations such as the Care Quality Commission, Court of Protection (CoP), Department of Health and Social Care, Law Commission and Office of the Public Guardianship, on issues that affect clients and impact on brain injury and complex medical conditions case management. The organisation is currently developing training resources that can be used by external organisations such as the CoP to raise awareness of the role of a case manager amongst stakeholders.

ARE YOU INTERESTED IN BEING A CASE MANAGER AND JOINING BABICM? If you would like to know more about case management and/or join BABICM then please get in contact. There are various memberships available from Advanced Registered Practitioner, Registered Practitioner, Practitioner, Corporate Associate, Affiliate, Student or Charity Associate.

For further information, please visit or

“BABICM is committed to excellent case management. The organisation will provide the education, training, and support so that members can meet the necessary professional standards and practice competencies to uphold the BABICM Code of Ethics and gain IRCM registration” commented Vicki.

202 2 /23



Collaboration & The Elephant IN THE ROOM (SUBSTANCE MISUSE) Supporting a Case Manager with a complex care plan and difficult decisions during a pandemic. CASE: A – Acquired Brain Injury & loss of support network due to partner leaving the family home.


uring the Global Pandemic and National Lockdown, Browns Case Management was asked to lend its team’s experience to assist a fellow Case Manager at another company. The Case Manager and Deputy knew that Browns Case Management had the knowledge and expertise that would benefit them on a particular case. Michael (pseudonym) was a young adult with a complex Brain Injury and care needs. Michael was initially discharged into the community to continue with his rehabilitation; however, a formal review of his DoLS Authorisation was outstanding. This was compounded by the fact that he was being managed and moved between two Local Authorities and adapting to the loss of his partner who had recently left the family home with their child, due to the psychological impact Michael’s brain injury was having on their child. This had resulted in a Child Safeguarding Referral. It was quickly recognised that there had been no formal capacity assessments, completed by either the individual Local Authorities or clinicians, in respect of specific decision making and Michael was using Cannabis on a regular basis, which further impacted the complexity of the case and the fragility of the existing care package. The initial assessment with Michael, his team and I confirmed that he displayed some aggressive behaviours when out in the community and that pre morbidly, Cannabis was a large part of his life. It was increasingly apparent that the care team had ‘turned a blind eye’ to Michaels’ Cannabis use and where this was coming from. It was clear that the care team and Michael’s


family were experiencing guilt over the losses Michael had experienced thus far (his job, social, and family life) and that the use of Cannabis was the ‘only thing he had left and had control over’. Cannabis was easily available to Michael via visiting family members, and this resulted in the care staff not feeling confident enough to challenge them regarding the legality of the activity or to consider that the use of pre rolled Cannabis joints could be harmful. Further, ‘enabling’ Michael to continue to access Cannabis appeared to be an effective method of managing the more undesirable aspects of his negative behaviours. Due to the large number of essential professionals involved in Michaels rehabilitation, clarity in respect of agreed strategies and methods was lacking. Browns Case Management facilitated discussions with the team to identify the need to review the ongoing use of Cannabis, that pre dated the Case Manager’s involvement. It was agreed that the priority was to confirm Michaels capacity to make decisions regarding illicit drug use, namely Cannabis and confirm the outcome, with Michael, his care team and family members. The team agreed that it was extremely important that Michaels family were involved in the process and that they needed to be very clear in respect of the rationale for clinical decisions, that needed their support. Further, all parties, including staff members required urgent training and supervision to ensure that they understood the legality of Cannabis use in the UK and their role in ‘enabling’ a vulnerable adult to access illegal drugs. Upon completion of the Capacity Assessment with Michael, a number of strategies were agreed and an updated care plan was confirmed. This covered plans for family contact at Michaels home, rather than family homes, clear Person Centred Strategies and Protocols for care staff to follow and implement, as well as an audit of Michael’s spending and access to money, that then could not be used to reimburse others for Cannabis and

Browns Case Management facilitated discussions with the team to identify the need to review the ongoing use of Cannabis, that pre dated the Case Manager’s involvement.

202 2 /23

CASE MANAGEMENT minimise the risk of financial exploitation by family and friends. Michael agreed to the following, with the support of his case manager and rehabilitation team:

Contact with family would be within his own home. This would facilitate a more robust response to any aggressive or unsolicited behaviour from Michael when family would not provide him with Cannabis. Michael understood that they would leave and not return. The support team would complete an audit of his spending and allowances, which would support a more safe and effective method of safeguarding Michael against the purchase of Cannabis and risk of financial exploitation by others.

The Rehabilitation Team were able to discuss and come to an agreement to make contact with the local police and remove all paraphernalia associated with Cannabis from Michaels home, with his permission. Due to an unrelated and pre planned hospital admission, Michael to abstain from Cannabis for ten

days. The Rehabilitation Team were able to discuss and come to an agreement to make contact with the local police and remove all paraphernalia associated with Cannabis from Michaels home, with his permission. This enabled him to return home following a period of abstinence and managed triggers. Although very difficult, the nationally imposed restrictions in response to the Global Pandemic impacted contact arrangements and visits with people outside of Michaels ‘bubble’, which supported the agreed strategy that family would not be asked to supply Cannabis. This was maintained throughout the ongoing lockdown. The support from Browns Case Management continued beyond this initially complex and challenging situation and has evidenced how a collaborative approach between agencies can ultimately support clients with very complex needs and social issues, to remain safe within their preferred local community. Michael is now settled, has regular supervised contact with his son, an established support team, that continues to support his abstinence from Cannabis and meaningful and supportive contact with his family. Browns Case Management remains in close contact with the Case Manager, Deputy and the Rehabilitation Team to offer support, guidance and intervention as required to maintain this successful regime. ■

This is another example of Browns Case Managements client centred approach, to find out more about how we can help please contact us at: Web:

202 2 /23



Innovation and Quality are at the forefront of Case Management PROVISION AT STANLEYSMITH As a company we’re dedicated and passionate to provide best practice.


ad hoc to tap into collective intelligence of the in-house MDT. ver the last year we’re proud to have set up Friendly and approachable team’. psychology led peer support sessions for our experienced case managers and individual mentoring for newer case managers. We have WHAT DRIVES YOU AS A Case Manager? recently employed a Care Team Coordinator to ensure care ‘Motivation to make a difference and enable the client and family teams are appropriately supported and trained. This enhances to understand the client in the context of the index accident and an already strong team that residual difficulties, but ensuring we includes an RGN to over see get the appropriate team around the medication administration. client and family to support them Quality of case management through at times a very difficult provision for the client and their journey’. family underpins the way we lead Advocacy to ensure that the StanleySmith Case Management. client can access services; whether We value the high level of statutory or privately even if it knowledge and experience our makes you unpopular’. team of case managers have and ‘Advocacy for client, holistic collectively we are able to specialise approach and the potential to in working with highly complex access funds to supplement clients. statutory provision in order to We celebrated our 3rd birthday as a improve quality of life of a person’. company in August 2021. We asked some of our case managers for their feedback on WHAT INNOVATIVE CM IDEAS StanleySmith Case Management: HAVE YOU IMPLEMENTED TO ASSIST YOUR CLIENTS? ‘Worked with a client to become a public speaker at conferences WHAT DO YOU FIND MOST CHALLENGING ABOUT - he was an ex pilot in the Navy and had the aptitude for public WORKING WITH COMPLEX CASES? speaking’. ‘Ensuring there are sufficient contingencies in place and risk ‘During COVID setting up a virtual personal tutor, within 24 hours, assessments to try and cover all possible eventualities. Sometimes for a university student which continues to work really well’. when managing crisis along with other case loads, it can be a ‘One of my clients decided to defer Year 2 in a Fine Arts challenge to remain balanced’. extended diploma so to ensure that she continued being creative, ‘Depending on whether the case is settled or unsettled can be which was important for her, and in preparation for returning to challenging with the demands of litigation which can sometimes the course after a period of rehabilitation we are supporting her impact on the rehabilitation with a client’. to access a local artist studio with a mentor’. ‘Managing complex personalities within teams whilst following employment law can be tricky when you know that you have done FINAL SUMMARY FROM DIRECTORS HEIDI STANLEY AND everything to support an employee’. NIKKI SMITH ‘Ensuring my own CM hours remain within budget whilst We’re passionate and dedicated to ensuring high quality case vigilantly meeting the duty of care’. management for our clients and we are very proud of the team we have here at StanleySmith Case Management. Please do WHAT SUPPORT DO YOU RECEIVE FROM SSCM TO ENABLE contact us on 01752 466 173 if you would like more information YOU TO BE EFFECTIVE AND HAPPY IN YOUR ROLE? about what we do and how we may be of assistance or if you’d ‘Excellent support from directors, peer group support and clinical like to join the team. supervision from a clinical psychologist. We all work really well together so we call or contact other case managers who have specialist interests in particular areas. Also we can’t forget the fabulous support from the office. I would say that everyone who works for the company has just as an important role in ensuring that everything works smoothly but also we provide support to each other’. web: ‘Excellent mentor and office support, access to brain injury webinars. Supervision and appraisals. Peer support- planned and tel: 01752 466 173


202 2 /23

EMPOWERING YOUR QUALITY OF LIFE Our ethos is to tailor our work to our client’s individual needs, putting the client at the centre. At StanleySmith Case Management we:

Who we are, the team:

Î Have the experience, knowledge and skills to steer case management so that it is individual to the client’s needs.

Î We are a friendly team of highly experienced HCPC registered Therapists and Case Managers.

Î Listen to the client and their families promoting autonomy.

Î Members of CMSUK and BABICM.

Î Lead case management through adopting a collaborative approach with the client their family, professionals and services involved.

Î We each have over 10 years experience within our individual discipline.

Î Promote quality of life, rehabilitation, vocation and recreation which underpins our work. Î Value individual carers, ensuring that they are skilled and competent to manage the client’s individual needs. Î Are registered with the Care Quality Commission (CQC).

Î We are directed and supported by dynamic and experienced clinicians. Î We ensure Case Managers are appropriately trained, supported and valued to complete their role effectively. Î We have administration, finance, HR and office support to ensure swift and effective Case Management implementation.

01752 466173


ABI Case Management Ltd Covering the Midlands, North West, North East of England and North Wales, ABI Case Management Ltd is a dedicated and professional service providing specialist case management to clients with acquired brain injuries, spinal injury other catastrophic injuries.


aking single or The input from (ABI Case joint instruction Management) over the last 18 from Defendants, months, during lockdown, has Litigation Solicitors, Court of Protection been invaluable, we couldn’t have Deputies, lay Deputies or continued to support the clients the client themselves - we provide assessment and without your help …. ongoing case management COURT OF PROTECTION DEPUTY services assessing and facilitating support for our clients from the post-acute and rehabilitative stages of recovery through to ongoing maintenance and longer-term support programs. Our case managers have extensive backgrounds and clinical experience in neuro-rehabilitation and the longterm management of the health, medical and social needs consequent of head injury and spinal cord injury. Our innovative and dedicated team of case managers

include specialist occupational therapists and nurses who adopt a collaborative, proactive and needs led approach to supporting our clients through their rehabilitative journey to maximise their recovery, potential and reclaim their lives. ■

For further information please visit our website at For referrals, please email Ann Unsworth at

Specialist Case Management Occupational Therapy and Nursing Assessment For Acquired Brain, Spinal and Catastrophic Injury For referrals and information please email Ann Unsworth at Or visit our website -


202 2 /23


Regulated HR Services for Court of Protection Teams BALANCING SENSITIVITY & COMPLIANCE

performance and conduct, and encourage care staff retention, that in turn enhances client care. Our diligence ensures that roles, responsibilities, and contractual agreements are relevant to each client’s practice. We use HR software to support efficient and secure storage of all documentation. We operate as your partner in managing your HR requirements to free up time and costs for deputies’ teams and case managers, to concentrate on care provision and staff management. Our HR specialists are members of the Chartered Institute of Personnel & Development (CIPD) - this internationally recognised body promotes a commitment to high professional standards in HR.

I have found Embrace sensitive, receptive and highly professional. The HR advice I have personally received has made my job a good deal easier, freeing me up to deal with my own professional priorities.

Cecily Lalloo Chartered MCIPD, and the team at Embrace HR Limited, specialise in providing deputies and case managers with HR services for clients with brain injury who require complex care.


ince 2013, Embrace HR have been delivering people management solutions to clients requiring complex care. We are an experienced, approachable team that works with many deputies and case managers whose private clients require staff to assist in care and rehabilitation. We recognise the trauma and changes that families go through in cases of brain and spinal injury. We balance sensitivity to their complex care needs, with robust HR that complies with regulations. Our approach encourages good working relationships to manage

We can work with you to manage the full employment lifecycle. This includes focused recruitment campaigns, managing capability, disciplinaries, grievances, absences and exits, along with redundancies and settlement agreements. Working with Embrace HR, you gain cost-effective HR expertise and reduce workload pressures for deputies’ teams and case managers, as well as parents and individuals, resulting in better outcomes for all concerned with client care provision. ■

Pattern Architecture Contact Cecily Lalloo and her team for a confidential, no-obligation consultation on 01296 761288.

Embrace HR Limited are proud to be a Corporate Associate Member

Deputy, Case Manager, Court of Protection teams requiring HR support? We have been providing HR advice to support specialist complex care teams since 2013.

New book available!

Contact MD Cecily Lalloo Chartered MCIPD for a confidential, no obligation consultation. Embrace HR Limited Claydon House Business Centre 1 Edison Road, Aylesbury, Bucks HP19 8TE

t: 01296 761288 w: e: KM05 Alison Page - BABICM Advert Nov 2021 P2_ART.indd 1

02/11/2021 17:04

202 2 /23




EXPERT EXPERT REHABILITATION REHABILITATION EXPERT REHABILITATION CASE CASEMANAGEMENT MANAGEMENT SERVICES SERVICES CASE MANAGEMENT SERVICES Proclaim Group the UK’s foremost independent provider of rehabilitation ProclaimGroup Groupisisisthe theUK’s UK’sforemost foremostindependent independentprovider providerof ofrehabilitation rehabilitationcase Proclaim case management, treatment anddiagnostics diagnostics services. case management, treatment and services. management, treatment and diagnostics services.



e are recognised by solicitors and e are e are recognised recognised byby solicitors solicitors and and insurers insurers insurersand asand independent and expert as independent as independent expert expert in in what what wewe in what we do. WeWe employ employ a diverse a diverse range range of health of health professionals with with extensive extensive We employ aprofessionals diverse range of health clinical clinical experience experience to allow to allow us to us match to match thethe case case manager manager to to thethe professionals with extensive clinical experience to allow us client’ client’ s specific s specific needs. needs. to match the case manager to the client’s specific needs. Our innovative approach to working with clients OurOur innovative innovative approach approach to working to working with with clients clients impacted impacted by spinal brain and/or spinal injuries include a dual byimpacted brain by brain and/or and/or spinal injuries injuries include include a dual a dual case case manager manager approach; approach; thisthis combines combines different different health health professionals, professionals, with case manager approach; this combines differentwith health differing differing skills skills andand expertise expertise aligned aligned to the to the needs needs of of a client aaligned client professionals, with differing skills and expertise throughout throughout thethe duration duration of the of the case. case. to the needs of a client throughout the duration ofUniquely the case. Uniquely with with Proclaim Proclaim Care, Care, rehabilitation rehabilitation services services cancan Uniquely with Proclaim Care, rehabilitation services be seamlessly be seamlessly co-ordinated co-ordinated forfor thethe client client through through ourour can be seamlessly co-ordinated for the client through specialist specialist sister sister services; services; Obair Obair Associates Associates andand Resolve Resolve Health. Health. This This joined joined up up multi-disciplinary multi-disciplinary approach delivers delivers to and to thethe clients, clients, our specialist sister services;approach Obair Associates their their families families andand their their representatives, representatives, a simple a simple andand clear clear Resolve Health. This joined up multi-disciplinary rehabilitation rehabilitation journey. journey. Client Client surveys surveys have have evidenced evidenced thethe approach delivers to the clients, their families and value value thatthat thisthis approach approach brings brings in achieving in achieving thethe clients clients goals goals their and and therepresentatives, the bestbest outcomes. outcomes.a simple and clear rehabilitation journey. Client surveys have evidenced the value that this approach brings ina achieving the goals and Obair Obair Associates Associates provides provides full a full range range of Occupational of clients Occupational Therapy Therapy andoutcomes. and Vocational Vocational services, services, with with thethe consultant consultant working working the best hand hand in hand in hand with with thethe case case manager manager to achieve torange achieve thethe desired desired Obair Associates provides a full of goals goals andand outcomes. outcomes. Occupational Therapy and Vocational services, with the consultant working hand in hand with the case manager Resolve Resolve Health Health Treatment Treatment andand Diagnostic Diagnostic Service Service offers offers a joined a joined to achieve the desired goals and outcomes. up approach up approach to co-ordination to co-ordination of treatments, of treatments, therapies therapies andand other other Resolve Health Treatment and Diagnostic Service required required clinical clinical services services recommended recommended by by thethe case case manager. manager. offers a joined up approach to co-ordination of Proclaim Proclaim Training Training Academy Academy regularly regularly delivers CPD CPD accredited accredited treatments, therapies and otherdelivers required clinical training training courses courses andand workshops workshops tocase our case case managers managers to to make make services recommended by to theour manager. suresure their their knowledge knowledge andand skills skills areare kept kept up-to-date up-to-date with with thethe Proclaim Training Academy regularly delivers CPD most most recent recent clinical clinical developments. developments. accredited training courses and workshops to our case managers toatmake sure their knowledge The The client client is placed is placed the at the centre centre of everything of everything wewe do,and do, andand thisthis has has been been recognised by CMS by CMS UK, UK, when when we we were were chosen chosen as Case as Case skills arerecognised kept up-to-date with the most recent clinical Management Management Company Company of the of the Year Year 2019. 2019. developments. The client is placed at the centre of everything We We have a team athis team of of clinically clinically qualified qualified and highly highly we do,have and has been recognised byand CMS UK, when experienced experienced Rehabilitation Rehabilitation Case Case Managers Managers located located we were chosen as Case Management Company throughout the UKUK ready ready to to support support your your clients. clients. ■■ ofthroughout the Year the 2019. We have a team of clinically qualified and highly experienced Rehabilitation Case Managers located throughout the UK ready to support your clients. ■

For further information please call on01698 01698 207 755, For For further further information information please please callcall onon 01698 207 207 755, 755, email or email or email or visit or visit or visit

600 6 00

202 2 /23

award-winning Specialist Rehabilitation Case WeWe areare an an award-winning Specialist Rehabilitation Case Management company. Our case management services support Management company. Our case management services support people across range illnesses and injuries categories people across thethe fullfull range of of illnesses and injuries categories from complex most catastrophic. from thethe lessless complex to to thethe most catastrophic. Our rehabilitation case managers work specialist areas Our rehabilitation case managers work in in thethe specialist areas acquired brain injury, amputation, complex orthopaedic of of acquired brain injury, amputation, complex orthopaedic psychological trauma with adults and children. andand psychological trauma with adults and children.

Obair Obair Associates Associates is aisspecialist a specialist Occupational Occupational Therapy Therapy andand Vocational Vocational Rehabilitation Rehabilitation company. company. TheThe standard standard of of ourour vocational vocational assessments assessments and and vocational vocational case case management management services services areare recognised recognised as as market market leading leading and and used used by by case case managers, managers, personal personal injury injury insurers insurers and and solicitors, solicitors, disability disability insurers insurers andand occupational occupational health health providers. providers. Occupational Occupational Therapy Therapy services services areare delivered delivered toto personal personal injury injury insurers, insurers, solicitors solicitors and and case case management management companies. companies.

Resolve Resolve Health Health is Proclaim is Proclaim Group’ Group’ s specialist s specialist Treatment Treatment andand Diagnostic Diagnostic Service. Service. WeWe offer offer thethe fullfull range range ofof physical physical andand psychological psychological therapies, therapies, diagnostics diagnostics and and hospital hospital services. services. Many Many services services cancan bebe delivered delivered through through virtual virtual technology. technology. WeWe focus focus onon delivering delivering thethe easiest easiest access access toto services services forfor thethe client, client, with with thethe highest highest quality quality ofof service. service. With With a focus a focus onon self-management, self-management, thethe service service is outcome is outcome focused. focused.

Our Academy Rehabilitation and Vocational Expertise was Our Academy of of Rehabilitation and Vocational Expertise was established in 2018 offer CPD training Proclaim Group established in 2018 to to offer CPD training toto Proclaim Group insurance, corporate and case management market. andand thethe insurance, corporate and case management market. have a passion providing education industry WeWe have a passion forfor providing education toto thethe industry enable maximum benefit achieved through to to enable thethe maximum benefit toto bebe achieved through rehabilitation and vocational services. thethe useuse of of rehabilitation and vocational services.

Rehabilitation & Vocational Specialists

Proclaim Group brings together award-winning specialist rehabilitation, vocational & occupational therapy services Back to health • Back to work


Breakthrough Case Management ‘CASE MANAGEMENT WITH CARE’ Breakthrough Case Management’s co-founders, Annabelle Lofthouse and Catrin May, know what high quality case management and effective rehab provision looks like.


stablishing the Southwest based company positive future. in 2018, each with over 30 years of clinical Breakthrough’s Case Management and Care services experience, they set out with a shared set co-exist to significantly reduce the outsourcing so of values and a clear vision – to keep often associated with complex personal injury the client at the heart of everything they cases. Serving as a single point of access do and provide an all-encompassing, to a network of highly experienced responsive service to law firms and professionals, the Breakthrough care solicitors. model ensures quality care provision As the company has grown, in size as alongside continual functional well its geographical coverage, (recently rehabilitation and evidences branching out in the Northeast measurable outcomes. and South of England), so too has its reputation for excellence. In a recent The importance of survey, both clients and solicitors rated the Annabelle Lofthouse company’s ability to respond effectively in a Innovation’ timely manner as outstanding. Our case managers keep abreast of the very latest developments in rehabilitation technology, trialling Life’s greatest difficulties innovations and emerging digital solutions to secure happen before life’s greatest transformational outcomes for their clients. We work closely with our allied clinical colleagues, including breakthroughs rehab assistants; neuro physiotherapists; occupational therapists; nurses; psychologists and the wider At Breakthrough Case Management we multi-disciplinary team to identify every support and guide individuals and their resource out there that will support the families who have experienced a best possible outcome for their clients. catastrophic injury – to realise their full All this with a steadfast personpotential and improve their quality of centred approach that keeps the client life. With an ever-expanding cohort of at the heart of everything we do. ■ case managers, all highly experienced experts in their fields, and a strong internal mentorship programme, Your breakthrough Breakthrough prides itself on its ability starts here… to tackle each and every eventuality in any Catrin May case.

