Intermediate Care

Enablement Service

Our team is an multi-disciplinary service, jointly funded and staffed by Lewisham and Greenwich NHS Trust and London Borough of Lewisham. We provide rehabilitation and support to adult Lewisham residents to return them to an optimum level of function after an admission to hospital.

We work with people who live in Lewisham, who are 18 or older who need some form of physical rehabilitation after a stay in hospital. 

We see people in their own homes and in 25 nursing home beds, based in Brymore Nursing Home in Grove Park.

Our service is available 7 days a week, 8am to 8pm. Currently referrals are only accepted on Monday to Friday between 9pm and 5pm.

Location

Supported Discharge team: based in Honor Oak Health Centre, 20 Turnham Road, Honor Oak, SE4 2HH

Bed Based Rehabilitation team: Brymore House Care Home, 243 Baring Road, Grove Park, Lee, London SE12 0BE

How to get a referral

Referrals are made by wards to the Discharge to Assess team. Our service is available 7 days a week, 8am to 8pm. Currently, referrals are only accepted from Monday to Friday between 9pm and 5pm.

If you need bed-based rehabilitation, the Discharge to Assess team will work with the ward and the bed-based unit to ensure that the patients discharge to there is as smooth as possible.

If the plan is for you to return home, the Discharge to Assess team will assist with discharge arrangements and visit you soon after you have been discharged home.

Our team will assess you to ensure that the you are safe in your home and then decide whether you require further support. This could be a full discharge from the service with no further input required, an additional assessment for a permanent package of care,  referral to the Enablement Care Team or a supported discharge (including stroke early discharge).

Who we can see

If you requre bed-based rehabilitation, we can see people who:

  • live in the London borough of Lewisham,
  • are 55 or over, although exceptions may be arranged,
  • is likely to improve significantly within two weeks,
  • can transfer with maximum assistance of one person (there are 5 beds where the patient can require double handed care),
  • can follow and remember simple instructions,
  • is willing to be treated by the Enablement staff including therapists,
  • Requires rehabilitation input from one or more disciplines from the team.

 

If you need help from our Supported Discharge Team (including stroke pathway early discharge team) we can see people who:

  • live in the London borough of Lewisham,
  • are 18 or over,
  • can transfer independently or with the help of one carer and transfer equipment,
  • can follow and remember simple instructions,
  • If you are living alone, you must be safe at home overnight and for periods during the day
  • is willing to be treated by the Enablement staff including therapists, and if a carer is involved, they are willing to have person treated by Enablement
  • requires rehabilitation input from one or more disciplines from the team.

Our Supported Discharge teams usually see people for around 4 weeks, but can provide intervention for up to 6 weeks depending on your recovery progress.

Our team members

Our multi-disciplinary teams are made up of nurses, social workers, physiotherapists, occupational therapist, therapy assistant practitioners and enablement officers, together with business support.

We have support from the Care of the Elderly Consultant Team at University Hospital Lewisham for people undergoing bed-based rehabilitation and also have support from a speech and language therapist for all teams as appropriate.

  • Enablement nurses will help with medication reviews, monitor skin breakdown, help with incontinence issues, check pain management and work closely with the GP to support you becoming more independent.
  • Physiotherapists will give you individual exercise programmes to help you move from one place to another, become stronger, less likely to fall, be more active and suggest and provide equipment, walking aides and other device to support your mobility.
  • Occupational therapists will help you with activities that allow you to be more independent in washing, dressing, toileting, cooking, improve your memory, attention and problem solving, work leisure and education. They may advise on different methods of performing an activity or pieces of equipment to help you become more independent.
  • Social workers will help you, your family and carers to deal with changes in your life, help you to organise paid carers to support you at home, make sure that you are safe and your needs are met appropriately and advise you about local resources.
  • Enablement officers will visit you daily and practice activities like washing and dressing, preparing a meal and help get you as independent as possible.
  • Therapy Assistant Practitioners work closely with the therapists to monitor, review and progress your therapy.