Rehabilitation and Recovery Services

Rehabilitation
and Recovery
Services
A REAL AND LASTING DIFFERENCE FOR EVERYONE WE SUPPORT
Priory’s
commitment to
rehabilitation
and recovery
For service users with severe and
enduring mental health problems or
physical disabilities, we recognise
that rehabilitation and recovery is
the ultimate goal. Our services
support people on their journey
towards increased independence
and the highest quality of life.
Priory provides recovery-focused mental health
Our care pathways are categorised under:
• Severe and enduring mental ill-health
• Neurodevelopmental including Autism
and learning difficulties (LD)
• Dementia
services, along with specialist medical rehabilitation
services treating Traumatic Brain Injury (TBI), Acquired
• Neuro-disability
Brain Injury (ABI) and neuro-degenerative conditions.
Our services at a glance:
Priory’s stepped care pathway provides seamless access into higher or lower
intensity treatment
Our recovery model is underpinned by a proactive focus on the whole of a service
user’s care programme
Our mental health services use a variety of tools including the Recovery Star and
My Shared Pathway
The service users we rehabilitate often have a range of healthcare needs and
comorbid presentations
Service user care programmes incorporate a diverse range of therapies, including
Psycho-education and Cognitive Behavioural Therapy
Priory is a trusted partner of the NHS in delivering clinically effective,
evidence-based treatment programmes
We work closely with commissioners to create a flexible and bespoke package and
cost framework
Proactive discharge planning
Our recovery model is underpinned by a proactive focus on the whole of a service user’s care programme.
Discharge planning is central to Priory’s model, with plans for step-down included in initial consultation with
commissioners and stakeholders during the admission process. We provide a comprehensive footprint of
services including supported living accommodation, offering service users and commissioners complete
continuity of person-centred care.
Most Intensive Care
Admission and
assessment
Least Intensive Care
Engagement
and treatment
Active
rehabilitation
and quality
of life
Move on to
community
placements and
less intensive support
Discharge
planning
and identifying
next steps
Integrated Care Pathways
Compassionate, Individualised and Positive Care
Who do we support?
What is Priory’s approach?
Priory specialises in behaviour
support for people needing stable
and safe services within a broader,
but focused pathway of care
towards rehabilitation. The service
users we rehabilitate often have a
range of healthcare needs and
comorbid presentations, and may
be adults who are:
In order to achieve full engagement of service users in their care plan,
our mental health services use a variety of tools including the Recovery
Star and My Shared Pathway. We incorporate positive behaviour
support alongside therapeutic interventions – enabling service users to
be active determinants of their care. Our recovery model ensures that
our holistic care and support is focused on enabling service users to
have as independent, healthy and enjoyable a life as possible.
During assessments, our service users improved or
• Stepping up from community
maintained functionality in the following domains:
placements
• Moving across from acute mental
health wards
Pain
96%
• Moving across from acute
general, ITU or specialised neuro
Mobility
89%
wards
• Stepping down from a secure
Aggression
91%
provision
95%
Activities
• Moving from other mental health
95%
services with no improvement in
outcomes
Daily Living
Outcomes taken from
service user reviews between
April 2015 and March 2016
Severe and enduring mental health
Priory’s stepped care pathway provides seamless access into higher or lower
intensity treatment to reflect the service user’s changing needs as they progress
towards recovery. Service user care programmes may incorporate a diverse range of
therapies, including psycho-educational, cognitive behavioural and creative, in order
to best catalyse an individual’s road to a better quality of life.
Service user programmes, focused on quality of life
to ensure that those with such a disability are
goals, exist to stabilise and mitigate psychotic
treated with the same compassionate,
presentations, whilst supporting them in the most
person-centred care that they should expect.
compassionate manner to facilitate improved mental
and physical wellbeing.
Our nationwide network of specialist mental health
rehabilitation services include acute facilities and
step-down units to facilitate as quick and smooth a
transition into local provision wherever possible. Priory
also has its own network of enhanced community
homes, nursing homes and supported living schemes
that offer a consistent pathway of care for service users
and commissioners.