Case Management with Care Our CQC registered complex case management and ongoing care and rehabilitation service exists to empower people. We give our clients the practical and emotional support they need to feel in control, right now. And the purpose and energy to move towards a


202 2 /23

Web: AnnabelleLofthouse: 07703 103843 Catrin May: 07595 226097

Case Management with Care h Case Care Management with Care Case Management with Care Case Management with Care h Case Care Management with Care High impact case management delivered by experienced xperienced High impact case management delivered by experienced

High impact case deliveredbybyexperienced experienced High casemanagement management delivered he clinicians - very supporting youwith with safe safe start. hands the very start. clinicians - impact supporting you handsfrom from the very start. clinicians supporting you with safe hands from the very start. clinicians - supporting you with safe hands from the very start. xperienced High impact case management delivered by experienced he clinicians - very supporting you with safestart. hands from the very start. throughcm .com se: 07703 103843 Annabelle Lofthouse: 07703 103843 Annabelle Lofthouse: 07703 103843 7595 226097 Catrin May: 226097 throu ghcm . c07595 o m Annabelle Lofthouse: 07703 Catrin May: 07595 226097 103843 Annabelle Lofthouse: 07703 103843 se: 07703 103843 Annabelle Lofthouse: 07703 103843 Catrin May: 07595 226097 7595 226097 Catrin May: 07595 226097 Catrin May: 07595 226097


TRAUMATIC BIRTHS what do we know and how can we support Families as Case Managers? Lyndy-Lee Green BSc (Hons OT), Case Manager and Dr Rebecca Blanshard MbChB BMedSci (Hons)


s Case Managers working with children who have sustained birth injuries, we will also work closely with parents who have experienced trauma surrounding the birth of their child. After 40 long weeks of pregnancy, with emotional adjustment to the idea of a baby in your lives, the expectancy and build up, the birth is the moment that your new future is realised. It is a time that you have imagined and talked about with loved ones, and made careful plans for. In the 21st century, the labour suite is the place where we trust medical and health professionals to care for us during one of the most wonderful, but also one of the most complex and critical events of our lives (as babies and parents). At this time, parents are at their most vulnerable, relying on the knowledge and experience of healthcare professionals to guide decision making. Things do not always go to plan, and when things go wrong there can be life changing consequences for the families we work with.

In an instant, all of the excitement and anticipation of the arrival of our first child suddenly turned to mass confusion and terror. I tried to wrap my mind around the painful reality of what {baby} had been through, the massive uncertainty surrounding his long-term prognosis, and a life we knew would now entail regular trips to the hospital.

during the birth of their child, and their feelings of lack of control, panic, fear, confusion, being disregarded, not listened to and not being informed. In my role as Case Manager, I find that I need to allow time for parents to speak about their experiences, and start to find a way to cope with the emotional and psychological aftermath.

I feel so angry and let down – this should have been one of the most wonderful days of my life, I can’t stop thinking about what happened on the day to try to make sense of it . PARENT Parents also talk about the anger that follows, and mistrust of any professional after that. How can they trust anyone again after their child suffers a birth injury with life changing consequences for all of them? That mistrust can remain, and cause further heartache and anxiety. Inevitably a child with complex needs following birth/ brain injury will need significant amounts of input from medical, health and social care professionals. In researching experiences reported during traumatic births, common themes arise: Feeling uncared for – during labour some mothers (and fathers) feel that they were either abandoned, unsupported or in some cases even ignored by health professionals or their family.


Feeling uninformed – birthing mothers feel that things happened to them and they were not communicated with effectively to make informed choices.

In several of my cases I have spent a lot of time talking with Mums and Dads who are visibly still traumatised and confused about how quickly things appeared to go wrong

Feeling powerless – especially when there has been a lot of medical intervention, many mothers feel that they had no control over what happened during the birth.


202 2 /23


Feeling discarded – some women report that while the focus was on the baby, the mother’s own needs were not met during the labour Feeling let down – women access maternity services from a point of trust, so don’t question things, as they trust health professionals to know best There can be serious consequences for mothers who have a traumatic birth experience with many going on to develop postnatal mental health issues. These can be even more devastating when the baby has complex health needs of its own. Common issues include: Inability to bond or attach with baby Reduced likelihood of subsequent births and pregnancy Possible interferences in breastfeeding Conflict in interpersonal relationships after the birth Difficulties in sexual relationships Postnatal depression or anxiety Post-traumatic stress disorder (PTSD) When birth trauma results in PTSD a parent (mother or father) might experience several symptoms including: Intrusive reminders of the birth via nightmares, flashbacks, and intrusive thoughts that lead to psychological distress; Avoidance of anything that reminds the mother of the labour or birth including doctors, hospitals, sometimes the baby and possibly others involved in the delivery; Increased bodily arousal which can impact on sleep, make it hard to concentrate and increases feelings of anxiety or irritability. This is like being on edge all the time as though the body is still under threat.

This PTSD is sometimes likened to “combat trauma”. It will be helpful for Case Managers to gain an understanding of not only what the parents may have experienced when becoming aware of their baby’s potential long term difficulties and health prognosis following a difficult birth, but also the traumatic events of the birth itself. It may help to understand a few of the reasons/ factors/ signs and

clinical indicators that may lead to a very quick response by the medical staff, or a dramatic change to a set birth plan. Case Managers usually come from backgrounds of occupational therapy, social work, physiotherapy or nursing. They are not doctors or clinicians working on obstetric wards, and are not privy to the knowledge or experience to understand this environment. We do not have an insight into what may suddenly occur, even in cases with the best possible care being delivered, and would struggle to empathise with the lived experience of the parent. In order to understand what the clinicians on the ground may need to deal with on a day to day basis, and the what they may need to do, I sought advice from a doctor with experience of working in this challenging environment. This is what Dr Blanshard explained:

Working as a junior doctor in both obstetrics and paediatrics I have been part of the multi-disciplinary team working on labour ward. I have seen uneventful labours become lifethreatening to mother or baby. I have seen situations necessitating immediate, unplanned delivery via instrumental augmentation or emergency caesarean section. I have attended deliveries that have required unexpected or prolonged resuscitation of the newborn and subsequent admission to the neonatal unit. Management of these situation requires co-ordination and communication between the midwifery staff, obstetric team, paediatric and neonatal team and often multiple other professionals such as anaesthetics and theatre staff. Each person involved has a specific role in response to a given emergency. There is a growing recognition of the trauma surrounding birth with conversations starting earlier within a family’s pregnancy journey and some centres employing midwives with a specialist interest or knowledge in birth trauma. However, as often is the case within the NHS, underfunding and lack of time and resources means there is still significant capacity for improvement. Dr Rebecca Blanshard MbChB BMedSci (Hons) This illustrates how quickly the birthing mother particularly, can very quickly be out of control and surrounded by activity that she does not understand, and actions that must be carried out very quickly by the medical team in order to get the best outcomes for mother and baby.

202 2 /23


CASE MANAGEMENT Maternity services are under scrutiny, for example the report published in March 2022 investigating the failures of maternity care at the Shrewsbury and Telford Hospital NHS Trust, reported as amongst the most serious cases ever seen with cases including stillbirths, neonatal deaths, maternal deaths and babies born with brain injuries. Findings indicated evidence that staffing levels were a major factor. According to the Royal College of Obstetricians and Gynaecologists (RCOG) thousands more midwives and hundreds more obstetricians are needed and maternity services are significantly underfunded. Since 2017, the CQC has been rating the safety of maternity services in England and recent figures show that 41% of units need to improve their safety, while just 1% are rated as outstanding. Personal injury Solicitors and Case Managers are often the first or only contact that families may have where they are offered the chance to get professional help, and deal with the trauma and get back some feeling of control. The support, guidance, education and services we can put in place can improve the outcomes for families as a whole, not just the child that has sustained the birth injury. Case Managers need to have an appreciation of traumatic birth events in order to effectively engage in conversations with parents who may be experiencing anger, confusion, lack of psychological adjustment, lack of trust of professionals or even PTSD. We need to acknowledge the mother or father who remains traumatised by their experience, and put in place effective therapeutic support, early on. Case Managers need to be ready to make the appropriate referral to a specialist Psychologist, and ensure that Solicitors/Deputies/ Defendants are aware of the need, and costs. Further discussion and learning is needed, with case studies to hear from the families themselves, to help us to understand and respond with empathy and effectiveness. The following are a few available resources we can point families towards: The Birth Trauma Association: Home - Birth Trauma Association https:// The Special Needs Jungle: The emotional impact of parenting a disabled child - Special Needs Jungle Mums Matter website: Understanding birth trauma: SCOPE: Navigate: emotional support for parents | Disability charity Scope UK http://

Mind: Postnatal depression and perinatal mental health The British Psychological Society Website: Supporting parent carers | The Psychologist ( British Association for Counselling and Psychotherapy (BACP) You can search for a counsellor on It’s good to talk under ‘Disability’. British Psychological Society (BPS) You can search the Directory of Chartered Psychologists under ‘Parenting’ and any other relevant information, i.e. diagnosis. Health and Care Professions Council (HCPC) The HCPC regulates health and care professionals (including practitioner psychologists) so you can check if your professional is registered. Counsellors and psychotherapists are not currently covered. United Kingdom Council for Psychotherapy You can search on Find a therapist under ‘Disability’. Physiotherapy Association for Obstetric Gynaecology: Information for Patients | (

REFERENCES Understanding psychological traumatic birth experiences: A literature review Madeleine Simpson , Christine Catling 2015 Australian College of Midwives. Post-Traumatic Stress Disorder after childbirth and the influence of maternity team care during labour and birth: A cohort study. Sarah De Schepper , Tinne Vercauteren , Jolein Tersago , Yves Jacquemyn , Filip Raes , Erik Franck . Midwifery. 2016 Jan;32:87-92. Childbirth and criteria for traumatic events Rhonda J Boorman , Grant J Devilly , Jenny Gamble , Debra K Creedy , Jennifer Fenwick Midwifery 2014 Feb;30(2):255-61 A prospective longitudinal study of the prevalence of posttraumatic stress disorder resulting from childbirth events K L Alcorn , A O’Donovan, J C Patrick, D Creedy, G J Devilly Journal of Psychological Medicine 2010 Nov;40(11):1849-59. The Association between Birth Satisfaction and the Risk of Postpartum Depression Eva Urbanová , Zuzana Škodová, Martina Bašková Int Journal of Environmental Res Public Health 2021 Oct 5;18(19):10458.

Affinity Hub: emotional support for parents of children with special needs from https://www. Child Brain Injury Trust: https://

Web: Email:


202 2 /23

Case Management Solutions Ltd Guiding you to your potential Brain Injury | Birth Injury |Cerebral Palsy | Spinal Injury | Orthopaedic injuries We provide specialist Case Management services to children and adults who have sustained life changing injuries, including traumatic brain injury, birth injury / cerebral palsy, spinal cord injury and amputation. Working throughout Yorkshire, Nottinghamshire, Derbyshire, Leicestershire and Staffordshire, we provide a personalised holistic, knowledgeable and responsive service, working with clients and their families to help them achieve the highest quality of life and fulfil their potential Our highly skilled, experienced Case Managers can refer you to specialist independent rehabilitation professionals and therapists available in your area. We are a CQC Registered service and this assures you a safe, effective, caring and well-led service.


We understand the devastating effect that a serious injury has on a person and their family, and we are experienced, client centred, and experienced in meeting your needs. Your Personal Injury Solicitor will contact us to arrange an initial meeting, and we can start to identify what is important to you and your family, and how help and support can be tailored around your needs. Following the initial assessment we will normally complete a detailed report with a summary of recommendations and associated costs. This will be sent to your Solicitor, to enable them to get funding for the things you will need including care and therapy. It is sometime for improved housing or access to leisure activities. You will stay in control throughout, and can decide whether you are happy with the recommendations, and service will be tailored around your needs. You will be able to choose your Case Manager, and that person will remain working with you as long as you need them.

Areas we may recommend that we help you with: Providing information about your injury and condition, about the help available, about the medico-legal process and how to get the best out of services Assistance with securing funding for support, healthcare and education support Commissioning and managing your rehabilitation: finding suitable private therapists; for example Physiotherapists, Occupational Therapists, Speech and language therapists and Psychologists Getting together a rehabilitation plan based around your goals, facilitating progress, monitoring and managing therapy teams For children, supporting integration and progress with education; including going in to school and working with teachers Working with rehabilitation centres and assisting with discharge planning

Resourcing and advising on specialist equipment, vehicles and housing adaptations Finding and organising holidays and leisure activities Developing bespoke care and support packagesrecruiting, training and supervising Support Workers Payroll services for clients who have chosen to employ their own staff, but want support to manage them Assisting with post 16 college or specialist school placements and transitional living Enabling a return to work Pain management advice


We can refer you to a range of skilled private rehabilitation therapists who can work with you at your pace, for as long as you need. This includes among others, Occupational Therapist, Physiotherapist, Speech and Language Therapist, and Psychologist.


We can find you a Personal Assistant to help you enjoy some of the things in your life that you have missed, and manage this service for you. We are a fully CQC Registered service and can assure you of excellent, safe, well led and effective services. If you have any further queries please do not hesitate to contact us: Registered Manager: Lyndy-Lee Green Case Manager | Advanced Registered Practitioner


Brain Injury and Complex Needs Case Manager Advanced Registered Practitioner Registered Occupational Therapist

Melissa Marum

Brain Injury and Complex Need Case Manager BABICM Registered Practitioner

Stacey McCullagh

Brain Injury and Complex Needs Case Manager Specialist Nurse Practitioner


Taking the holistic approach TO REHABILITATION AND CASE MANAGEMENT Lauren Paikin, Clinical Lead and Specialist Rehabilitation Case Manager at HCML, outlines why every brain or spinal cord injury rehabilitation programme must address the physical, psychological and cognitive factors not only for the client, but their families and support networks too.


ajor trauma impacts all aspects of life. The physical, psychological and cognitive state of the client is often dramatically changed by the event, leaving them unable to fulfil Lauren-Paikin the life roles they had pre-injury, whether at home, in society or at work. Effective rehabilitation needs to consider all the aspects of their lives and draw in many key people to achieve successful outcomes in the journey to recovery.

EDUCATION Managing expectations is an enormous part of a Case Manager’s role. Client and family are often experiencing a variety of emotions, from initial shock, to upset and anger. The ramifications of traumatic injury and what life might reasonably look like moving forward are hard to comprehend and, indeed, an ever-changing landscape to navigate. It is the Case Manager’s job to educate all involved parties on what is likely to be achieved from rehabilitation and to ensure that they are supported throughout the journey. A spouse wanting to look after their partner post-injury at home is often thrust into adopting a different role as a caregiver, tending to physical personal care, assisting with everyday activities and accessing services. While doing all we can to support the client and family’s wishes, we also need to make sure that decisions are safe and sustainable for all parties. To do so, we often need to draw on a number of different professionals in order to put the right packages of care and intervention in place. We facilitate regular meetings between the client, family and the treating team to proactively guide and manage the rehabilitation journey.


The complex nature of brain and spinal cord injury means that changes in symptoms – particularly psychological POSITIVE ENGAGEMENT and cognitive – are likely to Training and education for The emotional and physical occur over a lengthy period support of family and friends in the the families is a huge part of throughout the client’s recovery. rehabilitation process often has what we do, as their perceptions Training and education for the a positive impact on the client’s families is a huge part of what and understanding change rehabilitation. NICE guidelines for we do, as their perceptions and ‘Rehabilitation After Traumatic throughout the rehabilitation understanding change throughout Injury’ recommend the involvement the rehabilitation journey. journey of families and carers in planning and Changes in the client’s behaviour making decisions across all aspects and cognitive state may prove of the rehabilitation process. Their inclusion can help shape a challenging, so in addition to continuously reviewing client proactive and purposeful role for the family that inspires, motivates goals and adapting rehabilitation programmes, we also ensure and reassures their loved one. the right support is in place for the families as they realise the full extent of what life post-injury looks like. SETTING REALISTIC GOALS Family members can help the Case Manager and other health professionals understand what the person was like pre-injury, supporting them to develop suitable rehabilitation goals. It is often important to include the family when conducting Immediate Needs Assessments (INAs), to help effectively evaluate the current difficulties and plan for optimal intervention, particularly when the client’s impairments might limit their input into these discussions.


202 2 /23

tel: 020 8649 8006 email: web:

Extraordinary outcomes for clients and their families We provide bespoke rehabilitation programmes to achieve exceptional functional outcomes and maximise independence for our rehabilitation clients across all physical, psychological, vocational and social aspects of their lives.

We work with our clients to establish what’s important to them and ensure their input and engagement when it comes to setting goals for their recovery. We build a personalised programme with careful consideration of what they want to achieve from their rehabilitation. We work collaboratively with other healthcare professionals, the client’s existing support network and wider stakeholders to get a comprehensive understanding of the client’s needs. Our Rehabilitation Case Managers communicate openly and honestly throughout the rehabilitation journey, with compassion for clients and their families. Our Rehabilitation Case Managers are experienced clinicians specialising in traumatic injury, with a wide range of evidence-based treatment at their disposal through our clinically governed network of providers. Combining expertise with empathy, they’re committed to developing interventions that result in extraordinary outcomes for our clients.

Make a referral 020 8649 5759



Is HR an integral part of your MDT as a CASE MANAGER?

directly employed team is one of the biggest challenges for a Case Manager, the Deputy, and the family. Working in a family home, with minimum supervision, but caring for a vulnerable adult or child requires a team who are not only highly skilled, but who are also respectful, professional, and empathic whilst maintaining boundaries. Case Managers, Deputies and the client’s family develop an MDT around the client, ensuring that there is a specialist team working to maximise the client’s potential to live their life as independently as possible, and in a cost-efficient way. Yet many Case Managers and Case Management companies try to manage the directly employed team without a qualified HR professional as part of their MDT, or they engage with an agency, to overcome the burden.


providing the full range of HR, Recruitment and Payroll services whilst being recognised as a key member of the MDT. CMSUK define Case Management as: “a collaborative process which assesses, plans, implements, coordinates, monitors and evaluates the options and services required to meet an individual’s health, care, educational and employment needs, using communication and available resources to promote quality cost effective outcomes” Proud of specialising in the Case Management Sector, our passion and commitment shines through with the client at the centre of every decision. HR 4 Case Management Limited is the Chesney Hawkes of specialist support for Case Managers, Deputies, and their families – the one and only specialist HR, Recruitment and Payroll Company dedicated to the Case Management Sector. The full HR support service also includes managing challenging staffing issues and finding solutions to ensure that the client receives high standards of care. Our flexible approach allows us to recruit for families either Since 2010 we have worked on a pay as you go or fixed price in the Case Management option, and we offer payroll services to complement our Sector, providing the full range HR support, working seamlessly of HR, Recruitment and Payroll between the two – including the calculation of annual leave services whilst being entitlement over 52 weeks, in line recognised as a key member of with the Good Work Plan.

The Case Management sector is unique, it is not a profession per se. It involves a group of individuals with specialist regulated skills, knowledge, and experience. HR 4 Case Management Limited was founded to focus on providing HR, Recruitment, and Payroll specifically for the Case Management Sector. Our aim is to become an the MDT. integral part of the client’s MDT, releasing the Case Manager, and ensuring that the directly employed team is managed within employment legislation, CQC regulations and good practice, and with empathy and understanding to the unique working environment of a family home and the litigation process.

OUR SERVICES Working with many Litigation Solicitors, Case Management Companies, Independent Case Managers and directly with families, we are recognised for our specialist knowledge, caring approach and professional support. Since 2010 we have worked in the Case Management Sector,


202 2 /23

Contact: Lynda Goncalves Tel: 0800 072 2877 Email: Web:

LOOKING FOR A BESPOKE CASE MANAGEMENT HR, RECRUITMENT & PAYROLL COMPANY? Providing bespoke and flexible HR, Recruitment, and Payroll support to Case Managers, Deputies, Clients, families, and Case Management Companies HR, Recruitment & Payroll in-house specifically designed for the Case Management Sector Appoint as a member of your MDT Provision of HR, Recruitment & Payroll support with our knowledge & expertise of working in the Case Management Sector since 2010

Payroll C ontracts

Practical, empathic, and professional support High levels of communication with all stakeholders Work collaboratively with Case Managers and Deputies

HR Advice Recruitm

Keeps the client at the heart at every decision To enquire and find out how we can work with you, supporting your client’s email Email: | Tel: 0800 702 2877


Annual Leave Calculating


Are you looking for a case manager IN THE SOUTH OF ENGLAND? We provide a specialist case management service that enables a better quality of life for our catastrophically injured clients.


ur aim is to help our clients across the south of England to achieve their maximum level of independence and the highest possible quality of life, for the rest of their life. We provide specialist case management services for clients who have suffered catastrophic life-changing injuries. We are client focused and passionate about delivering excellent support to each individual client. Our case managers, who have a minimum of seven years’ post qualification experience, bring their wealth of knowledge, commitment and passion for supporting clients to the rehabilitation journey, enabling our clients to achieve their goals. By setting realistic goals we enable our clients to address the new challenges presented to them and to look forward with a sense of positivity. The experience and expertise of our case managers enables


202 2 /23

them to devise and co-ordinate the most appropriate and effective rehabilitation and care solutions, ensuring that all involved with the client work together in an integrated way to achieve the best possible outcomes. Our case managers are highly responsive to clients and instructing parties, as well as readily adaptive to change, providing excellent communication and regular updates on progression towards the agreed goals. Working together, we strive to give clients, and their families, the best opportunities to reclaim their lives as empathetically and cost effectively as possible. We develop services that are truly integrated, bringing together our clients, their families, the multidisciplinary team, solicitors and insurers. ■

If you have any clients you would like to discuss, call us on 01202 978900 or email



MCCM – Mary Campbell CASE MANAGEMENT MCCM is an independent case management company where the main objective is to provide high quality case management services to adults and children who have sustained catastrophic brain injuries or have complex case management needs.


CCM is based on the Wirral, and available to travel around the North West, including Liverpool, Chester, Manchester, North Wales including Anglesey. Mary Campbell, Director of MCCM, is a qualified Occupational Therapist, graduating from the University of Liverpool in 2001. In 2007 Mary joined a leading case management company in the North East, this was the beginning of her case management career.

WHAT MAKES MCCM DIFFERENT? Mary was introduced to rehabilitation at a young age. Her brother sustained a brain injury as a premature baby, his resilience and her parents’ strength in their battles to achieve the best for their son has been an inspiration. Later in life Mary’s mother was involved in a road traffic collision which resulted in a life changing spinal injury. These experiences shaped her career path as a Specialist Neurological Occupational Therapist within the NHS and then a Brain injury Case

Manager within litigation. Mary has learnt the importance of family involvement and communication from being part of a family on the receiving end of rehabilitation Mary is experienced in supporting parents, either those who have sustained brain injuries or the parents of clients who have sustained injuries. Assisting parents with brain injuries in their rehabilitation to resume their role of ‘parent’ and manage the care of their children, whilst acknowledging the development of their children and the impact on their lives. Mary has supported parents of brain injured clients. Providing them with reassurance that their children will be well supported in their later years, acknowledging the concerns of the parents and the conflict they face as the carer/parent roles blur.

