bramacare transitional eating disorders service · bramacare provides specialist care and support...
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BRAMACARE
TransitionalEatingDisordersService
AdultServices:ResidentialCare,DayCare,DomiciliaryCare
Adultservices;ResidentialCare,Daycare,DomiciliaryCare
BRAMACARE–THEWHITEHOUSE:TRANSITIONALEATINGDISORDERSSERVICE 1
CONTENTSServiceoverviewandourphilosophy 3Whoistheserviceforandeligibilitycriteria 4OurService 5ServiceSummary 6Howtomakeareferral 7Carepathways 8Ourfacilities 9Team,ContactdetailsandTestimonials 10
Adultservices;ResidentialCare,Daycare,DomiciliaryCare
BRAMACARE–THEWHITEHOUSE:TRANSITIONALEATINGDISORDERSSERVICE 2
SERVICEOVERVIEW
TheWhiteHouseisaTransitionalEatingDisorderServiceforadults,basedinIpswich.Weprovidenursingandresidentialcare,astep-downprogrammeanddomiciliarycareforthosewhoareleavinghospital,butrequireahigherlevelofsupportthatcanbeprovidedelsewhere.Weworkcloselywithmentalhealthteamsandsocialcareproviders, togetherwithcommissionersand local authorities from around the UK, to provide tailored care packages offering the leastrestrictiveapproachtoresidents.The White House is located in the heart of the community which encourages our residents toparticipateinthewiderworldandlifebeyondtheireatingdisorder,whilsthavingthesafetynetofadedicatedNursingTeamonhandtohelpguidethemeachstepoftheway.Residents also have access to specialist therapy and dietetics, as well as local primary care andcommunity services,whilst they are here. And regularMultidisciplinarymeetings and reports areprovided to referrers and Responsible Clinicians, throughout the resident’s stay. We also liaiseextensivelywithothermedicalspecialitiesasnecessary, inordertoassistwiththemanagementofanymedicalcomorbidities(e.gType1Diabetes).OURPHILOSOPHYToprovidepatient-centredcareforindividualswhoneedhelpmanagingtheireatingdisorderinthecommunity.Ouraimsareto:- Optimise themental and physicalwell-being of each individual and help themachieve their
goals.- Provideaservicethatisbasedonthebestavailableevidenceanduptodateguidelines.- Disseminateknowledgetopeoplewitheatingdisorders,theirfamilies,healthcareprofessionals
andotherrelevantparties.- Workinpartnershipwithallrelevantagenciestoachievethebestpossibleoutcomesforevery
individual.
Adultservices;ResidentialCare,Daycare,DomiciliaryCare
BRAMACARE–THEWHITEHOUSE:TRANSITIONALEATINGDISORDERSSERVICE 3
WHOISTHESERVICEFOR?Bramacare provides specialist care and support to people with eating disorders, in a communitysetting.Thisincludes;• Thoseintransitionfromhospitalbackhome;asasteppingstone,• Thosewhoneedlongertermcare(SevereandEnduringEatingDisorders), inorder-toprevent
readmission,• AndthosewhorequestRespiteCare,forre-establishmentofnormaleatingpatternandgradual
weight restoration, inorder-toavoidworseningof their symptomsandadmission tohospital.ThiscanbeprovidedaseitheraNursingCare,ResidentialCareorDayCarePackage.
TheWhite House provides 24/7 Nursing Care for residentswithmore complex needs and highermedicalrisk(e.g.lowBMI).WealsoprovidelessintensiveResidentialCarepackagesforthosewhoaremorephysicallystable(e.g.BMI>15).Additionally,wecanprovideHomeSupporttoserviceuserswholivewithinourlocalcatchmentarea,withourHomeSupportTeam.ELIGIBILITYCRITERIAIndividualswillbeassessedonacasebycasebasisinorder-todeterminethattheircareneedscanbesafelymet.• >17yearsofageandabletoconsenttotreatment
• Diagnosisofanorexianervosaorothercomplexeatingdisorder
• Retainscapacityandiswillingtoremainonavoluntarilybasis*andworktowardstheirgoals,
followinganagreedcareplan.
• Willingtoworktowardsbecomingabletomanagetheeatingdisorderwellenoughtostayoutofhospitalandachieveimprovedsocialinclusionandqualityoflife(e.g.engaginginvoluntaryworkoremployment,improvingnumberofleisureactivitiesandcircleoffriends)
*ServiceusersunderMHASection17A,CommunityTreatmentOrder(CTO),areaccepted.