Priory can adjust interventions, communication
strategies and service environments to best support
individuals also presenting with intellectual disabilities,
In a Priory Satisfaction Survey,
91.6% of service users across
our rehabilitation and recovery
services said staff communicate
in a way they understand
As Consultant Psychiatrist Dr David Scull notes:
“Our personalised approach to meeting
the individual’s communication and
occupational needs plays a large part
in reducing levels of aggression and
challenging behaviours… One of
Priory’s great strengths is our ability
to quickly adapt services to changing
needs and goals.”
Tony’s story
Tony was diagnosed with schizophrenia in his late twenties. He suffered a
number of relapses resulting in admissions to hospital, and for many
years he was unwilling to engage with health professionals. In his early
fifties, he was diagnosed with frontotemporal dementia. At this point, he
had spent most of his life in institutional care.
Between 1st March 2014 to 28th
When Tony was admitted to The Priory Hospital Hemel Hempstead, he
was distressed by his beliefs and did not feel he needed any medication.
Working to a creative approach alongside the multidisciplinary team,
staff were able to collaborate with Tony to develop a bespoke care and
recovery plan for both his psychosis and cognitive impairment. Tony was
encouraged to express his creative side and, with timely support from
Priory staff, took guitar lessons at MIND. He would also have ‘jamming’
sessions on the ward with the other service users and staff members.
February 2015, from the 29
As his treatment progressed, our therapists and consultants focused on
relapse prevention helping Tony understand the connection between his
medication and staying well, in addition to understanding why he had
relapsed in the past. There was a huge reduction in distressing psychotic
symptoms; his self-care improved and he began to self-medicate.
Priory can also manage comorbid
personality disorders through a
recovery-focussed programme with
Dialectical Behaviour Therapy (DBT)
at its therapeutic centre. The skills
taught within the DBT programme
promote greater self-awareness and
help to build resilience, while
managing overwhelming situations
more effectively.
As a result of his progress at The Priory Hospital Hemel Hempstead, Tony
stepped down into supported living on a Community Treatment Order.
He has been stable for the last six months in his placement and
continues to make positive progress.
discharges at The Priory
Hospital Hemel Hempstead, the
average length of stay for these
service users was 15.2 months
Spotlight on: Recovery First, Widnes
2. Ash Ward – Active recovery ward
The focus of our recovery and rehabilitation ward is active
treatment. Each service user will have a bespoke care plan with
access to a range of psychological interventions such as DBT,
CBT, CAT and EMDR which can be tailored to the individual.
This will enable the service user to acquire and strengthen the
necessary skills in regulating affect, to learn new ways of
tolerating distress, develop interpersonal skills and mindfulness
and improves self-management. It also provides a therapeutic
Recovery First is a joint venture between Priory and Greater
environment where group therapies and activities help
Manchester West Mental Health NHS Foundation Trust.
promote and enhance a person’s recovery and wellbeing.
The overall aim at Recovery First is to improve the mental health
3. Dove Ward – Discharge planning
and wellbeing of service users so that our service users can
A 12 bedded ward which focusses on discharge planning in a safe
ultimately live successful and fulfilling lives within the community.
clinical environment. This ward is the third stage of our clinical
The three wards at our hospital in Widnes offers a specialist
clinical pathway, taking into account different levels of acuity.
This robust programme of care empowers service users to
pathway and helps service users embark upon re-entering the
community, through developing independence and autonomy in
a safe and supportive environment.
maximise therapeutic interventions, facilitate positive
“The three stage pathway at Recovery First provides us with
engagement and reduce risk behaviours
the opportunity to closely support women’s individual needs.
1. Beech Ward – Intensive support ward
A 12 bedded ward that focuses on admission assessments,
mental state stabilisation and management of acute behaviours
such as self-harm, aggression and hostility. We have created an
This means we can provide increased relational security at
times of crises in a safe and supportive environment, while not
losing focus on continuing to enable independence and
recovery, and progression back into community living.”
enhanced clinical environment focused on safety and privacy,
Dr Mark Swinton, Clinical Lead and Consultant Psychiatrist,
which is suitable for service users with a higher-risk profile.