Mary is experienced in supporting parents, either those who have sustained brain injuries or the parents of clients who have sustained injuries. The infrastructure Mary has set up at MCCM allows her to work flexibly and accommodate her client’s needs, whether that be an evening appointment or a meeting at school or work. Mary demonstrates empathy to her clients and their families knowing first-hand how challenging these circumstances can be. Mary thrives on the challenges she faces as a case Manager. ■

email: web: tel: 07783900783

202 2 /23



A care sector in turmoil IS DIRECT RECRUITMENT A SOLUTION? There is no doubt that the care sector is in turmoil and in some ways may never be the same as a time before Brexit and the Covid-19 pandemic as, before all of that, factors such as an ageing population, pay and conditions and increased sector competition were already putting a strain on care.


Concerns can be mitigated further by the way that care is o B Wilkins, Head of Care Support Services at Bush provided and for many, direct recruitment is the solution. & Co, a leading brand in case management and expert witness services, shares her views on the care sector and the world of direct recruitment for THE BENEFITS OF DIRECT EMPLOYMENT people following catastrophic injury. As the name suggests, direct employment uses available funding The level of uncertainty and to recruit dedicated support workers disruption in the UK care sector has Bespoke packages of care to deliver social care, as opposed to reached unprecedented levels in recent using a care agency to source staff. Both can be developed and years. Inconsistencies in government approaches have benefits, with direct implemented, providing patients employment offering consistent and funding for business owners and support workers within the sector is often quoted with all the benefits of being an monitored care,while the care agency route as the main driver of a reality where employer and the peace of mind perhaps offers greater agility to react to the resources are stretched to their limits and unexpected. that the administration is all operators within the sector are struggling Whether funded using a settlement to meet the standards of care needed by from a court action or a local authority taken care of. an increasing number of patients. personal health budget, direct employment Many of the challenges within the sector have existed for many places greater control with the patient, making them the recognised years, but others have surfaced more recently and will have a employer of their support worker and allowing them to select and lasting effect. Traditional challenges are seen as including an ageing develop relationships with the people providing their care. ■ population, changes to the levels and structure of government funding, pay and conditions for support workers, a fragmented care home sector and increased competition. Add to that the new At Bush & Co, Bush Care Solutions challenges of Brexit and Covid-19 and the care sector creaks further provides comprehensive, cost-effective under the pressure. patient care management using the direct These issues have had a profound impact on patients and their families, with the uncertainty surrounding immediate and employment model, with dedicated Case continuing care the cause of great anxiety and distress.

THE COST OF CARE The diversification within the sector has seen a number of independent care home owners struggling financially and selling to larger operators with more resources. Costs often increase as a result, as higher fees are needed to meet greater operating costs and shareholder expectations. The inability of government funding to keep pace with the changes in an individual patient’s needs can also create a deficit in funding, leaving families and care providers vulnerable to being without sufficient funding to maintain levels of care at short notice. Increases in care costs place greater emphasis on ensuring awards remain aligned, so appropriate levels of care continue and don’t become too expensive. Knowing they are in the right place receiving the right care from the right people has an enormous positive impact on people’s mental health and wellbeing.


202 2 /23

Managers or Care Managers (where a case manager is not in place) operating under delegated responsibility to oversee a patient’s care plan and perform a supervisory role over support workers.

To find out more about the benefits of direct employment and Bush Care Solutions, contact Jo Wilkins, Head of Care Support Services and CQC Registered Manager at

Bush Care Solutions COST EFFECTIVE


Within Bush Care Solutions, we have a range of support in place to help you oversee well-led and safe packages of care and provide your clients with the support and reassurance they need as an ’employer’. Our dedicated team offer peace of mind with direct employment of support workers and nurse led packages including support with activities such as:


Why choose Bush Care Solutions? Over the past 35 years Bush & Co have supported thousands of clients following a life-changing injury. Our direct employment model can be tailored to your client, taking into consideration their specific needs and circumstances, as we know that everyone is on a different pathway.


Here when you need us


To find out more about the service or to discuss your clients needs in more detail please get in touch with Jo Wilkins, Head of Care Support Services and Registered Manager. 01327 876210

Payroll CQC Compliance Care planning Case Audits Risk Assessment


Struggling to find trained, rehabilitation assistants who have SOMETHING SPECIAL?


Managing the ups and downs of the the climb from serious injury to a clear and optimistic future.

Brain Injury Case Management in Lincolnshire

• Initial needs assessments

• Case management Maia Rehabilitation have been building To Young and teams older adults with rehabilitation complex needs resulting around clients who have from brain injury, received catastrophic orthopaedic injuries and/or polytrauma injuries for over 12years.


e have Contact 16 years as a specialist brain injury/serious injury experienced Anne-Marie Burnett MCSP case manager the difficulties Based in in Lincoln finding and keeping workers Setsupport up, coordination and management of complex rehabilitation 01522 581 781 andskill support with the andpackages passion with to person-centred SMART goals at the centre of service delivery......and much more....... meet our client’s needs and who can accurately identify and record their findings. Because of this, we developed our own SeriousInjury-RehabilitationService (SIRS). Our very carefully selected teams are often psychology graduates or experienced with personal knowledge of Experts, Neuro Psychologist and training team. injuries, an ability to learn, observe, feel compassion We ensure the most recent medical concentration and attention, and motivation and initiation. We aia Rehabilitation Assistants are directly and encourage. We can equip them with tools to be developments are implemented weuse work with, look at how to support people with limb and loss and expert, employed by us and provided with fully aware and tuned-in to the beyond mandatory external speakers to train our and RAs. listen to the client’s monthly training strive and We also ensure RAs are supported in terms of their own symptoms of clients. We provide case managers, adjusting requirements in areas suchWe as fatigue and to identify wellbeing because we know how isolating it can be when you’re pain, relaxation techniques, and managing anxiety, to necessary training wherever the support package maximise potential and growth your own. working in the community onaccordingly. provide withthey enhanced, possible for clients the client work holistic care that not We believe Overall, the skills and techniques we provide all Maia RAs only supports their injuries but also their wellbeing. so we can help individuals be withMaia andhas webeen provide First Aid so clients must have a solid are constantly evolving, interesting and culminate in a skilled, supporting clients for over 12 years and in that theytime canwe’ve manage medical risks in and enjoyable be. positive and energetic team welcomed by clients,relationship families, case learned a lot. Our goal was always the findingbest ways to they can the client’s We run with those who they are managers and instructing parties. meet thehome. client’s needs but we knew we could do more to Why? Because we know ittheir will achieve best results forisour maximisemonthly success. seminars on brain and spinal responsive, comfortable investing time.the Our process to clients and themwith the highest chances of success in returning decided to bring ourSIRS Rehabilitation Assistants in their injuriesWe and we supervise monthly, monitor match thegive client the most appropriate SIRS to to a life of fulfilment house and provideand, themencourage with ongoingthem, training,nurture learning and recordings weekly them meet their needs.. ■■ development that benefits not just our clients but also them as and usually keep them! individuals. This approach has transformed the way we care for

MAIA REHABILITATION ASSISTANTS Transforming the care of clients with brain or spinal injury


our clients and the results we achieve for them.

PRODUCING CLEAR EVIDENCE As well as mandatory training, we look at all the other

issues thatwe clients experience, fromfriendly relationship For acomplex monthly fee, canmay produce court and family issues to constant painwhich and fatigue, inabilityclear to work, electronic daily report sheets provide changed personalities isolation. clear evidence for details for teams whileandproducing We teach techniques for relaxation and managing anxiety, instructing parties. SIRS are Personal Assistants how to understand and recognise the difference between trained to the highest standard of care in Brain and Spinal Injury Rehabilitation by our in-house Care


202 2 /23

For further details please contact:

tel: 01234 262 863 email: Tel: (01234) 262863 web:





We provide a bespoke case management and therapy service to adults and children who have an acquired brain injury or complex physical injury.



Caring Case Management

We’re a small company committed to focusing on the client, their journey and the personal aspects of Case Management.


Sensitive To The Client’s Needs


We build a supportive relationship with the client to achieve their goals in the short and long term.






Understanding & Listening


Through the process of assessment and planning we help the client to understand their injury to aid adjustment and acceptance.

A Collaborative Pathway To Care

We are committed to working closely with our client’s families, care and therapy teams and legal representatives to guide our clients through their journey of rehabilitation.


0115 871 7607 A Client-Centered Approach

We Focus On Wellbeing

We Maintain Dedicated The Highest CQC in-house HR support Compliant Standards for the client

JE JACKSON Brain Injury Case Management

Vikki Sturgess

Jane Jackson

Co Director

Managing Director

Our team possesses years of experience as brain injury case managers with specific skills in traumatic injury, rehabilitation and occupational therapy.

Lucy Allen Shirtcliffe

Associate Case Manager

Sue Harlow

Office Manager


202 2 /23

unlocking the potential

Helen Smart

Associate Case Manager

t: 01536 724485 / 07908 577861 e: w: 37 Grosvenor Way, Barton Seagrave, Kettering NN15 6TG


Bespoke Case Management Services for children, young people and adults with catastrophic injuries Our team of highly skilled case managers are able to support clients with complex needs through the medico-legal process and beyond. We are a passionate team with a proactive approach Always keeping the clients needs at the centre of everything we do. E. T. 01257 686070

Desktop, Multi-Trauma & Specialist Case Management Major Incident Response Service Treatment & Diagnostic Services Vocational Case Management

Award-winning Case Management With over 20 years’ experience, we are one of the UK’s largest impartial

and independent providers of award-winning rehabilitation case management, treatment and diagnostic services.

Let’s be friends. Follow us on Social Media



202 2 /23



A Case Manager’s Perspective: BUILDING RELATIONSHIPS WITH CLIENTS AND FAMILIES By Rebecca Taylor, Case Manager at Social Return Case Management


ase management supports clients to progress toward aspirations and goals for their lives. Integral to this is building a positive relationship with each client, and those close to them. Rebecca Taylor My focus as a case manager is on each unique client and what they may need; something I really enjoy about the role. That said, there are common themes within our work. One theme pivotal to meaningful support and progress is the ability to build trust and rapport.


alongside their aspirations and their needs. A collaborative assessment and planning process at an early stage is usually a good foundation upon which to build rapport. We can only progress toward providing recommendations that are appropriate and meaningful by listening and understanding each person and what motivates and engages them. From this, rapport grows with the opportunity for trust to develop and deepen. There must be room for debate, choice and challenge from our clients. This can be an opportunity for further discussion and reflection, deepening our understanding of their needs and situation, leading to deeper insight and strengthening of rapport.

Trust has to be earned and should come only after the passage of time”.


A Google definition of the word It is important to understand the ‘rapport’ that fits my work is; “A right approach for each client in all close and harmonious relationship stages of the relationship. Clients in which the people or groups and family members have often concerned understand each other’s been though a variety of challenging ARTHUR ASHE feelings or ideas and communicate experiences. I find that some clients well.” Rapport is highlighted as a necessary communications and families have gone for so long without the support they skill within the BABICM Competency Framework need, that they are very enthusiastic and quickly welcome ( any input and ideas from their case manager. For others it can Client and family feedback frequently indicates the take a number of meetings and some positive action, before importance of skilled case management support following a sense of mutual understanding and meaningful rapport life-changing injury. We may be the first professional with begins to build, which promotes trust in a case manager and such a wide remit and sufficient time to spend with the the case management process. client to deeply explore the changes since injury in their lives, It is most certainly the case that trust and rapport are not gained simply by being an experienced professional with a great CV full of evidence of knowledge and skill. Case managers must build rapport upon which trust can be earned. As the great American tennis player Arthur Ashe said “Trust has to be earned and should come only after the passage of time”.

For more information Rebecca can be contacted at, tel: 0191 375 0256


202 2 /23

Specialist Case Management for Neurological, Complex Orthopaedic and Amputee Rehabilitation

Our Approach

Areas covered by Social Return Services...

It’s as individual as you are... Social Return case managers share a wealth of experience across a wide variety of complex conditions and bring their expertise and individual flair to the people they support. Through comprehensive assessment we gain a full understanding of each person’s past, present, potential and aspirations for their future to inform our recommendations for case management interventions.

A fresh approach... Imaginative



Current Coverage Referrals Considered on a Case by Case Basis

Our case managers and support staff think laterally, targeting resources creatively to best meet the needs of the indidual client.

Our practice is underpinned by specialist knowledge of neurological and other complex conditions with considerable experience of working with survivors of catastrophic injuries.

We structure our work and manage our time effectively to ensure that we are available to respond to our clients and professionals involved in the case.

Contact us: Social Return Case Management Ltd. Adelaide Court, Belmont Industrial Estate, Durham, DH1 1TW

Call: 0191 3750256 email: twittter: @SocialReturnCM

tful • Responsive • Imaginative • Insightful • Responsive • Imaginative • Insig



embodies Compassion, Respect, Equality, Acceptance, Trust and Environment (CREATE) in all its work. For you, this means:

Being kept fully informed by proactive clinicians with a system that means you do not have to chase us.

Where our trauma-informed and inclusive support is filling a crucial gap in provision says Dr Shabnam Berry-Khan, Director, PsychWorks Associates.

Creative, flexible and comprehensive support where carbon-offset home visits and effective liaison is built into our timetables so we always offer efficient, timely and thoughtful input.

sychWorks Associates is the UK’s only Treating Psychology and Rehabilitation Case Management service. With more than 20 Associates and 15 languages, we are uniquely placed to support your injured clients’ rehabilitation journey using trauma-informed interventions.

Working with the most suitable clinicians who are litigation-aware and trauma-informed, with specialist skills of working with the individual, family or professional network.


Shabnam is…professional, responsive, practical and kind. She heads up a very effective team…and her expertise in psychology adds particular value in clinical negligence matters.

Using a formulation-based approach to support your client, all our clinicians can facilitate therapy and care teams to be greater than the sum of its parts. Culturally-aware practises for diverse clients who will benefit from representation in their professional team.

This is what our service promises to deliver

ANGHARAD VAUGHAN, PARTNER, LEIGH DAY At the heart of our service are our six core values. They represent the foundation upon which we build our support and they shape what we do and how we do it. PsychWorks Associates

For more information, contact us on For our free Personal Injury resources, visit our website on

A collaborative, creative and integrative approach to physical emotional rehabilitation


07942 691070



202 2 /23


Registration, registration, REGISTRATION Niccola Irwin, MD of Keystone Case Management, on the much-needed changes the case management sector can expect to see this year

final version and register in place later this year. The eventual accreditation process will be overseen by the Professional Standards Authority (PSA), an independent body which is accountable to the UK parliament, and already oversees the professional registers of the Nursing and Midwifery Council and the Health and Care Professions Council. In 2021 I began chairing the Standards Committee of the IRCM. I can safely say that there is a lot of change to come t is now over a decade since in the industry, not just with the launch of the register, but the British Association of in the years immediately afterwards as the accreditation Brain Injuries and Complex process matures. Case Management (BABICM), Initially, we envisage a period during which membership the Case Management Society UK of the IRCM will be open to members of the founding (CSMUK), and later the Vocational organisations who have at least two years FTE as a registered Rehabilitation Association (VRA) Niccola Irwin health professional and have at least two years FTE first began to collaborate on the experience as a case manager or have a minimum of four development of a professional body for case managers. years FTE experience as a case manager. As it stands the case management profession remains Moving forwards, and once the certificate of proficiency largely unregulated. Most case managers do have a is available, it is planned that all applicants will need to have background in the health and social care profession, but the achieved the certificate, have a minimum of two years FTE industry has for at least two decades felt that this alone is as a case manager, and provide a self-audit that evidences not automatically enough to undertake case management at working in line with the IRCM Code of Ethics and Conduct the highest level. and meeting the IRCM Technical and Business Standards. To become an Occupational Therapist, for example, As well as my work with the IRCM, I serve as MD of I was required to complete a degree in occupational Keystone Case Management, and have over 20 years therapy and gain practical experience for the delivery of of experience in the case occupational therapy through management field. This is a In 2021 I began chairing the supervised placements. As project that Keystone has case management is not Standards Committee of the IRCM. worked very hard to support. currently taught in any I can safely say that there is a lot of We intend to be prepared at the qualifying programmes, earliest opportunity to support however, there is currently change to come in the industry, not our existing case managers to no equivalent qualification in just with the launch of the register, meet, and indeed exceed, the case management for those requirements of the IRCM. but in the years immediately crossing into the field. Ultimately, our job is to protect This means that literally afterwards as the accreditation the service user, who can surely anyone could establish process matures. . only benefit from an end to the themselves as a case manager current situation of unregulated with no qualifications, no case management and the arrival of a degree of protection professional accreditation, and no experience in the role. Given that we frequently work with some of the most vulnerable and regulation. members of society, this situation is something the industry has long been seeking to address. An early success was the Joint Code of Ethics, which was amended in 2017 to reflect the inclusion of the VRA in discussions. This year, it looks like the long-sought-after official register of case managers may finally come to pass, thanks to the creation in January of the Institute for Registered Case Managers (IRCM). In 2021, an extensive consultation was held on an initial draft standards of practice, and the IRCM hopes to have a Web:


202 2 /23



Callum’s story: RETURNING HOME WITH LIVE-IN CARE Agincare is a family-owned care provider that has been delivering affordable, reliable and flexible care across the UK for over 35 years. Our care services suit a range of personal needs, including live-in care, home care and residential care homes.


t age 16, while making a stunt video for his Youtube channel, Callum fell 30 feet. He sustained an extensive head trauma and memory loss as well as numerous broken bones and fractures in his spine. Due to his injuries, Callum spent the next two years in hospital. For a year, Callum moved wards as part of his rehabilitation. However, despite making astounding progress, he never felt truly supported. This took a toll on his mental health and his mobility started to decline. His social worker decided to research live-in care.

LIVE-IN CARE Many care companies were not able to meet Callum’s specific needs but through Agincare, he found hope. With live-in care, a trained care worker lives with the individual in their home so to provide 24-hour, personalised support. They can deliver support specific to the person’s needs such as personal care, getting out and about, or companionship. Our live-in care service enabled Callum to move back home. We worked with him and his family to create a bespoke care plan and carefully matched a care assistant to his specific needs.

RETURNING HOME WITH LIVE-IN CARE The move was emotional. Callum sometimes has difficulties processing feelings but his care worker, Pawel, was patient, understanding and considerate as Callum adjusted to the change. Since then, Pawel and Callum have worked together and become friends. Callum has regained some memory and his mental health has improved. His speech has also developed and he is starting to draw and write poetry again. Callum was and still is an adrenaline junkie and, with the help of Pawel, continues to look for activities he can do, such as swimming and going to the gym. With live-in care


202 2 /23

these possibilities are endless and Callum once again looks towards an exciting future.

I have my life back to the best it can be, I can see my friends when I want and my family, I have a better sense of stoicism. I am so happy and want others in my position to have the same level of care I have, and most importantly… hope. AN EXCITING FUTURE FOR CALLUM When asked what has been the biggest improvement since receiving care from Agincare, Callum said, “All the staff from the home care and live-in care workers, talk to me like a human being.” Callum also sees his daughter often and, before lockdown, he and Pawel would frequently attend live rock gigs in local pubs and clubs. These activities are the highlight of his week. In his own words: “it makes me feel normal.”

Contact: Agincare Tel: 0808 301 4231 | Web:





said of clients was re a c n live-i ery easy easy or v up to set at


ro m

2021 C

li e n t S a t


c ti



Care that changes


Agincare's live-in care offers oneto-one support, around-the-clock, in the comfort of your own home. We provide high-quality personalised care from £995 per week. Our friendly, professional and experienced care workers are prepared to support a wide range of needs. Live-in care enables you to live life your way, giving you control of your schedule, your environment, and the reassurance of daily care at home.


I really appreciate the fact that they genuinely care about their clients as individual people, with individual needs and circumstances. Sarah - Client


We are one of England's largest care groups, have remained family-owned and run since 1986, and are fully regulated by the CQC for your peace of mind. Find out more today to see how live-in care can change your life.

CALL US NOW ON 0808 301 4231


The care and support I receive from Active Care Group allows me to live the best life possible. I started off in a specialist rehab facility and eventually moved back home with a full-time live-in carer to help me with my daily needs. It’s the best support I could have possibly asked for! Graham Service User

01732 779353

We're specialists in care and believers in people. We make sure people with complex needs are surrounded by the collaborative, holistic and expert care they need and the kindness they deserve to live a brighter future.

Award Winning Complex Care Providers, Brain Rehabilitation Experts and Adapted Living Specialists

As one of the UK’s leading complex care providers, our mission is to help people with complex needs remain in their own homes, maintain their independence and live as full and as rich a life as possible.

Call JAM Care today on 01952 443613 92

202 2 /23



JAM COMPLEX CARE Helping you live a rich, independent & full life at home JAM CARE was born out of desire to make a difference! In 2018, our founder James Nichols decided to turn his back on corporate life and his 20+ year career in Finance, so he could do something that would make just such a difference. Having seen family members and close friends struggle for years to access consistently good complex care at home, James set his sights on building an organisation that would do just that. if caring is not in your DNA then JAM isn’t the company for you. WE EMPOWER - We recruit smart people and empower them to show us what great looks like. WE ARE AGILE - We never let bureaucracy & committees get in the way of a great work & ideas WE COMMUNICATE BRILLIANTLY - We are supremely active in communicating with all key parties (clients, families, friends & loved ones, colleagues, or our MDT), using whatever method works for them (F2F, phone, WhatsApp, text, email, video call, we even pen the odd letter!) WE SUPPORT CHIMNEY POTS - JAM’s support isn’t just for the client, it’s for everyone under that chimney pot: the families, friends & loved ones


t JAM CARE, we do things a little bit differently…so we are not going to waste this opportunity telling you things you already know…yes our care is person centred, yes it’s nurse led, yes we offer the full range of B&SI support services, and yes we truly understand catastrophic injuries and how they impact our clients lives etc…these are all a given at JAM CARE, as they are for every one of the great complex care providers featured in this BS&I handbook. So, we want to take this opportunity to tell you what makes JAM CARE just a little bit different. WE INNOVATE - Every JAM colleague is coached to be an innovator. On a daily basis, they “review, assess, and update” how we support each & every client. CARE IN OUR DNA - We only recruit people who genuinely care. Training courses are essential, but

JAM CARE make the impossible possible. They ensure clients receive a consistent and trusted team of carers, who build positive relationships, and know and understand the client’s needs. This in turn eases the challenges complex care clients undergo as part of daily life. Finally, the personal sacrifices I see JAM carers make honestly restores my faith in the industry.

web: email: facebook: @FBJAMCare

202 2 /23





aplewood Independent Living was founded as a result of personal experiences and a genuine passion to provide the best possible support, empowerment and independence to those that need it. We genuinely believe that all people should lead as fulfilling and independent a life as possible, which is made a reality with the right support in place. Every aspect of what we do is undertaken in a personcentred way and all case managers, care and support staff are matched to the individual as no two people are the same. It is our belief that mental health is just as important as physical wellbeing, and we recognise the important link between the two. We provide case management, rehabilitation, care and support services, including palliative care, to both adults and children who suffer from complex needs such as those arising from an acquired injury, inherited condition, other life limiting condition or following surgery, for example: Brain Injuries Cerebral Palsy Multiple Sclerosis Stroke Orthopaedic Injuries Mental Health


202 2 /23

Spinal Injuries Motor Neurone Disease Multi-Sensory Impairment Amputations Multiple Complex Injuries Clinical Negligence

A bespoke and comprehensive service is provided from initial assessment, planning and management, through to the ongoing rehabilitation and day to day care and support, and encompassing all steps in between; whether for a determined recovery period or lifelong. We manage all aspects of the case management, care and support under cover of a case manager, CQC registered branch manager and the care and support teams and we work seamlessly with multi-disciplinary teams where necessary. Management, recruitment, training, supervision and compliance are all undertaken in house, so everything is in one place ensuring our high standards and continuity of service are maintained. We have over 25 years’ experience, are CQC registered, and all staff are enhanced DBS checked and undergo regular and comprehensive training and assessments. We pride ourselves on the high standards we consistently deliver to those we support. ■

Web: Tel: 01371 877707

SPECIALISED NEUROLOGICAL CARE SERVICES AT HAWTHORNS CARE CENTRE Hawthorns Care Centre provides care and rehabilitation services for those who require Specialist and Complex Neurological and Respiratory Care. At the heart of the Hawthorns team is a shared passion to provide the best care possible for each individual.

