Inpatient
Meeting the growing demand for specialist care services
With the numbers of people living with complex disabilities and dual diagnoses rising, the pressure on care homes to deliver appropriate care is growing significantly.
To help meet this demand, and ensure people receive the specialist nursing care they need, Exemplar Health Care is embarking on a programme of expansion to bring significant new resource across England. NR Times learns more.
With significant and mounting pressure on NHS wards as the peak winter months arrive, many much-needed hospital beds are often taken up by people who have recovered from the reason they needed urgent medical intervention, but who continue to need ongoing care.
For many people with complex needs, they are not able to be discharged to live independently - but neither do they need to occupy a hospital bed, a resource already at a huge premium in an under-pressure health service.
The lack of provision nationally in this area is a significant problem - and one which can see people remain in acute environments for far longer than they need to be, due to a shortage of places in specialist care homes which can meet their needs.
And this huge demand on resources is set to grow in years ahead - statistics show that in 2020/21, there were more than 1.9million requests for adult social care, particularly among those of working age. Furthermore, Council for Disabled Children research shows there are growing numbers of children with complex needs, who will go on to need adult services in future years.
Meeting the need
This rocketing demand has been a key factor in the significant and ongoing growth of Exemplar Health Care. The specialist care provider, known for its capability in supporting those with high-acuity complex needs and behaviours of concern, is aiming to open ten care homes during 2023 across England, to help increase provision for those for whom resource is scarce.
The ten planned for next year follow two recent openings - Cheshire Springs in Ellesmere Port and Edgewater in Wallasey - which are helping to bring additional provision in their local areas to ease pressure on NHS resource.
All of the new homes will follow the format of Exemplar Health Care’s current portfolio of homes, which pride themselves on their person-centred approach to care and high staffing levels - with an average of one nurse for every six health care assistants on each small unit.
The first new homes of 2023 are set to be unveiled in spring, with the openings of Roseside in Liverpool, Woolston House in Warrington and Tees Grange in Stockton.
“Finding the right environment for someone after leaving a hospital setting is an ongoing problem, and particularly for someone with complex care and health needs,” says Rachel Calladine, business development director at Exemplar Health Care.
“There is a lack of suitable care homes which have the expertise to provide this type of care, and within the care homes that do exist, there are very few beds available.
“This problem exists all year round, but particularly as we saw during the COVID-19 pandemic, and then the annual winter pressures, it is very much heightened at this time of year.
“The pressure on the NHS and social care is very significant at present, and combined with the recruitment challenges and impending nurses’ strike, the pressures on the system show no signs of relenting.
“Looking into the future, this is only going to increase - the number of people living with more complex health issues is increasing, and we have an ageing population and growing numbers of people with dual diagnoses. The need for complex care is only going to increase.
“And that is why services like ours, which provide very specialist nursing care for people with complex needs, are so vital. Not only can we help to relieve some of the pressure on NHS frontline resources, but we can ensure that people are being discharged into the right environment for them, which is crucial in avoiding the distress of a failed placement.”
Overcoming the challenges in finding a placement
Increasingly often, in the desire to discharge those from NHS settings, people can be discharged into environments which are not entirely appropriate for the complexity of their needs - leading to problems further down the line and, in many instances, a failed placement.
Cost pressures can be an issue for commissioners and can prove a barrier in some cases, says Rachel, but placing someone in the right placement, that meets their complex needs, the first time round, is critical to breaking the cycle of failed placements, that often leads to their needs being exacerbated.
For Exemplar Health Care, their track record in supporting people who have experienced one or more previous failed placements is particularly strong. Over 60 per cent of their service users come to their homes following a failed placement.
“It’s hugely important that people receive the right level of care and support for their needs. Where possible, we’re committed to ensuring that people receive this care close to home and their loved ones, in the communities they’ve always lived in,” says Rachel.
“Understandably, at the times, this is difficult, which increases our commitment to providing specialist nursing care in more locations across England.”
New provision to help relieve mounting pressure
The new openings - a combination of purpose-built developments and extensive refurbishments of existing sites - see Exemplar Health Care strengthening presence in existing counties like Yorkshire and Merseyside, while establishing presence in new areas across the North including Sunderland, Leicester and Telford.
“It’s very much demand-led, and in several of the areas, we are answering specific demand that we know exists in that area after speaking with local commissioners,” says Rachel.
“We are building new homes in response to that, and our refurbishments are so extensive they are fully refurbishing the
entire building to ensure they are totally fit-for-purpose, so we’ve remodelled the interiors to make sure that the bedrooms
are big enough for people with ventilators or use large wheelchairs, or those who might need the rails on the ceiling for bariatric care.
“We have specialist nursing capability which means we’re able to provide support for people living with very complex care and health needs. This includes those with conditions such as
brain injuries, dementia, neurological conditions and spinal injuries.
