Category Archive: Neurotrauma

Sintons continues its expansion with the announcement of promotions

Law firm Sintons continues its expansion with the announcement of six promotions across the different areas of its business.

The promotions, involving two new partners, one senior associate and three associates, recognise the talent, commitment and dedication of the individuals concerned in their specialist fields of work.

Corporate lawyer Emma Pern and private client specialist Paul Collingwood have each been promoted to partner.

Both have been instrumental in the growth and development of their respective teams and in overseeing complex matters on behalf of clients from across the UK.

Sintons has also promoted residential conveyancing specialist Suzanne Dixon to senior associate and has named three new associates – private client solicitor Lauren Fraser, dispute resolution lawyer Adam Hutton and Neurotrauma specialist Nicki Waugh.

The two new Sintons’ partners spoke of their delight at their promotion.

“It feels great to be recognised for all my hard work, but I could not have done this without the support of everyone at Sintons, my clients and my contacts. I’m looking forward to this next stage in my career,” said Emma.

Paul said: “Being promoted to partner means a great deal to me, especially in a firm like Sintons. It is a great place to work and to progress within.

“I have been supported throughout my career here and I really look forward to the future and the different challenges that my promotion will bring.”

On becoming a senior associate, Suzanne said: “I’m so pleased and proud. It reflects my hard work and dedication, and the support that I’ve had from my supervisors and colleagues along the way.”

Sintons’ new associates also spoke of their pride at the recognition of their efforts.

“I am delighted to have been promoted to associate in the private client team said Lauren.

“The firm has been incredibly supportive of my professional development, and I’m thrilled to have the opportunity to be part of its growth, both regionally and nationally.”

Adam said: “This is a firm that is committed to investing in its employees to allow them to grow and progress in their careers.

“The dispute resolution department has an excellent reputation and I look forward to contributing to its growth and development whilst continuing to work with new and existing clients.”

Nicki added: “It means a lot to receive recognition for the work I do. I thank the firm for the support and encouragement they have given to me in achieving this goal.”

Christopher Welch, managing partner of Sintons, said: “We are lucky to have talented and committed people throughout Sintons. As an Investor in People we believe in nurturing and supporting all our people and encouraging them to achieve their full potential. It is a privilege each year to be able to reward the outstanding efforts we have seen with promotion.

“Emma and Paul have been with Sintons for a number of years and have excelled in their respective fields, becoming trusted advisors to clients from across the country and supporting them in some milestone moments in their lives. I am delighted to welcome them both as partners in the firm.

“Suzanne, Lauren, Adam and Nicki have all shown outstanding dedication to their clients and their roles, playing a key part in their growth and development of their respective teams.

“We wish them all the very best of luck as they continue to progress their careers at Sintons.”

Sintons wear their Hats for Headway

Staff at law firm Sintons are wearing Hats for Headway, in support of the national initiative to raise awareness of brain injury and its impact.

As part of ABI Week, Hats for Headway has become an annual tradition, where people across the country wear wacky hats in support of those living with brain injury.

This year, Headway has extended its Hats for Headway tagline to also include Hats for Headway at Home, in recognition of the many people who are still isolating or working from home.

Sintons, and in particular its specialist Neurotrauma team, is a longstanding supporters of brain injury charity Headway and its work, and is also a member of Headway’s approved legal provider list in recognition of the legal and client service excellence it delivers.

The Neurotrauma team acts for people nationally who have sustained life-changing injuries, and are known for fighting hard on their behalf to secure the best possible outcome and bespoke package of rehabilitation possible.

“We’re wholeheartedly supporting ABI Week, as we do with the work of Headway all year round,” says Andrew McGowan, head of Neurotrauma at Sintons.

“Working with so many people and families across the country whose lives have been devastated by brain injury, we see first-hand the fantastic work Headway does in supporting them to rebuild their lives, and we’re proud to work closely with them in doing that.

“Hats for Headway is a fun annual initiative which reminds us in a lighthearted way about brain injury and how we can all pull together to help those who are affected.”

* Headway are asking anyone taking part in Hats for Headway to wear a wacky hat, donate £2 to Headway by texting HFHW to 70085 and post a picture on Facebook, Twitter or Instagram using the hashtag #HatsForHeadway.

Sintons supports Action for Brain Injury Week 2021

Law firm Sintons is throwing its support behind a national campaign to shine a light on social isolation after brain injury.

Isolation is something that affects many brain injury survivors, with the effects of brain injury, such as problems with memory, information processing, or speech, compounded by a lack of understanding of this often hidden disability, often leaving survivors lacking the confidence to interact with society.

However, the COVID-19 pandemic and repeated lockdowns has amplified that to affect many more people than in normal circumstances, with stories of survivors seeing no-one for weeks – or even months – being a regular occurrence.

This year’s Action for Brain Injury week will highlight the issue and aims to give a voice to survivors and carers, to help them better explain to their friends and families the challenges they face as a result of brain injury.

Action for Brain Injury Week, organised by brain injury charity Headway, will run from May 17 to 23.

