Our holistic and compassionate service encompasses everything from essential health needs to lifestyle, ensuring that our clients and their families are confident that every aspect of the client’s life is fully supported.
We take a positive, empathetic and personal approach to supporting our clients to achieve their potential through rehabilitation and therapy.
We work closely with the client and family to complete a detailed and comprehensive assessment, and use that information to create full care plans and risk assessments.
Once a case management plan is in place, we are here to ensure the highest quality of care and support, to answer your questions and help you to adapt to new challenges – from changing clinical needs to pursuing hobbies and managing intimate relationships.
Every case management plan is bespoke to a client’s specific needs, and is developed and managed through a process of ongoing assessment and collegiate collaboration.
Typical stages of a client assessment:
Referral
In some cases, we are approached by Court of Protection deputies or litigating solicitors, before, during or after a personal injury or clinical negligence litigation. In such circumstances, we have positive experience of being jointly instructed by claimant and defendant solicitors.
Alternatively, we may be approached by a deputy, or other representative, where someone has suffered a brain injury, or other complex injury, and has settled their litigation but continues to require a case management intervention.
We may also be approached to provide case management to people diagnosed with complex conditions, such as cerebral palsy, serious learning difficulty or a chronic mental health condition.
Assessment
A comprehensive immediate needs assessment (INA) will be carried out face-to-face with the client and, where possible, family members. We will produce an immediate needs assessment report that will identify immediate requirements, and provide recommendations for all necessary case management, medical interventions, therapies and support worker inputs.
Our INA report will provide a detailed estimation of all anticipated costs for case management time for implementing a care package, along with all other recommended services and interventions.
Our INA report will identify the types of care services that will be needed – for example personal care and support, specialist therapies, accommodation and specialist equipment. We also consider the support needed for other aspects of life, like transport, education, employment and the ability to pursue leisure interests. The report will detail how the case management service will work alongside statutory services and will apply for all appropriate benefits.
Care team provision and management
As part of our case management service, we will – where required – put in place and manage a care and support team to meet the client’s needs, and will ensure that all regulatory requirements are met. We will, in collaboration with relevant stakeholders (such as deputies), be responsible for recruitment, induction, training and ongoing supervision and management of the care team, and provide all documentation and monitoring to ensure high-quality, compassionate and safe care.
Our case management service focuses on goal-oriented actions to meet the client’s care and rehabilitation needs. The case manager coordinates the necessary services including the NHS and local authorities (e.g. social services and education) along with private therapy providers and other services (such as transport, accommodation and specialist equipment providers).
Regular client contact
Close relationships are vital to ensure the comfort and confidence of our clients and their family members. As well as keeping in touch by phone and email, our case managers regularly visit our clients and their families at home or in hospital, rehabilitation centre, educational setting or workplace. Your case manager is the lynchpin of the team, providing family support as well as being a key point of contact for you and all the professionals involved. As a small team, we all know all our clients, assuring you of continuity and all-encompassing support.
Progress reports and reviews
People with complex health conditions often find that their needs fluctuate – sometimes rapidly. At Kevin Cross Case Management will ensure that progress and changing needs are monitored and reported regularly.
If requested by the referrer, client progress and changing needs can be recorded through case management progress reports.
This longstanding client is a young girl with a serious brain injury resulting from a negligent misdiagnosis as a baby. Kevin first met her and her family, together with her first case manager, when he was instructed by the Court of Protection deputy to carry out an immediate needs assessment and write a recommendations report.
Finding a Way to Help
A few years later, some things for the family had moved on, but the rehabilitation of their daughter had not. In difficult circumstances, Kevin met with the family again. The family spoke of their frustration with the existing case management team, as the parents felt that they were not being listened to and that their daughter’s needs were not being managed proactively enough. The family expressed their concerns that rehabilitation efforts were lacking and were not joined-up, and that communications generally were poor.
With the agreement of the family, the litigating solicitor and the Court of Protection deputy, Kevin took over the case management provision at this time.
Several years on, KC-CM’s depth of experience, and structured, proactive approach, have made a tangible difference.
Involving the family in all significant decision-making; we co-ordinate a multi-disciplinary team (MDT) including a clinical psychologist, speech and language therapist, occupational therapist, physiotherapist, hydrotherapist and dietician.
We recruit and manage a small team of support workers, to whom we provide ongoing training and supervision. We schedule and chair regular team meetings – which always include the family – to enable a process of true interdisciplinary rehabilitation. We collaborate with everyone in that team to enable effective clinical planning and information sharing, and the family feels confident that communications are regular and open.