Hawthorns Care Centre at a glance:

We enable individuals to regain control and independence where possible and ensure that not only the individual, but their families and friends, are supported through challenging times.

– Care for those recovering from traumatic or non-traumatic brain or spinal injury.

Our approach to care is to provide a safe, homely environment in which our clients can achieve their maximum potential. We facilitate this through open and honest communications with the client, their families and all healthcare professionals involved.

– Active rehabilitation packages.

Regular MDT meetings in which goals are set and reviewed enable us to ensure we are meeting the individual needs of our clients, using a holistic approach to their rehabilitation journey.

– Long-term and respite placements.

– Tailored therapy programmes. – Higher dependency floor for those with complex neurological, respiratory care and rehabilitation requirements.

For more information on the types of complex neurological services we care for please visit our website or call 0191

4487 239 Hawthorns Care Centre, O'Neill Drive, North Blunts, Peterlee, SR8 5UP

COMPLEX CARE SERVICES AT HAWTHORNS CARE CENTRE, PETERLEE Finding the right kind of care can be difficult for everyone involved, but finding the right care service can relieve worry, knowing that you have found the best possible care for you or a member of your family. Designed with the people we care for in mind, Hawthorns Care Centre provides purpose-built accommodation, specifically created for adults with complex neurological, physical or cognitive needs. Run by Barchester Healthcare, Hawthorns provides neurological care services for those recovering from traumatic or non-traumatic brain or spinal injury. This includes support for those with long-term neurological conditions within a higher dependency unit, where care is provided for people with complex neurological and respiratory care and rehabilitation needs. Our specialist care service provides support for individuals who require higher dependency nursing and multidisciplinary team interventions, as well as patients with complex respiratory needs. In addition, we also support patients with minimal consciousness who require invasive and non-invasive ventilation support.

Active rehabilitation packages at Hawthorns are available for both long term and respite placements. Our goal-orientated therapy programmes are all tailored to an individual’s ability and potential. We’re proud to have a Headway accreditation as an approved provider. Treatment plans use the SMART method (Specific, Measurable, Accountable, Realistic and Time Limited) to provide accurate assessments and treatments. Our experienced and highly qualified care and therapy teams, led by a Consultant in Rehabilitation Medicine, are passionate about independence, dignity and choice for all patients within their care. Our well-trained care staff focus on the individual needs of each patient, developing a bespoke care plan for each and every person.

To find out more about our services, please visit our website or call us to arrange a visit:

Tel: 0191 4487 239 Hawthorns Care Centre, O'Neill Drive, North Blunts, Peterlee, SR8 5UP


Helping to IMPROVE LIVES Making a real difference to those less able


are & Independence is a British manufacturer of safe patient moving and handling sling and bathing equipment designed to improve the lives of those less able, the infirm and elderly.

The GLOVE SLING™ and BATHING RANGE brands together with COMFORT VALUE™ for stores and catalogues, provide an extensive portfolio of product styles with multiple applications and, include a ‘Specials’ service for adaptation and custom-made solutions where required.

What do we do? We improve lives. Simple as that. JAMES BENNETT, SALES & MARKETING DIRECTOR National coverage with local support gives a personal service. Expert product specialists have extensive product knowledge and field-based experience so are well versed in identifying the right solution for the often complex needs of individual situations. Free assessments and free training to healthcare professionals are provided as standard. Investing heavily in research and development and having pioneered performance in the marketplace as a result, Care

& Independence hold patented innovations for product design and user comfort. Additionally, independent pressure mapping trials have returned scientific evidence and insight for solutions that help combat tissue viability risks, pain and other health-associated user concerns. Working closely with occupational therapists, clinicians, carers, the NHS, Local Authority-managed Social Care as well as Care Homes and Community Equipment Stores, Care & Independence is repeatedly the preferred supplier for professionals and healthcare providers throughout the UK. An assured supply-chain unaffected by import or overseas-related issues, Care & Independence offer one of the fastest lead times in the industry. Thousands of items are in stock on the shelves and ready to deliver. ■

Visit: to discover more.

Free Assessments Free Training National Coverage Expert Local Support Individual-based solutions

Thousands of products in stock with short lead times too!


Bathing R an e

033 012 80808


202 2 /23


Empowering U Transforming choices and offering exceptional standards of care to those in need


e are a family-owned provider, regulated and rated ‘Good’ by the Care Quality Commission.

Empowering U is a specialist provider for people with complex care requirements. Our service is person-centred and packages of care are tailor-made for individuals with learning disabilities, autism, complex medical needs and behaviours that challenge. We are currently implementing and accepting new referrals across the Midlands, Lincolnshire, Northamptonshire & Yorkshire.

believe that through vision, perseverance and a little humour, we can offer an exceptional service of care to those in need. With 30 years of operating experience in the health and social care sector, our ambition is to promote dignity and choice through quality staffing. We pride ourselves on our ability to combine our expertise and knowledge with compassion and a genuine, people-focused service. This makes Empowering U the right choice for you. Our logo, the tree of life, represents all that we offer at Empowering U - it is not just enough to make do, we want our clients to live their lives to the fullest.

With 30 years of operating experience in the health and social care sector, our ambition is to promote dignity and choice through quality staffing At Empowering U, everything we do is underpinned by the firm belief that we can transform choices through time, dedication and going that extra mile for our clients. We

For more information on our services, please visit, email: or call us on: 0330 128 1722.

Empowering U

is a family-owned specialist provider for people with complex care requirements. We provide person-centred packages of care which are tailor-made for individuals with learning disabilities, autism, complex medical needs and behaviours that challenge. Our services cover the Midlands, Lincolnshire, Northamptonshire and Yorkshire.

For further information, please visit: email: or call us on: 0330 128 1722

202 2 /23



COMPLETE CARE AMEGREEN... Connecting Healthcare and Wellbeing with our Trusted Partner, the Spinal Injuries Association (SIA) Complete Care Amegreen is a familiar name to B&SI readers, this is our third year of publishing a service update. However, this year we would like to introduce you to an exciting new partnership with the Spinal Injuries Association (SIA).


s a well-established nurse-led homecare provider we support a diverse range of clients with services that not only focus on an individuals’ clinical needs and safety, but empowers and enables clients to realise their potential, achieve personal goals and live their life with choice. SERVICES DESIGNED AND LED BY YOU

From working with individuals who often have life changing injuries and health conditions including;

8.4% experiencing post-traumatic stress disorder *Statistics taken from the Spinal Injuries Association’s 2022 “Its not just physical” report

Therefore, care needs to go beyond the physical manifestation of health conditions and injury, delivering exceptional care services that unify clinical excellence with specialist support, information, advice and guidance.


Our Trusted Partnership with SIA will benefit your clients living with spinal cord injury, and their families or loved ones, by creating a community of specialists and clinical experts able to provide services and sessions that combine matters of the body, mind and life in a truly collaborative approach to personalised care. It is designed to enrich and empower our clients, physically and emotionally. This partnership offers you and your clients:

Spinal cord injury Acquired brain injury Respiratory requirements Cerebral palsy Stroke (CVA) Other neurological conditions We know it is crucial to ensure that physical, emotional and social needs are given equal focus to deliver well-balanced care, support positive risk taking that enhances our client’s life and optimises their opportunities. We ensure that person-centred care is at the core of everything we do. No matter how complex the need, we offer support in everything from personal care incl. bowel and bladder management, medication and respiratory care. Providing support at home, at work and in educational settings, encouraging our clients to take part in new/old activities and travelling on holiday. We challenge the perception that receiving care is passive and one dimensional, by enabling our clients to take the lead in developing unique care plans.

Clinical expertise from our care teams with specialist and professional Spinal Cord Injury training from the SIA Academy’s accredited training programme. Spinal injury specialists Rapid hospital discharge 24 hour adult and paediatric care clinical nurse oversight 24/7 clinical support line Supportive therapies including counselling, physio, hydro, to name a few Employment support, whether returning to work or retraining Exercise and Nutrition plans Support with equipment and travel Financial planning via NHS Continuing Healthcare Funding, Private Financing, Direct Payment or Personal Health Budgets CQC/CIW registered care

It is reported that spinal cord injury doubles the risk of mental health problems, with: 48.5% of spinal cord injury survivors experiencing depression 37% facing anxiety with a quarter experiencing clinically significant levels of anxiety


202 2 /23

For more information please contact us: 0333 121 5301 email: web:

Another expert avenue for support, from a partner we trust Purpose is an incredibly powerful thing. It provides the focus to help us achieve our clients’ personal goals; it tells their story, builds our teams and defines your care plan. Our integrated care solutions enable professionals to work together to deliver coordinated support. Your clients benefit from clinically led services from our expert Care Staff whilst providing seamless access to a range of additional partner support services, including the Spinal Injury Association.

Enabling individuals to overcome or manage life changing injuries and health conditions by providing adult and paediatric services, support from hospital to home and specific services for those living with; 3 Spinal cord injury 3 Acquired brain injury 3 Respiratory requirements 3 Cerebral palsy 3 Stroke (CVA) 3 Other neurological conditions

Contact our team today to find out more Call: 0333 121 5301 Visit: Email:

Registered for services in England (CQC) and Wales (CIW)


Consumer Lead Healthcare that positions ADVANTAGE HEALTHCARE AS YOUR PROVIDER OF CHOICE and social networks. Whether they want to stay on top of work, socialise with friends, attend family occasions, or just get out and about – our team of expert and qualified Registered Nurses, Healthcare Assistants and Support Workers are here to enable your clients to live life to its fullest. Our locally based Care Service Managers will be on-hand from the second you contact us, assuring you and clients a reliable single point of contact, whatever your query. They will manage a comprehensive assessment of your client’s requirements and build a bespoke support package unique to them, recruiting expert care staff who match your client’s lifestyle. We are market leaders in mobilising our care packages, ensuring our clients get the right service at the right time, from the right people whilst working at a pace that respects an individuals or families need to see and feel progress balanced with sound and safe clinical services.


electing the right healthcare provider for clients can be a complex and challenging process, thwart with a different range of choices, assessment processes and service offerings to work through. By working alongside Advantage Healthcare, you’ll be benefiting from over 40 years’ experience of UK wide complex care planning and service management, delivered by care service experts that can assist you and your clients to identify and appoint the right service for them, based on choice. Whatever the situation, our qualified and expert Care Service Managers will craft and commission the right care plan that meets both your client’s clinical requirements and reflects their personal expectations and aspirations to live as independently as possible. We support a diverse range of clients, of all ages facing a wide range of complex healthcare situations. Whether it’s care following a personal injury, head and spinal injury rehabilitation, or support with home tracheostomy and ventilation – your Care Service Manager will build a personalised service around your client delivered by capable and adaptable staff, no matter what your client’s needs may be.

Our team of expert and qualified Registered Nurses, Healthcare Assistants and Support Workers are here to enable your clients to live life to its fullest BUILDING FOR THE FUTURE Alongside our comprehensive quality assurance and clinical governance systems, this summer we’re launching an entirely new way to manage care – bringing even more flexibility to our services by giving our clients the choice to control any sensitive information in their homes though a secure and user friendly digital technology. As well as enabling our teams to react quickly to changes, your client will retain control of their personal data, with the choice to easily share it with family or other health professionals.

Healthcare Limited

ENABLING BETTER LIVES Everyone’s situation is unique. That’s why your client can rely on our network of local branches and teams of care professionals to enable them to optimise their local support

1 02

202 2 /23

Tel: 01952 278 300 Email: Web:

Get a local focus with Advantage Healthcare Call us today to get an assessment of your client’s needs and a bespoke support package from a dedicated local care service manager working closest to you and your client. They’ll get you a quotation in less than 24 hours, and have your care package up and running smoothly and safely, working to your timescales.

We have regionally expert Care Service Managers available in: • • • • •

Suffolk and Essex, Norfolk area of Peterborough, North London, Tees Valley North West & Yorkshire, Nottingham, Tees Valley South Coast, South Wales and West Peterborough, Shropshire and North Wales, North West and Yorkshire London and South East

Speak to Gareth Williams from the Advantage Healthcare team today on 07425 858366 or email us at for a call back and quotation within 24 hours.

Healthcare Limited

To find out more about us, our teams and the wider range of conditions we can support please visit

Registered for services in England (CQC) and Wales (CIW)


There’s nothing like the comfort OF YOUR OWN HOME At Nurseplus Care at home, our experience means that we understand everyone’s care needs are different and that finding the right type of care begins with identifying what’s important to you.


he flexibility of Care at home and one-to-one companionship is designed to enable you to live safely and independently in the comfort of your own home.

So we will work closely with you and your loved ones to create a tailored support plan that fits your health and lifestyle needs. We handpick your Dedicated Care Professionals, so that you can genuinely connect with your support team. Our skilled DCP’s will make sure you’re able to continue doing all things you love, such as staying active, socialising or cooking your favourite meal. We have been recruiting trained and friendly homecare


202 2 /23

workers, support staff and nurses since 2005 and now have a network of more than 50 branches nationwide. We work with a variety of healthcare professionals, brokerages, legal teams and case managers offering a bespoke service to clients requiring visiting care, Live-in care, night support, 24-hour care and respite care. We aim to empower clients with full control over their support plans. Together, we can build a schedule that enables clients to live a full and independent life at home. Care at home offers a practical and affordable alternative to moving into a residential setting helping you to keep your independence. Whether you require weekly, daily or Live-in care, we can build a unique plan that empowers you to continue living life just the way you want and provide reassurance when you need it most. ■

Get in touch with our friendly team today by calling 08000 44 88 48 or visit

Newcross Healthcare helping Britain get the care service it deserves

Wherever and whenever we’re needed, Newcross Healthcare’s Community Care teams are there, providing the highest standards of care.


ith an incredible army of over 10,000 nurses and carers working with dedication across every part of the country, our highly-skilled carers and nurses are providing the best levels of care to people, wherever they are.

At Newcross, our community care offering incorporates our YourLife and YourCare services. Newcross YourLife is a declaration of independence and we’re here to empower people to live their best lives, and to develop life skills so that they can take pride in their own achievements. Newcross YourCare is about 360º plans built around an individual that take in every aspect of their needs and circumstances. It’s about seeing the person, not just the condition, and managing their specialist clinical care needs safely and in a more personal way.

Making a difference to Dolly & Daisy At Newcross, we offer the best possible community care to those who need it most. For example, one of our case management packages is for two sisters who grew up in a convent and had a very sheltered and often abusive upbringing.

These two sisters are twins with learning difficulties. Before Newcross visited them, they had a very limited social life, with only each other for company and a friend who would bring them shopping. They never went out and had never even been to a coffee shop. We have been supporting the sisters for a while now, and they go out with their carer every day, a big difference from the life they lived before when they wouldn’t leave the house. Our dedicated staff have adapted to the twins’ routine. Each sister has their own jobs that they do around the house, and their carer has supported and promoted their independence with those. The carers also threw the twins a birthday party, the first one they have ever had. A truly lovely occasion!

Supporting case managers 10,000 Staff Nurse Led 24/7 AdHoc support Fully registered packages There are two different ways in which we can support case managers. Firstly, we can assist with your existing rotas and step in to provide sickness or holiday cover when required. This gives you peace of mind that there’s always someone available to help, wherever and whenever you need us. Secondly, we can take on the responsibility for delivering your commissioned care packages under our CQC registration. We’ll make the whole process seamless and hassle-free, and you can be confident that every service user will receive the highest-quality care when you choose Newcross. Contact me to discuss how we can help you to support children & adults in our communities

Claudia Joyce

National Complex Care Development Manager

07918 941900


Prestige Nursing & CARE Benefits of a fully managed service when sourcing brain and spinal injury care


o achieve the best possible outcome for patients having suffered a life altering incident such as a brain or spinal injury a holistic approach is considered by many as being the most effective.

A large team of multidisciplinary professionals such as case managers, healthcare professionals, therapeutic care providers, and other community support services are often involved in the organisation and delivery of complex care packages. A home care provider that can manage these packages can ensure that all elements of the patient’s care plan is delivered.

Brain injury or spinal injury patients typically receive targeted, outcome-focussed care, enabling them to recover lost skills and learn new skills to improve their overall quality of life and increase their independence. Supporting their mobility, physical rehabilitation and promoting positive mental health to support emotions, relationships, and wellness also form an integral part of any care package following a serious and life altering incident. Prestige Nursing & Care provide a clinically led, fully managed and regulated home care service across Scotland and England. Our patients, their families and our professional partners can be reassured that our services are of the very highest quality. ■

Prestige Nursing & Care provide a clinically led, fully managed and regulated home care service across Scotland and England Professionals and providers working in collaboration also enables a patient’s unique requirements to be shared and understood, allowing adjustments to be made to meet their evolving needs.

To find out more about how we can support your clients please contact us on 0808 239 9359 or email: Web:

BRAIN AND SPINAL INJURY CARE SPECIALISTS Providers of intensive support programmes for those with acquired brain or spinal injuries and neurological conditions Management of holistic care plans in partnership with multidisciplinary professionals Clinically led and regulated home care service Over 30 branches in England and Scotland

Call us today to discuss your care needs


202 2 /23

0808 239 9359


RESOLUTION CARE SERVICES Providing Specialist & Personalised Complex Care solutions in Wales We are proud of our reputation for delivering a professional, personalised, and reliable care service in South Wales; supporting Clients, Case Managers, Health Boards and Local Authorities with bespoke care pathways.


e provide a resourceful, progressive, and empathetic approach, whilst delivering cost effective and tailored care packages. This personalised service is delivered by our exceptional care team, overseen by our care manager and clinical Lead.

OUR PERSONALISED APPROACH INCLUDES: Working in collaboration with the client and their multidisciplinary team, to achieve the client’s personal needs and outcomes.

Clinical care management systems overseen by our Clinical Lead. Providing fully managed, complex care packages, through the provision of our trained care and support staff. A robust and supportive Human Resources department to maintain the high standards within the care team. A proactive approach to Positive Behavioural Support and Management. Developing and maintaining supportive relationships with relatives who are involved in the client’s care. Registered service with Care Inspectorate Wales 24/7 on-call support that allows a quick and responsive approach to the management of the service. Our dedicated & passionate care team are trained and developed, with a genuine passion for care, recovery, and rehabilitation. Through our commitment to staff development and wellbeing, we ensure they excel in the care that they deliver. ■

For a full & confidential discussion with our expert team, call 01656 502506 / 07828 428948 or email:

Case Manager Support Staffing Solutions

FLEXIBLE CARE PACKAGE SOLUTIONS Specialists in providing high quality, bespoke and flexible care package solutions across South Wales, enabling people to live independently and safely in their own homes

Domiciliary & Specialist Care & Support at home

Contact 01656 502506 / 07828 428948

202 2 /23 1 07


Eximius Live-in care Ltd – PERSONALISED LIVE-IN CARE IN YOUR OWN HOME Eximius Live-in support is a nationwide company providing exceptional 24 hour live-in care. Rated “outstanding” by the CQC, our highly experienced team provide livein support to those recovering from a life changing accident or injury. Our fully trained, dedicated carers are led by our complex care team to ensure they are matched exactly to the person they will care for.


Eximius Live-in Support is a trusted partner of the Spinal Injuries Association

life changing condition that affects brain function or the spine will have far reaching consequences for the person with the brain or spinal injury and their family. The profound impact on emotional and mental health requires as much care and attention for the family as the person being cared for. Putting the right care in place is paramount in helping clients return to the highest level of function and independence as possible. Our aim is to help them have the best quality of life that they can – physically, emotionally, and socially.

I have complex care that requires three live-in carers which is a challenge. All the staff at Eximius are passionate about providing the right staff to make my team suitable for all my needs. My team are very caring and go the extra mile to make my life more enjoyable. WHY CHOOSE EXIMIUS LIVE-IN SUPPORT We have been providing care to clients with brain and spinal injuries since 2016. We are one of only 5% of care providers in the UK to have been rated outstanding by the Care Quality Commission. Our team have extensive experience, so we understand the many challenges when caring for someone with a brain or spinal cord injury. Having a brain or spinal cord injury becomes even more challenging when faced with relocating to a residential facility for ongoing support. Our clients continue to stay in their own homes supported by us, leading fulfilling, active and independent lives. At Eximius we deliver a fully managed service, which means we support every need associated with the delivery of care. We have a very experienced and fully qualified support and management team, so you can be confident you are in safe hands. With access to a private GP and our carers led by a clinical lead, the care we offer is of the highest standard. Find out more on our website at https://

KEY ADVANTAGES OF OUR SERVICE We provide a comprehensive and flexible client centred care package. This includes:

Clinical lead with mental health expertise to assist with the adjustment to living with a brain or spinal injury. Matching the carer to our clients and including our clients in the interview process if wanted


202 2 /23


An ever-fluid care plan, which can be adjusted daily based on our clients’ needs Organising off site accommodation for carers if clients want privacy, or lack living space Consistency of care, building a solid team of carers trained to our clients’ individual needs Spinal specialist carers trained by The Spinal Injuries Association and Stoke Mandeville. Appointed supervisor in place to oversee the delivery of care. Carers are required to document the administration of medication on a secure electronic system. This helps carers monitor intake and reassures the client’s family that their loved one is being looked after.

Exceptional care and companionship. Helping our clients with complex conditions live their lives to the full.

MEET THE TEAM Maria Climie – Managing Director Maria has been working in the care industry for over 20 years. She started out in domiciliary care and now manages live-in care services. She has experience of working with people with spinal injuries, head injuries, MS and a range of other clinical conditions. Contact: Lisa Witts – Field Care Supervisor Lisa has worked in the care sector for 23 years in both domiciliary and hospital settings. She has experience caring for people with a wide variety of complex needs, including MS, motor neurone disease, brain injury, palliative care and dementia. Contact: Dawn Gaul – Care Supervisor Dawn joined the Eximius Team in August 2021. She has been working in the care sector for 6 years. She has experience of caring for people with a wide variety of complex needs including spinal injuries, MS, Motor Neurone Disease and brain injury. Contact:

We have a very experienced and fully qualified support and management team, so you can be confident you are in safe hands. With access to a private GP and our carers led by a clinical lead, the care we offer is of the highest standard.