Through its nationally-renowned Neurotrauma team, Sintons regularly works with brain injury survivors in enabling them to rebuild their lives.

The team has a first-rate reputation for fighting hard on their clients’ behalf to secure the best outcome for them and their family, which will include a bespoke package of rehabilitation and compensation.

Sintons also works closely with Headway and is one of the charity’s long-standing specialist advisors, repeatedly reaccredited in recognition of its standards of legal excellence and client service.

Andrew McGowan, Head of Neurotrauma at Sintons, says: “Living with a brain injury has many challenges, isolation being one of them, and we are well aware that so many people have felt that acutely during the past year.

“Being on your own takes an immense toll on mental wellbeing and amplifies the effect of isolation people with brain injuries feel in normal circumstances. As a firm that works very closely with clients and their families, we appreciate what a huge issue this is for so many people.

“Action for Brain Injury Week is an excellent opportunity to discuss this subject and highlight the challenges that survivors are facing. Through encouraging conversation around this topic, we will help to inform so many people and hopefully effect change.

“As a long-standing partner and supporter of Headway, we are only too pleased to again lend our support to Action for Brain Injury Week and its hugely topical and relevant theme.”

Sintons secures six-figure settlement

A cyclist left seriously injured when he was hit by a car has secured a six-figure settlement with support from Sintons.

The man was knocked off his bike and thrown over the bonnet of the car while negotiating a roundabout, leaving him with a catalogue of injuries including a traumatic brain injury, fractured temporal bone and a fractured collarbone.

Alongside the physical injuries, the cyclist also experienced significant psychological trauma, alongside cognitive impairment, memory issues, headaches, dizziness and tinnitus.

As a result of his injuries, the man – a Polish national – was forced to give up his job.

He turned to serious injury specialists at Sintons to support him in securing the access to rehabilitation he needed to rebuild his life. In addition to the law firm’s nationally-renowned specialism in life-changing injury work, it also has a dedicated Polish personal injury department, which supports nationals through the process of their claim.

With the support of Rachael Jobson, a specialist serious injury solicitor, and Polish lawyer Lucas Wojcik, he was able to access neuropsychological support as a priority.

He also secured a six-figure settlement to help fund his bespoke package of rehabilitation and provide for his future.

“Our client sustained very serious injuries in this incident, which have left him with lasting consequences,” says Rachael.

“This has been a very traumatic experience for him but he has shown great resilience and determination throughout. Despite his ongoing symptoms, he has managed to find a new job, which is testament to his strength of character.

“While some aspects of his rehabilitation have been subject to some unavoidable delay due to the COVID-19 lockdown, we have been with him every step of the way to support him through the process and the pandemic, to ensure he was given the best possible resources to rebuild and live his life.

“At Sintons, we are known across the country for our commitment to fighting hard on our clients’ behalf to secure the very best outcome for them and their families, and are proud of our reputation for doing so.

“We are very pleased that our efforts on behalf of our clients in this case have secured an outcome that gives the bespoke support he needs, and we wish him all the very best for the future.”

Neurotrauma specialist joins Sintons

A leading lawyer who specialises in life-changing injury work has joined Sintons, adding further strength to its nationally-renowned Neurotrauma team.

Hannah Fitzpatrick is an experienced serious injury lawyer who has handled cases from across the country in matters ranging from fatal road collisions to complex neurological injuries.

Hailed as an Associate to Watch by Chambers for the past two years, the independent legal guide praised her “amazing technical knowledge and understanding nature”.

Hannah, a member of APIL, has now joined Sintons as an associate, bringing further capability to its Neurotrauma team, which is regularly instructed in cases of the highest complexity from across the UK.

With a reputation for legal excellence and outstanding client service, the team is expanding on the back of its fast-increasing case load.

“Sintons is well-known for its capability and the outcomes it secures for clients, and its dedication to securing the very best for them and their individual situations matches my approach exactly,” says Hannah, who sits on the committee of Headway Darlington and District.

“I look forward to being part of such a renowned team and in helping to increase our capacity to support even more clients and families nationally.”

Andrew McGowan, head of Neurotrauma at Sintons, says: “We are absolutely committed to securing the best bespoke outcome for each of our clients and will fight hard on their behalf to make that happen. We’re very proud of the reputation we have earned for doing so.

“Hannah has a great reputation for her work in life-changing injury work and her capability and commitment make her a great asset to our team.

“We look forward to working with her as we continue to build our presence even further in this very specialist area of work.”

Neurorehabilitation and COVID-19 – a 360 degree view of the sector – episode 8

The COVID-19 pandemic is affecting all aspects of the world of neurorehabilitation, with people and businesses working within it turning to innovative new ways of working to protect and support clients.

Here, in the latest insight brought to you by the neurotrauma team at Sintons, Dr Kate Heward, clinical director at Rehabilitate Therapy, discusses how her team have made best use of technology for the benefit of their clients.

Back in early March, once it became clear that lockdown was on the horizon as Coronavirus swept through the country, we decided to take steps to prepare ourselves and our clients as best we could for what lay ahead.

