Welcome to Magnolia Neurorehabilitation Inpatient Unit RDaSH
Magnolia Neurorehabilitation Inpatient Unit Tickhill Road Hospital Tickhill Road Balby Doncaster DN4 8QN Tel: 01302 796408 2 Welcome to Magnolia Rehabilitation Inpatient Unit
Contents Introduction to the Neurorehabilitation Inpatient Unit 4 Our aim 5 What is rehabilitation? 6 Clinical leadership team 7 Your rehabilitation team 8 Ward routine 14 Medical management 18 Practical issues 19 Compliments and complaints 22 www.rdash.nhs.uk 3
Welcome to Magnolia Neurorehabilitation Inpatient Unit Magnolia is a neurorehabilitation unit for people aged 16 and over, who have a neurological condition or injury and need rehabilitation before leaving hospital. The kind of neurological problems that Magnolia can help include: Traumatic brain or spinal injury that some people experience following a accident. After a relapse or deterioration in people who have long-term conditions such as Multiple Sclerosis. Magnolia takes a person-centred approach to assessing your needs and delivering your care and rehabilitation. We do this by taking the time to talk to you and your family so we can establish what your individual needs are. We understand that no two people have the same needs and we are committed to offering you an individualised rehabilitation service. The team will care for and respect the beliefs and values of all service users and their families. 4 Welcome to Magnolia Rehabilitation Inpatient Unit
Our aim To provide an integrated rehabilitation service for adults with a neurological diagnosis that will enable the individual to regain their optimum level of physical, cognitive, social and behavioural function and to adapt to newly acquired difficulties/changes in their condition. Objectives To provide a consistent neurological rehabilitation approach throughout the 24 hour day to the achievement of rehabilitation goals To assist the person with a neurological problem to set and achieve their goals, relating to their rehabilitation as an inpatient and beyond. To assist in the specialist management of neurological symptoms through a range of therapeutic approaches medicinal, remedial and complementary To ensure a safe transition between hospital and discharge, taking into consideration the individual s strengths and abilities and co-ordinating support from outside agencies to deal with long term care needs. To provide an advisory and educational service that promotes the effectiveness of rehabilitation. www.rdash.nhs.uk 5
What is rehabilitation? Rehabilitation is: A dynamic process through which a person is assisted to achieve optimal physical, emotional, psychological, social and vocational potential and to maintain dignity, self-respect, and a quality of life that is as self-fulfilling and satisfying as possible. (Joanne. V. Hickey, 1997) So, what does that mean to me? Rehabilitation is about you: Your team at Magnolia will work with you to identify what the priorities are and what your rehabilitation programme should focus on. Rehabilitation is about achieving your goals: Before any rehabilitation goals are set a member of your team will discuss them with you and your family. Throughout the process of rehabilitation we will give you lots of feedback about your progress to encourage you and keep you motivated. We are here to support you achieve the best outcome. Rehabilitation is about identifying what is important to you: If there is anything you are not happy about or want to change in your rehabilitation programme, please ask any member of your team. We do the main planning of your rehabilitation with you at progress meetings, but you do not have wait until the next meeting to make a change to your goals; you can often do it straight away, why not ask today! Our approach is that where your rehabilitation programme is concerned, you are the most important member of the Magnolia team. 6 Welcome to Magnolia Rehabilitation Inpatient Unit
Clinical leadership team Magnolia is led by a consultant in rehabilitation medicine. An appointment can be made to discuss matters relating to medical management any time Monday to Friday 9am 5pm, on 01302 796408. The doctor will review every patient on each working day so please discuss any ongoing or concerning medical issues with him or her as they arise. If you wish to make an appointment to speak to either sister please contact 01302 796408 or 796827 (with answer machine). The modern matron for the service is available to discuss any aspect of your care while you are on the ward, and would welcome feedback from you and your relations. Please contact him or her on 01302 796693. The senior sister and ward sister are responsible for the effective management of the unit. Both are experienced nurses and are fully involved in all aspects of your care planning, goal settings and care delivery. As clinical sisters they are based on the ward. www.rdash.nhs.uk 7