Tel: 01494 424222 email: web:

202 2 /23 1 0 9

Rated outstanding for caring by CQC

Supporting people with brain or spinal injury to live at home At Eximius we provide highly trained, dedicated live-in carers so someone who is recovering from a life changing accident or living with a long-term condition can return safely to their own homes with outstanding care support in place. Whether you are a Case manager, health professional, family member or anyone looking for clinical care, then talk to us about how we might help.

Our clinically led team can: Liaise with health professionals and discharge teams to ensure comprehensive care plan in place prior to discharge. Work with physios, OTs, community nurses to ensure rehabilitation and physical development plans are adhered to. Manage all aspects of care needs including medication, personal care, peg feeding, bowel management.

Our carers are fully trained in all these areas: Acquired brain injury and neurological conditions Autonomic dysreflexia Bowel management Continence care (including catheter care) Emotional and mental health changes Medication administration Paraplegia and tetraplegia PEG tube or nasogastric feeding Pain management Respiratory care (including tracheostomy and ventilation) Tissue viability We create a bespoke care plan based on the actual needs of the individual, both physical and emotional. We then identify a suitable carer, or it may need a team, including hoisting and night care. We can even arrange housing for the care team nearby to a clients home, to ensure that the client can protect their privacy and family space, while still receiving safe and exceptional support.

Please call us for a confidential chat to see if we’re the right company for you.

Contact us today for a free no obligation assessment

01494 424 222 0203 794 9933



Our brain and spinal injury experts can: z Demonstrate advanced knowledge/skills and clinical reasoning within varied disability presentations. z Provide comprehensive clinical and functional assessments and present recommendations, tailored to the individual client’s condition and consider family lifestyle, educational potential and adult living scenarios. z Critically appraise evidence within the context of their own assessment findings and clinical experience, and provide robust opinions in relation to quantification of past and future heads of claim. All Somek and Associates experts undergo medico-legal training in relation to specific types of claims, such as birth

injury and wrongful birth, traumatic brain injury, cognitive dysfunction and brain and spinal cord injury. An understanding of the legal processes and continuous professional development in relation to recent judgements is integral to our approach and ensures that reports provided enable appropriate determination of quantum costs in complex claims. All our experts accept instructions from both claimant and defendant parties. n

I was very impressed with your expert’s input on the claim and her reports/performance in Conference (SOLICITOR)


e have over 25 years’ experience of providing care/occupational therapy, physiotherapy and speech and language therapy reports for adult and paediatric brain and spinal injury clients.

To request a sample report or to discuss instructing one of our experts, please email: or call us on 01494 792711.

We are the largest provider of HP expert witnesses in the UK, renowned and respected in the field

Join our team of Expert Witnesses

Occupational therapists play a key role acting as expert witnesses in clinical negligence and personal litigation. We require experienced OTs specialising in all clinical areas, especially those working in the fields of spinal cord injuries, amputation and elderly care/dementia. Requirements: z Self-motivated OTs with 8 years’ post qualification

experience and practicing clinically in a senior role, either within the NHS or private sector z Registered with HCPC We offer you: z Excellent remuneration on a self-employed basis z Opportunity to subscribe to our Annual Training and

Resource Package

z Networking opportunities with our 200+ associates

01494 792711


202 2 /23


Your client can travel safely in their wheelchair Wheelchair Accessible Vehicle Hire K

m 0808 258 3252

Wide range of vehicles depending on your clients’ needs Short or long-term hire available Receive expert advice and support from our mobility advisors

Allied Mobility can help you find the best specialist driving solution for your client.


A simple solution to independent living after BRAIN OR SPINAL INJURY Disability resulting from illness or injury can impact at any age. And it’s well-recognised that creating a positive environment, once discharged home, can be pivotal to successfully managing an acquired or progressive brain or spinal injury.


hen a house ceases to work adequately in terms of layout and accessibility, it’s important to address adaptations quickly. Because losing the ability to perform simple daily tasks or maintain childcare responsibilities, on top of the psychological impact of life-changing disability, can be difficult to deal with. Holistic home adaptations take into consideration the needs of everyone living in the home and providing safe access between floors has to be a priority to help normalise a complex and stressful time for all involved. Installation of a homelift can support independence and enable positive family living, keeping the family dynamic as stable as possible. Stiltz Homelifts provide inclusive home access solutions to support users with conditions such as TBI, SCI, ABI and neurological conditions including Parkinson’s and MS. Offering a contemporary and attractive homelift range suitable for both younger clients as well as more senior homeowners, which comfortably marries form and function, Stiltz own installers can quickly deliver a full-service installation, while the whole process is supported by clinically-led assessment in collaboration with healthcare professionals.

REINSTATING ABILITIES FOR YOUNGER INDIVIDUALS Team BRIT racing driver, Aaron Morgan, 31, is on track for the

prestigious British GT Championships, despite breaking his vertebrae and spinal cord in a racing accident in 2006. However, Aaron’s racing success contrasted starkly with a lack of freedom in the home he shares with his partner and her son. He was unable to access upstairs without assistance, until a homelift from Stiltz reinstated independent living. “The stress of worrying about how to get upstairs has gone. With a homelift, I’m far more independent now and not stuck downstairs all day. I work from home, and I can go Paraplegic racing driver, Aaron Morgan and his recently-installed upstairs if I need to. It’s lovely Stiltz Trio+ Homelift. that I can tuck my stepson in at night and read him a bedtime story - it feels as if I have the same freedom in my home as I have on the racetrack.”


A healthcare professional’s view: As an OT, I assess how clients can maintain or improve their independence. With seamless transfers between floors, a next generation through-floor lift from Stiltz perfectly demonstrates how home accessibility can be improved for a wide range of conditions and successfully managed moving forwards. As a respected manufacturer of domestic homelifts, Stiltz have combined aesthetics and design with the latest safety features and efficient operation. This type of home adaptation is an ideal solution for clients of any age group looking to regain safe movement around a multi-floor home, without reliance on anyone else. STUART BARROW, OCCUPATIONAL THERAPIST

Following a stroke in 2019, Steve Waller, 64, also installed a domestic homelift from Stiltz, to secure ongoing independence with his retirement guide dog, Evie. Steve lives with reduced mobility and balance issues. An additional visual impairment presents risks of falls on stairs. Part-funded by a Disabled Facilities Grant, Steve chose a wheelchair-accessible Stiltz Trio+ Homelift, which has allowed him to continue living alone and engage in daily activities, without additional carer support. ■

Stiltz specialist advisors can be contacted on: tel: 01384 880 343 email: web:

202 2 /23 1 1 3

Rated Rated‘Excellent’ ‘Excellent’ RatedRated ‘Excellent’ ‘Excellent’

Make Make life easier and and Make Makelife life lifeeasier easier easierand and safer safer atathome, home, with safer saferat home,with withaaa Stiltz Stiltz Homelift Stiltz StiltzHomelift Homelift

specify the most suitable toto specify the most suitable to specify the most suitable to specify the most suitable product, inthe the best position product, position product, inbest the best position product, ininthe best position within the home. within the home. within the home. within the home.

The Trio+ Homelift model The Trio+ Homelift model The Trio+ Homelift model The Trio+ Homelift model is isis is specifically designed for specifically designed for specifically designed designed for for room, andbetween between floorsand and andspecifically floors Home Home isiswhere the heart heart is;is; ititit is; it toto toand room, and between floors toroom, room, and between floors and Home Home iswhere where isthe where the heart the is; heart wheelchair users. The Trio+ hashas wheelchair users. The Trio+ has wheelchair users. The Trio+ wheelchair users. The Trio+ has in order for this to take place, in order for this to take place, isisalso also where where we we often often feel feel the the infor order take place, thisfor to this taketoplace, is also iswhere also where we often wefeel often the feel the order a gentle access ramp plus the a gentle access ramp plus the a gentle access ramp plus the a gentle access ramp plus the modifications and adaptions modifications and adaptions modifications and adaptions and adaptions safest. safest. Where Where we we can can regroup regroup safest. safest. Where Where we can we regroup can regroup modifications option of powered doors and thethe option of powered doors and the option of powered doors and option of powered doors and the need to be made. The optimal need to be made. The optimal need to be made. The optimal to be made. The optimal and and recentre recentre ourselves after after the the and recentre and ourselves recentre ourselves ourselves after the after the unique ThruCar configuration. unique ThruCar configuration. unique ThruCar configuration. unique ThruCar configuration. way to secure safe, comfortable way to secure safe, comfortable securesafe, safe,comfortable comfortable way totosecure day’s trials day’s and trials tribulations. and tribulations. This This day’s day’s trials trials and and tribulations. tribulations. This This This means you can enter means you can enter and This means you can enter andand This means you can enter and travel between is to install This travel between floors totoinstall travel between between floors floors isisfloors isto install all the ismore all more the important more important ifthere thereif there isisallis allthe the more important important if ifthere exit the lift from opposite sides exit the lift from opposite sides a homelift best able to meet the a homelift best able to meet the exit the lift from opposite sides exit the lift from opposite sides homeliftbest bestable abletotomeet meet the a homelift has been has some been kind some kind traumatic of traumatic has has been been some some kind kind ofofof traumatic traumatic of the car without the need of the car without the need to needs of the user. needs of the user. thecar carwithout withoutthe theneed needtoto to ofofthe needsofofthe theuser. user. event event such alife-changing life-changing as a life-changing needs event event such such asasaassuch alife-changing reverse out at any point. reverse out at any point. reverseout outatatany anypoint. point. reverse Stiltz Homelifts isUK’s the UK’s StiltzHomelifts Homelifts the UK’s injury involved injury involved and we’re and we’re Stiltz Homelifts theUK’s Stiltz isisisthe injury injury involved involved and and we’re we’re But a Stiltz is also unique because But a Stiltz is also unique because largest provider of lifts designed But largestprovider provider lifts designed Buta aStiltz Stiltzisisalso alsounique unique because because returning returning home home from hospital from hospital or or largest provider liftsdesigned designed largest ofofoflifts returning returning home home from from hospital hospital oror it looks like no other lift. The it looks like no other lift. The especially use inhome. the home. it itlooks especially for use the home. lookslike likenonoother otherlift. lift.The The rehabilitation. rehabilitation. especially foruse usefor thehome. especially for inininthe rehabilitation. rehabilitation. elegant, clear-sided car runs elegant, clear-sided car runs Stiltz works directly with the user Stiltz works directly with the user elegant,clear-sided clear-sidedcar carruns runs elegant, Stiltzworks worksdirectly directlywith withthe theuser user Stiltz twodiscreet slim, discreet slim, verticalvertical or via Healthcare Professionals on twoon Professionals Key toKey reassurance to reassurance at home at home is the is theor via Healthcare twoslim, slim,discreet discreetvertical vertical onontwo viaHealthcare HealthcareProfessionals Professionals Key Keytotoreassurance reassuranceatathome homeisisthe the ororvia as Occupational Therapists rails which Occupational Therapists rails which lift to be allowsallows the liftthe to be ability ability to move to safely move from safelyroom from room such assuch ability abilitytotomove movesafely safelyfrom fromroom room

such suchasasOccupational OccupationalTherapists Therapists

rails railswhich whichallows allowsthe theliftlifttotobebe

ForFor FREE a FREE brochure brochure or no obligation obligation survey survey For For aaaFREE FREE brochure brochure or oror no nono obligation obligation survey survey

positioned ininalmost location positioned any location positioned in almost any any location positioned inalmost almost any location ininthe home - it- it-doesn’t toto the home need in the home - it doesn’t needneed to in the home itdoesn’t doesn’t need to fix to, or stand against, a wall. fix to, or stand against, a wall. fix to, or a wall.a wall. fixstand to, oragainst, stand against, only our products which It’snot not only our products which It’sIt’s not only our products which It’s not only our products which are tried and tested though. are tried and tested though. are tried tested though. All AllAll areand tried and tested though. All surveyors, assessors, builders our surveyors, assessors, builders ourour surveyors, assessors, builders our surveyors, assessors, builders installers employed and installers are employed andand installers are are employed and installers are employed fully trained byby Stiltz. We and fully trained Stiltz. We andand fully trained by Stiltz. We and fully trained by Stiltz. We have 3 offices in the UK, with have 3 offices in the UK, with have have3 3offices officesininthe theUK, UK,with with ourour global headquarters being our global headquarters being global headquarters being our global headquarters being in the Midlands. ButBut our teams in the Midlands. But our teams ininthe Midlands. our teams the Midlands. But our teams operation nationally. This enables operation nationally. This enables operation operationnationally. nationally.This Thisenables enables us us tous provide unrivalled customer us to provide unrivalled customer totoprovide provideunrivalled unrivalledcustomer customer service andand help manage the the service and help manage the service help manage service and help manage the entire process, from specification entire process, from specification entire process, from specification entire process, from specification to installation and beyond. to installation and beyond. totoinstallation installationand andbeyond. beyond.

Why should should IIIconsider consider Homelift Homelift from from Stiltz? Stiltz? WhyWhy Why should should I consider consider a Homelift aaaHomelift fromfrom Stiltz? Stiltz? Wide entrance/exit doors Wide entrance/exit doors Stiltz willwork workdirectly directly with ••• Stiltz will with • Wide •• •entrance/exit Wide entrance/exit doors doors • Stiltz will Stiltz work will directly work directly with with end user or OT end user or OT end user endoruser OT or OT Gently-angled ramp Gently-angled ramp • Gently-angled •• •Gently-angled ramp ramp Cost-effective purchase ••• Cost-effective purchase • Cost-effective Cost-effective purchase purchase Powered door option Powered door option •• •Powered door option door option Nationwide coverage for• Powered ••• Nationwide coverage • Nationwide Nationwide coverage coverage for for Simple, flexible and quick Simple, flexible and quick assessment installation• Simple, assessment ///installation •• •Simple, flexible flexible and quick and quick assessment assessment / installation installation to install to install to install to install • Intelligent Intelligent designdesign design -design spacious Intelligent - spacious ••• Intelligent - spacious yet compact yet compact yetcompact compact yet • Minimal •• •Minimal structural structural work work Minimal structural work Minimal structural work • Freestanding Freestanding designdesign design -design no - no Freestanding - no needed ••• Freestanding needed needed needed wall needed wall needed wallneeded needed wall • Unique •• •Unique Thru-Car Thru-Car optionoption for forfor Unique Thru-Car option for Unique Thru-Car option • Wheelchair • Wheelchair modelmodel model available available Wheelchair modelavailable availableof easeofofease • • Wheelchair transfer of transfer easeofoftransfer transfer ofofease • Manufactured, Manufactured, installed installed and and Manufactured, installed and ••• Manufactured, installed and • DFG-eligible • DFG-eligible product product fully guaranteed fully guaranteed by Stiltz bybyStiltz Stiltz DFG-eligibleproduct product • • DFG-eligible fullyguaranteed guaranteed Stiltz fully by • 12 months • 12 months parts and parts and • Contemporary • Contemporary styling styling monthsparts parts and • • 1212months and Contemporarystyling styling • • Contemporary labour labour cover cover • Flexible • Flexible positioning positioning labourcover cover labour Flexiblepositioning positioning • • Flexible • Advanced • Advanced safety safety features features • Extended • Extended warranty warranty available available Advancedsafety safetyfeatures features • • Advanced

Extendedwarranty warrantyavailable available • • Extended

Call Call 0808 0808 239 239 7995 7995 oror or visit visit Call Call 0808 0808 239 239 7995 7995 or visit visit


INTRODUCING CAREFLEX & THE BENEFITS OF SPECIALIST SEATING Specialist seating can be critical to optimum recovery following a brain or spinal injury. CareFlex are here to support individuals, families, carers and professionals from assessment through to prescription and review.


hen an individual’s ability to achieve good sitting posture is affected it can have a significant impact on their quality of life. Specialist seating aims to allow individuals, who might otherwise have difficulty, to achieve their optimum sitting posture to sit out comfortably, reduce the risk of body distortion, enhance physiological function, manage pressure injury risk, interact with their environment, and participate in activities of daily living.

We have and continue to submit our products for independent testing and evaluation, including pressure mapping and published clinical research to enable customers to reason and justify their provision.


Lucy experienced a traumatic brain injury as a teenager, resulting in limited active movement, hypertonicity, contractures, pelvic instability, and unequal loading of tissues. Lucy utilised her wheelchair for all activities of daily living and had no alternative seating. She WHO ARE CAREFLEX? required a specialist seating system to aid postural Since 1995 CareFlex has stability, encourage normal been collaborating with movement and promote Health & Social Care engagement in daily life. Professionals to develop Flexible postural support at innovative and effective all body segments allowed specialist seating; we The opportunity to relax unique accommodation of understand the importance her asymmetries. Adjustable of balancing the four throughout the day also seat dimensions ensured key objectives (Comfort, encouraged energy conservation, individualised set-up for Function, Postural stability and security, whilst Management and Pressure which was critical to Lucy’s ability enhancing comfort and Care Management) for to engage meaningfully and reducing the risk of pressure optimum seated posture interact socially. injuries. The opportunity with a sound holistic to relax throughout the day approach. We have also encouraged energy conservation, which was critical to confidence and pride in our specialist seating and the Lucy’s ability to engage meaningfully and interact socially. positive impact we know it can have on individuals’ lives.


202 2 /23

LONG-TERM SUPPORT INTRODUCING THE SMARTSEATPRO II The SmartSeatPro II is a highly adjustable modular seating system that takes specialist seating to the next level for those with complex postural management and pressure care needs. It has been designed to provide maximum adaptability to optimise posture, function and comfort for individuals in all health and care environments.

Tilt-in-Space to aid pelvic stability and achieve pressure redistribution without affecting the critical angles for sitting. Back angle recline to promote comfort, manage generalised weakness and allow for periods of rest for energy conservation. A multi-segmental back support that can accommodate, or correct where possible, any scoliosis and/or rotation through the spine and pelvis, to promote trunk alignment and physiological function. A channelled leg rest and angle-adjustable footplate to support the lower limbs and feet.

A comprehensive holistic seating assessment is critical to an effective seating prescription; please do not hesitate to contact us to discuss any queries, our clinical education, or to book a free assessment.


At CareFlex we also offer a tailored seating solutions service, for special modifications based on individual requirements. This service is available on all CareFlex chairs and can include any of our accessories to enable the provision of a unique seating system.

LONG-TERM SUPPORT CareFlex is more than a manufacturer; we pride ourselves on our white glove service to offer customers long-term support to ensure individuals are supported through their recovery and beyond.

We offer face-to-face and virtual training events developed by Rebecca Dunstall, our Clinical Specialist, to improve competence and confidence with assessing, prescribing and using specialist seating through a combination of theory and practical hands-on sessions. We also take our responsibility as a specialist seating provider seriously and recognise that clinical education is the key to appropriate and successful seating as part of the 24-hour postural management and pressure care programme. Rebecca has also developed our Pocket Book and Encyclopedia of Specialist Seating, both designed to help professionals navigate this topic and give them the knowledge needed to advocate on behalf of those who need them. ■

We are dedicated to supporting your educational journey, so we are giving the first 100 B&SI readers a FREE Postural Care & Specialist Seating Education Pack. This includes our 168pg book ‘Encyclopedia of Specialist Seating’ worth £24.99, the ‘Clinician’s Pocket Book of Seating’ and a Seating Assessment Guide. Email quoting B&SI Education Pack.

Specialist Seating web: email: 0800 018 6440 Book a free assessment, demonstration or training

202 2 /23 1 1 7


Brotherwood Electric Wav IS THE PERFECT FIT FOR SUSSEX CHARITY A Sussex-based veterans’ charity is celebrating the arrival of its new sustainablypowered mini ambulance, funded entirely by its supporters.


he vehicle is powered using electricity generated from solar panels installed last year at Care for Veterans, a charity which provides care and rehabilitation to ex-service personnel from its 60-bed facility on Boundary Road, Worthing. Current residents are aged between 34 and 96 years old and the majority have Acquired Brain Injury (ABI) or a degenerative neurological condition, such as multiple sclerosis, motor neurone disease and Parkinson’s. The electric-powered ambulance from Brotherwood is the next step in the charity’s project to reduce its environmental impact as it replaces an old and unreliable diesel vehicle. The fully wheelchair-accessible ambulance is used to transport residents to hospital and other appointments, as well as for admissions and discharges. The new mode of transport has been funded by donations from Rampion Community Benefit Fund, Sussex Community Foundation, Aldershot Church of England Services, BAE Systems and Brotherwood Automobility Limited. Matthew Li, Registered Manager at Care for Veterans, said: “This new electric-powered ambulance is the next phase of our ‘green’ project and will provide wheelchair users with a smooth, jolt-free and near-silent ride. Using a quieter vehicle is really


202 2 /23

beneficial for our residents with a brain injury as this often causes increased sensitivity to noise. “There is also the added benefit of saving money on fuel costs as it will use the energy generated by our solar panels, which have already saved us £13,000 on bills since they were installed last year. By reducing our running costs, we can spend more on the care and rehabilitation we provide to our resident veterans. We are thrilled to have our new mini-ambulance and incredibly grateful to our sponsors who made it possible. Thank you from everyone at Care for Veterans.” Site Director for BAE Systems’ Electronic Systems sector in Rochester, Dave Banks, said: “We are extremely proud to support Care for Veterans through our Community Impact program, and the arrival of their new electric powered ambulance is great news. As a passionate supporter of veteran causes and provider of electric propulsion systems, it is fantastic to partner with organisations that are delivering sustainable support to our veterans.” Since 1919, Care for Veterans has provided the highest possible standard of care and rehabilitation to disabled exService personnel and their families. It provides services such as nursing, physiotherapy, occupational therapy, and speech and language therapy to help rehabilitate those who live there to live more independent lives. As an independent provider, the charity can fill the gaps often found between healthcare and social services. ■

Tel: 0808 274 5888 Web:


Innovations in wheelchair VIBRATION DAMPENING Jordan Davies (BSc, IPEM), Rehabilitation Engineer at Wheelfreedom, brings us an extract from their CPD accredited course: Innovations in Wheeled Mobility and Seating.


hen walking, a large percentage of the ground reaction force or vibration is lost or absorbed before it can be transmitted beyond the thighs. When using a wheelchair, being in a seated position to move can mean increased vibration through the legs and upper body, and often for a prolonged period of time. RESNA describes wheelchair users as “particularly at risk from whole body vibration”. From a biomechanics perspective, it is ideal for vibration to be redirected at the earliest stage, or as distally as possible.

absorbers at the connection between the top frame and subframe. Another noteworthy innovation in this area is the Loopwheel. Loopwheels chose to move away from the traditional central axle with spokes, instead crafting a trio of carbon loops with a moving hub that houses the axle pin. The elliptical carbon loops work in unison with the “floating” hub, allowing the wheels to act as springs and resulting in significantly reduced vibration transmission to the wheelchair user.


CONSEQUENCES OF OVER EXPOSURE TO VIBRATION Increased exposure to whole body vibration has been shown to induce or exaggerate back pain, neck pain, fatigue, spasticity, and pressure injuries. The consequences of these for daily life as a wheelchair user are a serious issue.