From looking at what was happening elsewhere in the world, we imagined that restrictions on our movement were imminent which would, of course, impact on the very personal and bespoke rehabilitation service we traditionally give our clients. We realised that if we couldn’t go to see them in person for however long a period, we would need to replace that with something – so we set about giving our team of 17 occupational therapists a crash course in video conferencing so that they could each, in their final face to face visits and since, support and educate their clients (and families) to use the technology.

I had realised how well video could work in certain situations a few weeks before lockdown, when I was contacted about a client who was living in the Highlands of Scotland and there was no-one anywhere near who could help. I was asked whether I would consider doing an assessment remotely with a view to providing remote rehabilitation. While this was not something we would usually do, I was surprised how well it could work. Of course, not everything can be completed as effectively as in person, and technology will never be able to replace that, but I came to realise that it could work as an effective temporary substitute or supplement when circumstances dictated.

Using the likes of Zoom and FaceTime, we developed a step-by-step guide for how to access and use these apps for our team, clients and other professionals we worked with, as we knew this would be central to what we did in the weeks and possibly months ahead. The need to be proactive was so important and this is why we visited our clients ahead of lockdown and made sure they knew how to use videoconferencing. I would, for example, go into their house and help them set it up, then go into their garden to test out a call between us, so I remained on-hand to help with any uncertainties or issues.

Once we had established that clients were comfortable in using videoconferencing, we were able to design a programme around that. As well as our ongoing and programmed therapy sessions being held via video, we put together a an extra programme of free to access groups and classes. We offer at least one group every day by Zoom, ranging from exercise and fatigue management to creative writing and social groups, and the uptake has been fantastic. One of our clients, whose therapist is our senior associate Sara Grimshaw, gained a personal training qualification post-brain injury and leads our exercise classes and the feedback has been fantastic – already two physiotherapists want him to do some work with them post-lockdown. This has meant that with support of his occupational therapist, he has actively continued to pursue his rehabilitation goals even in the very restrictive lockdown. Results like this are so satisfying as vocation is at the heart of our business.

As well as offering services to our wide range of clients geographically, we are also giving opportunities for them to develop their skills and confidence in this way. Our groups are all friendly, inclusive and free of charge via our website – www.rehabilitatetherapy.co.uk. We have also made them available to clients associated with other professionals we work with – not just Rehabilitate therapy clients. Other therapists and case managers refer their clients to our online groups, and we are really pleased to include them. It does feel that we are all in this together, and other professionals such as Steve Wiseman from Steve Wiseman Associates is also facilitating a group.

Technology has helped in us being able to continue to give structure to our clients’ days – the ones who are coping best are those who have structure and have embraced our new ways of working. We always recommend to those who use diaries and planners to schedule things, even if it is just doing a YouTube workout, it’s important that is put into the diary so they can develop a plan for their day and week and maintain a structure and routine which is so important particularly after a traumatic brain injury, for example. One of my OT’s has been providing remote functional upper limb therapy to a client she had never met in person, as he was referred at lockdown. But the case manager has since contacted the OT and reported how before seeing her he was barely using his hand in any functional tasks; now he is using it to hold cutlery and eat meals. Both the client and case manager could see both the functional and psychological changes.

A routine is so important, at this time more than ever. We have a client, for example, who was  making significant progress in their community rehabilitation prior to the lockdown, and for them it has been hugely disruptive and disconcerting. All the planned sessions ended and the only visit she had was once a week from a support worker who did her shopping. As occupational therapists we are often integral in coordinating rehab support, so I quickly realised the need to be creative in re-establishing these routines. Now, this client is having two remote sessions a week with me, sessions with the psychologist, physiotherapist and speech therapist, takes part in online groups for Yoga and creative writing and has visits three times a week from support workers who go for a cycle ride and long walks with her. Her week is now full and purposeful, which is such a huge transformation from how the outlook was initially. Although it is significantly different to pre-lockdown and there are still many day to day challenges, her week has a clear structure and routine. I am certainly experiencing that those clients with structure and routine are coping much better than those who don’t.

Use of video has also therefore been really important in supporting our team. Our team have been absolutely amazing in how they have positively adapted, they have been so dedicated and proactive. Additionally, our senior associates Emma and Sara have been extremely tenacious in showing leadership to keep things progressing. Even though we can’t all get together in person, communication is absolutely essential and we want our team to know they are being supported, as well as ensuring appropriate supervision is in place. We offer our associates, who are geographically widespread, one-to-one video meetings each week, as well as the offer of weekly team catch ups, which are beneficial for us all – they enable us to deliver the best possible service to our clients while looking out for each other, as well as enabling us to share tips and best practice to keep clients engaged remotely.

We are currently prioritising putting a plan in place for when we emerge from the current situation, when social distancing is eased, and are assessing the priorities for each client. It’s very individual and bespoke to the needs of each individual, with the common theme that we need to keep our clients safe while also having very clear guidance in place so our team feel safe and supported in the job they are doing, while also ensuring we are working towards their rehabilitation goals wherever safe and feasible to do so.

The past few weeks have not been without challenges – and ironically in lockdown we have been busier than ever – but our team has really responded in the best possible way. Our use of video has been very effective and we are delighted with how many of our clients have responded positively.