Recovery First.
Neurodevelopmental including Autism and LD
Priory offers specialist services for individuals with autism and comorbid health
problems through inpatient sites at The Priory Hospital Aberdare, the Keston
Unit at The Priory Hospital Hayes Grove and Recovery First in Widnes.
Our experienced teams work with individuals that would benefit from programmes which:
• Holistically seek to support and correct co-existing mental ill health
• Incorporate positive behaviour support to reduce incidences of aggression and agitation
Priory’s activity programmes and care plans are built around individuals’ abilities and tolerance to
stress, and focus on improving daily activities, living skills, community integration and mental and
physical wellbeing. We understand that some people may face difficulties in understanding
information, learning new skills or coping with everyday life. We therefore adopt positive behaviour
methods which aim to ‘support and correct’. This may include improving communication, undertaking
pharmacology reviews, minimising use of medications and stabilising each individual’s placement.
Our experts in positive
behaviour support are
nationally recognised, and our
current team includes the
PROACT-SCIPr-UK®
Instructor of the Year 2014.
Priory is also a member of the
DH Positive & Safe
Champions’ Network working to reduce restrictive
practices.
Investing in services
For individuals with autism, Priory understands that our
service must get the clinical environment right. In
addition, people with a primary diagnosis of learning
disability or autism require therapeutic interventions to be
communicated in a manner that is sensitive to their
individual needs, whilst maintaining awareness of any
comorbid conditions.
Facilities at our specialist
sites such as Recovery
F1rst include spacious
en-suite bedrooms,
communal relaxation
areas, controlled access
to IT facilities, dedicated
gardens, quiet rooms,
plus therapy and activity
rooms.
The Priory Hospital Aberdare:
M's story
M was admitted to The Priory Hospital Aberdare in a
crisis situation due to a breakdown of his preceding
placement. He had been admitted to a generic mental
health ward at a local hospital which was unsuitable due
to his primary diagnosis of autism. M found this
environment stressful and began to display heightened
levels of anxiety which were unmanageable at the
hospital. It was agreed that M would be admitted to The
Priory Hospital Aberdare the following day under section
3 of the Mental Health Act (1983).
On arrival M was deeply stressed and agitated. Initially he
was receiving 2:1 support due to the high levels of
challenging behaviour he displayed. M found it difficult to
develop relationships with others and was reluctant to
engage in therapy. The MDT worked with M to create a
package of care to help him engage with others, reduce
his anxiety and reduce his dependence on medication. M
"The Priory Hospital Aberdare has been
a wonderful example of what a
specialist inpatient unit should be – if
they were all like this there would be no
need to ‘Transform Care’."
Blackburn with Darwen CCG and Borough Council
appeared to benefit immediately from the structure and
routine within the hospital and his anxiety levels reduced.
Within his first week his support was reduced to 1:1.
M began to develop meaningful therapeutic relationships
with the MDT and engage in his therapy. Therapeutic
sessions including art, music and occupational therapy.
As he progressed along his rehabilitation pathway his
medication was reviewed and reduced, having a positive
effect on his behaviour. The team have helped M to
develop coping strategies that help reduce his anxieties.
M has recently been discharged from section and is ready
to be discharged from The Priory Hospital Aberdare. With
support from Priory, his local team are sourcing a
placement to enable M to step down to an enhanced
community home setting.
The average length of stay for a service
user at The Priory Hospital Aberdare is
11.3 months
Dementia
We understand that high quality services for adults must meet the needs of an ageing population with increasingly comorbid
presentations. Whilst most will not benefit from inpatient services, we are there for those that do. Supplementing our 28-day MDT
assessment offering, our services can offer support for a short period during a diagnostic phase or during a rapidly progressing
illness. This ensures that an ongoing care plan is in place to fully address crisis and prevent deterioration in health and wellbeing.
We offer a full pathway for adults with:
• Dementia, including Korsakoff’s, Parkinson’s, Huntington’s and Alzheimer’s
• Additional health needs, including service users with enduring mental health issues that may have behaviours that challenge,
and comorbid physical health and frailty
• Young-onset dementia
Innovative services
Priory’s specialist dementia teams champion a progressive
model of care, with staff training at the heart of everything
we do.
