Richmond Community Neuro Rehabilitation

Who we are

Richmond Community Neuro Rehabilitation Team (CNRT) is an NHS service for adults with a neurological condition.

The team consists of neuro rehab specialist:

  • Physiotherapists (PT)
  • Occupational Therapists (OT)
  • Speech and Language Therapists (SLT)
  • Dietitian
  • Multiple Sclerosis Nurse
  • Parkinson’s Disease Nurse
  • Neuro Wellbeing Nurse
  • Therapy Assistants 
  • Administrative staff

What we do

We work with people and their family/carers to help them achieve maximum independence in all aspects of daily life.

We aim to:

  • help you use tools and strategies to manage any related difficulties
  • help you to live well with your neurological condition.

Therapy is delivered in the most appropriate setting, either as an outpatient at Richmond Rehabilitation Unit, or at their home or in the community.

We also provide a Stroke Early Supported Discharge (ESD) service. This is an intensive rehabilitation service for stroke patients to facilitate early discharge home from hospital.

Richmond MS Nurses.JPGWho we see

We see adults (18 years+) with a neurological diagnosis and whose primary presenting need is related to that condition.

This service is for people who live in Richmond and have a Richmond GP.  

physio at workWho we are

We are a team of specialist Physiotherapists (PT) with experience in treating people with neurological conditions. Our assessments and treatment programmes use detailed analysis of movement and how it impacts on every day function.

The aim with all treatment programmes is to facilitate the person to self-manage their condition as much as possible and to support care givers. 

What we do

We provide:

  • Assessment of postural control and movement 

  • Assessment of motor skills - bed mobility, transferring, sitting and standing balance, walking, managing stairs and getting up from the floor.

  • Exercise programmes

  • Re-education of balance and gait. 

  • Provision of appropriate walking aids including orthotics and/or referral to a specialist clinic. ​​​​

  • Spasticity management including referral to spasticity clinic  and provision of timely rehabilitation following Botox injections.

  • Positioning and Posture Advice 

  • Exercise and balance classes
     

 

OT photo 2015.jpgWho we are

We are a team of specialist Occupational Therapists (OT) with experience in treating people with neurological conditions. 

The aim with all treatment programmes is to facilitate the person to self-manage their condition as much as possible and to support care givers.

What we do

Occupational Therapy  provides practical support to help increase peoples independence, enabling people to do the activities (occupations) that matter to them. This could be essential everyday tasks such as looking after yourself, work or social activities.

For example, we help people manage:

  • Personal care tasks (e.g. washing and dressing)
     
  • Household tasks (e.g. cooking and cleaning)
     
  • Vocational rehabilitation (i.e. returning to work)
     
  • Leisure and social activities
     
  • Arm and hand function
     
  • Functional mobility and transfers
     
  • Fatigue management 
     
  • Adapting to changes in vision or visual perceptual difficulties (e.g.hemianopia)
     
  • Cognitive rehabilitation (e.g. memory, attention)
     
  • Equipment to aid independence
     

speech therapists talkingWho we are

We are a team of specialist Speech and Language Therapists (SLT) trained to treat communication and swallowing disorders for people with a neurological condition. 

We also see people who not have a neurological condition (such as, dementia) for swallow assesment and advice (dysphagia). We are not commissioned to support people with communication difficulties related to dementia or other non neurological conditions. 

What we do

We assess, diagnose and, where appropriate, provide goal-led therapy programmes to support aquired communication difficulties relating to their neurological condition.

For example:

  • Dysarthria (unclear speech): difficulty achieving clear or loud speech secondary to a neurological condition, eg, Parkinson's
     
  • Aphasia (language impairments): difficulties understanding and expressing spoken or written language 
     
  • Cognitive Communication Disorder: communication disorder primarily associated with cognitive impairment  


We provide direct therapy as well as education, advice and support to family and carers, includig referrals to local support groups.

We assess, diagnose and provide safe swallowing recommendations for people with swallowing difficulties relating to the mouth and throat (oral-pharyngeal dysphagia). Please note: oesophageal stage difficulties should be referred to gastroenterology.

 

Hospital SignWho we are 

A specialist Dietician with experience in treating people with neurological conditions.

What we do

  • To integrate patient’s nutritional treatment into their overall CNRT care
  • Provide impartial and evidence based advice about nutrition and health for a range of neurological conditions.
  • Advise on food related problems, treatments and disease.
  • Advise on dietary management to limit future neurological events e.g. stroke
  • Ensure dietary advice is person specific and meets nutritional needs
  • Raising awareness of importance of good nutrition with patients, carers, health and social services, family and friends.
  • Work jointly with other team members and other professionals e.g. Speech and Language Therapists for patients with dysphagia (swallowing problems)
  • To support and counsel patients throughout their  decision regarding artificial nutritional support e.g. Percutaneous Endoscopic Gastrostomy (PEG)

 

Who we are

  • Janice Newbery - Multiple Sclerosis Nurse Specialist
  • Wioletta Kironde - MS Administrator  

What we do

  • Support,advice and information for patients who have recently been diagnosed with MS

  • Ongoing support for patients with MS and their carers via telephone or direct contact

  • Specialist nursing assessment and advice on the management of MS, working closely with therapy colleagues within the Community Neuro-Rehab Team      

  • Links between community and hospital services      

  • Case management for patients with complex needs      

  • Links to other services supporting people with MS, making referrals when required 

  • Education and training for health and social care professionals involved in MS 

For more information please see MS Nurse Specialists - Richmond 

Parkinsons nurse.JPGWho we are

Neda Rahmani-Khezri - Parkinson's Nurse Specialist to support people with a diagnosis of Parkinson's Disease (PD).
 