Neurorehabilitation and COVID-19 – a 360 degree view of the sector – episode 7

The COVID-19 pandemic is affecting all aspects of the world of neurorehabilitation, with people and businesses working within it turning to innovative new ways of working to protect and support clients.

Here, in the latest insight brought to you by the neurotrauma team at Sintons, Dr Graeme Flaherty-Jones, a Consultant Clinical Psychologist with extensive experience of working with complex neurological disorders and leading services across the independent and NHS care sectors, discusses how the Clarity Psychology team have adapted and responded.

We are collectively living through an unprecedented time that is steeped with a sense of threat and uncertainty, yet we have also witnessed examples of true compassion that shine a light in the darkest of days. As central government measures changed how we all connect, the greatest challenge facing our team has been to adapt quickly whilst still holding true to our core values of delivering high quality service that holds the individual at the centre of all that we do.

As lockdown took effect and plunged the country into the unknown, the team recognised that many people were searching for answers and plans to bring a sense of emotionally security. This natural psychological reaction affects us all and can provoke high levels of anxiety. It can also bring about a sense of responsibility in healthcare professionals, which endangers us to ‘react’ rather than ‘respond’ sensitively to the needs of the individual we are supporting. One way of preventing us from falling into this trap has been to deliberately pause, slow it down, and create psychologically safe spaces to truly consider what our clients are experiencing.

The concept of psychological safety is all about creating an environment where individuals in the team do not fear making mistakes, asking questions, feeling uncertain or asking for help. If someone in the team worries about looking incompetent, they won’t admit mistakes, which they and others can then learn from. If a person fears looking ignorant, they will not ask the questions which could enable us to come to an answer that helped our client. Now more than ever, psychologically safe spaces have been vitally important in planning our responses during the pandemic, so that all energy is devoted to identifying what matters for that individual client, in their unique situation. When we get this right, what tends to emerge is a response for our clients and their families that has the greatest impact and offers most support.

It can seem such an obvious thing to say, but each individual has and will continue to have, different needs, at different times during the pandemic. Clearly, no individual is going to be able to adapt to remote working on cognitive rehabilitation strategies, if they don’t have access to the basic things that allow them to feel safe, such as food, finances, and so on.

Early on, we each took time out to talk with our clients, their families and other members of their care team. Asking people ‘What do you need?’ is very powerful. From these conversations we co-produced a plan around each individual, detailing how we should we respond and what will be the consequences of doing this, both now and down the line. As with the ever-changing nature of the pandemic, we all ensure that these plans are reviewed at every opportunity, which we hope allows our clients to always feel that they are ‘held in mind’.

Much has been said about the impact on mental health as a result of the pandemic, be it the enforced social distancing, the fact we cannot see our families, or fear of contracting the virus. This is certainly true for many and the true effects of the pandemic on each individual’s mental health may continue to be felt for some time.

Many colleagues have also spoken about the internal challenges we all face in having realistic expectations of ourselves – whether this be home schooling or providing enough support to clients. At a time when every day fundamental life chores are ever more difficult (figuring out a time to go food shopping which takes 2 hours instead of 1 with queuing; having to plan weekly meals ahead because ‘nipping out for something’ isn’t possible), we are all finding it difficult to flex, adapt and cope. It takes time to adjust but the expectation we might feel is that we should carry out this complex psychological process as quickly as we can.  This goes entirely against the advice given in therapy – adjustment is a process with many ups and downs, it can’t be done quickly.

We know that people tend to experience positive mental wellbeing when they have some variant of connection, hope, identity, meaning, and empowerment (often referred to as CHIME in a recovery framework). It doesn’t take a psychologist to recognise that for most people, one or more of these factors will have been affected in some way in the current climate. For example, someone who may have lost their job, or who has been put on furlough leave and can no longer financially support their family in the same way may feel that their identity has been shattered.

For many of our clients the sense of empowerment and ownership over their rehabilitation has been affected and required us to think of different ways in which they can hold onto this. However, it is important to note that there have also been examples where some experience improvement in one or more of these areas – one positive example being the emergence of increased community spirit that has increased a sense of connection for some clients who are isolated. It’s hard to overstate the importance of staying connected for positive mental wellbeing, whether that is through using video calls to keep in touch with friends and loved ones, hand writing letters, or even clapping for our key workers on a Thursday night; all of these things can all play an important role in helping us to get through this situation.

At Clarity, we are here for our clients in whatever circumstances they need us. We believe in delivering exceptional quality services, which doesn’t always involve complex solutions. Indeed, some of the most meaningful actions I’ve had the privilege to witness, have come from simple acts of kindness. Holding true to our values of kindness, compassion and exceptional quality services that are person-centered, will remain our guiding ‘compass points’ to navigate through what lies ahead.

Neurorehabilitation and COVID-19 – a 360 degree view of the sector – episode 6

The COVID-19 pandemic is affecting all aspects of the world of neurorehabilitation, with people and businesses working within it turning to innovative new ways of working to protect and support clients.