Adultservices;ResidentialCare,Daycare,DomiciliaryCare
BRAMACARE–THEWHITEHOUSE:TRANSITIONALEATINGDISORDERSSERVICE 4
OURSERVICEOurdedicatednursingteamandcarestaffarehighlyskilledinsupportingindividualswiththedaytodaychallengesoftheireatingdisorder.EachserviceuserhasaKeyNursewhowillworkwiththemtoformulateaperson-centredcareplan,basedontheindividual’sideas,concernsandexpectations;aswellastheirphysicalandmentalhealthneeds.RegularcarereviewsandMultidisciplinarymeetingsensurethatcareplansareaccurateanduptodate.Our teamemploysaSpecialistSupportiveClinicalManagement (SSCM)approach,whichcombinesregularclinicalmonitoring*andreviewoftargetsymptoms,psychoeducationandgeneralsupport,in-order-to normalise eating. Staff supervision is provided by Consultant Clinical Psychologist, Dr LizMitchell.OurSpecialistDietician,HelenWest,superviseseachserviceuser’snutritionalrehabilitationduringtheirstay.Examples of therapeutic activities and groups include reflexology, goal-setting, cooking group,nutrition,wellbeingandlifeskills,flexibility,exercisemanagement,anxietymanagement,self-esteem.Serviceusers are also supportedwith thepractical tasksofmeal planning, shopping, cooking andsettinggoalstotransferskillshome,whenappropriate.We very much encourage residents to engage in community activities and support them inpreparationfordischarge,whetherthatmeansreturningtouniversity,work,gainingvoluntaryworkexperience,orhelpwithmanagingthefamilyhome.Additional individualised one-to-one therapy, under the supervision of Consultant ClinicalPsychologist, Dr Liz Mitchell, can also be provided, depending on the service users’ needs; oncefundingisagreedbythereferringteam.*MARSIPANguidelinesarefollowedforresidentswithaprimarydiagnosisofAnorexiaNervosa.
Adultservices;ResidentialCare,Daycare,DomiciliaryCare
BRAMACARE–THEWHITEHOUSE:TRANSITIONALEATINGDISORDERSSERVICE 5
SERVICESUMMARY
• NursingCare
• PhysicalobservationsandMedicalriskassessment
• SSCMapproach
• Individualisedmealplans
• ArrangementofBloodtestsandECGmonitoringasneededviaGP.
• Providingaccesstoahigh-qualitysupportprogrammethatoffersopportunitiesformotivationalenhancement,psycho-education,dietetic/nutritionalrehabilitation(supervisedbyaspecialistdietician),developmentofemotionalcopingskills,independentlivingskills,socialskills,adaptivefuturelifestyleskillsplusrecreationandsocialactivities
• Tailoredcarepackagesforindividualsbeingdischargedfromhospital,whorequiresupportinorder-totransitionsafelybackintothecommunity.ThismaybeunderMHASection17A,CommunityTreatmentOrder(CTO)
• Respitecarepackagesforindividualswishingtorestoreweightand/ornormalisetheireating
pattern,(preventingpotentialhospitaladmission).ThismaybeprovidedasDaycareifappropriate.
• NursingandResidentialcarepackagesforthosewithSevereandEnduringEatingDisorders.
• Whereanindividualhasco-morbidproblemsorcomplexneedstheservicewillworkwiththeir
hometeam/responsiblecliniciantoarrangefundingandaccesstoNICE*approved,evidencebasedtherapeuticinterventions.
*NationalInstituteforHealthandClinicalExcellence(NICE)–MentalHealthandBehaviouralconditions–EatingDisorderRecognitionandTreatment
Adultservices;ResidentialCare,Daycare,DomiciliaryCare
BRAMACARE–THEWHITEHOUSE:TRANSITIONALEATINGDISORDERSSERVICE 6
HOWTOMAKEAREFERRALReferralsareacceptedfrom:
• SpecialistEatingDisorderTeams• CommunityMentalHealthServices• InpatientMentalHealthServices• Primarycare
Requiredreferralinformation:
• Recentdetailsofeatingdisorderbehaviours• Weighthistory• PresentingBMI• Previoustreatmenthistory• Currentcareplandetails• Mostrecentbloodresults• ECG• Fundinginformation• Bramacarereferralform
Oncereceived,weacknowledgereceiptofthereferralthesameworkingday.Ifyouareuncertainabouttheappropriatenessofareferral,wearehappytotalkinconfidence.