Examples of training for staff include:
• Understanding the impact of dementia on the person and
family
• Enabling communication and positive experiences for
people living with dementia
• Understanding stress and distress reactions in dementia
• Promoting dignity and respect for people who are living
with dementia
• Living life – meaningful activity for people living with
dementia
As of July 2016, Priory will also offer a
specialist Dementia service at The Priory
Hospital Dewsbury. This will provide a 10
bedded ward for male service users.
Spotlight on:
The Priory Hospital Keighley
The team at Keighley have created an environment that
closely follows the King’s Fund Enhancing Healing
Environments for Dementia recommendations. Everything in
the environment is geared towards maximising orientation
for our men. We probe all suspected causes of agitation and
we make sure we use the style of interaction that best suits
the particular cognitive deficits each man has. Our
person-centred plans often include the following key areas:
1. Physical health vigilance
In many cases an episode of agitation can be caused by
Case study
How Priory dementia services go beyond ‘care’
– a letter from the wife of a service user.
physical illness. Our men are very likely to develop delirium,
which leads to increased confusion and agitation. We
monitor our men's health every day with regular physical
observations.
2. Rationalisation of medication
Some of the men in our care are on complex cocktails of
medication when they first arrive, which in many cases makes
problems worse. We work to reduce all medication and
simplify treatment, and in many cases are able to stop all
psychoactive medication.
3. Nutrition
There is evidence that good nutrition and hydration contributes
to mood and wellbeing in dementia. Some of our men can be
undernourished when they arrive, but thanks to the
dedication of our staff we are very successful in helping our
men achieve a healthy weight and a good level of hydration.
4. Person-centred care
This approach to dementia care has the best evidence to
reduce agitation. All of the staff are trained and regularly
supervised in delivery of this essential approach.
5. Non-pharmacological interventions
We use all evidence-based techniques to reduce agitation in
dementia. This includes sensory interventions, the use of
music and engaging our men in many different activities
suited to the level of cognitive impairment that affects them.
Dear Priory,
I want to say how very grateful I am for the
care my husband received on Oakworth Ward,
Priory Keighley. In the six months that Richard
has been with you, at each of my many visits,
that sense of Oakworth being RIGHT has
grown.
At all times Richard’s physical condition,
medication, feeding, hydration and cleanliness
have been carefully looked after, as are the
needs of the other patients. I’ve been there at
meal times, activity times and sleepy times
and never have I seen staff disengaged with
the patients.
Any potentially difficult situation is contained
with calm warm reassurance and
understanding. I’ve always been included in
decisions about Richard’s care and know that
it goes beyond his physical wellbeing to a real
and deep consideration of him as a person.
I don’t think “loving” is too strong a word for
Oakworth. Nothing can alter the tragedy that
befell Richard, but I know that on Oakworth
he’s treated as an individual and given the best
loving care that he could possibly have.
6. Pain management
Aggression in dementia can be linked to pain. Our staff are
trained to spot signs of pain in the men in our care and we
intervene proactively to keep them comfortable and pain free.
I’m so very grateful for that, and for the
unfailing support and encouragement that I’ve
been given too.
Neuro-disability
Alongside our range of
mental health services,
Priory offers additional
specialist services for
those with a
neuro-disability.
Through our services at The Priory Highbank Centre, Bury
and The Priory Mount Eveswell, Newport, Priory provides
leading person-centred neuro-rehabilitation and continuing
care programmes that are bespoke to the severity and
complexity of the person’s neuro-disability – such as
Traumatic Brain Injury (TBI), Acquired Brain Injury (ABI) or
neuro-degenerative conditions such as Motor Neurone
Disease, or Multiple Sclerosis.