Here, in the latest insight brought to you by the neurotrauma team at Sintons, Deborah Harrison, neurophysiotherapist and group clinical lead at Neural Pathways, discusses how she has overcome the many challenges of lockdown.

In physiotherapy, where the nature of our work is having personal contact with clients and being hands-on with their therapy, the current situation of distancing and remote working is totally alien to us.

Back in early March, we recognised that lockdown was coming, so started to prepare our clients and team for what lay ahead. We made sure all of our documents were updated so we knew what support our clients and carers would need, we gave out equipment which may prove important, such as resistance bands, and updated our home exercise programmes, in anticipation of such time when we may not be able to visit clients.

When that situation became reality, I found it hard to deal with. That first day of sitting at my laptop, doing emails and calls by phone or video, instead of being out there with clients, was very surreal. In the several weeks that have followed it has become more ‘normal’ but it’s still not a situation I would ever want to adopt once lockdown is lifted. I could never imagine not getting out to see clients or not meeting in person with the team.

Many of our clients are very vulnerable so we have had to turn to measures we have never used before to ensure we continue to communicate with them. Relying on technology when we are such a client-centred service is very new for us all but something we have had to do. We had previously had some team meetings via video, but never for any work with clients. People have generally responded very well, but we appreciate it is more difficult for some than others. For some, it has been a case of starting from the basic level of getting used to using an iPad or being on a screen. Several people have said they don’t want to do video calls as they don’t feel comfortable with it, so we have to check in with them by phone instead.

Although some people were initially adamant they didn’t want to use video and would be fine on their own, we are really pleased when clients change their minds of their own accord. With one of my clients, after two weeks of isolation she got back in touch saying she had lost the structure to her day and felt she was losing all the progress she had made, and asked for us to schedule in some video calls. We hope more clients may change their minds about using video as time passes and they realise they need more interaction.

It is far from ideal but we are doing the best we can. I know it’s not my fault and is entirely dictated by the circumstances, but as a physiotherapist, you do feel a great responsibility to your clients. I am so conscious of my clients’ mental health, how much their progress will deteriorate if it the work is not sustained, but we can only do what we can, particularly when we are forced to do so remotely. It is hugely frustrating not being able to deliver what you want to.

Some of us at Neural Pathways, myself included, continue to go out and see clients in person, subject to a stringent risk assessment to ensure the safety of our team and the client. When assessing whether it was workable to go and see clients, we had to follow CSP guidelines, OT guidelines and achieve consensus from the MDT. My boss then had to sign off on this, so there were extensive measures taken to ensure it was safe for everyone involved. We highlight any issues as they occur on an ongoing basis and continue to assess the risk against the benefit.

Like most organisations working in this sector, we have had trouble finding PPE, but as this only applies to a small percentage of our client caseload, thankfully we have always been able to source what we needed. We have not faced the challenges of bulk buying PPE that so many others have faced. I have always felt safe and properly protected.

We are very keen to look ahead and are planning for such time when we can get back out to visit clients. One of our focal points at present is looking at re-opening our neuro hub, which will be such a huge boost for us all. We will have a PPE station in place and a one in, one out system of visiting, with no overlap so clients don’t come into contact with each other. Many of our clients are subject to 12-week shielding as they are particularly vulnerable, and we are looking at ways we can gradually help them get back out into the community once that period is over, with their safety of course being of paramount importance.

Our priority will continue to be our clients and we will support them however we can during this difficult period. Video calling can never replace the hands-on therapy we provide, but until such time as we can get back out to visit and treat them as we always have done, we will continue to do our best and ensure our clients know we are always just a call away.

Neurorehabilitation and COVID-19 – a 360 degree view of the sector – episode 5

The COVID-19 pandemic is affecting all aspects of the world of neurorehabilitation, with people and businesses working within it turning to innovative new ways of working to protect and support clients.

Here, in the latest insight brought to you by the neurotrauma team at Sintons, Jane Paige and Ella Cornforth, of Northern Lifetime, discuss their efforts to adapt to the unprecedented situation while maintaining the care their clients need.

Building trusting relationships with clients is absolutely fundamental to case management and that is certainly being tested at the minute with the unprecedented circumstances of COVID-19.

The care and support our clients receive will always be paramount for us, and since the social distancing measures began to be introduced, and then lockdown was enforced, we have had to be very creative and flexible in our responses. Although the business has been around for a number of years, we only joined six months ago , so this was a huge unforeseen challenge very early into our journey, but thankfully we have many years of experience of working in case management and have a strong team who are committed to adapting to this ever-changing situation.

We keep telling ourselves these are unprecedented times, there is no rule book, no-one knows what is going to happen, so we can only respond as best we can. No two days are ever the same in case management anyway, so we are viewing this as the latest challenge to get through. We are building as much supportive scaffolding around our clients as possible, so we can get through the weeks and months ahead together.

In the first week of lockdown, one of our clients had two of their staff go into self-isolation, which meant we had to respond very rapidly to ensure their usual care provision was maintained. We have also had to change traditional shift patterns in many instances to accommodate absence – whereas usually there may have been a day and night shift, now we look at what resource we have available and make provision from there. We may risk assess whether a person can manage on their own for short periods of time, and with some of the child clients we have, their parents have opted to play a greater role in their care and dispensed with paid carers altogether. This, however, needs careful monitoring.