Reducing vibration transmission lowers pain and fatigue, whilst protecting skin and muscle tissue integrity JORDAN DAVIES (BSC IPEM), REHABILITATION ENGINEER AT WHEELFREEDOM

Previously the industry has looked to reduce the vibration that reaches a wheelchair user’s body with cushions or in the material of the chair, favouring titanium and carbon over aluminium frames. As healthcare equipment becomes more sophisticated, solutions have come to market that redirect vibration earlier in transmission which results in reduced end transmission to the wheelchair user. Ki Mobility released an active chair called the Ethos which has an interesting two-part frame that shows substantial reduction in vibration transmission to the occupant. The top part of the frame is in contact with the wheelchair user (backrest, seat, footplate) and the subframe houses the propulsion and caster wheels. The design of most active chairs links the casters to the footplates resulting in undesirable vibration transmission. Isolating the top frame means there is no transmission directly up through the feet and legs. This design also allows for the inclusion of shock

12 0

202 2 /23

Reducing vibration transmission is not just about short-term benefits such as reducing pain and fatigue. Technology now allows us to record real time numerical data so we can observe the true impact of improved designs. There is real potential for measurable longterm benefit in protection of both skin and muscle integrity.


At Wheelfreedom, our accredited CPD course provides Occupational Therapists and other interested healthcare professionals a chance to learn about exciting new developments across the mobility and seating industry. It’s a great opportunity to get hands on with a diverse range of equipment whilst receiving expert and impartial advice from our specialist team.

Unit 61, Barwell Business Park, Leatherhead Road Chessington, KT9 2NY tel: 0800 025 8005 email: web:

PRESCRIPTIVE MOBILITY SPECIALISTS Wheelfreedom are specialists in supplying prescriptive products for over 14 years. Products include:

☑ ☑ ☑ ☑ ☑ ☑

Wheelchairs Powerchairs Paediatrics Specialist seating Power add-ons Mobility scooters

One-to-one assessments are held at their industry leading showroom in London to provide tailored solutions. Services include pressure mapping, custom-made seating and special controls. Wheelfreedom are CPD accredited to support health professionals and Occupational Therapists. Gain 3 CPD points as you learn about the latest innovations in Wheeled Mobility at their showroom in London. 0800 025 8005 | |


WHY MANAGE POSTURE? A wheelchair users very independence can hinge on effective postural management within the wheelchair. Postural management can and does influence:Systemic function (i.e the effect of posture on all the bodily systems including the cardiovascular system, respiratory system and digestive system). Ease of propulsion in a manual wheelchair. Ease of access to driving controls in a powered wheelchair. Management of the interface between the wheelchair and other equipment of daily living. Access to and completion of all activities of daily living inclusive of personal care, work/ education and leisure activities. Access to communication and other assistive technology devices such as environmental controls.


ucy Weech is the Clinical Director leading the Wheel of Health team based throughout the UK and Ireland. The team consists of 17 Clinical Associates who all have extensive post graduate experience in the postural management of complex clients. Presentations range from physical disability following trauma to those with profound and multiple learning difficulties. These clients frequently present either during the litigation process or post settlement. All Clinical Associates manage a highly complex caseload of children and adults. Within this role, clincians complete 24hour postural management assessments (including medico-legal reports); assessment, prescription and provision of specialist equipment; assessment for provision of wheelchair accessible vehicles; personal care and manual handling assessments.

WHY IS POSTURAL MANAGEMENT SO CRITICAL FOR WHEELCHAIR USERS? Posture is often seen as static, with the posture presented at assessment identified as being the clients permanent posture, likely to stay that way. But consider how our own posture changes as we age, and our lifestyle changes. How much more so, then, will the postural requirements of wheelchair users change under the influence of rehabilitation, variable and changeable muscle tone, spasticity patterns, behavioural changes and so forth.


202 2 /23

HOW DOES A POSTURAL MANAGEMENT SPECIALIST/EXPERT EVALUATE A CLIENT’S NEEDS WHEN ASSESSING? The first step in an assessment process is to carefully evaluate the client’s physical presentation taking account of deformity, altered muscle tone, spasticity patterns, impaired sensation, effects of trauma and so forth. These findings should be clinically recorded to give a baseline to subsequent problem solving. It is important to evaluate how much correction is achievable for that which is obviously seen. For example, where there is a pelvic asymmetry that is correctable, then any seating solution should seek to correct it. If it is not correctable, then a posture management solution should seek to accommodate it, to reduce the risk of the deformity becoming worse.

HOW DO THE FINDINGS OF THAT EVALUATION INFLUENCE THE SELECTION OF THE MOST APPROPRIATE EQUIPMENT? Having completed postural analysis and recorded clinical findings in detail, the professional clinician’s responsibility lies in the selection of equipment that is clinically appropriate and addresses issues identified during the assessment process. Features of wheelchairs and posture management equipment informs this process. The professional is therefore responsible for ensuring that they have a good grasp of the features of the equipment and how they affect posture. It is rare to find a single product that will effectively manage

LONG-TERM SUPPORT client’s postural needs but rather a range of products used together to reach an effective clinical solution. We consider it of the utmost importance to actively work in direct collaboration with the client, their carers and stakeholders and take a multidisciplinary and holistic approach.

WHICH COMES FIRST; THE WHEELCHAIR OR THE VEHICLE, AND WHY? It is of paramount importance to “work from the inside, out”. That is to say, that during the process, it is imperative to start with the client and their presenting postural needs, then work “outwards” in the selection of clinically appropriate products. Therefore, posture management products interface into wheelchairs which then interface into vehicles. We are then able to select a suitable vehicle to fit the wheelchair, rather than trying, usually unsuccessfully, to find a clinically appropriate wheelchair to fit the already purchased vehicle. Retrospective adaptations to previously purchased wheelchair accessible vehicles can cost tens of thousands of pounds.

HOW CAN YOU ENSURE THAT EQUIPMENT SELECTED MEETS BOTH THE NEEDS OF THE PRESENT AS WELL AS BEING ABLE TO FUTUREPROOF ONGOING CLINICAL NEEDS? Competent clinicians need to work with equally competent technical teams and mutual collaboration

Wheel of Health “Opening doors to maximise independence...”

is of the utmost importance. Equipment suppliers have variable strengths and for wheelchair users who have a full-time dependency on all their equipment require both clinical and technical input that can address those complex needs. Additionally, it is true to say that the clinician needs to be able to crystal ball gaze as much as is possible with regard to the presenting condition (be that positive rehabilitative progress or degenerative progression). Our ethos is to work in direct collaboration with competent equipment suppliers who can provide, maintain and assist in the adjustment of equipment to meet the ongoing clinical changes of our clients. ■ Do you have a client in mind, (or are you the client) that would benefit from a postural management assessment?

Please contact myself or Wheel of Health HQ to discuss further: Email: Tel: +44 (0) 23 8076 8583 Mob: +44 (0) 78300 72700 Web:

UK & IRELAND Specialists in Wheelchair, Seating & 24hr Posture Management Solutions... » Specialist wheechair, seating and 24hr posture management clinical practice. » Specialist provider of wheelchair, posture management and allied equipment solutions for adults and children with complex needs. » Highly specialist and skilled professionals with specialist postgraduate training and expertise.

CONTACT US Office: +44 (0) 23 8076 8583 Mobile: 078300 72700

Email: Web:

202 2 /23 123


Historical merged with contemporary MOVING ACCESSIBLY BETWEEN THE CENTURIES


he combination of old and new architecture provides unusual views and insights. When an old English farmhouse with a building structure dating back to the 15th century meets a creative team of architects from the 21st century, special moments are created. This was certainly the case with the extension of the Batelease Farm in the county of Devon. The original Batelease Farm was built back in the 15th century and the building has been changed and extended over the centuries. A large barn for cattle adjoining the main house was destroyed by a bomb during the Second World War. An empty site was left in its place until 2017.

literally. Because the goal wasn’t merely to create a new build - it also had to be accessible and enable access between the old and new building. This will allow the client, a wheelchair user, to navigate between the buildings independently and to move between the centuries, so-to-speak. A glass structure connects the main house and the new build and covers two floors, including a lift. Access has been created between the buildings on both the ground floor and the first floor. There is also an entrance and exit here, which enables the client to enter or leave the building independently at any time. When designing the residential building with larch woodsteel element construction and the plain zinc roof, the creative designers at New British Design used style elements common in earlier agricultural barn designs and revived and re-interpreted the original technical-agricultural design. The interior design is modern and linear. The residential area is 145 square metres per floor. The building is dominated by generous and bright rooms. Exposed beams in the interior spaces also add technical-agricultural style elements whilst also being extremely useful. A Guldmann GH1 ceiling hoist system, installed by Direct Healthcare Solutions Ltd, is used in the client’s bedroom with the rail system integrated subtly into an exposed timber beam, so that the practical aid is almost invisible.. ■ +44 (0) 1793 611892

The Devon-based “New British Design” architecture and design company took over the planning and execution of a new build to be built on the site of the former barn. Because the Batelease Farm is a Grade II listed building everything had to be approved by the responsible heritage officials. The modern extension to the old farmhouse creates a contrast between old and new and combines the two - quite


202 2 /23

For further details please contact: Tel: +44 (0) 1793 611892

T: +44 (0) 1793 611892 | W: WWW.DHSLIMITED.CO.UK

Accessible and Inclusive Environments Removing barriers by design


William Martin’s specialist personal injury division comprises senior, experienced accommodation experts who lead a team of architects and designers to provide a service to those requiring a home intended to promote their independence, mobility and rehabilitation. We have undertaken many successful new build and adaptation schemes including adaptations to temporary accommodation. We are accustomed to working closely with the injured party often in conjunction with their Case Manager, Occupational Therapists and legal team. We are able to offer innovative and bespoke solutions to meet the needs of each client.

Julian Rendall: James Nocker: London: 0207 378 5800 Manchester: 0161 457 0336 32 Threadneedle Street, London, EC2R 8AY 3 Hardman Square, Spinningfields Manchester M3 3EB


FUNCTIONAL ELECTRICAL STIMULATION (FES) for correction of dropped foot FES is increasingly being seen as a first line intervention to improve the mobility of people with neurological disability. Paul Taylor has pioneered its use within the NHS.


ropped foot is the inability to lift the foot as the leg swings forward when walking. It is caused by weakness in the muscles that lift the foot and/or excessive activity (spasticity) in the antagonist muscles. Dropped foot Paul Taylor increases the risk of falls, reduces mobility and participation in activities of daily living.

WHAT IS FES AND HOW DOES IT WORK? Functional Electrical Stimulation (FES) is the production of functional movement in paralysed or weak muscles by the application of small pulses of electrical current to the nerves that supply them. The Odstock Dropped Foot Stimulator (ODFS®) Pace was developed at Salisbury District Hospital. It stimulates the common peroneal nerve at its most superficial point where it passes the head of fibula, using self-adhesive skin electrodes. Stimulation is timed to the walking cycle by using a pressure switch placed in the shoe under the heel. Stimulation begins when the heel is lifted from the ground and ends just after heel strike. Stimulation causes the foot to lift and stabilises the ankle when it is returned to the ground. Stimulation feels like pins and needles and most people quickly become used to the sensation.

I have been using a single channel stimulator for foot drop, due to MS, for 5 years. I wear it every day and it has allowed me to carry on working full-time. It is the single most helpful thing in this journey as a patient, and has allowed me to remain as active as possible. The ODFS® Pace is primarily used as a long-term assistive device. However, therapeutic training benefit has been demonstrated in people who have a dropped foot due to

12 8

202 2 /23

stroke, spinal cord injury, Parkinson’s and some people with MS. It can also be used in early gait re-education to help facilitate a normal gait pattern, including the retraining of knee and hip control. Because FES can reduce spasticity though activation of reciprocal inhibition, it is often a more effective mobility intervention than passive orthotics and can enable greater range of movement.

THE MAIN EFFECTS OF THE ODFS® PACE (FES DEVICE) ARE: Increased safety due to reduced tripping and increased stability in stance, reducing falls by 72 % Increased walking speed, functional ambulation category and distance range Reduced effort of walking Greater confidence, independence and quality of life

The ODFS® Pace is a practical device with adherence to treatment at one year of 86%. FES can be used to assist walking in any neurological condition resultant from an upper motor-neuron lesion (lesion within the brain or spinal cord above T12). This includes stroke, MS, spinal cord injury, traumatic brain injury, cerebral palsy, hereditary spastic paraplegia and Parkinson’s disease. FES for correction of dropped foot is a recommended treatment in NICE guidelines IPG278 and ANPT clinical guidelines. OML provide training courses for clinicians wishing to use FES in their clinical practice. Please visit our website for further details. ■

web: email: tel: 01722 439 540


Living with a SPINAL CORD INJURY Individuals living with spinal cord injuries can be faced with a lot of day-to-day challenges. With limited or no mobility, spinal cord injury patients may struggle to maintain their independence. With this in mind, it’s important to understand the mobility options available and how ongoing innovative technologies can help. WHAT IS A SPINAL CORD INJURY? A spinal cord injury (SCI) is when there is damage to the spinal cord, which can result in a loss of function, including movement and/or feeling. Some of the most common causes of spinal cord injury are diseases such as Spinal Bifida, Polio, and more. Other causes include injuries from motor or sports accidents. The spinal cord is a collection of nerves that travel from the bottom of the brain down a person’s back. With 31 pairs of nerves going to a person’s arms, legs, chest, and abdomen. These nerves communicate with the brain, which gives commands to muscles, resulting in the movement of the arms and legs.

A spinal cord injury complete means that there is no sensation or movement below the level of the injury on both sides of the body. LEVELS OF SPINAL CORD INJURY There are two different types of spinal cord injury. A spinal cord injury complete means that there is no sensation or


202 2 /23

movement below the level of the injury on both sides of the body. An incomplete spinal cord injury indicates that there is some function, movement, and feeling in parts of the body. There are nine levels of spinal cord injury. A C2-C3 injury is the most severe injury which normally results in the individual lacking the ability to breathe and a patient with this level of injury is totally dependent on others for care. At the other end of the spectrum, a person living with an L1-L5 injury typically has varying degrees of muscle movement in the legs. They may be able to walk a short distance with assistive technology.

POWER CHAIRS FOR INJURY TO THE SPINAL CORD In addition to ongoing medical care and physical therapy, individuals living with a spinal cord injury may benefit from a powerchair. Quantum Rehab offers solutions to help SCI patients live a more independent life. The Edge 3 Stretto powerchair is available with optional iLevel® Power Adjustable Seat Height technology. This means that the seat elevates up to 12 inches while driving at 3.5 mph. Kevin Atkins the UK Senior Quantum Sales Manager states ‘ILevel has Extra Stability Technology®, which increases safety for cooking, reaching, transferring, and grooming while the seat is elevated. With iLevel, individuals living with a spinal cord injury can be at eye level with their family and friends. This can reduce neck pain associated with to having to look up at people from a standard wheelchair’. ■

For more information about Quantum Rehab products and how they may help you get in touch: Quantum Rehab UK contact: 01869 324600 email: web:



*iLevel Optional


From Strength TO STRENGTH “Frenkel Topping’s growth plans will always have clients at their core” says CEO, Richard Fraser

provide a Major Trauma Signposting Partnership (MTSP) support service. It is the sole commercial organisation operating in the space and has a five-year track record of contracts with the NHS, with a 100% contract renewal rate. Cardinal is also in high demand from PI legal providers t’s been a challenging two seeking quality multi-track cases and provides a clear years for all of us, but as we opportunity to expand the Major Trauma Signposting move ahead into 2022 we Partnership into additional Major Trauma Centres. finally seem to have cause for Through its core business, Frenkel Topping Limited, optimism that the worst of Covid the group supports litigators pre-settlement in achieving is behind us. Restrictions are the right level of damages by providing expert witness lifted, hospitalisations are falling, services, and post-settlement to achieve the best longRichard Fraser and the world of work is finally term financial outcomes for clients after injury. This returning to normal. acquisition of Cardinal provides a clear and direct link to That’s not to say that Frenkel Topping Group has claimants, and their professional representatives, at the been idle during the months of uncertainty, however. earliest stage possible after injury or illness, introducing In 2020, the group raised a £13m war chest with the the portfolio of Frenkel Topping Group services in a intention of embarking on an ambitious strategy relevant and timely way to clients in the PI and CN of mergers and acquisitions that would allow us to litigation space as well as claimants themselves. strengthen and consolidate our position as the market At each of the MTSP sites, Cardinal has selected a legal leader for providing financial advice and asset protection panel which comprises of firms who are able to provide services to clients at times of financial vulnerability, with the highest quality of care and service to patients at each particular expertise in the field of personal injury and site, providing opportunity for Frenkel Topping Group clinical negligence. We have continued with that mission, to further strengthen its relationships with PI and CN pandemic or no pandemic. departments within law firms The strategy has seen nationally. We know from the strong and us strengthen the group Bidwell Henderson, long-standing relationships we with a number of notable meanwhile, is a leading legal acquisitions, each of which costs consultancy, based in have with our clients that their enables us to apply our Derbyshire and Newcastleindependence and ability to engage principles of trust, care, upon-Tyne. Over the last 7 with individuals and firms that are compassion and reliable years it has built a leading legal expertise to more points in aid costs agency in England best suited to a case or a client, are the vertical supply chain. and Wales. It holds a marketparamount. Most recent among these leading position in drafting the are the 2021 acquisitions high-cost case plans which are of Cardinal Management Limited (Cardinal), and Bidwell required when significant costs are involved in largeHenderson Costs Consultants Ltd (Bidwell Henderson). scale and complex legal cases. Bidwell Henderson covers These latest additions to the group join fellow 2021 specific areas of law such as complex public and private acquisitions Partners in Cost (PIC) and A&M Bacon, as well family, housing, judicial review, Court of Protection, as the previous addition of Forths Forensic Accountants abuse and clinical negligence cases. In addition, Bidwell and the creation of Keystone Case Management. Together Henderson challenges the traditional legal aid costs firm they add even further to Frenkel Topping Group’s ability model and has built its success on developing ancillary to provide first-rate client services at every stage of this services in legal aid processing, legal cashiering and costs often complex field, from pre-litigation right through to training. the long-term management of settlements and support in As a result, Bidwell Henderson is highly integrated specialist care. into law firms’ back-office systems. So, while litigation is Cardinal works in close partnership with a number of transactional, the business model deployed by Bidwell key NHS Major Trauma Centres (MTCs) nationwide to Henderson means the nature of the revenues are of a


1 32

202 2 /23

FINANCIAL & LEGAL repeat/recurring nature. Given the close links Bidwell Henderson has to law firms, this represents a clear opportunity for Frenkel Topping to offer its other services such as expert reports, in addition to the Court of Protection work and traditional legal costing that both the group and Bidwell Henderson undertake. Finally, a number of legal aid funded cases result in large awards to claimants, so Bidwell Henderson offers the prospect of access to additional meaningful opportunities to secure assets under management (AUM) for Frenkel Topping. Both of these acquisitions are firmly in line with the company’s strategy to pursue quality opportunities in, and to drive consolidation of, the pre-settlement professional services marketplace in Personal Injury (PI) and Clinical Negligence. Frenkel Topping Group doesn’t stop at the presettlement stage, however. We also offer a full range of post-settlement advice and investment services, including through the independently managed and monitored Ascencia Investment Management. Ascencia is particularly strong in the field of ESG investment. It does not believe in a one-size-fits-all approach or in short-term gains, instead its team of experts understand that it is key to provide life-long financial security for clients with vital, and individual investment needs. Rarely has this been so crucial as in the recent unsettling era. The year 2021 was an eventful one in investment markets, mainly led by several themes including higher inflation and the continuing of the covid19 pandemic. The prevalence of these themes created market volatility, however, in general pushed asset prices higher over the year. Policy makers globally worked to balance the health and economic impact of the pandemic, whilst orchestrating a plan for the reversal of policy, following unprecedented fiscal and monetary policy which was introduced in the first half of 2020. 2022 is already showing signs of continued volatility, with uncertain markets, rising inflation and spiralling energy costs all entering the fray early in the year. Thankfully, the Ascencia team are well-placed to deal with such unsettled market conditions. The team has more than 60 years’ combined experience, along with access to the full investment market. Portfolios are not managed by individuals – instead, Ascencia believes in a disciplined team approach, where knowledge and expertise are shared between professionals to produce a more beneficial outcome. The team remains confident that, despite the likelihood of rising interest rates, inflationary pressures, falling disposable income and elevated US equity valuations combining to potentially undermine investor confidence in 2022, Ascencia’s multi-asset strategies continue to offer diversification and are suitably positioned for the pending challenges ahead. As we’ve enacted our growth strategy over the last 18 months, and added relevant services under the Frenkel Topping Group umbrella, we have been asked whether our approach creates a conflict that could negatively

impact our clients in any way. Our belief is that by extending our principles of fairness, transparency and expertise across more touchpoints in our field, we are only doing right by those clients who choose to use our services. We know from the strong and long-standing relationships we have with our clients that their independence and ability to engage with individuals and firms that are best suited to a case or a client, are paramount. In the field of personal injury and clinical negligence, there are, quite rightly, very robust processes and controls to guard against any practices wrongly influencing the right and fair outcomes. While we are proud of our 99% client retention rate, we work hard to maintain that. We don’t rest on our laurels and we hold ourselves to incredibly high standards. Frenkel Topping Group also aims to make 2022 the year it achieves B Corps certification. This is a designation that a business is meeting high standards of verified performance, accountability, and transparency on factors from employee benefits and charitable giving to supply chain practices and input materials. In order to achieve certification, a company must: Demonstrate high social and environmental performance by achieving a B Impact Assessment score of 80 or above and passing a risk review. Multinational corporations must also meet baseline requirement standards. Make a legal commitment by changing their corporate governance structure to be accountable to all stakeholders, not just shareholders, and achieve benefit corporation status if available in their jurisdiction. Exhibit transparency by allowing information about their performance measured against B Lab’s standards to be publicly available on their B Corp profile on B Lab’s website. The principles that surround B Corps recognition are principles that are already deeply engrained within Frenkel Topping Group’s corporate culture. Through certification, the group will demonstrate that to the world.

Tel: 0161 886 8000

Web: Email:

202 2 /23 1 33

The Closomat Palma Vita Wash and Dry toilet.

“I am so grateful I have it. It is brilliant.” Dave Ralph, a former garage owner, suffered a prolapsed disc at work, but carried on working, and unfortunately he severely damaged his spinal cord as a result. Dave realised that he needed extra help when going to the toilet. “It was getting more and more difficult to clean myself, as I couldn’t get my hands behind my back. I wouldn’t expect my wife to wipe my bottom: it’s embarrassing!” explains Dave. A friend told him about Closomat Wash and Dry toilets, so he spoke to his Occupational Therapist; and under a Disabled Facilities Grant, a Closomat Palma Vita was installed. Dave says, “I am so grateful I have it. It is brilliant. I just push the pad with my elbow, and the toilet does the rest.” To find out more about how life-changing a Wash and Dry Toilet from Closomat can be, visit


How we help seriously INJURED PEOPLE Traumatic brain injuries cause around 160,000 people to be admitted to hospital and around 2,500 people sustain a spinal cord injury every year in the UK.


t Slater and Gordon we’re proud of our expertise in lifechanging injury claims and provide advice nationally for our clients injured through negligence. We also help clients in ‘second opinion’ cases where Crystal Eaton they have lost faith in their lawyers and want to get their claims, and often their lives, back on track. We obtain the best results with rehabilitation to maximise our clients’ recovery and compensation to provide for their losses and future needs. We relieve any unnecessary strain and stress for our clients and their families, minimising the impact of lost or reduced earnings due to injuries and obtaining interim payments to help financially.