In our recent satisfaction
surveys, at least 90% of service
users at The Priory Highbank
Centre were satisfied with the
skills and ability of their
multidisciplinary teams
Priory Group has developed an Integrated Care Pathway for its Neuro-rehabilitation services:
Pre-Admission
Assessment
Predicting
Outcomes
Admission
Discharge/Transfer
of Care
Implement
Programmes
Review of the
Rehabilitation
Process
Assess
Outcomes
Post Discharge
Review/Reflective Practice
Our neuro-rehabilitation services use a range of recognised outcome measures based on the
UK Rehabilitation Outcomes Collaborative (UKROC) initiative.
Spotlight on: The Priory Highbank Centre
The Priory Highbank Centre specialises in the following areas of neuro-rehabilitation:
• Mechanical ventilation management and complex chest and
respiratory management
• Tracheostomy management including cuffed tracheostomies
• Assessment and rehabilitation of prolonged disorders of
consciousness (low awareness or minimally conscious state)
patients including SMART® assessment
• Postural and spasticity management with onsite use of
botulinum toxin therapy
• Dysphagia management/PEG and PEJ fed service users
• Nutritional assessment and review
• The use of assistive communication and augmentative
technology
• Sensory Regulation and Stimulation Management
Programmes
• Cognitive rehabilitation and functional retraining
• Management of violence and aggression
• The service has a fully equipped gym, featuring tilt tables,
treadmills, exercise bikes and balance trainers
D's story
D is 32 years old and a mother of
three children. Following surgery, D
complained of breathing difficulties
and consequently sustained a heart
attack, causing a lack of oxygen to her
brain and resulting in a severe brain
injury.
With help from Highbank’s MDT, D made rapid
D was admitted to The Priory Highbank Centre unable
As D’s rehabilitation continued her independence
to move her limbs or parts of her face and having little
improved to a point where she could eat and drink
awareness of activities going on around her. She also
safely, self-propel her wheelchair and read and chat
had a tracheostomy tube and could not communicate
with others. She only needed a little help to look after
verbally. She became very agitated, had to remain in
herself and began to enjoy leisure activities. D was
bed and was fed via a tube to her stomach. Priory’s
discharged to a supported living environment.
progress, meaning the difficulty of her therapy goals
had to increase on a regular basis. Her posture
improved and she was able to spend long periods of
time sitting in her chair. Her tracheostomy tube was
removed and she began to be able to swallow small
amounts. D was also able to use face wipes unaided by
staff and was taught to communicate by pointing to
“yes” and “no” cards in response to questions.
skilled SMART® assessors worked with D over the first
few weeks of her placement, designing a bespoke
rehabilitation programme to optimise her potential.
Rehabilitation goals were set to help D reduce her
anxiety and agitated behaviour, enabling her to start
learning to care for herself with help, and be able to
communicate and move herself around in her
wheelchair.
In our recent satisfaction
surveys, 100% of services users
at Mount Eveswell and
Highbank were satisfied with
the quality of care received
Step-down facilities
Along with The Priory Mount Eveswell, The Priory Highbank’s Elton Unit provides slow stream
neuro-rehabilitation that enables service users to safely step-down from the higher acuity units in the hospital.
Additional mental health
rehabilitation and recovery services
Priory is a trusted partner of the NHS in delivering clinically
effective, evidence-based treatment programmes for adult
service users who require secure and step down care in a setting
providing physical and psychological security.
Our additional services include mental healthcare, learning
disability care and substance misuse treatment across open and
locked environments as appropriate.
Spotlight on: The Priory Hospital Sturt House
The Priory Hospital Sturt House is a locked rehabilitation
service in a rural setting within the M25. Offering
excellent care, it is delivered by an experienced
multidisciplinary team, for service users detained under
either civil or Ministry of Justice restriction.
Individuals will receive a personalised package of care
and personalised recovery-orientated treatment
programme. This personalised approach supports each
individual to develop the life skills needed to live a safe,
positive and independent life in the community.
The hospital is located in a modernised and upgraded
building with extensive, well maintained grounds, away
from the destabilisers which may be present in more
urbanised environments.
Our services are committed to a whole person-centred
approach. They are supported by an effective
multidisciplinary team experienced in rehabilitation,
recovery and caring for service users with complex
needs. The team includes:
Our aim is to maximise the individual’s quality of life,
promote independence and provide a range of
opportunities to be reintegrated into the community.