Agencies are being very dynamic, and there are many agency staff available should we need them, but that is not always something that is welcomed by our clients, who don’t want new people coming into their homes. Some people have chosen to go into self isolation, which is working well for now, but we will continue to evaluate their situations. At some point, they may need additional help, but it depends entirely on the client and their circumstances. Every situation is wholly different, and can change by the day, which is challenging in itself.

Building a routine for our clients is very important. Whereas previously they may have had a club they attended twice a week, that has gone now, with nothing to replace it. We are working with other agencies to ensure they continue to have some structure, as that is very important for people with brain injuries. It might be the case that the once-a-month session with their psychiatrist can be broken down into shorter twice-a-week sessions, so they have that regularity of contact. Even building walking the dog into the daily routine can give some kind of structure, and can offer a form of activity that gives a sense of purpose.

We also miss the communication we have with each other. While we work across the country and will speak to each other every day, we would see each other at least once a week and that’s a very important opportunity for us to offload. Case management is an emotionally and psychologically challenging job, one which we love, but that human contact with each other is hard to replicate via video.

That is the case in dealing with our clients, too. While many are getting used to it because they have to, it’s far from ideal for the role we play and we both feel our clients are missing out by not having face to face contact. There is something very powerful about sitting down with someone, having a cup of tea with them, chatting through what’s happening in their world. They might have barriers up that we have to find ways to break down, perhaps they’ve had a bad experience with a medical or care professional previously and are not going to trust easily, so they are harder to engage. That process is even more difficult when you can’t even be in the same room.

We spoke to someone last week on video call and couldn’t see she was crying until she wiped her eyes. You can’t see the little cues and gestures that you would be able to if you were sitting down with them, and that is very difficult. If we have someone in distress then ordinarily we can say ‘Let me come and see you and we’ll chat’ but we cannot be as comforting when you have to communicate by phone or video. Clients are trying to adapt to using this form of communication but it is very challenging for them to hold meetings in this way, and can contribute to their cognitive fatigue. We are well versed in investing the time and effort to build relationships with clients, often in creative ways. That may come in the first instance from engaging through looking at photos on their wall, the fact they have a dog, the fact they have children – one client, who was particularly difficult to engage, would only open up when we went for long walks with his dogs. These are very people-centred communications which we are really missing.

Our concern is that this new-found reliance on technology may become the ‘new normal’. As many benefits as it does have – for example, we now have a WhatsApp group among our team, which is a great additional way of communicating and keeping in touch on client matters, although never as a substitute for the formal paperwork and evidence – it can never replace the power of face-to-face interaction for us and the way we work. We may be called old fashioned, but our years of experience in case management have shown us time and again that this is how relationships are built and trust is gained. Nothing can replace that for us and as soon as we are allowed, we will be back out there, seeing our clients.

We will get through this pandemic and will continue to focus on ‘making the most of life’, which is our company strapline. When we come out of the other side, we will look back and reflect on what an achievement it was to get through these enormously difficult times and know that we can get through anything, whatever the next challenge may be.

Neurorehabilitation and COVID-19 – a 360 degree view of the sector – episode 4

The COVID-19 pandemic is affecting all aspects of the world of neurorehabilitation, with people and businesses working within it turning to innovative new ways of working to protect and support clients.

Here, in the latest insight brought to you by the neurotrauma team at Sintons, Fausto Pereira, director of PH Partnership Architects, discusses how the sector is finding a technology-led way forward.

The biggest impact for us and our clients, many of whom are disabled or vulnerable, is that the majority of the jobs that were on-site with ongoing building work have had to be paused. Often the people we are adapting properties for are in hospital or temporary accommodation and, due to what has happened in the world, have been forced to stay there longer than anticipated.

We have one client who is currently in hospital and we are looking to convert two properties into one to accommodate their needs. While they own one of the properties, there are tenants in the other, which means the surveyor cannot gain access during this period of lockdown. We are keen to move as quickly as possible, so are looking at options including trialling the use of a remote camera to allow the surveyor to gain a form of access, but that is not proving easy. We will continue to look at all possibilities to allow our client to get into this property at the earliest opportunity.

Another client is an older person with a disability, who was also in hospital, following a road traffic accident, when we began plans for adapting a property for them and their family. However, after discharge to a care home this person was diagnosed with COVID-19 and had to go into hospital, but was unable to go back into the care home and is now in isolation in temporary accommodation.

Such situations are clearly very challenging, but due to the current lockdown, we can only try and get things moving behind-the-scenes as quickly as we can. The work for the second client has now started on site.

Finding alternatives centred around use of technology has been key to adapting traditional processes to enable things to proceed. We have always used technology including Building Information Modelling (BIM) and 360 degree photography, but only for our own purposes and not to share with clients – however, we have now found that this has enabled us to adapt quickly to the circumstances in which we find ourselves.