What we do 

The Parkinson’s Nurse Specialist provides people with information and advice to support and help self-manage condition.

This service aims to help maintain a good quality of life for patients  and their family/carer through:

  • Advocacy

  • Support for patients, families and carers

  • Facilitating medication management

  • Management of symptom control

  • Providing co-ordination of care with other professionals that are involved

  • Education about condition and how to self-manage

  • Information and advice

  • Telephone advice line 

We provide a 6-week PD exercise class and also run a weekly newly diagnosed PD clinic alongside a physiotherapist. We also offer a newly diagnosed PD education group which is run twice a year.

The Parkinson’s Nurse Specialist can provide advice over the phone, at clinic or at home for house bound patients.

Who we see

People who have a confirmed diagnosis of Parkinson's. This service is for people who live in Richmond and have a Richmond GP.

Self referrals are accepted. 

 

physio at work.jpgWho we are

We are a team of specialist Physiotherapists (PT), Occupational Therapists (OT) and Speech and Langauge Therapists (SLT).

What we do

The stroke early supported discharge team (ESD) provides an early, intensive rehabilitation service for people who have had a stroke. This service enables people to leave hospital early to continue their therapy and rehabilitation in their own home. The aim is to maximimise independence as quickly as possible after their stroke. 

This service is provided for up to 6 weeks; at home, at the Richmond Rehabilitation Unit or in the local community.

Once a referral has been received, we aim to assess within one working day (Monday to Friday) at home.  We offer daily therapy sessions (if required)  for the first two weeks. After this time treatment will gradually reduce in intensity over the next four weeks.

People may also be supported by a care package or district nurse if needed and must be organised prior to discharge. Any equipment must also be organised prior to discharge.

Who we see

A person who has a confirmed diagnosis of a new stroke by Consultant or scan and lives in the borough of Richmond with a Richmond GP.
The person must:

  • Have adequate cognitive ability and communication to be safe at home
  • Able to transfer with assitance of 1 +/- equipment 
  • Able to actively participate in daily rehab
  • Have identified goals
  • Agree to rehab at home with this intensity

How to refer

We accept referrals directly from stroke units.

 

Who we are

Memory Musamadya - Neuro Wellbeing nurse
 

What we do

This service supports people with a neurological diagnosis who experience psychological symptoms, including anxiety, low mood and feeling overwhelmed which impacts their rehabilitation and general wellbeing. We aim to provide strategies and tools to help manage these symptoms. 

In cases where people experience symptoms which are a high risk to their life or others, we can refer to secondary mental health services, emergency services, GP or Kingston and Richmond Assessment Team for an advanced mental health assessment.
 

Who we see

We see people with a neurological diagnosis who are experiencing psychological symptoms. This service is for people who live in Richmond and have a Richmond GP.
We accept referrals via Single Point of Access.

 

 

Pressure Ulcers

Pressure ulcers (also known as pressure sores or bedsores) are injuries to the skin and underlying tissue, primarily caused by prolonged pressure on the skin.

They can happen to anyone, but usually affect people confined to bed or who sit in a chair or wheelchair for long periods of time

(source: www.nhs.uk/conditions/pressure-sores)

For more information, please visit page below:

www.hrch.nhs.uk/patients/patient-safety/pressure-ulcers

Sepsis

Anyone with an infection can get sepsis. It can be life threatening and difficult to spot. Please see link below for more information on symptoms and advice.

www.nhs.uk/conditions/sepsis

Urinary Tract Infection (UTI)

If you are concerned that you may have a UTI, please see the link below for a list of symptoms and advice

www.nhs.uk/conditions/urinary-tract-infections-utis

Chest infection

If you are concerned that you have a chest infection, please see the link below for a list of symptoms and advice

www.nhs.uk/conditions/chest-infection

Falls

What should I do if I fall? (pdf)

Falls and injury booklet (pdf)

Referrals

We see adults (18 years+) with a neurological diagnosis and whose primary presenting need is related to that condition. This service is for people who live in Richmond and have a Richmond GP. 

The Speech and Language Therapists also see people who have an acquired or long term dysphagia (swallowing difficulty) and do not need to have a neurological condition. 

How to refer

We accept referrals from GPs, consultants and all health and social care professionals. 

All referrals should be made via Single Point of Access (SPA) using the form linked below. 

No referrals will be accepted via phone or email.

DOC file iconReferral form

Who we don't see

  • Learning disability
  • Mental health problem
  • Substance misuse (ongoing)
  • Dementia (however the SLT service provides swallow assessment and advice  for these patients)
  • Traumatic injury or new medical condition unrelated to their neurological condition. E.g. a fracture or pneumonia
  • Multiple active unresolved medical needs taking priority over their underlying neurological condition
  • Peripheral neuropathies – discuss on an individual basis
  • Single nerve palsy related to trauma
  • Nerve root involvement related to disc protrusion
  • Non-organic conditions (e.g. functional neuro disability) and M.E
  • People whose needs are for equipment or environment adaptation only- please contact Richmond Social Services Adult Access team on 020 8891 7971
  • People with a voice disorder. Please refer to Specialist Voice Therapy SLT Team via SPA
  • People with a developmental or acquired stammer
  • People with difficulty swallowing secondary to an oesophageal diagnosis
  • People with communication difficulties secondary to dementia
  • People with communication difficulties relating to a learning disability or mental health problems 
  • Support with enteral tube feeding (Kingston Hospital Dietetic Department support with this)