Traumatic Head Injury: Guide to Care Options - Part 2

Our serious injury care options series details personal injury treatment and options available for individuals and their families who have experienced a traumatic head injury.

• Part 1 – Emergency & Hospital Head Injury Treatment
• Part 2 – Post-Hospital Head Injury Rehab & Funding
• Part 3 – Brain Injury Support in the Community
• Part 4 – Care Navigators & Returning to Work after Brain Injury
• Part 5 – The Importance of Sleep after Head Injury
• Part 6 – Brain Injury Support & Financial Assistance
• Part 7 – Long Term Effects Of Head Injury
• Part 8 – Assistive Technology for Traumatic Brain Injury

For further information please see our Serious Injury homepage.

Post-Acute traumatic brain injury rehabilitation

After time spent in hospital, individuals will often require further traumatic head injury rehab, specific according to their needs.

This will usually take place in an acute trauma rehabilitation centre, and might include physical, occupational and speech brain injury rehabilitation, dependent on the service an individual requires.

The extent of a person’s serious injury and also how they react to any rehabilitation will often determine the amount of time a person spends in a dedicated centre.

A post-acute brain injury rehabilitation centre should ultimately assist individuals to be well enough to return to their home and the wider community.

Post-acute rehabilitation can take place in NHS or private sector facilities.

Nursing/Residential Care

If a person has spent time in a trauma rehabilitation centre but is unable to return to their home, nursing or residential care may be required.

Ongoing head injury rehab would need to be in a nursing or residential home specialising in specific traumatic injury, such as a brain or spinal injury.

Nursing and residential care not only provides the specialist care required according to the needs of an individual, but can continue the brain injury rehabilitation process, helping people to become more independent.

Depending on the needs of the person the stay in a nursing or residential home may be temporary or permanent.

Specialist Community Care

Also known as Home Care or Community Care, Specialist Domiciliary Care is an alternative to residential care.

People are cared for in the familiar setting of their own home for the next part of their head injury rehab, by specialist healthcare professionals.

In order to provide Specialist Domiciliary Care, a person’s home may need to be adapted, and/or a person may require specialist equipment.

In addition to support with personal care and activities of daily living, Specialist Domiciliary Healthcare providers may assist with accessing services in the community and other activities to people are able to maintain active social lives.

Care package/care plan

The exact nature of the specialist head injury rehab care delivered to a person with a severe or traumatic brain injury will usually be decided on by an assessment.

The assessment is carried out by a healthcare professional, social worker or a multi-disciplinary team.

Domiciliary Care

Domiciliary Care is care in the home where an individual requires less-specialist care following their traumatic head injury. This may involve assistance with personal hygiene, support with cleaning or assistance when taking part in social activities.

Domiciliary Care may be for several hours every day or just a short time, depending on what an individual needs.

Funding for Care & Regulations

Funding
The issue of funding for care can be complex following a traumatic head injury.

Certain services are provided through local council authorities, which are responsible for healthcare services that fall outside the remit of the National Health Service (NHS).

NHS Continuing Healthcare can be accessed if a person has significant care needs and the assessment to determine whether or not a person meets the criteria. A funding for care assessment would consider the following:

• behaviour
• cognition (understanding)
• communication
• psychological/emotional needs
• mobility
• nutrition (food and drink)
• continence
• skin (including wounds and ulcers)
• breathing
• symptom control through drug therapies and medication
• altered states of consciousness
• other significant needs
• These needs are then given a weighting marked “priority”, “severe”, “high”, “moderate”, “low” or “no needs”.

The multi-disciplinary team doing the assessment will then consider:

• what help is needed
• how complex these needs are
• how intense or severe these needs can be
• how unpredictable they are, including any risks to the person’s health if the right care isn’t provided at the right time

Funding for care services that fall outside of the NHS begins with an assessment of an individual’s needs.

Depending on a person’s savings, they may be asked to pay or contribute to a service that is recommended to them. An assessment of a person’s financial status is then carried out every year.

Care Quality Commission (CQC) Reports

The CQC is an independent regulator of England’s social and healthcare services.

Working with people who have accessed health and social care services as well as industry organisations and charities, the CQC inspects centres across the country, monitoring standards, publishing their findings and working with centres to help them improve.

CQC reports are an excellent way of finding the quality-level of care that a particular service may offer.

Headway-Approved Care

Headway, the brain injury association, has compiled a list of Approved Providers, and is able to offer an accreditation to residential care services for brain injury rehabilitation if a particular service opts to be assessed by the association.

Headway has compiled an expert list of standards that must be met by a service before it can be accepted onto the list.

As with reports from the CQC, Headway’s Approved Providers scheme gives individuals who have experienced a traumatic head injury a real insight into the quality of care they are likely to receive before accessing a particular service.