Thomas Edward Mitton - The Disabilities Trust

Thomas Edward Mitton
House

“We aim to provide
the best quality
neurobehavioural
rehabilitation
for people with
complex and
challenging needs
after brain injury.
Ultimately, we want
to enable service
users to participate
in life as fully as
possible, needing
the least possible
assistance.”
Professor Michael Oddy,
Director of Clinical
Services, BIRT
2

What is Thomas Edward
Mitton House
Located in Milton Keynes, Thomas Edward Mitton
House is a specialist rehabilitation centre that provides
residential rehabilitation for people with acquired
brain injury. It forms part of the nationwide network of
rehabilitation support services provided by The Brain
Injury Rehabilitation Trust (BIRT).
What does it do
Thomas Edward Mitton House works with people
who have to cope with a range of cognitive, physical
and/or emotional symptoms following a brain injury.
Rehabilitation is based on a neurobehavioural approach
and focuses on enabling service users to function more
independently and to participate in as many of their
previous roles and activities as possible, while developing
their lives with privacy, dignity and respect.
3

Facilities
Set in attractive landscaped gardens, Thomas
Edward Mitton House offers an outstanding setting
for rehabilitation. All service users have their own
comfortable en suite bedrooms, complemented by
spacious and well-appointed communal areas for dining
and relaxation.
Rehabilitation takes place in a modern, tranquil and
superbly equipped environment, with a special emphasis
on assistive technology. Service users enjoy access to
a wide range of therapeutic and recreational activities
including cooking and computer skills and a dedicated
games room.
In addition to the main 16-bed residential centre there are
two nearby transitional living units where service users can
continue their rehabilitation in a community environment.
We also offer a supported house in the local community,
where residents who have reached their optimum level
of independence are able to live with staff support, and
an assistive technology bungalow for assessment and
rehabilitation.
4

Environment
Access to the wider community forms an important part
of rehabilitation. Its close proximity to shops and leisure
facilities and easy access to the centre of Milton Keynes
makes Thomas Edward Mitton House ideally situated
for social integration and also offers opportunities for
education and work placements.
Family support
Thomas Edward Mitton House operates a family support
group for relatives of service users to provide education
and emotional support, both individually and within a
group setting.
5

Assessment
When a service user is admitted to Thomas Edward
Mitton House they undergo a 12 week neurobehavioural
assessment to determine their potential for social
reintegration and increased independence. This includes
assessments of, for example, cognitive skills, the nature
and frequency of any challenging behaviour and the
service user’s ability to engage with the community and
complete functional daily tasks.
At the end of the assessment period, a meeting is held
at which family, funders and other involved parties join
the team to discuss the results. This enables the team
to identify any barriers to recovery and link these with
a course of rehabilitation and support, while also taking
into account the aspirations of the service user and
family members.
6

Rehabilitation
If a formal course of rehabilitation is recommended,
the service user begins an individualised treatment
programme. This includes learning and therapeutic
sessions, personal, social and domestic skills, guided
leisure time, community access, behavioural management
and vocational training and support. Service users are
actively involved in reviewing their progress against
pre-agreed outcomes.
The average length of a residential placement varies
depending on an individual’s needs, with many of our
service users moving on to live in a more independent
supported environment in the community. There are
also opportunities for short-term and weekdays-only
rehabilitation .
7

“This service
is very
professional and
well organised.
I would highly
recommend it.”
Referrer
Clinical practice and
clinical team
The clinical team at Thomas Edward Mitton House
comprises professionals from a wide range of disciplines,
all of whom are recognised in their field as having special
expertise in the management of brain injury. The team is
led by a consultant in neuropsychology and rehabilitation
and includes a clinical psychologist, speech and language
therapist, physiotherapist, occupational therapist and
rehabilitation support teams.
Clinical practice is based on a neurobehavioural approach
and focuses on a combination of social and behavioural
interventions to aid recovery of independence. The
emphasis of assessment is on a systematic and structured
observation of behaviour and skills in everyday situations
and tasks. Clinical governance is promoted through BIRT’s
Clinical Executive, a national forum comprising consultants
in neuropsychology and rehabilitation from across BIRT’s
services. Led by Professor Michael Oddy, the Clinical
Executive is committed to promoting clinical governance,
training and research, as well as developing and reviewing
clinical policies and procedures.
Accreditation
Thomas Edward Mitton House has been awarded full
accreditation with the Commission on Accreditation of
Rehabilitation Facilities (CARF), and is registered with the
Care Quality Commission (CQC), receiving consistently
excellent reports.
8

Continuum of care
BIRT offers a nationwide continuum of services for people
with acquired brain injury including post-acute hospitalbased
rehabilitation, assessment and rehabilitation,
continuing rehabilitation and community support services.
The duration of placements at Thomas Edward Mitton
House varies, depending on the service user’s level of need
and their potential for rehabilitation. A service for those
with longer term rehabilitation needs is also available.
9