“Often, the care we provide would otherwise only take place in hospital, such as tracheostomy and respiratory care, and these are done in the homes by our in-house teams, it isn’t done by community resource.
“In addition, we are creating more bespoke environments to care for people with complex behaviours of concern.
“We are able to provide them with the appropriate environment and support that ensures wherever possible, there is not a
revolving door scenario back into secure settings.
“Our schedule for opening is continuing during 2023 and 2024, but we realise the level of demand and need for us to help meet this, and it’s very exciting that we can play our role in delivering the high quality, specialist care that is needed to help give people a better quality of life while also relieving pressure on the frontline.”
Richardson Care
Restructures to Provide Seamless Care Pathway
Richardson Care has restructured its specialist services for adults with acquired brain injury or learning disabilities and complex needs to provide a seamless and flexible care pathway.
The Northampton-based care provider has six residential care homes and a long proven track record of delivering successful outcomes for service users. It remains an independent family business and Director Laura Richardson-Cheater explained the reasons for the restructure: “We have always placed the service user at the centre of their care and the business has evolved to deliver different types of rehabilitation and therapy. We realised that by making some small changes, we could redefine our services to make them clearer for commissioners and take the business forward to a higher level of excellence.
“With six residential care homes, we have the flexibility to provide a seamless rehabilitation pathway. This enables the individual to progress within the supportive environment of the Richardson Care family.”
The services are:
1. ABI assessment & complex diagnosis unit, The Coach House
2. ABI rehabilitation & transitional service, The Richardson Mews
3. Long-term community neuro-rehabilitation service for men, 144 Boughton Green Road
4. Transitional & long-term LD & complex needs service, 23 Duston Road
5. Long-term community LD & complex needs service, 2 & 8 Kingsthorpe Grove
Laura continues: “Our admissions policy has always been to place an individual in the home that is most appropriate –
both for their needs and the needs of the existing residents. This restructure has formalised that process while retaining flexibility.
“We have over 30 years of experience in supporting people with acquired brain injury and complex needs and have found that they need an initial period of stability before we can fully assess their needs. The Coach House is the ideal environment for this because it is self-contained and secure. After this period the individual may stay in the Coach House or move to our transitional or long-term community rehabilitation services. We are also planning to provide high-input supported living accommodation for people with acquired brain injury or learning disabilities.”
Richardson Care combines a unique homely environment with a therapeutic regime devised by an experienced multi-disciplinary team of therapists. The focus on community is clear in
all of the homes where a wide range of activities are on offer. This supportive environment contributes to engagement in therapies with the ultimate goal of service users being able to live a happy and fulfilling life.
For more information call 01604 791266 or
visit www.richardsoncares.co.uk
What does it take to deliver a successful neuro conference?
In 2019, the team at Elysium Neurological decided we were at a point where we would like to host a national conference to explore some themes linked to the services and pathways we provide and to network with professionals in the field of brain injury and neurological conditions.
The conference finally came to fruition in November 2022 and was a great success with excellent feedback. We have taken some time to look back and reflect on what we did that made the event work so well.
Firstly we needed to decide if we were going to organise the conference ourselves. We have a talented marketing team who organise internal conferences and events to a very high standard but we felt this event needed to be developed in partnership with a specialised conference organiser.
We have been attending successful ABI Solutions conferences and events for years and I had previously been involved with sponsorship for the Head First conference which had opened my eyes to the possibilities of the conference scene.
We approached Jason and Helen at ABI Solutions to ask if they would be prepared to work with us on our first national conference and they agreed, with some conditions….
They were very clear that there are certain things that they insist on in order to partner for an event of this type. The main things we discussed right at the beginning were music to my ears and we found an immediate synergy with our organisational values, drive and intentions.
The first things Jason and Helen said were:
1. Content is the most important thing, linked to meaningful learning outcomes. Delegates want to go away from a conference or CPD event with new ideas that positively impact on their own practice or that they can use in reflective practice.
2. Expert speakers are a must – people who have something new and interesting to share that promotes discussion and debate.
3. Attention to detail and a drive to deliver an excellent overall conference experience for the delegates makes the process more enjoyable and ensures people go away feeling that they have been valued as a delegate.
So, we chose a venue that we had used before, 1 Great George Street. It is a beautiful setting for a conference and makes people feel great as soon as they arrive. The lobby and entrance to the hotel are stunning and the conference theatre is well laid out with good acoustics to allow delegates to relax and easily engage with the content.
ABI Solutions have an extensive database of neuro specific contacts to offer the conference to and they also approached a range of exhibitors to come along and provide great networking opportunities for the delegates.
Irwin Mitchell agreed to sponsor the day. They were approached as we felt that they have similar values and aspirations to Elysium in relation to education and learning and we were delighted that they agreed.
We set about thinking about the content for the day and felt that it was important for the day to reflect the different service pathways Elysium Neurological offer across the country.