While we would normally go out to clients and use a projector to show our designs, we have found we are able to do that by video conference. Our use of BIM technology, which essentially builds a digital model of a building, is something which we are now sending to clients instead of traditional flat plans. We can share our screen via a video call so they can see exactly what the plans entail and can ‘walk through’ the property. If they want a room to be expanded, we can literally drag the cursor there and then to make the room bigger. It is proving to be hugely valuable. While BIM is not something that is usually used in small projects, we use it as part of our workflow, and are now able to share this to the benefit of our clients.

We are holding a pre-start meeting this week with a contractor by use of video call, which would ordinarily be held in person on site. We usually take some 3D views of the site for our own records, but on this occasion we will be using these instead of visiting the site. We have panoramic pictures of every room, so if there is a query, we can use our digital walk-through as reference, rather than putting people at risk by visiting together. Once work recommences on sites, matters like inspections on site could be completed by means of sending a photo or video – it does not always have to be in person.

Similarly, I did a survey on a property for a family pre-lockdown, and while they cannot visit at the minute, I took some 3D photographs during my visit which I have been able to show them so they know exactly what the property looks like.

There was also a project for a disabled client which involved us needing some permission around a public drain in the back garden, which we needed to deal with the local utility company. Experience tells us these things can take some time – but on this occasion, due to the company’s home-working policy, we were able to avoid going through the usual process and contacted the relevant person directly at the first time of trying. They immediately responded, asking for a photo or video, and things were moving within two days. This is almost unheard of, but this was a very refreshing change which has significant benefits for organisations like ours, and most importantly, the client.

This use of technology has been a natural progression of what we do already, and we hope we have given people more incentive to follow the digital process. In the past, some of our clients have been quite reluctant to use digital means, but now there isn’t a choice. Many of our meetings are across the country and in many circumstances we are discovering that videoconferencing can work just as well as face-to-face. There seems to be definite potential for this to be more widely adopted even once we have returned to ‘normal’.

Currently, it seems many of our contractors are looking to get back on site by mid-May, which will hopefully mean some of our projects can begin or resume in the near future. The construction sector as a whole has never really stopped work during the pandemic but the Government has been keen to keep things going. Our projects stopped work for the safety of everyone involved, and once work recommences we will be sure to ensure the new Health and Safety measures in terms of distancing and practices are implemented. Contractors are used to working with deadly asbestos and in other hazardous situations, so hopefully this is something that will be straightforward and they will willingly adopt.

We have been surprised how well the process has worked so far. We have been able to get planning applications in and tender enquiries out, as well as completing design work for vulnerable client projects, meaning we are doing all we can to get it as far along the process as possible. Our use of technology has allowed us to adapt quickly and ensure our service has not been interrupted – we have also been keen to share best practice in this area with other businesses we work with, for the benefit of us all going forward.

Neurorehabilitation and COVID-19 – a 360 degree view of the sector – episode 2

The COVID-19 pandemic is affecting all aspects of the world of neurorehabilitation, with people and businesses working within it turning to innovative new ways of working to protect and support clients.

Here, in the second of a series of insights brought to you by the neurotrauma team at Sintons, His Honour Judge Jeremy Freedman, Designated Civil Judge for Northumbria and Durham, shares the sweeping changes made to the justice system.

As with all aspects of life at the minute, the impact of the COVID-19 pandemic on the justice system has been far reaching and dramatic. However, the wheels of justice have not come to a standstill although we have had to make very significant changes to the Court process.

Criminal trials have ceased completely since even before the formal lockdown and the level of hearings in criminal courts has reduced by more than 80 per cent. Only case management or sentencing matters are being heard and they are being done remotely. This is creating a massive backlog and there are already starting to be very lengthy delays between a first appearance and the likely start of a trial. This will create huge pressure once we get back to normality.

In the civil jurisdiction, we are not having any live hearings and most people, myself included, are working remotely. We are using a variety of different platforms, such as telephone or Skype, although we will also be able to use Video Cloud once that is rolled out across the justice system.

Urgent applications remain exactly that – urgent – so they will be dealt with as such, although remotely through the use of telephone or Skype. A judge needs to be sent an e-bundle we are currently working in a paperless way as far as possible, given the difficulties in the transmission of bundles of documents. We will then deal with it remotely. I have dealt with a number of matters by telephone and Skype already and that has been fine.

The use of electronic means is working well for sending in bundles and applications to the court and I would encourage solicitors and barristers to cooperate with this. By sending an application to the court in paper form, it then has to be linked to the file by a member of the court team but, inevitably, our team is greatly reduced at present. It will then have to be forwarded on and processed, and as Judges are working remotely in the main, this can add further delay. If it is sent electronically either to the Court or a particular Judge, that is a far better course of action.

Courts are still staffed so they are operational, while working within the rules to ensure the safety of everyone who works there. We hope that in the near future we may be able to make use of Video Cloud to recommence some of the proceedings which cannot take place at the minute. Contested trials, where witnesses need to give evidence, have stopped in the current circumstances, but with better technology we could perhaps revisit this. This is an area which is continually under review.