Your rehabilitation team Registered nurses A team of registered nurses will lead you with 24 hour care. On admission you will be allocated a named nurse and an associate nurse who will co-ordinate an individual plan of care with you. A care plan will be created with you and your family (whoever you choose to represent you). This will guide the team to provide care which meets your individual needs. Your preferences, likes and dislikes are important to this care planning process so please discuss these with your named nurse. Your named nurse is...... Your named nurse is expected to meet with you on a weekly basis to discuss your progress and support you fully in all aspects of your care. The nurse will share with you a record of your care and ensure that documented goals reflect your personal needs, wants and desires wherever possible. Your nurse will support you through your rehabilitation programme and will be your first point of contact if you need any assistance or guidance regarding your care pathway at Magnolia and beyond. Rehabilitation assistants Rehabilitation assistants (RAs) will be available at all times to meet your care needs and support you with your rehabilitation throughout the 24 hours. Your associate nurse is 8 Welcome to Magnolia Rehabilitation Inpatient Unit
Physiotherapists Physiotherapy helps people to maximise their physical ability. Neurological conditions can cause various physical problems, such as weakness and lack of coordination as well as loss of function and independence. We work with patients, their families and carers to identify goals. Most patients have an individual exercise programme to complete independently on the ward. Sessions are organised with the physiotherapist or rehabilitation assistant to further enhance rehabilitation and recovery. Physiotherapists will assess your mobility/functional abilities and formulate a treatment plan with you. This could include: re-education of walking, stairs practice, group or individual exercise programmes or hands-on therapy sessions specific to your physical needs. Please add your named physiotherapist is...... and your named occupational therapist is...... Occupational therapists Activities of daily life which were previously taken for granted, such as washing, dressing, bathing and domestic tasks may become difficult to achieve. Our aim is to assist you to become as independent as possible in these activities by adapting how they are carried out, or by using equipment to help you. Your occupational therapist also assesses for perceptual problems (i.e. how we interpret what we see), and cognitive problems (such as memory difficulties) which can reduce independence in daily activities. We can help to treat these problems and advise on strategies to maximise independence again. www.rdash.nhs.uk 9
Speech and language therapist (SALT) The speech therapist will assist you to establish communication methods; this may be through speech, writing, reading, gesture, and so on. If you are experiencing swallowing difficulties, the speech therapist will assess your abilities and advise you to ensure your safety when eating or drinking. Social workers A social worker is linked with the team and a referral can be made if their input is required. Dietician You may need help to maintain a healthy weight due to swallowing difficulties or recent weight loss. Magnolia provides a healthy diet which meets nutritional requirements and can be modified or supplemented where necessary. Menu selection and choices have been researched and is based on meeting individualised needs, and can be supported by the dietician. The dietician is responsible for assessing and advising you as to how many and the type of nutrients you require and how you will be able to take them. If you have a P.E.G tube or N.G tube, the dietician will supervise your nutrition closely. Neuropsychologists When you have a neurological condition, it can affect you in a number of ways that a neuropsychologist can help with: The way you think or remember. Often people have difficulties with reasoning, remembering, keeping track of or concentrating on everyday things. It may be an important part of your rehabilitation programme to complete exercises to help improve your thinking or memory skills. Another way of helping you might be to develop ways of coping, like keeping a diary/ 10 Welcome to Magnolia Rehabilitation Inpatient Unit
timetable or to do list. The neuropsychologist will often do assessments by asking you to complete specialist tests of memory and thinking. After discussing the results of these tests with you and your family the neuropsychologist will agree with you the approach you would like to take to improve your memory/thinking. Other members of the rehabilitation team may also get involved in this area of your programme and most often this will include the occupational therapist, health care assistant and/or registered nurse. The way you feel emotionally. When you have experienced a neurological condition the changes in your life and your family s life can be very upsetting. It is not unusual for people to feel very distressed, particularly in the early stages of your stay and at the stage where you getting ready to leave Magnolia. The neuropsychologist is there as part of your team to help you and your family improve your confidence and to ensure you are supported psychologically/ emotionally. Doctors Your doctor will be responsible for making sure you are medically well and for providing medical treatment for any medical problems you may have. This may involve a team of doctors, depending on their speciality. House keeper/domestic The house keeper/domestic is an essential part of the team as they are responsible for ensuring that the ward is clean, tidy and fit for use, (that there is adequate laundry for example,) and that patients are being cared for in a clean and comfortable environment. www.rdash.nhs.uk 11