The facility can accommodate up to 21 service users. All
service users will have access to a self-catering
pathway with the potential to reside in fully
self-contained studio accommodation.
• Consultant Forensic Psychiatrist
• Social Workers
• Psychologists
• Experienced registered Mental Health Nurses and Health
Care Assistants
• Occupational Therapists
Who is it for?
• Males aged 18 and above
• Service users who may be detained under the Mental Health
Act (1983)
• Service users with Ministry of Justice restrictions
Service users achieved or partially
achieved identified goals
• Service users who may have forensic histories and
addictions
• Service users with behaviours that challenge associated
with mental health and who may not be able to be
managed in a non-hospital setting
• Service users with a level of vulnerability that may put them
at risk in other services
84%
Tertiary
Goals
84%
Primary
Goal
• Service users who may have previously been in a secure
facility due to the complexity of their needs
• Service users who may be diagnosed with enduring mental
health problems such as schizophrenia or Bipolar Disorder,
Personality Disorder or Autistic Spectrum
• Those who may have a history of co-morbid substance
abuse or mild Learning Disability
78%
Secondary Goals
Priory’s compassionate approach to recovery and
rehabilitation remains consistent for all of our service users.
We support individuals towards their most independent
lifestyle possible in the shortest amount of time;
rehabilitating them to their own maximum potential whilst
understanding that no two service users’ pathways of care or
desired outcomes are the same.
Funding
Referrals
We work closely with commissioners to create a flexible
and bespoke package and cost framework, ensuring the
purchasing process is easy, efficient and transparent. For
commissioners who purchase regularly with Priory we are
able to provide innovative pricing plans delivering
significant cost savings. We can also provide all-inclusive
packages of care for people requiring ongoing 1:1 or
special duty nursing.
Referrals to our services can be made by
any health service professional and
funding is usually provided by the NHS
and/or social services. We can also accept
people who wish to self-fund. Our
hospitals will assess referrals within 48
hours and respond with a written
summary assessment report within 7 days.
Our locations
Priory offers specialist rehabilitation and recovery services at locations
across England and Wales, meaning we are well placed to provide
services close to family networks.
East of England
01. The Priory Hospital St Neots
Greater London
02. The Priory Hospital Hayes Grove
North West England
03. Recovery First Widnes
04. The Priory Highbank Centre – Bury
05. The Priory Hospital Cheadle Royal
26
South East England
06. The Priory Cloisters, Newbury
4
3 5
07. The Priory Hospital Hemel Hempstead
24
2023
2122
08. The Priory Hospital Ticehurst – Sussex
1
South West England
18
13 19
25 1617 10
12 14
11
9
15
09. The Priory Hospital Bristol
7
6
2 27
8
Wales
10. Residential community home –
Abergavenny
11. Avalon – Cardiff
12. Beechley Drive – Cardiff
13. Brynawel – Monmouthshire
14. Princes Street – Cardiff
15. Priory Mount Eveswell – Newport,
Wales
16. The Priory Hospital Aberdare
17. The Priory Hospital Church Village –
Pontypridd
18. The Priory Hospital Ty Gwyn Hall –
Gwent
Yorkshire & The
Humber
Forensic locked
rehabilitation
20. The Priory Ghyllside
25. The Priory Hospital Cefn Carnau
21. The Priory Greenhill – Yorkshire
26. The Priory Hospital Middleton St
22. The Priory Hospital Dewsbury
23. The Priory Hospital Keighley
24. The Priory Hospital Market
Weighton – Yorkshire
George
03. Recovery First Widnes
27. The Priory Hospital Sturt House –
Walton on the Hill
19. Ty Ffynu - Abergavenny
To ensure the listings of our rehabilitation and recovery services are up to date, we produce a separate
brochure dedicated to our locations, specialisms and admission criteria. This is available in printed format or
can be downloaded at: www.priorygroup.com
Get in touch
For more information on our services or to
discuss treatment options:
Call us today: 0207 605 0926
Email: [email protected]
Visit: www.priorygroup.com
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