Adultservices;ResidentialCare,Daycare,DomiciliaryCare
BRAMACARE–THEWHITEHOUSE:TRANSITIONALEATINGDISORDERSSERVICE 7
CAREPATHWAYSNursingCare
• Referral&Assessment• RecommendNursingCarepackagebased
onmedicalriskassessment*• Fundingapproval• ProvisionofNursingCarepackage• Person-centredcareplanagreed• Careplanimplemented• MonthlyMDTreview• LiaisonwithHomeTeam/Referring
Clinician• CarePlanApproachreview• Continuecarepackageor• StepUp/StepDowncareasappropriate
ResidentialCare
• Referral&Assessment• RecommendResidentialCarepackage
basedonmedicalriskassessment*• Fundingapproval• Provisionofcarepackage• Person-centredcareplanagreed• Careplanimplemented• MonthlyMDTreview• LiaisonwithHomeTeam/Referring
Clinician• CarePlanApproachreview• Continuecarepackageor• StepUp/StepDowncareasappropriate
DayCare
• Referral&Assessment• RecommendDayCarepackage• Fundingapproval• Provisionof6-9monthDayCarepackage• Person-centredcareplanagreed• Careplanimplemented• WeeklyCareReview• MonthlyMDTreviewofprogress• LiaisonwithHomeTeam/Referring
Clinician• CarePlanApproachreview• DischargePlanning• StepUporStepDowncareasappropriate
HomeCare
• Referral&Assessment• RecommendDayCarepackage• Fundingapproval• ProvisionofHomeCarepackage• Person-centredcareplanagreed• Careplanimplemented• Monthlycarereview• LiaisonwithHomeTeam/Referring
Clinician• CarePlanApproachreview• Continuecarepackageor• StepUporStepDowncareasappropriate
*MARSIPANguidelinesarefollowedforresidentswithaprimarydiagnosisofAnorexiaNervosa.
Adultservices;ResidentialCare,Daycare,DomiciliaryCare
BRAMACARE–THEWHITEHOUSE:TRANSITIONALEATINGDISORDERSSERVICE 8
OURFACILITIES
TheWhiteHouseisagradeIIlistedbuilding,fullofcharacteroverlookingthelocalpark,situatedintheheartofthecommunity.Itofferscomfortableaccommodationforbothfemaleandmalepatients.
Ourhomeprovides;• FiveEn-suitebedrooms• Awheelchairaccessiblebedroomandbathroom• Acompletelyself-containedflat.• Brightandspaciouskitchen• Diningroom• Leisureroom/TV/lounge/library/games• ArtandCraftareas• Consultingroom• Laundryroom• Clinicalroomandtreatmentroom
WearesituatedinIpswich,Suffolk,withineasyreachofLondonandCambridgeviaexcellentroadandrailtransportlinks.Weareonly45minutesfromStanstedAirport,65minutesfromLondonbytrain,andconnectedbytheA12andA14.
Thenearbytowncentreprovidesagoodselectionofretail,leisureandcommunityfacilities;includingshops,outletstores,cinemas,theatres,restaurantsandcafes,parksandcommunitycentres,andIpswichTownFootballClub.
Adultservices;ResidentialCare,Daycare,DomiciliaryCare
BRAMACARE–THEWHITEHOUSE:TRANSITIONALEATINGDISORDERSSERVICE 9
OURTEAMMsLaetitiaBeaujard–CareManagerDrSachindevRamoo–ClinicalDirectorandGeneralPractitionerDrLizMitchell–ClinicalPsychologistHelenWest–SpecialistDieticianCONTACTDETAILSBRAMACARETheWhiteHouse,LimerickClose,Ipswich,Suffolk,IP15LREmail:[email protected]:01473740872Fax:01473206588AdmissionsandReferrals;Email:[email protected]“Thankstoyourefforts,youhavegivenmeachancetolivelifeandenjoyittoo.Ihavegainedconfidenceinmyselfandmyabilities.”Laura,Suffolk“Thankyousomuchforgivingmethischanceatrecovery.Ifelthelplessayearago,butnowIamexcitedtostartmynewlifebackhome&livelifetothefull.Iamgoinghometomynextstageofrecovery,yougavemethestrengthtonevergiveupbutalsobelievingthatIamworthitandnothingcanstopmetolive.”Amy,Jersey