Team communication The rehabilitation team meet weekly on a Monday afternoon to discuss the rehabilitation plans for our patients. Each patient is discussed every other week unless it has been identified that they require more frequent discussion. The outcome of this discussion should be shared with you and should reflect your current needs and priorities relating to your rehabilitation programme. Every patient and their representatives will be invited to attend a number of communication meetings which are spread throughout the rehabilitation process. The purpose of these meetings is to provide an opportunity for all involved to discuss openly the process required to achieve identified goals and to enable everyone to agree how goals will be achieved. Each meeting will come with a formal invitation by letter to those attending. Please let us know who you feel would be appropriate, for example if you have a district nurse, social worker, advocate or friend you would like to attend. Meetings may include, for example: Initial goal setting Goal reviews Pre-discharge Best interests. The purpose of the meeting should be clearly identified and understood prior to the meeting. Your named nurse will aim to attend every meeting which takes place, and will identify a deputy when this is not possible. Please discuss any meetings with your named nurse to prevent any unnecessary anxiety. If you feel there is an issue, concern or need which requires additional meetings or one to one with a particular individual, this can be arranged please ask. 12 Welcome to Magnolia Rehabilitation Inpatient Unit
Infection Control Management of infections and prevention of the infections spreading is essential in the hospital. The team aim to prevent our patients from contracting/spreading infections during their stay or investigation. Special precautions may be required to identify and manage infections. All healthcare staff must wear clothes which do not come below the elbow and are not allowed to wear watches or excessive wrist jewellery. You should see professionals frequently washing their hands or using alcohol gel before or after they perform a task with you. You are encouraged to ask if the professional has washed their hands. Sinks, soap and hand towels should be accessible to you at all times to wash your hands. If your condition restricts this there are soft wet wipes which you can use. Please ask the team to provide hygiene equipment whenever you need it. Your relative/friends may have infections which they have contracted outside the hospital. Anyone with symptoms should be encouraged to refrain from visiting for 48 hours after the last symptoms e.g. vomiting, loose stools, coughing. Instructions to use hand gel There is alcohol gel provided in dispensers throughout the ward and situated at entrances and exits. All visitors should use the gel on arrival and when leaving the ward. Use the dispenser and rub the gel around the hands, between fingers and around the thumb. If you or your family/friends require information or have any concerns relating to infection control please raise this with your named nurse or the shift leader. www.rdash.nhs.uk 13
Ward routine Shift leader Each shift is led by a shift leader, a registered nurse who is in charge of the shift. This person is responsible for planning the shift and allocating tasks to the nurses and rehabilitation assistants on duty, to meet the needs of all patients on the ward. If you have any concerns or needs on a specific day please ask to speak to the shift leader. Your nurse today You will be allocated a nurse for every shift who will be responsible for providing your care for that shift, following the goals and care plans agreed by you and your named nurse and other team members. If you are unsure who your nurse is today, please ask. General ward routine Morning activities consist of patients being supported to get washed and dressed and ready for the day. While getting washed and dressed you are working towards your recovery and you will be encouraged to participate wherever possible. Breakfast Wherever possible you will attend breakfast in the day room once you are ready to eat. A rehabilitation assistant will support you to prepare your own breakfast from a variety of choices. This may include use of the therapy kitchen for a full cooked breakfast if you have been assessed to do this, or alternatively a buffet style continental breakfast depending on your preference. Those who are unable to prepare or feed themselves breakfast will be assisted to do so. Morning activities Rehabilitation activities occur at all times during the day, even sleep is essential to the process. Patients will be helped to get ready for bed at whatever time they choose. 14 Welcome to Magnolia Rehabilitation Inpatient Unit