The wider support we offer to our seriously injured clients includes: accident investigation witness appeals and support at criminal hearings inquest and inquiry representation complimentary welfare benefits advice Court of Protection services independent financial advisers

EXAMPLE CASE We recently achieved a settlement of £438,000 for a cyclist who sustained a brain injury and other significant injuries when a pothole caused him to fall from his bike. The local authority denied liability for failing to inspect and maintain the highway. We obtained witness statements on the state of the road and a highways expert’s report. Court proceedings were issued, we went to trial on liability and won 100% in our client’s favour. Our client’s significant ongoing symptoms included memory and concentration difficulties, low mood, anger and frustration, PTSD, anxiety, pain, fatigue and sleep issues. We obtained medical expert reports from a wide range of medical specialists, plus a care expert too. Our client found it difficult to cope at work and his relationship with his wife and children also suffered due to his ongoing issues. We successfully applied to the court for substantial interim payments to fund a specialist brain injury case manager who organised a specialist team of clinicians alongside rehab and treatment privately to avoid NHS delays. She liaised with the client’s employer for reasonable adjustments, and organised crucial counselling for the client and his family, which was included in the claim. This helped the family understand the effects of his brain injury and provided coping strategies. The case settled successfully and we arranged investment advice. We’re thrilled that our client’s rehabilitation has achieved an excellent outcome and he is again enjoying his cycling.

Family lawyers specialised in supporting clients after injury

We are Headway and Spinal Injuries Association affiliated, and work with many other charities and member organisations.

Contact: Slater and Gordon Lawyers Crystal Eaton Senior Associate | tel: 0330 995 5027 email: web:

202 2 /23 1 35



e the through

ve he s on

Br ex

At Sl a bra

That’s best po access

Our na approa proces their w



Authorised and

rain Brain andand and spinal spinal injury injury Brain spinal injury experts xperts experts At Slater and Gordon, we understand how life-changing

later and At Slater Gordon, andwe Gordon, understand we understand how life-changing how life-changing a brain or spinal cord injury can be. ain or spinal a braincord or spinal injurycord caninjury be. can be.

That’s why we do everything we can to ensure our clients receive the best outcome to their case; just financially, also receive through the s why we That’s dopossible everything why we dowe everything can to ensure we not can our to clients ensure receive our but clients the to additional support, treatment and ossibleaccess best outcome possible to their outcome case; to not their justcase; financially, notrehabilitation. justbut financially, also through but also through

s to additional access to support, additional treatment support, and treatment rehabilitation. and rehabilitation.

Our nationwide network of expertise, combined with an innovative approach to technology, allows us to guide our clients through the ationwide Ournetwork nationwide of expertise, network of combined expertise, with combined an innovative with an innovative process of legal support from start to finish, so that they can focus on ach to technology, approach to allows technology, us to guide allows our us clients to guide through our clients the through the their wellbeing and recovery.

ss of legal process support of legal fromsupport start to from finish,start so that to finish, they can so that focus they on can focus on wellbeing their and wellbeing recovery.and recovery.

0800 916 9084

00 916 0800 9084 916 9084

Authorised and regulated by the Solicitors Regulation Authority.

d regulated by the Authorised Solicitorsand Regulation regulated Authority. by the Solicitors Regulation Authority.


Opening up the law AFTER A SERIOUS SPINAL OR BRAIN INJURY A life changing injury is something we all hope we will never experience, but if the worst should happen its important to know what support is available to help with the road to recovery.


t Simpson Millar, we understand the devastating impact that an injury can have, not only on you, but also on your family.

It can affect you physically, mentally and financially. It can prevent you from going to work, or caring for your children or loved ones. Our expert lawyers know that the road to recovery is more than just a claim for compensation. That’s why we have a Major Trauma Unit who work with our clients to help them understand the law and how it can support and protect them after their injury. Rehab can feel like a daily challenge and requires much determination and motivation. But with the right support and understanding from loved ones, progress is possible.

A TAILORED APPROACH TO YOUR RECOVERY Your injury can impact on every area of your life. We know you will need rehabilitation and support and have immediate concerns about the impact of your injury on your finances, work, family and children, or if it’s a child that’s affected, their education needs. Longer term there will be your future care needs and financial planning. There’s no one-size-fits-all approach. The aim of our Major Trauma Unit is to connect the dots for you after a catastrophic injury and take the burden away from you allowing you to focus on recovery. Our solicitors specialising in serious brain and spinal injury claims, employment law, the court of protection, family and children law, wills, trusts and education form one service opening up the law, supporting and protecting you after a major trauma.

HOW THIS HAS HELPED OUR CLIENTS Our Personal Injury team secured £18 million for a 17-year-old who suffered a traumatic brain injury after being hit by a car. He was left with a profound level of disability, is unable to walk and requiring lifelong care. Our Court of Protection team continues to work closely with the family to put in place the long term care the client will need for the rest of their life. This involved putting in place and managing a care team. They are also purchasing and adapting a property suitable to the client’s needs and have appointed a financial advisor to invest the remaining


202 2 /23

compensation, working with the family to create a future budget to make sure the award will last for the rest of their life. In another case, our Employment Lawyers were able to help with negotiating a better financial package for a client who had issues at work following a spinal cord injury. The client was off work due to sickness as a result of their accident, but wanted to return to work. Their employer would not facilitate much needed adjustments to the client’s role and instead wanted to end their employment and pay compensation for ending the employment. WHATEVER YOU MAY BE FACING, OUR MAJOR TRAUMA UNIT ARE THERE TO GUIDE AND SUPPORT YOU EVERY STEP OF THE WAY.

0808 239 1189

Opening up the law for you

SIMPSON MILLAR The open lawyers

When people suffer serious brain and spinal injuries, they need specialist support. That’s why we’re here. At Simpson Millar, our Major Trauma Unit work together to provide you with a team of legal experts.

We are experienced Brain and Spinal Injury Solicitors who specialise in high value claims on a No Win, No Fee basis and we build our service around your needs, offering services including:

▶ Deputyships & Personal Injury Trusts ▶ Conveyancing ▶ Employment

▶ Family Law & Divorce ▶ Education Law including EHCP reviews

Meet the team:

Melanie Varey Head of Court of Protection

Melanie Burden Head of Serious Injury Employer’s Liability

Imogen Jolley Director of Public Law

0808 239 1189

Anita North Head of Employment

Christopher Johnson Director of Private Practice

Authorised and Regulated by the Solicitors Regulation Authority. Registration No. 424940.


After the Event Insurance – MORE THAN A PROMISE


fter the Event (ATE) insurance is unique. For all insurance customers, the moment it really matters is when they make a claim, but for ATE this is often many years after a policy is taken out. A good ATE product relies on a provider keeping its promise to pay, backed up by proven experience, stability and financial solvency in order to do so.


that’s capable of providing continued protection throughout the life of a claim, no matter how long it may take.

FINDING THE RIGHT ATE INSURER Key considerations: Financial security When it comes to assessing financial security, solicitors and claimants need to understand who the ultimate insurer is for any ATE policy. Fortunately, there are some easy questions to ask: -

Injuries can be life changing. Pursuing an injury claim not only involves solicitor fees, but also costs to instruct appropriate specialists, like medical experts, to provide evidence reports. Other experts may also need to be called upon, for example who’s the insurer responsible for paying claims? accountants where loss of earnings is considered as part of (This may differ from who a policyholder thinks a claim. they’re contracting with) The costs of these reports, even for minor claims can run are they UK registered and regulated by the into thousands of pounds, and for complex injuries, more Financial Conduct Authority? than one medical expert may be required. These costs fall is the insurer a recognised name with proven to a claimant to bear. If a legal case is successful, usually the experience and longevity in providing ATE costs will be recovered. But should the case be unsuccessful or discontinued due to the likelihood of a settlement no insurance? longer being viable, a claimant must pay them despite not recovering any compensation. This can be a huge financial burden. Expertise ATE policies protect a claimant Claimants put their trust in the ATE policies protect a against the costs of expert and solicitor representing them. A court fees (disbursements) if claimant against the costs of solicitor must have confidence a legal case is unsuccessful or that an ATE provider will deliver expert and court fees discontinued. The premium for their customer and meet payable by a claimant is (disbursements) if a legal case is their promise to pay claims. deferred until the end of the Solicitors must challenge unsuccessful or discontinued. case, but is only payable should providers to demonstrate their compensation be recovered. The premium payable by a underwriting expertise and


claimant is deferred until the end of the case, but is only payable should compensation be recovered.

ATE policies are unlike insurance products we’re all familiar with. Car and home insurance policies are valid for a contracted time period. Claims tend to be restricted to losses happening within that time and typically for non-liability claims, they’re settled quickly when they’re for tangible items such as car repairs and losses to personal possessions. ATE is different. Policies are effectively open ended until the legal claim has concluded. That’s where the importance of an insurer’s financial security comes in to play. Insurers need adequate solvency to pay claims when an ATE policy is called upon, often many years after it’s taken out. Solicitors must have confidence in recommending an ATE product to clients


202 2 /23

market credentials so they can establish a relationship built on trust between all parties. ■ Author: James Barclay – Head of Sales & Distribution, Allianz Legal Protection

Tel: 03702 434 340 or Email: Web:

We your client. client. We deliver deliver for for your We about our ourpartnership. partnership. We care care about We Legal Protection. Protection. We are are Allianz Legal

We’re a specialist legal expenses We’re a specialist legal expenses insurer, providing solutions since 1986. insurer, providing solutions since 1986. Behind you for what’s ahead. Behind you for what’s ahead.

      @allianzuklegal @allianzuklegal Allianz Legal Protection Allianz Legal Protection


The hidden victims of Covid-19 AND HOW WE CAN HELP THEM Martin Usher, a Partner at Lime Solicitors specialising in supporting people following serious injury and major trauma, explores how Covid-19 has impacted the support available to people recovering from serious injury and highlights the important of us all coming together to fill the void.


ollowing serious injury, such as traumatic brain injury and spinal cord injury, it is of paramount important that both the injured person and their loved ones have access to medical treatment, rehabilitation, care and support Martin Usher at an early stage to ensure that they make the best possible recovery and to enable them to as far as possible return to independent and fulfilling lives. Many of the services available to people following serious injury have been greatly impacted by the Covid-19 pandemic, like NHS resources that have been understandably redirected to deal with the pandemic, and support from charities, such as Spinal Injuries Association and Child Brain Injury Trust to mention a few, whose funding has invariably been hit by the economic conditions that accompany a pandemic. Now that all restrictions have been lifted and we move our way towards summer it would be easy to assume that everything will quickly return to normality. The development of multiple vaccines in record time and the successful rollout of the same is beyond miraculous, as is the sterling work of all of the NHS staff and volunteers who have helped our society navigate its way through the pandemic. There is however still a long way to go and there are many great challenges that we will need to overcome before we have a society that is even close to resembling what we had prior to the pandemic. Perhaps one of the greatest challenges of all will be returning the NHS to where it was before the pandemic. NHS resources are still heavily focused on tackling the pandemic

1 42

202 2 /23

and, as has been the case throughout the pandemic, these resources have invariably been redirected from elsewhere. By way of example, as at January 2022 the number of people on NHS waiting lists for consultant-led elective care stood at 6.1 million people compared to a figure of 3.31 million people in September 2015. There is no doubt that people who have sustained serious injury, including traumatic brain injury and spinal cord injury, are amongst the people that are waiting for further investigations, operations and therapies. These are the hidden victims of the Covid-19 pandemic. I have spent my whole career supporting people who have sustained serious injury and as such have seen first-hand how detrimental to outcomes that delays in the provision of medical treatment and rehabilitation can be. I have also seen on countless occasions the benefit that early access to appropriate medical treatment and rehabilitation can have and how appropriate care and support going forwards can transform lives in terms of enabling people to lead independent and fulfilling lives following serious injury.

There is no doubt that people who have sustained serious injury, including traumatic brain injury and spinal cord injury, are amongst the people that are waiting for further investigations, operations and therapies.

FINANCIAL & LEGAL It is fair to say that people who are disabled as a consequence of serious injury have been disproportionately impacted by Covid-19 and that even in the absence of the pandemic they were already amongst the most marginalised people in society. This makes it all the more important that support is available for the people that need it the most to bridge the gap whilst the NHS deals with the enormous backlog it is facing. It is the responsibility of all the stakeholders in our society, including private businesses such as insurance companies, who reportedly made enormous savings during the various lockdowns, to do what they can to help to alleviate this crisis and take the burden off the NHS.

It is fair to say that people who are disabled as a consequence of serious injury have been disproportionately impacted by Covid-19 and that even in the absence of the pandemic they were already amongst the most marginalised people in society. Further funding to support people with disability would be most welcome given that this is an area that has been drastically under resourced even prior to the pandemic. Whether such funding will be forthcoming given the present state of the economy and the huge debt the government has had to take on to get the country through the pandemic is another matter. It is welcome that the Department of Health and Social Care last year acknowledged the

problem but the commitment to provide a further £2.4 million of funding to charities to fund projects to help improve disabled people’s physical and mental wellbeing suggests that the extent of the issue has not been fully grasped given that this is a drop in the ocean compared to the level of funding that would be required to make a real material difference. It is inevitable given the Covid-19 pandemic and resulting economic climate that no matter how much extra funding is provided there will still be a shortfall in terms of what is needed to give people the optimum level of support to enable them to lead as independent and fulfilling lives as possible, which of course they should be entitled to do. The key here is to provide support in as joined-up holistic manner as possible. This means all stakeholders working with people who have sustained serious injury coming together. All people involved, from the person allocating the local authority budget, to the disability charity support worker or the lawyer supporting someone who has sustained serious injury, can provide valuable input into the best strategy. I am not suggesting that there is an easy solution to be reached but open and transparent dialogue about how best everyone can work together for the common goal has to be the best place to start.

Contact: Lime Solicitors tel: (0207) 264 4401 email: web:

202 2 /23 1 43


MORR & Co Morr & Co is a Surrey, Hampshire and London based law firm.


ur Personal Injury and Clinical Negligence department work exclusively for Claimants who have suffered catastrophic and life changing injuries, including brain injury, spinal injury, amputations and degloving and complex muscular skeletal injuries.

The Personal Injury and Clinical Negligence team at Morr & Co understand how traumatic and debilitating a life changing injury can be for an injured client and their family. We pride ourselves on taking a rehabilitation focussed approach. This means we pro-actively work within and encourage agreement of The Rehabilitation Code 2015. This protocol encourages parties to a claim to use the Code to identify the needs of any injured client and address the cost of providing for their needs on a private basis. This approach ensures that our clients make the best and quickest recovery. Acting in the best interests of our clients goes beyond just securing reasonable financial compensation. We work with our clients, their families and independent experts, to improve their present and / or long-term health, well-being and lifestyle by facilitating the provision of privately funded treatment and equipment.

We have a strong network of experts who we work alongside to explore and provide bespoke rehabilitation plans such as Medical Experts, Case Managers, Pain Management experts, Prosthetic experts and home adaption and technology experts. Our approach is to deal with cases compassionately and robustly, working to achieve the best all round results for our clients. We also work hard to maximise compensation settlements for our clients and are very confident in our ability to understand the impact that the injuries have on them personally, so we can ensure that we work collaboratively with them and support them to get their life back on track. ■

Tel 020 8971 1020 or email: Web:

We work hard to help get your life back on track. Morr & Co’s personal injury and clinical negligence team will support you through the claims process and help you move positively into your future.

hinking of ve our ovide.

• • • • •

Brain and spinal injury specialists Free initial consultation No win, no fee funding options available Access to rehabilitation treatment Court of protection

Contact our expert team of solicitors on: 0208 971 1055

Offices across London, Surrey & Hampshire

1 46

202 2 /23



“The ‘impressive’ Old Square Chambers is an ‘excellent choice’ In the personal injury market. The set has a longstanding reputation in

for claimants but has recently significantinjury defendant presence.” Legal 500 2020 “The ‘impressive’successfully Old Squareacting Chambers is an ‘excellent choice’ built In thea personal market. The set –has a longstanding reputation in successfully acting for claimants but has recently built a significant defendant presence.” – Legal 500 “Old Square Chambers is well regarded for its expert representation of both claimants and defendants in complex personal injury matters. Areas of particular expertise for the set include catastrophic and fatal accident claims, and its members are often instructed in “Old Square Chambers is well regarded for its expert representation of both claimants and defendants in complex personal injury cases involving injuries sustained in RTAs and workplace accidents.” – Chambers & Partners 2020

matters. Areas of particular expertise for the set include catastrophic and fatal accident claims, and its members are often instructed in cases injuries sustained RTAs workplace accidents.” Chambers & Partners Our clients choose Oldinvolving Square Chambers because ofinour firstand class reputation, because of– our experience and knowledge, and because we listen. We put our clients at the heart of all we do. We will fight tirelessly for your interests and to achieve the best

Our clients choose Old Square Chambers because of our first class reputation, because of our experience and knowledge, and because results. we listen. We put our clients at the heart of all we do. We will fight tirelessly for your interests and to achieve the best results. For more information, please call one of our clerks on 0207 269 0300 or email LONDON

BRISTOL For more information, please call one of our clerks on 0207 269 0300 or email 9 Queen Square

10-11 Bedford Row





9 Queen Square

10-11 Bedford Row

T +44 (0) 117 930 5100

T +44 (0) 20 7269 0300



F +44 (0) 117 927 3478

F +44 (0) 117 927 3478



DX 78229 Bristol 1

DX 1046 Chancery Lane

T +44 (0) 117 930 5100

T +44 (0) 20 7269 0300

F +44 (0) 117 927 3478

F +44 (0) 117 927 3478

DX 78229 Bristol 1

DX 1046 Chancery Lane

Leading EXPERTS Leading EXPERTS A A “ Specialists of clients in allinforms of personal injury.injury. Specialistsacting actingfor fora multitude a multitude of clients all forms of personal

rebuild their lives and cope with these life-changing specialist set with 79 members, including injuries with expert rehabilitation, medical 17 specialist Queen’s Counsel, Old Square Chambers set with 79 members, including to get the compensation our clients and familiescare needand to provides advocacy, advice and drafting of support. Our team’s experience in other associated help rebuild their lives and cope with these life-changing 19 Queen’s Counsel, Old Square Chambers such as medical clinical negligence, the highest quality, at trialadvice and and drafting of injuries expertareas, rehabilitation, care and provides advocacy, Recognised forwith their appellatethe level. Ourquality, exceptional costs work, product liability and highest support. Our team’s experience regulatory clerking team are also recognised experience in high value professional at trial and appellate level. Our in other associated areas,disputes, such allow us to provide a fully and provideclerking friendly and exceptional team are also as clinical negligence, costs work, Recognised for their and complex claims professional comprehensive recognised andsupport. provide friendly product liabilityservice. and professional experience regulatory disputes, allow to We and professional support. has proven expertise, Old Square Chambers at all in high We value put our clients at the heart of all weusdo. Old Square Chambers has provide fully comprehensive levels of seniority, encompassing the full will fight tirelessly for youra interests and to achieve andspectrum complex claims service. proven expertise, at matters. all levels of of personal injury Our members are the best interests. ■ seniority, encompassing We put our clients at the heart of particularly recognisedthe forfull their experience in high all we do. We will fight tirelessly for your interests and to spectrum personalclaims, injury matters. Our members value andofcomplex frequently acting forare particularly recognised for their experience high value achieve the best interests. ■ both claimants and defendants in casesininvolving and complex claims, frequently actingand for traumatic both claimants catastrophic and fatal accidents, For more information, and defendants in cases involving catastrophic and fatal For more information, brain, spinal and life-altering injuries. We service a please call one of our clerks on 0207 269 0300 accidents, and traumatic brain, spinal and life-altering please call one of our clerks on 0207 269 0300 wide range of work across the UK to get the or email injuries. We service a wide range of work across the UK or email compensation our clients and families need to help


202 2 /23 1 47


What are the effects of the care crisis on COMPENSATION CLAIMS? The crisis in the care sector has been the subject of great concern in recent months. The National Care Forum has described it as the “most acute recruitment and retention crisis” in its history. 1


t produced a survey of more than 2,000 social care services, identifying that 74% of providers had reported an increase in staff exits. Staff turnover was estimated to be in the region of 30% at a time of increasing need for care services. Similarly, a report by the charity Skills for Care found that an average of 6.8% of roles in the adult social care sector were vacant in the year 2020/21. This is equivalent to 105,000 jobs being advertised on any given day.2 In relation to pay in other sectors across the country, the Consumer Prices Index rose by 5% in the 12 months to January 2022.3 UK employers expect to award pay rises of 3% in 2022, the highest for at least a decade. Job vacancies have reached record levels.4 The National Living Wage will increase in April 2022 by 6.6%. 5 Looking further into this area, the British Association of Brain Injury Case Managers (BABICM) published its report “Perfect Storm Survey Results” 6 . It makes for sobering but unsurprising reading for those of us working with brain and spinal cord injury survivors. Prompted by reports of increasing difficulty in recruiting and retaining skilled support workers, the crisis appears to be worsening with no clear end in sight. BABICM conducted a survey that would gather objective statistics to go alongside the more anecdotal evidence in this specific sector of the care industry. BABICM wanted, among other things, to highlight to those involved the pay rates for support workers that are now being requested and paid. Of 200 responses, more than 90% had experienced problems with staff recruitment. The reasons for the shortage of support workers included:

1. 2. 3. 4. 5. 6.


Low wages. Increased rates of pay in other sectors. Poor working conditions. Loss of candidates and loss of some existing staff due to Brexit. Impact of the pandemic on the role. Introduction of mandatory vaccinations.

202 2 /23

The report mentions that these factors increase case management costs as well as increasing support worker wages. This is in part because difficulty finding appropriate support workers increases the time case managers need to be engaged in that part of their role. The pressure on wages generally to go up is significant, as outlined earlier, but the other factors mentioned in relation to support workers in this sector only exacerbate these pressures. The respondents in the survey expected increasing difficulty with recruitment because of the factors mentioned above. The recruitment crisis appears to be ongoing, with no end in sight. Wage increases were identified as necessary, an unsurprising conclusion in any industry, but again exacerbated by the other factors that disproportionately affect support worker recruitment. The cost of retaining support workers in the future, after the case has been settled, is often the largest part of a compensation claim for those who have been seriously injured.7 The effect on a claimant if the future care claim is not correct can be catastrophic, as it means they will not have sufficient funds to pay for the care they require for the rest of their lives. This task can become much more difficult in an environment of rapidly accelerating care costs. This crisis is therefore having an ongoing effect on claims for brain and spinal cord injury, which all the professionals involved in these claims need to appreciate and act upon. Future care claims have always taken a great deal of time and effort from all the professionals involved in a claim. As ever with compensation claims, it can be easy to achieve a settlement, but achieving the right figure is difficult.