Meg’s Story
“I am settled into my room and my new lifestyle
and I’m pleased to say that I love it. Moreover, I’m
moving onto my next step of living independently
in my own house.” Meg Elliot
In August 2010, Meg Elliot, 26, was involved in a serious accident while
climbing in Snowdonia. She was a very experienced climber and
worked as an instructor for a local climbing centre. However, due to an
unfortunate sequence of events, she fell from a height of 30 feet off a
vertical rock face, striking her head upon impact and suffering a severe
brain injury. She also received a broken neck, back, ribs
and a punctured lung.
Meg was admitted to Liverpool Hospital Intensive Care
Unit where she remained for four months. The first
two months she spent in a coma. When she regained
consciousness, she had no recollection of the accident.
Meg was transferred to Thomas Edward Mitton
House (TEM) in December 2010. With the help of the
TEM team, and much self-determination, she made
rapid progress, with a programme that included occupational therapy,
physiotherapy and speech and language therapy.
When she arrived at TEM, Meg found it a challenge to walk, even with
a wheeled walking aid. Not only is she now able to walk with just one
stick, but, with her sister Ruth, she has also come second in a sailing
competition.
Shortly before her accident, Meg had graduated from Bangor
University with a 2:1 in English, and she continues to pursue her
passion for words by creating a newsletter for TEM House, as well as
writing an article, on which this case study is based.
10
Meg has now moved to a community house in Northampton,
run as a part of BIRT’s continuum of care. She is living much more
independently and hopes to find work as a writer.

“I have been very
impressed by the
multi-disciplinary
team; particularly
the goal setting for
each rehabilitation
period and the
accuracy of reports.”
Referrer
Outcomes for service users
BIRT uses a series of standardised rating scales to assess
cognitive, emotional and behavioural changes over time.
Each service user is assessed during their first month of
admission. These results are then compared with the same
measurements sampled during the last month prior to
discharge. This includes monitoring of mood, behaviour
and motivation, together with any demonstration
of verbal or physical aggression. As well as enabling
us to measure service users’ progress, the outcome
measurement system also acts as a valuable tool for
individual goal setting during the rehabilitation programme
and informs the ongoing care pathway.
Of service users admitted to Thomas Edward Mitton
House in 2011 over 90% required either direct or
indirect full-time supervision on admission. At the
point of discharge, only 59% of service users had fulltime
supervision needs, with 32% requiring part-time
supervision and 10% independent in their supervision
needs. This represents a considerable reduction in the
level of supervision required on discharge compared with
admission.
86% of service users were admitted from residential care,
yet on discharge only 27% continued to require residential
care, nearly half (46%) were discharged to supported
living, and 27% were able to discharge to independent
accommodation with family. This represents a very
positive result for the majority of service users.
12

People admitted to Thomas Edward Mitton House
generally require very high levels of support as a result
of their brain injury. The fact that so many can return
to living at home is a tribute to the success of the
neurobehavioural approach used by BIRT and the skills
and dedication of our staff.
13

Quality and value for money
BIRT’s continuum of care ensures that in most cases a
reduction in costs occurs as a service user moves towards
greater independence. On average, the lifetime cost
savings are between £800,000 and £1 million, if a service
user is admitted within one year of brain injury.*
Reducing costs through the BIRT continuum - a case study:
When Steven came to BIRT, any attempt to engage with
him resulted in outbursts of violence and aggression. After
moving through BIRT’s continuum of services, costs were
reduced as follows:
Challenging Behaviour Assessment & Rehabilitation Centre
Reduction of
£750 per week
or 39k per annum
Challenging Behaviour Continuing Rehabilitation Centre
Reduction of
£438 per week
or 22k per annum
Assessment and Rehabilitation Centre
Reduction of
£712 per week
or 37k per annum
Community Supported Housing scheme
The savings shown are the costs that would have been
incurred had Steven not moved through the BIRT
continuum. Coupled with the high satisfaction ratings
from service users, families and referring agencies, research
data confirms that BIRT delivers quality and value for
money from admission to discharge.
14
* Peer-reviewed research data references are available at
www.birt.co.uk/valueformoney. Fees correct at time of print.

Where we are
Thomas Edward Mitton House is situated on a residential
development in the heart of Milton Keynes, close to the
MI and only 40 minutes by train to London.
Service Manager, Brain Injuries Rehabilitation Trust
Thomas Edward Mitton House
37 Belvoir Avenue
Emerson Valley
Milton Keynes MK4 2JA
Tel: 01908 504778
Fax: 01908 505103
Email: thomas.edward@thedtgroup.org
For further information about Thomas Edward Mitton
House please contact the service manager at the
address above.
“The staff gave me
really terrific support.
I now realise just
what an invaluable
resource BIRT is.”
Luke
Referrals
Referrals should be made directly to Thomas Edward
Mitton House. We accept referrals from a wide range of
agencies including health, social services, medico-legal
and other specialist providers.
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The Brain Injury Rehabilitation Trust
The Brain Injury Rehabilitation Trust (BIRT) provides a
continuum of care for people with acquired brain injury,
from post-acute hospital based rehabilitation, assessment
and rehabilitation, continuing rehabilitation and supported
housing and home support. Through our range of
specialist services, we aim to enable people to function
more independently in the wider community and develop
their lives in ways they choose.
For more information about our work please contact:
The Brain Injury Rehabilitation Trust
60 Queen Street, Normanton, Wakefield, WF6 2BU
Tel: 01924 896100
Fax: 01924 899264
Email: director@birt.co.uk
The Brain Injury Rehabilitation Trust is a division of The
Disabilities Trust and the means by which it provides its
brain injury services.
Founded in 1979, The Disabilities Trust is now established
as one of the UK’s leading charities, offering imaginative,
progressive services to people with autism, brain injury,
physical disability and learning disability.
The Disabilities Trust
First Floor, 32 Market Place, Burgess Hill, West Sussex, RH15 9NP
Tel: 01444 239123 Fax: 01444 244978 Email: info@thedtgroup.org
The Disabilities Trust is a company limited by guarantee incorporated
in England and Wales under 2334589 and registered as a charity in
England and Wales under 800797 and in Scotland under SC038972.
Registered office as shown.
www.birt.co.uk