Mid morning activities will begin with the coffee morning at 10.30-11.00am This is a social gathering where staff and patients can join together to enjoy a drink, and then an activity will follow e.g. quiz, keep fit sessions, games, crafts or a guest speaker. Lunch Lunch is served at 12.30pm and consists of a light lunch, sandwich and soup or salad etc If you prefer a hot meal at lunch time then please let staff know well in advance (at least 24 hours before) so that arrangements can be made to escort you to The Servery. This is only currently available to patients who can walk or use a wheelchair to get out and about. A rehabilitation assistant will be happy to support you to prepare your own lunch if you choose to do so. We are able to provide limited storage for your own food produce if you wish to purchase items for cooking. The patients kitchen is available for your use if you have been assessed to use this, e.g. for making drinks, lunch, tea, snacks etc. Afternoon mug club is open to you and your visitors. This is an open opportunity for relaxation and fun and also a forum for discussion with staff about your care or other issues. There is a social space in Magnolia with a variety of items available for use at all times: television, stereo, library, Wii console, games, (indoor and outdoor) activities, crafts, gardening etc. All are freely available at all times and you are encouraged to use these any time - please ask. Therapy programme Each patient will have a weekly therapy schedule. The scheduled sessions are allocated for the variety of professionals who are involved in your care. Sessions are a time for individualised rehabilitation, assessment and review of your plan and progress. These sessions www.rdash.nhs.uk 15
are primarily to provide the lead professionals with the opportunity to review your progress. The key element of rehabilitation is how you use the skills and strategies you are taught when you are outside of these sessions. Meal times Breakfast is available from 8.30am. Morning coffee 10.30-11.00am. Lunch is available from 12.30pm. Mug club afternoon tea 2pm-3pm. Evening meal is available from 5.30 pm. Milky hot drink and snack at about 9pm. Snacks and hot drinks are available contiunually throughout the day. Please use the facilities available, (patients kitchen / breakfast bar areas in the social lounge) to prepare drinks and snacks as needed. The rehabilitation assistants are here to help you to perform tasks you find difficult please ask if you need some help. We encourage our patients to eat in the dining area at the table, but this is entirely the patients choice. A menu is made available to you before each meal time. Special dietary requirements Anyone requiring a specific diet for medical or religious reasons will be catered for. Should you have any food allergies or religious requirements it is essential that you let the staff serving meals know so that they can meet your needs. Protected meal times Magnolia operates a protected mealtime policy on the ward. This means that no clinical activity takes place other than in an emergency during times when patients are eating food. This is to ensure that every patient can be supported to eat and feel comfortable and relaxed to enjoy their meal without interruptions. 16 Welcome to Magnolia Rehabilitation Inpatient Unit
Protected meal times also require the support of relatives and friends, as visiting times are closed over mealtimes. However, if patients and relatives wish to share a meal together, facilities can be arranged to support this which do not affect other patients. Alternatively, with minimal 24 hour notice, patients and relatives can attend The Servery. This is the hospital canteen where patients can eat a hot meal, if prebooked, provided by the hospital. Anyone with the patient will be required to pay the canteen menu charges. For those patients who require assistance to eat or support whilst eating, family are encouraged to provide this support if they wish to do so, particularly for those patients who have memory problems or other cognitive problems. Please discuss this with your named nurse as soon as possible. www.rdash.nhs.uk 17
Medical management Medication will be prescribed by the doctor as soon as possible to meet your medical requirements. The doctor will carry out regular reviews of your health. This may include performing simple tests, referring you to other departments or prescribing medication. You are encouraged to selfmanage your medical conditions in preparation for discharge from Magnolia, or you may have a long-term condition that you are competant at dealing with, for example, diabetes or angina. Wherever possible you will be supported to self-manage your condition and to self-administer medications. This will form part of your rehabilitation goal plan please discuss this with the doctor and / or your named nurse. Discharge planning Discharge needs will be a key focus of your rehabilitation plan. This may include equipment to help you to move safely around your home, adaptations to your home, and any care support that you many need. Some equipment may not be essential for discharge and will therefore be delivered once you are at home. Your discharge needs will be assessed and discussed with you and your family. 18 Welcome to Magnolia Rehabilitation Inpatient Unit