While we have had to adopt a number of new ways of working, and will continue to do so as more options around technology become available, it is important to stress that we are still working. Urgent applications are being dealt with as the priority they are, although some other matters are subject to delay. Our court teams are coping well to ensure as much is being done as possible.

Neurorehabilitation and COVID-19 – a 360 degree view of the sector – episode 1

The COVID-19 pandemic is affecting all aspects of the world of neurorehabilitation, with people and businesses working within the sector turning to innovative new ways of working to protect and support clients.

Here, in the first of a series of insights brought to you by the neurotrauma team at Sintons, Jules Leahy, development director at STEPS Rehabilitation, a dedicated rehab facility in Sheffield, shares how the centre is achieving many positives from the most difficult of times.

Protecting our clients is always our priority, but keeping them safe during these current times is the overriding concern. For some of our clients, due to the nature of their injuries and conditions, they could have a survival chance of less than 50% if they contracted COVID-19, so we addressed the risks in this area at the earliest opportunity.

We have been planning for the onset of Coronavirus since the end of January and introduced lockdown in mid-March, a week ahead of the official Government instruction.

A swift redesign of our centre layout followed and we moved our most vulnerable clients – those who have a tracheostomy – to the top floor, in an area of the building that can be closed off by doors normally left open. We relocated our games room and created a mini gym just for their use, so they could have some time outside of their rooms In the last week we have also introduced rehab sessions in our garden for certain clients to attend, one at a time, and with extensive cleaning of our lift and equipment between each patient’s use.

We have gone to great efforts to give all our clients as much normality as possible in these far from normal times. Not having regular visits from family and friends is enormously challenging so we have created folders for every client with a record of things they like, compiled in association with their loved ones, so we can be sure we are doing something with them they enjoy.

Everyone has access to an iPad, we have invested in 15 more so we have enough within the centre, so they can video call family and friends, as well as each other. We have had afternoon teas and we are doing a quiz every week for all of our clients, as communication and social interaction is so important, even if that can’t be achieved in person. We realise being in their rooms for such a long period of time each day is very challenging for our clients and their mental health, but we ensure they have one-to-one time with a rehab assistant or wellbeing co-ordinator for some time for an activity they enjoy, be that playing a game, potting plants, having a hand massage, or anything else they enjoy.

We have discovered a number of new ways of working and of delivering rehabilitation, which benefit us greatly, one of the main ones being that some of our therapy sessions and medical assessments are now being delivered by video. Our neurologic music therapy sessions, which are hugely popular, are now held via Zoom, with an assistant on-hand in person to assist if needed with any movement.

Recently Dr Liz Iveson, a wonderful consultant we work with, diagnosed a problem via video which could have led to this particular client losing their sight had it remained untreated. We have always worked in an interdisciplinary way, but currently that is even more useful to us. For example, instead of nurses having to put on their full PPE to enter clients’ rooms to do a temperature check, if a physiotherapist is already there, they can do that instead.

A number of new staff members have joined us, who are fantastic, and we adopted a new way of recruiting which may well become more widely used. We couldn’t hold our usual recruitment days so held telephone interviews and then offered on-site experience to see how they took to the roles and interacted with our clients. We have found several really excellent new team members – some are students who are not able to go to university in the current climate, some are self-employed people who cannot do their usual jobs, and we have some brilliant physiotherapists with us who are ordinarily university lecturers with private practices – we have been able to build relationships with them we are confident will last well beyond the COVID-19 lockdown.

Our team have responded to the situation in the most superb way and we are genuinely all in this together. Everyone has stepped up and goes well above and beyond what is asked of them, working extra hours to ensure our clients are safe, well and happy. A really strong community has emerged among our staff as we all work to keep morale up. We are now a stronger team than we ever have been.

While we have discovered many new positives from this unprecedented situation, we have also had to deal with significant challenges. In early April, one of our clients became poorly and was taken into hospital with suspected COVID-19. The hospital wanted to send the patient back to us, and the family was desperate for them to be discharged, but we insisted this could not happen until the client was tested for COVID-19, so we could make proper provision in case of a positive diagnosis. The client was confirmed as having COVID-19 so we had to make some further rapid changes within the centre. We created a totally segregated section for this client, so they would not come into contact with any other clients, and a limited number of staff, all in the appropriate PPE, visit this area only.

As with other healthcare organisations across the country, we have struggled to obtain PPE. We were initially offered 300 surgical masks by PHE but that was nowhere near enough – we have clients with tracheostomies, we need full PPE to keep them and our staff safe. It has almost been a full-time job in finding this equipment ourselves. We have had to source overalls from a local decorating shop, as medical PPE has been so challenging to source – we have ordered 1,000 pairs. At one point we also had bin bags ready to turn into aprons – luckily some aprons arrived and we didn’t have to use them.

For a small business like ours, we have had to make huge investment into buying equipment, implementing new processes and taking on new staff, but this is what we will continue to do to ensure everyone stays safe. We have seen an amazing team effort from our staff and clients alike, the way everyone has pulled together during these very difficult times has been incredible, and I couldn’t be prouder of what we have done.