Good Practice: Children’s Trust Rehabilitation Centre

A purpose-built centre for children with acquired brain injury is being opened. Andrew Mickel reports

A lot has changed over the past seven months for Stuart Cade-Westcombe. In September last year, the 14-year-old suffered a massive brain haemorrhage, was rushed to his local hospital in Milton Keynes, and then on to Great Ormond Street Hospital where he was put in to a medically-induced coma that his mother was told he might never wake up from.

You wouldn’t know to see him now that Cade-Westcombe has been through so much drama – aside from the walker he needs to move around. He is one of the first people to use the Children’s Trust’s new rehabilitation centre for children with acquired brain injuries in Tadworth, Surrey, which officially opens this week.

“From the first day, everyone was trying to make me feel as welcome as possible,” he says. “They try to get you into the swing of things quickly, and if you have problems people help you.

“At a hospital I’d get speech and language therapy once a week, or even once in two weeks. But here it’s much more intensive. They know the areas you’re having problems with and they know that specific things to do. Staff go out of their way to help you and they often go above and beyond the session time. It really helps your skills.”

Therapy programme

The therapy programme is nothing new on the site. But the new fit-for-purpose building to help deliver it is. Liz Bray, the centre’s head of nursing and rehabilitation, says children no longer have to share rooms as they often had to do in the new building’s 24-year-old predecessor.

“Quite often there could be a fit and healthy teenager who had been knocked down by a car, who suddenly found themselves getting very personal care,” she says. “If you’re sharing these rooms, you could hear someone having their pad changed. It wasn’t very appropriate.”

The new building, by contrast, has 20 large bedrooms so that children will typically have their own room. There are only 13 residents there at present as the centre builds up to full capacity.

There is one bathroom between every two people, wide corridors to allow easy access for the large wheelchairs many of the children have, and big communal spaces to bring the residents together.

Routine needed

Lisa Kliem , a nurse manager at the new site, says: “Children with acquired brain injuries need to have a routine, and we can have a much more structured one here. Before, we couldn’t fit all the children in the dining area, and it was hectic because people were walking in and out,” she says.

“Now we can get all the children up, all sitting and having breakfast together, which we could never do in the old building. And it’s not just for eating – now can get everyone together in the same place.”

Kliem is one of a largely young and expanding staff that is settling in to the new building, which is being decorated with the children’s photos to make it their own.

Cade-Westcombe is a relatively mobile client, but the new site is fully equipped to take children on ventilators and with tracheotomies, and has hoists throughout the building to help residents move about quickly and easily.

The £7m centre, which was paid for entirely by fund-raising efforts, also has a family flat that allows parents of children either arriving or preparing to leave the centre to hand over the care of their child.

There are more rooms for staff to do their paperwork away from the delivery of care, a fully-equipped multi-sensory room, and a new hydrotherapy pool that allows faster and easier access for children than its predecessor.

Threatened placements

Places are typically funded by primary care trusts. Bray warns that tight public sector finances should not be allowed to threaten future placements. “Some areas are getting really tight with money and saying they can only have three-month placements,” Bray says. “But they often find therapies are just starting to work at that point.”

The team are currently busy trying to raise the profile of acquired brain injuries and of the unit itself, and is looking to expand its services to ensure children and young people like Cade-Westcombe receive the dedicated care they need.

Cade-Westcombe is now six weeks in to his initial placement, and, although he has much work left to do, his mobility has already improved.

His mother says that the centre has been the ideal place to channel his determination into real results. “Everything’s done really well here,” she says. “You can’t compare it to a hospital because this is the place to go if you have a brain injury. It’s been fantastic, there are amazing treatments. It’s completely exceeded our expectations.”

More about the centre


Award-winning service

The Children’s Trust pioneered rehabilitation service for children with acquired brain injury in 1985 and it remains the UK’s largest centre for paediatric rehabilitation.

The service won “Rehabilitation Initiative of the Year – Provider” at this year’s Rehabilitation First Awards last month.

This article is published in the 16 July issue of Community Care magazine under the heading Body and mind recovery

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