bramacare transitional eating disorders service · bramacare provides specialist care and support...

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:twh@bramacare.co.ukPhone:01473740872Fax:01473206588AdmissionsandReferrals;Email:referral@bramacare.co.ukTESTIMONIALS“Thankstoyourefforts,youhavegivenmeachancetolivelifeandenjoyittoo.Ihavegainedconfidenceinmyselfandmyabilities.”Laura,Suffolk“Thankyousomuchforgivingmethischanceatrecovery.Ifelthelplessayearago,butnowIamexcitedtostartmynewlifebackhome&livelifetothefull.Iamgoinghometomynextstageofrecovery,yougavemethestrengthtonevergiveupbutalsobelievingthatIamworthitandnothingcanstopmetolive.”Amy,Jersey