Supporting the Family Experience of Brain Injury
Brain injury is always a family experience. It could be said that this is particularly the case when a young child is the focus; but the family members of any injured person will always seek to be involved, consulted and informed about goals and plans. Our depth of experience and our appreciation of the issues that affect families have given us very good understanding that the only way to a truly successful outcome is for the whole family to be on board.
In the early days of Kevin managing this particular team, he needed to work hard to establish trust and rapport between family members and the therapy team. It was necessary for him to continually show to all parties that his commitment to placing the family at the centre of the rehabilitation process and decision-making would be unwavering. This involved his managing a number of complex dynamics, as some team members who were newer to community rehabilitation were not used to working in this way.
Having built that relationship, KC-CM now enjoys a very good level of trust with the client and her family, as well as with the now well-established team of therapists and support workers. KC-CM know that they cannot rest on their laurels, though! Ongoing maintenance of that relationship remains key.
These interventions are very long-term indeed, and we hope to continue working with this client and her family for the foreseeable future. To that end, we continue to liaise with her litigating solicitor, and we are required to occasionally meet with the expert witnesses and barristers instructed in that process. It is always our clear understanding that our role in that process is a neutral, purely clinical one.
This young adult man had sustained serious brain injuries in a road traffic accident. When we first met him, he was still in hospital, but determined to discharge himself and live independently. He was also in great need of a cranioplasty, as this was a major barrier to his progress, and we were able to liaise between him, his family and hospital services to enable this operation to be undertaken privately.
His case was pre-litigation and we supported him in finding rented accommodation, identifying a budget and geographical area, and liaising with property and letting agents. Once we found suitable accommodation for him, we ensured it was furnished and equipped to support his needs.
We then ensured he was registered with a local GP, and introduced him to a support worker team and therapy team including psychology, occupational therapy, language therapy, physiotherapy and personal trainer.
The client found a lot of this very challenging and it was necessary for the package of care to be constantly changed and renegotiated with the client to try and find solutions and overcome his reluctance to engage.
Managing behavioural challenges common in men with brain injury
Young men are the biggest demographic for brain injuries, as they tend to be the biggest risk-takers. This client was no exception.
Due to the nature of his injuries, he remained particularly vulnerable, but was also un-insightful about the risks to him and how he needed to live to mitigate them.
Exceptionally disinhibited and impulsive, he could be verbally aggressive and dismissive of the importance of rehabilitation and the value of his therapy team. His frustrations led to him demanding constant changes to his team and care package. Our role centred around negotiating with him to put in place support workers and therapists whom he would agree to work with (or at least tolerate).
With extensive experience of working with legal teams, as well as managing our client’s challenging behaviour, we were involved in a great deal of liaison with his solicitors and the Court of Protection deputy.
At the centre of everyone’s concerns was how to manage a young man with impulsive and faulty reasoning due to serious brain injury to enable him to live safely in the community.
Our client was an older gentleman with a learning disability who, since the death of his mother, was the sole beneficiary of her estate (managed by solicitors) and living in supported living accommodation. As well as learning difficulties, he had an ongoing medical condition requiring regular hospital visits, and extensive liaison with statutory services, hospital staff and his deputy team.
We were involved in mental capacity assessments, liaising with the hospital and consultants, and joining up individual strands of his care into a single therapeutic approach. This involved everything from facilitating his hospital visits for treatment to ensuring that his care home and social worker were meeting his needs.
Our client’s affairs were managed by the Court of Protection deputy, and we were also asked to add an extra layer of value to his care and support package by finding and facilitating leisure activities that he enjoyed.
He had a real talent for music, and loved to go to West End shows and the opera, as well as having an interest in trains. It became our role to research shows and attractions that he would enjoy, and accompany him. Over the years we took him to musicals and operas, for tea at the Drury Lane Theatre and on the Bluebell Railway.
We also had to keep a close eye on his care, as he was remarkably adept at hiding his level of need and declining assistance. This caused issues ranging from his refusal to wear a hearing aid, to more significant gaps in his health care. We had to challenge his social workers and care home as a result, as they were not always making the best choices for him about his care.
This is challenging, as we are not a statutory service, and have no statutory authority.
But through our experience, and proper use of the Mental Capacity Act, we were able to demonstrate the gaps in his care.
This case is an example of how, even when we are not directly responsible for co-ordinating a therapy and care team, we can add value to someone’s life in different ways. Our relationship with this client became close, and when this charming gentleman eventually died, since he had no family, we organised his funeral and gave the eulogy.
Kevin Cross Case Management
Unit 6, Ringles Business Park, Grigg Lane
Headcorn, Kent, TN27 9LY
[T] 07808 845985
[E] info@kc-cm.org
