The Beeches

The Beeches is a home in the community for men with acquired brain injury (ABI) or dementia presenting with neuropsychiatric symptoms.

The Beeches is part of The Croham Place Care Home and has been specifically designed to care for up to eight men suffering from acquired brain injury, dementia or other conditions affecting their memory and other mental functions. Our home caters for those whose neuropsychiatric symptoms put them and others at risk. Our services are delivered in partnership with local and health authorities, families and individuals:

• Dedicated to men with hard to manage neuropsychiatric symptoms
• Complex needs
• Community focused

Who is the service for?

The Beeches is a home specifically designed to cater to the needs of men with acquired brain injury, dementia and other conditions affecting cognition and behaviour.

Resident profile

• Men only
• Diagnosis of acquired brain injury, dementia or other condition affecting cognition and behaviour
• Typically over 30 years old
• May have been detained under the MHA including forensic sections
• May be under a Community Treatment Order, Guardianship or subject to a conditional discharge
• May be subject to DoLSMay have significant physical health problems
• May have mobility problems
• May need full personal care
• Typically presenting with a history  of aggressive or severely agitated behaviour
• May have failed multiple other community placementsMay have complex needs
• May have previous history of mental health problems or learning disabilities
• May have significant forensic history including a history of arson or sex offending

Diagnoses

The men in our care may suffer from Traumatic Brain Injury, Acquired Brain Injury, Stroke, Alzheimer’s Disease, Frontotemporal Dementia, Vascular Dementia, Parkinson’s Disease Dementia, Dementia with Lewy Bodies, Alcohol-Related Dementia, Korsakoff’s Syndrome, Huntington’s Disease, HIV-related dementia and other neuropsychiatric disorders.

Exclusion Criteria

• Severe physical health problems that require weekly or more frequent monitoring by a physician
• Severe mobility problems – our residents should be able to weight-bear and transfer even if it is only short distances
• Severe ongoing physical aggression
• Severe ongoing agitation
• Severe ongoing destruction of property
• Women
• Men who do not have an irreversible neurocognitive condition.

Community Focused

Our service focuses on maximising community access and meaningful activity.
Our staff focus on providing non-pharmacological interventions designed to reduce agitation and aggression.

We focus on maximising autonomy and quality of life.

We prioritise physical health through good diet, appropriate exercise, regular monitoring of vitals and access to community-based health-services.

Enhanced Healing Environment

We are designing a healing environment tailored specifically to the needs of our residents. We follow the King’s Fund Enhancing the Healing Environment (EHE) supportive design guidelines. Their research shows that the design of the environment can compensate for sensory and cognitive impairment and promote orientation. This leads directly to better quality of life for our men and a reduction in the number of incidents.

Our service has welcoming communal areas to encourage interaction and conversation.

We provide books, games, musical instruments, interactive artworks and memorabilia to promote meaningful activity.

We have an accessible garden which is safe for our residents. In the garden they have the opportunity to walk freely and interact with nature.

Familiarity is enabled throughout the service with photographs and memory boxes, traditional objects and recognisable sanitary ware.

Whilst the layout of the Beeches is simple in its presentation, orientation is enhanced by the use of appropriate signage,, easy read calendars and large clocks, as well as the use of natural light.

Model of care

We deliver an outcomes-driven model of care.

All our nursing and support staff are trained in the management of neuropsychiatric symptoms through interventions that do not rely on the use of medication.

Meaningful activities: Meaningful activities facilitated by our staff have proven to be effective in managing up to moderate agitation.

Music therapy: We engage with a local service who support our staff to deliver structured music therapy sessions. This intervention has proven to be effective in up to moderate agitation.

Access to Specialist Clinicians

At the Beeches our residents benefit from access to specialist clinicians on an internal referral basis. This is included as part of the service.

SaLT: Our SaLT will assess and create interventions for the men in our care that need them. Our staff are able to then deliver these interventions.

Physiotherapy: Our  Physiotherapy programmes are delivered by our Senior Pysiotherapist and Assistant Physiotherapist and where daily interventions are required, the members of staff supporting the men in our care will be trained to deliver personalised programmes..

Psychology: Our residents have access to a Clinical Psychologist who is utilised to conduct capacity assessments as well as assess cognitive functioning, both aspects being important in aiding the delivery of person centred care.

Neuropsychiatry: Our residents are assessed by our Neuropsychiatrist. His focus is to rationalise the use of medication, to maximise physical health in partnership with the local GP and to optimise function.

Why choose The Beeches?

A more appropriate environment: some men with neuropsychiatric conditions are trapped in hospitals as no residential services will accept them due to their risks and behaviours. Due to our specialist model of care and the design of our environment to maximise orientation in individuals with cognitive impairment we can manage their risks and behaviours while providing them with a better experience.

The right level of security: Some men are in services that have an excessive level of security due to their previous forensic history. Other community services are unable to offer them placement. We can accommodate men who have previously been detained under the mental health act, including those who are restricted.

Cost effective: We offer a service that will minimise the need for staff providing continuous support to these men. Our programme is effective in reducing the amount of sedation and we optimise physical health. This approach provides the best environment for these men: safe, bespoke to their condition and cost-effective.

Outcome driven: We use validated measures to track the effectiveness of our interventions. We have incident scales, a measure of quality of life, measures of stability of physical health, measures of mobility, measures of community access and measures of activity participation. We optimise for all of them.

Referrals

We accept referrals from clinicians and commissioners throughout the UK. Our assessment is free.  We aim to accept all men with a primary diagnosis of a neurocognitive disorder—such as acquired brain injury, Korsakoff’s syndrome or dementia—provided they are in stable physical health.

Please call us on to arrange for an assessment.  We aim to see any referral within 48 hours of referral and to have a decision on suitability within 36 hours.  We are able to give quicker decisions if referrers supply us with a recent complete report, including the history and the results of all tests and imaging.