However, these service pathways can be quite diverse and specialised (from neurobehavioural to supporting people with complex physical needs such as tracheostomy and ventilation) so we needed to find a golden thread to ensure the day made sense, had a good flow and that there was a relevance for everyone in the audience to connect with.
We decided that whatever the pathway, our specialised services all support people who face significant challenges, so we plumped for an overarching theme for the day of; “Rising to the Challenge”. To describe more about what people might expect, we added the description, “Managing the diverse challenges in the field of brain injury”.
This conference was not about Elysium Neurological promoting our range of services. It was intended to be a learning platform for people to share, debate, discuss and reflect on different elements of challenge in neurological services. We did have some content from expert clinicians who work with Elysium to start us off, so we had early discussions to explore possible themes.
We had some other expert speakers in mind who we had seen deliver excellent sessions in previous conferences that we felt would fit well with our core content so ABI Solutions contacted people to discuss the possibility they might present on the day.
This process was blown off course a number of times in the intervening years due to covid restrictions as we were unable to run the face-to-face event. We stayed in touch and whilst there were a couple of tweaks to the conference programme in the end as we had to ensure we were still fresh, current and relevant to the audience, much of the original programme survived.
ABI Solutions handled all the technical and organisational areas of the conference. They have been doing this for years and they have a very slick and effective method for bringing high quality neuro conferences to life. Their attention to detail was second to none and we knew that they would have thought of everything, right down to making sure that the speakers were able to travel to the conference with ease on the day and looking after individual dietary requirements.
We had a dinner the evening before the conference with the speakers so that people who had not met before could be introduced and feel more at ease. People discussed their presentations during the meal which resulted in the discovery of similar points or themes. This enabled people to refer to each other’s content when they spoke which gave a more seamless feel to the day.
On the day we had around 300 delegates arrive at 1 Great George Street. The lovely ABI Solutions team were set up at the front of house and registered the delegates, handing them their delegate bag containing everything they would need for the day.
There was time to have a coffee and network with each other as well as interacting with the exhibitors before the first session.
The day was jointly managed and hosted by Elysium and ABI Solutions and it is this genuine partnership working that was at the heart of making the conference a real success.
As the delegates gathered before the first session, there was a palpable optimistic energy in the room and many people commented what a relaxed and positive vibe they felt. This continued throughout the day with much smiling, laughter and genuinely interested dialogue between people.
We opened with a welcome from the conference sponsor Sarah Griggs, Partner, Irwin Mitchell and the conference was introduced by Professor Quazi Haque, Executive Medical Director, Elysium Healthcare & President of IAFMHS who reiterated the importance of CPD and learning and networking. Paul Mooney, Clinical Director Elysium Neurological chaired the day with a relaxed style making people feel comfortable and getting the most from questions that were posed by the audience using Slido, an interactive app to support audience interaction.
The printed conference programme informed people not only of the order of the day, speakers details and content but of useful information such as wi-fi facilities, the conference hashtag (to share their experiences of the day on social media), the lunch menu and post conference arrangements.
ABI Solutions conferences are always CPD Registered and the conference was accredited by APIL training which is a great help to clinical and legal professionals who need to demonstrate their learning in appraisals and revalidation processes.
We had a special edition of the NR Times printed for the event that contained the most recent articles published by Elysium Neurological and an index of previous articles for people to refer to. This is also available on the post conference website available to all those who attended.
We wanted to find something to add to the day that people would remember and we decided to have an energiser sessions after lunch to uplift people’s spirit and focus their mind for the afternoon session. We approached a musician, Adam Pickard and he came along and ran a fabulous interactive session with audience participation with a competitive edge.
The engagement with the session was impressive and the group rendition of ‘Brown Eyed Girl’ was shared a number of times on social media as people expressed their enjoyment of something a little bit different.
The feedback from the conference really speaks for itself. All the feedback forms reflected scores of good to excellent for every aspect of the day. Some of the general comments people left:
“Wonderful conference - speakers exhibition stands and appreciated opportunities to network”
“All was fantastic - well done!”
“Fantastic agenda! Held my interest all day.
I have left with much to think about. Thank you”
“Very useful and informative event!”
“Brilliant day! Thank you”
“Excellent day, thank you all very much”
“Overall great topics and well run conference. The whole programme was very educational.”
“Opened my eyes in a lot of ways.”
The comments and feedback for the individual speakers were also incredibly positive.
So the lessons learned?
Make sure you have content that people want to engage with and think about what they can take away from the day.
Focus on all the small details that ensure the overall experience really values the delegates and gives them value for money.
Work in partnership with each other, respect areas of expertise and really listen to each other when you are talking about what is proven to work.
The first Elysium Neurological conference is now available as a virtual event for people who mauy have missed it or not been able to attend.
We are looking forward to presenting some focussed CPD events throughout 2023 and hope to deliver another national neuro conference in Spring 2024. How we will top the first one will be a challenge in itself, but we like a challenge!
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