Practical issues Clothes Whilst at Magnolia we ask that you bring enough day and night wear, toiletries and sensible indoor and outdoor footwear for seven days. Toiletries include: Shampoo, conditioner, shower gel, soap, deodorant. Clothes include: elastic waist bottoms, (not jeans), t-shirts, jumper, underwear. We also ask you bring with you any walking aids or incontinence aids that you use at home. On Magnolia, we have our own washing facilities and this can be incorporated into your rehabilitation programme. Please provide your own washing detergents. At Magnolia we try very hard to make sure that everyone s personal clothing and belongings remain safe. However the Trust and its staff cannot accept any liability for loss or damage to personal property unless it is formally deposited with the Trust and a receipt is obtained. To help us with this there a few things you can do: Please send home any items of value, if you are wearing a cardigan or jumper please keep this with you if you remove it, only bring a small amount of money with you. Anything that you bring with you that you would like us to keep safe can be sent to our finance department and returned to you on discharge. Magnolia also has a locked door policy and has a key code entry to the ward. Parking/transport There is ample free parking space around the hospital and we ask that visitors use the Tickhill Road Hospital main car park entrance to access the ward. If you have special requirements please speak to your named nurse or the nurse in charge. Alternatively the www.rdash.nhs.uk 19
bus route that goes by the hospital from Doncaster town centre is the number 19 bus for Weston Road or the X28 which travels from Sheffield to Doncaster via Rotherham. Visiting Visiting times are currently being reviewed, please contact the ward for more details. We ask that if your relatives/friends have been feeling unwell e.g. temperature, cough sickness, loose stools in the past 48 hours that they should not visit until they have been symptom free for 48 hours. If there are people that you do not want to visit you while you are on the ward then please inform your named nurse or the shift leader. Use of telephones Patients on Magnolia may use the telephone if they wish and mobile phones are permitted in the ward area. However using a mobile telephone to take photographs of the staff, patients or facilities is strictly forbidden. Patients are asked respectfully to avoid using mobile phones after 11pm. Chaplaincy service There is a chaplaincy service at Tickhill Road Hospital. If you wish to speak to a member of the team please inform a member of staff and they will arrange this for you. However if you prefer, your community chaplain may come and visit you on the ward. If you have any requirements relating to faith or spirituality please speak to your named nurse or the shift leader. Refreshments The site has a number of facilities which provide a variety of hot and cold food and snacks. WRVS coffee shop The volunteer run coffee shop is in the entrance to Tickhill Road Hospital. Opening times: Mon-Fri 10.30am to 4.45pm, Sat-Sun 1pm to 4.45pm 20 Welcome to Magnolia Rehabilitation Inpatient Unit
The Volunteer Shop This is situated in the main entrance, across from the WRVS coffee shop. The shop sells a selection of gifts, toiletries and sweets. Newspapers can be ordered for patients and often form a part of the rehabilitation programme. The surrounding area has a number of shops and supermarkets which are within walking distance. Please ask your named nurse or the shift leader for more information. The Food and Drink Café This is located adjacent to the main car park from the Weston Road entrance. Opening times: Mon-Fri 9am to 2pm. The Garden Café Located on the ground floor to the rear of St Catherine s House. Opening times: Mon-Fri 9.30am to 2pm. Compliments and complaints. We aim to provide the highest possible standards of health care for the people using our services. If you have any comments, compliments or complaints to make about our service, we would be pleased to hear from you. Your views will help us in our efforts to improve every aspect of the service we provide. The Trust has a complaints procedure, however we are keen to address concerns immediately where possible to limit any distress caused by negative experiences. For these or any other complaints, compliments, ideas or suggestions please speak to your named nurse, the shift leader or use the anonymous comments box on the corridor. The clinical leadership team will deal promptly and respectfully with any matters raised. Alternatively you can access the Patient Advice and Liaison Service (PALS). www.rdash.nhs.uk 21
The address and contact details are: Patient Advice and Liaison Service, Rotherham Doncaster and South Humber NHS Foundation Trust, St Catherine s, Tickhill Road, Balby, Doncaster, DN4 8QN Tel: 0800 015 4334 Magnolia Lodge telephone number: 01302 796408 (this is a direct telephone number for the ward.) 22 Welcome to Magnolia Rehabilitation Inpatient Unit
This information is correct at the time of publishing Last Reviewed: June 2013 get approved We are a smokefree organisation DP7419/10884/06.13