HOW CAN THESE PROBLEMS BE DEALT WITH IN COMPENSATION CLAIMS? The lawyers running such cases need to think carefully about the benefits of seeking payment of care costs on an annual basis rather than as a lump sum.8 If the care costs are paid on an annual basis, then they will be linked to increases in wages in the sector. However, not every case is suitable for payments on an annual basis; they often do not work in cases involving significant liability disputes as the claimant then receives only

FINANCIAL & LEGAL a relatively low percentage of the money required to pay care costs each year. Further, a lower capital sum provides less flexibility for making use of the compensation. However the care costs are paid, the lawyers need to make strenuous efforts to ensure that the cost of providing care to the injured person is identified as accurately as possible. If the present cost of providing care is inaccurate, the future costs sought will become ever more insufficient as time goes by, leaving the claimant with a larger gap between what they need and what they have available to spend on their care costs. It is therefore vital that the legal team thoroughly investigates the cost of providing the care required. There is never a substitute for putting in place the care regime for the injured person so that the cost of doing so is known rather than guessed at. Unfortunately, this is not possible in every case, as the money for a proper care regime through interim payments might not be available in a case in which liability is strongly contested. When a care regime is put in place, it is all the more important in light of increasing care costs that the case manager thoroughly documents everything they have done to build and maintain the team of support workers. Difficulties in recruiting and retaining staff need to be recorded in the case management notes. There needs to be a particular focus on comments relating to pay in job interviews, which are often not well recorded. Exit interviews recording reasons should be considered as well, again with a focus on the reasons for leaving, particularly with regard to pay. 9 It may be necessary to think about not only the hourly rate for the support workers but also offering a retention bonus. This can be balanced out by the recruitment costs likely to be incurred if a particular member of the support worker team is not retained. Kirstie Donnelly, chief executive of technical skills and education organisation City & Guilds, says: “In the face of a growing labour crisis impacting these vital industries and

wider society, we need to collectively take a long, hard look at how we can make these jobs more attractive. We need to do more than simply clap for carers. We desperately need to re-evaluate the way we as a nation recognise these roles.” While this more general action cannot be implemented, consideration needs to be provided to the role of support workers in individual cases and how the role can be made more attractive, particularly for claimants who experience problems recruiting appropriately. 1

retention-crisis-its-history-not-for-profit-organisations-warn/management/ article/1728476




consumerpriceinflation/january2022#:~:text=current%20inflation%20rates.,The%20Consumer%20Prices%20Index%20(CPI)%20rose%20by%205.5%25%20 in,when%20it%20stood%20at%207.1%25. 4 5 6 7 Publications/consultation+papers/CJC+Costs+of+Care+Best+practice+guide.pdf 8




10 article/1728476 11

Contact Stewarts | tel: 020 7822 8000 web:

202 2 /23 1 49


Release the cash tied up IN YOUR ONGOING CASES Cash flow solutions from the UKs leading legal Funder, including; disbursement funding, cost advance, high-cost case funding. unknowns and worries it allows lawyers to do a great job for their clients.

Disbursement Funding Facility (DCF) Can be used to fund disbursements and issue fees on an individual file basis including releasing cash tied up in disbursements already incurred releasing up 100% of the external disbursements incurred on each case. We can release cash on dibs already purchased Costs Advance Funding (CAF) This is our most popular product and comparable to invoice discounting and can be used when a law firm has won a case and the bill of costs has been served. VFS will advance funds against the settlement of the expected costs. This enables the firm to negotiate the right settlement and not accept a lower offer just to get the case settled. High Costs Case Funding (HCF) For higher-value cases where there is an admission of liability, VFS can release part of the WIP and disbursements to date. This aids cashflow and is The uncertainty that repaid upon the natural conclusion of the case. surrounds the funding required VFS takes care of the for such complex cases often funding and cash flow leaves firms in a difficult enabling the law firm to do what it does best position when forecasting cash and focus on the case required to run a case or how and achieving the right they compensate for the cases outcome. ■


egal Clinical Negligence caseloads present challenges for law firms. Expensive disbursements, lengthy settlement times, salaries and overheads present challenges even for the best funded Law firms. Cash flow is the life blood of any firm and VFS have been that lose. the trusted partner of many Clinical Negligence firms for the past 10 years. By proving simple competitive cashflow solutions we increase your financial muscle. We recognise that not every firm have the same requirements and provide tailored made solutions for every firm regardless of size.

FLEXIBLE FUNDING SOLUTIONS ALIGNED TO A CLINICAL NEGLIGENCE FIRM’S CASH FLOW There is a lot of uncertainty and unknowns in running complex brain injury cases. By removing the financial


202 2 /23

To find out more about how we can assist or for an informal chat telephone 0203 747 9333 or email

Life after traumatic injury can be challenging Blesma is here for all serving and ex-Service men and women who have experienced loss of limb, use of limbs, hearing, sight or speech, either during or after Service

Get in touch to find out how we can support you and your family


I am his deputy so why is the Official Solicitor ACTING AS HIS LITIGATION FRIEND? The Official Solicitor’s office recently issued new guidance about when they will act as litigation friend in personal welfare and/or financial proceedings before the Court of Protection. H ere’s an example of when the Official Solicitor “OS” can be involved.

A WILL FOR JOHN John had an accident and suffered a brain injury. He lacks capacity to manage his financial affairs and to Jane Netting sign his own Will. Wrigleys act as deputy for John and think it would be in his best interests for a Will to be put in place for him. John is a widower with three children, but he has been estranged from one of them for many years. Under the rules of intestacy his estate would be divided equally between them, and this doesn’t feel right. Wrigleys apply to the Court of Protection for the authority to sign a Will for John and we call this a Statutory Will application. In the first order the Court invites OS to act as litigation friend for John and orders Wrigleys to serve them with a copy of the application.

WHY? The Court has the duty to consider whether John can participate in the proceedings and if he should be a party. John lacks the capacity to represent himself so a litigation friend must be appointed. In property and affairs proceedings, this is usually the OS.

HOW? The OS is invited to act as the litigation friend for John and, subject to their agreement, will be appointed by the Court.


The OS must be satisfied that John’s costs can be met, and this is usually fulfilled by the OS determining:

Evidence of adequate liquid funds owned by John; or A professional undertaking in a satisfactory form and of adequate value; or A payment on account.


The OS should not accept an invitation where costs are likely to become disproportionate and/or it would not be in John’s best interests to incur those costs.

The OS has agreed to act as John’s litigation friend, what next? Wrigleys will be informed which solicitor at OS is dealing with the matter. OS act as litigation friend and their role is to represent John and ensure his Will is in his best interests.

John’s health deteriorates, can the case be marked as urgent? Yes. Wrigleys inform the OS of the urgency and provide medical evidence that John’s life expectancy is limited. Although the terms of a Will can be urgently agreed and approved by the Court, this may mean that the OS cannot undertake all usual enquiries. The Will could be vulnerable to challenge after John’s death.

Costs The starting point is to presume that Wrigleys and OS’s costs will be paid from John’s funds. These costs are reviewed by an independent person to determine what is reasonable. ■

WILL THE OS ALWAYS ACT LITIGATION FRIEND? Before the OS can consent to act as John’s litigation friend, the following criteria must be met

1. 1 52

Evidence or reason to believe that John lacks capacity to represent himself.

202 2 /23

Tel: 0114 267 5621 or Email: Web:

Court of Protection Specialist Solicitors We have extensive experience of working with injured or disabled people with matters concerning the Court of Protection. We are uniquely placed to assist you in this specialist area as we are not part of a litigation firm and are independent.

Why Wrigleys? •

We are well known and respected nationally in this area of expertise and work with you to achieve the best outcomes for you.

We have experience in driving negotiations with the CICA meaning we are often able to redraft clauses of the trust deed with your interests in mind.

Our team of specialists deal with various matters that arise following catastrophic injury, such as: • Court of Protection applications • professional deputyship • professional trustee • property purchases and adaptations • issues concerning community care • statutory wills and liaison with the CICA • direct employment •

We have one of the largest trust and Court of Protection administration teams of any national law firm; this team includes tax specialists, trust specialists and legal experts

We believe a strong, long-standing professional working relationship is key and we pride ourselves in that we care. We build relationships that last a lifetime.



On site registered medical officer Specialist physiotherapy, plus the option to provide comprehensive exoskeleton trials Occupational therapy, plus an adaptive kitchen for assessing ADL’s skills & training Seating & posture clinic Splinting clinic Aquatic therapy Music therapy Speech & language therapy Psychology Dietician Wheelchair skills & confidence building Holistic therapies that include acupuncture and cupping Integrated specialist medical, therapy and nursing care team Wellbeing coordinator Intensive patient therapy programmes up to 25 hours per week Family support group therapy

Please do get in touch to discuss what outcomes and goals can be offered by our specialist nursing and therapy teams. 01296 678 800

sroticiloS tsilaicepS noitcetorP fo truoC


srettam suoirav htiw laed stsilaiceps fo maet ruO :sa hcus ,yrujni cihportsatac gniwollof esira taht snotiacilppa noticetorP fo truoC • pihsytuped lanoisseforp • eetsurt lanoisseforp • snotiatpada dna sesahcrup ytreporp • erac ytinummoc gninrecnoc seussi • ACIC eht htiw nosiail dna slliw yrotutats • Community Case Management Services is a tnemyoLtd lpm e specialist tcerid • provider of case management for the rehabilitation of severely injured adults and children throughout the UK and Worldwide. We provide quality-of-life solutions for truoC dna tsurt tsegral eht fo eno evah eW catastrophic, complex and life-changing injuries such as yna fo smacord et noinjury tiartsor inloss imdof a nlimb. oticeWe torensure P fo brain injury, spinal that the highest isaprovided xat sedlevel ulcnand i maquality et sihtof;mcare rfi w l lanotiaand n tailored to individual needs.

strepxe lagel dna stsilaiceps tsurt ,stsilaiceps

Our dedicated and experienced Associate Case Managers have varying clinical backgrounds which we match to nidnaclosely ts-gnowith l ,gntreating orts a eprofessionals veileb eW our clients. Wegwork and the teams, dnawell yektrained si pihscare notiand alersupport gnikrow lanoito sseachieve forp positive and measurable outcomes.

dliub eW .erac ew taht ni sevlesruo edirp ew

We are proudly known to go above and beyond to .emtiefil a tsal taht spihsnotialer provide opportunities, therapeutic holidays and retreats for our clients. These activities assist re-engagement and gives our clients the opportunity to live their lives to the full.

htiw gnikrow fo ecneirepxe evisnetxe evah eW gninrecnoc srettam htiw elpoep delbasid ro derujni .noticetorP fo truoC eht siht ni uoy tsissa ot decalp yleuqinu era eW mrfi notiagtiil a fo trap ton era ew sa aera tsilaiceps .tnednepedni era dna SPECIALISTS IN NURSING, REHABILITATION & NEUROLOGICAL CARE

?syelgirW yhW

yllanotian detcepser dna nwonk llew era eW ot uoy htiw krow dna estirepxe fo aera siht ni .uoy rof semoctuo tseb eht eveihca

snotiatiogen gnivird ni ecneirepxe evah eW ot elba nefto era ew gninaem ACIC eht htiw ruoy htiw deed tsurt eht fo sesualc ftarder WWW.CHASEPARK.CO.UK .dnim ni stseretni

For referrals please contact 0191 691 2568


202 2 /23


For over 20 years TBL have provided Case Management, Rehabilitation and Specialist Clinical Services for both adults and children. We offer a nationwide service with our consultant clinicians and case managers located across the country (including Scotland), all of whom are highly experienced with considerable skills to work alongside clients with complex cognitive, physical, emotional and behavioural needs.


Trainer Module Introducing the world’s only patient ceiling lift with Dynamic Body Weight Support

For more information visit us at, email us or call us 01257 473967.

Seeing is believing – contact us for a demonstration Email:

JJ&A is an independent expert witness reporting company, we provide our clients with a first-rate personal and professional service. Our reports are highly regarded within the areas of clinical negligence and personal injury.


Patients from the age of 18+ We offer both inpatient and outpatient services Spinal cord injury Acquired or traumatic brain injury Polytrauma Stroke Amputee rehabilitation Other medical conditions such as: Parkinson’s, Multiple Sclerosis, Guillain-Barré Syndrome, Cerebral Palsy, Meningitis, Impaired Consciousness, MND, Muscular Dystrophy, Muscular Atrophy Those who may remain medically complex & requiring specialised nursing intervention e.g, bowel and bladder management, skin management and nutritional support Tracheostomy or ventilated patients Post serious illness recovery and rehabilitation Post surgical recovery and rehabilitation

How to refer a patient to us for both inpatient and outpatient services.


Call or email Reception and ask to speak to:

Or, contact directly: Tracy Takaitei

Admissions & Discharge Co-ordinator

Admissions & Discharge Co-ordinator

01296 678 800

07702 496 459 #jointhejourney

202 2 /23 1 55

PERSONAL PROFILES At Simpson Millar, our Major Trauma Unit work together as a team of legal experts to build a service around our client’s needs.

Our specialist support includes: ▶ Personal Injury Brain & spinal injury specialists

▶ Education Law including EHCP reviews

▶ Family Law & Divorce

▶ Conveyancing

▶ Deputyships

▶ Employment

Frenkel Topping are expert financial advisers, and we help solicitors, barristers, and professional deputies achieve life-changing results for clients involved in litigation over personal injury and clinical negligence. From expert witness reports to lifelong financial planning pre, at, and post-settlement, we are involved at every stage of planning for your clients’ futures, and we always have their best interests at heart. Enquiries:

0808 239 1189

0161 886 8000

Web: Frenkel Topping Limited is authorised and regulated by the Financial Conduct Authority No: 145186. Registered in England No: 02312427.

Maximising independence and a better future for our clients through personalised rehabilitation programmes and compassion for clients and their families.

Expert clinical rehabilitation case managers specialising in traumatic injury and unrivalled clinical governance.

Rehabilitation and case management solutions nationwide.

Rehabilitation and case management solutions nationwide.

Make a referral

Make a referral

020 8649 5759

020 8649 5759

MCS Case Management Ireland We are a team of Community Physiotherapists and Occupational Therapists. Led by Susan Pattison, we specialise in Acquired Brain Injury, Spinal Cord Injury and other Complex Injuries in local regions such as Greater Manchester/Lancashire, Cheshire, and South and West Yorkshire. +44 (0) 161 764 3799 @SPTherapySvcs @SPTherapySvcs

1 56

202 2 /23

Siobhan McSweeney RGN, RM. Case Manager Nursing Consultant We have established an excellent reputation for successfully helping our clients with acquired brain injuries, cerebral palsy and spinal injuries. T: M: E: W:

+353 1 493 6948 +353 86 166 4318



Norman Kenvyn Founder & CEO

VFS can provide immediate funding against your issued bill of costs or when you have a case with admitted liability. +44 (0) 20 3747 9333 +44 (0) 7748 963 965


To advertise, please call 01959 543 650

RELEASING CA Veronika Thompson BSc Hons Occupational Therapy

Zoe Cocksedge DipCOT Occupational Therapy



Specialising in complex disability, multi-pathology, neurological, palliative conditions, trauma and manual handling.

Specialising in brain injury and complex case management with young people and adults.

t: 01752 466173 e:

t: 01752 466173 e:

Victoria Baker BSc Hons Occupational Therapy

Fiona Wylie BSc Hons Occupational Therapy



Generalist with specialist skills in complex disability.

Moving and Handling Specialist. Works with children and adults who have complex neurological conditions.

t: 01752 466173 e:

t: 01752 466173 e:

202 2 /23 1 57


Brain & Spinal Injury CONTACT INFORMATION Support groups, charities and other useful contacts and organisations across the UK. Vocational Rehabilitation Association UK

The VRA represents all those involved in delivering vocational rehabilitation services. A number of professional groups are involved from both health (NHS and private) and other government agencies e.g. the Department for Work and Pensions.

Brain Injury Rehabilitation Trust (BIRT)

BIRT is a division of The Disabilities Trust, a leading charity that provides services to people with physical and learning disabilities, autism and brain injury. The Brain Injury Rehabilitation Trust (BIRT) aims to provide the best quality neurobehavioural rehabilitation for people with complex and challenging needs after brain injury.

Brain Injury Hub

Online support centre for the families of children affected by acquired brain injury created by The Children’s Trust.

Brain & Spine Foundation

Provides support and quality information to people affected by brain and spine conditions, in order to reduce anxiety and help inform their choices. A free helpline is staffed by neuroscience nurses to answer questions about all neurological conditions and offer information and support on any medical and emotional issues. Helpline Number 0808 808 1000

Carers UK

An excellent source of information, advice and support, this charity is at the forefront of campaigning for carers.

The Children’s Trust

A national charity, The Children’s Trust provides care, education, therapy and rehabilitation to children with acquired brain injury, multiple disabilities and complex health needs. It runs the UK’s largest paediatric brain injury rehabilitation centre at Tadworth (Surrey), and services include nationwide support in the community for children and young people with acquired brain injury.

Child Brain Injury Trust (CBIT)

A leading charity providing non-medical services and support, including a telephone helpline, for families. CBIT also provides training for health and social care professionals working with families. Helpline Number 0303 303 2248.


A national brain injury charity that promotes understanding of all aspects of brain injury and provides information, support and services to brain injured people, their families and carers. Headway also operates a regional network of branches and support groups.

The United Kingdom Acquired Brain Injury Forum (UKABIF)

The United Kingdom Acquired Brain Injury Forum (UKABIF) is a membership organisation and charity which aims to promote the understanding of all aspects of acquired brain injury. There are also regional groups throughout the UK, and UKABIF works with these groups to set common aims, encourage sharing of information and practice and co-ordinate group work.

Spinal Injuries Association (SIA)

Brain & Spinal Injury 158

202 2 /23

Spinal Injuries Association (SIA) are a charity that provides information and support to spinal cord injured people, their families and health care professionals.


Association of Personal

Injury Lawyers (APIL) Association of Personal Injury Lawyers (APIL) is an independent, not for profit organisation providing accreditation to lawyers specialising in the area of personal injury law. Website includes a directory of accredited solicitors.

British Association of Brain Injury Case Managers (BABICM)

British Association of Brain Injury Case Managers (BABICM) is a professional association that was established in 1996 to promote the development of case management in the field of acquired brain injury.

Law Society

Law Society is the professional association that represents and governs solicitors for the jurisdiction of England and Wales. It provides services and support to practising and training solicitors, as well as serving as a sounding board for law reform.

The Case Management Society UK (CMSUK)

The Backup Trust

The Backup Trust provides support services for people of all ages with spinal cord injury. Services include wheelchair skills training, activity courses, mentoring and support to get back to work or school after an injury.


Aspire works with people with a spinal cord injury to create opportunity, choice and independence. They aim to support people to lead a fulfilled and independent life from the moment of their injury throughout their life. They are also committed to research in the field of technology to find cost effective solutions to improve the quality of disabled people’s lives.

The Case Management Society UK (CMSUK) is a non-profit association of Case Managers, committed to the delivery of quality case management through standards of best practice while promoting the individual and collective development of case management throughout the United Kingdom.

The Neurological Alliance

The Neurological Alliance is a wide range of neurological charities which have come together to make life better for people in the UK with a neurological condition. Their aim is to raise awareness of neurological conditions and their impact; inform and influence policy makers about the needs of people with neurological conditions; secure the highest standards of service and improved care for people with neurological conditions; promote research and the dissemination of information about neurological conditions.

202 2 /23 1 59


Tyler was diagnosed with a brain tumour at the age of eight. Following surgery, chemotherapy B&SI HANDBOOK and radiotherapy, Tyler was doing well and had returned to school.


As Tyler transitioned to secondary school, her difficulties with memory, fatigue, concentration, and balance became more apparent. She felt increasingly isolated and was quickly losing confidence.

to all our contributors

The Children’s Trust online awareness course helps to ensure teachers know what to look out for, and what assistance children might need in class to help them to continue to develop and learn.

coming months for teaching professionals who are interested in taking their learning to a more advanced level. The Children’s Trust aims to provide teachers with easily accessible resources so they feel confident in supporting a child who may be returning to school after acquiring a brain injury.

y schools and want to find reness programme? Trust via email:

support children with brain injury.


Disclaimer: Brain & Spinal Injury Handbook is published annually (once per annum) by Seven Star Media Ltd. No part of Brain & Spinal Injury Handbook may be reproduced, stored in a retrieval system or transmitted to any form without permission. Views expressed in the publication are not necessarily those of Seven Star Media Ltd, and are included to provide advice only. No content is a substitute for professional medical advice. During printing, images may be subject to a 15% variation. © Copyright of content belongs to individual contributors with the publication copyright belonging to Seven Star Media Ltd. All rights reserved. Please either keep this magazine for future reference, pass it on for somebody else to read, or recycle it.


202 2 /23


Navigator is a free patient support service delivered by Fittleworth that has been created for people living with a spinal cord injury. It is designed to help you find your way by providing useful information as well as connecting you with a personal expert to help with specific needs. When you join the Navigator service, you receive:Your own personal navigator managing your prescriptions and giving you expert support and advice on living with a spinal cord injury Your continence supplies delivered to your door each month from Fittleworth Online ordering and Live Chat facilities to make requesting your products simple Access to our online portal of blogs and advice from experts on living with a spinal cord injury

A free support service for everyone living with a spinal cord injury

We look after more than 800 people living with a spinal cord injury and joining is completely hassle free. Let us know a few details and we will manage the rest & ensure you have everything you need when it is required.

Ring your Navigator hotline to join today on 0800 373 858 Contact the Navigator team via email at

Respect & Restore Specialist residential care and rehabilitation for adults with acquired brain injuries. • Portfolio of services to meet a variety of needs • Innovative person-centred care • Unique ‘family’ environment • Focus on social integration • 30-year proven track record Proud to be an independent family business.

Call us on 01604 791071 to find out more or email The Richardson Mews, Kingsland Gardens, Northampton NN2 7PW

202 2 /23 1 61

Your client can travel safely in their wheelchair Wheelchair Accessible Vehicle Hire K

m 0808 258 3252

Wide range of vehicles depending on your clients’ needs Short or long-term hire available Receive expert advice and support from our mobility advisors

Allied Mobility can help you find the best specialist driving solution for your client.



*iLevel Optional

Release the cash tied up in your high value clinical negligence cases Disbursement Funding ALL third party costs incurred in running the case as covered by your ATE.

High Cost Case Funding When the case reaches a stage where liability has been admitted but there is still much more work to do to finalise, VFS can release the WIP incurred to that point.

Cost Advance You have won the case and the draft bill issued, VFS can release the cash tied up in the bill.

Simple, Innovative and Proven VFS provides an effective funding solution for these long tail cases.

To find out more visit or for an informal chat telephone 020 3747 9333 or email VFS Legal funding is a trading name of VFS Legal Ltd, Kingfisher House, 21-23 Elmfield Rd, Bromley, Kent, BR1 1LT