The CEO of a Headway charity in the South of England

The CEO of a Headway charity in the South of England spoke with us about the issues with assessments and reassessments by local authority social care teams that are affecting brain injury survivors at the charity.

On average, potential new clients there are waiting 15 weeks for assessment by the local authority – this is 15 weeks in which they are unsupported, waiting at home and likely to be losing any progress they made in the initial weeks following their brain injury. Once survivors are established at the local Headway, when it comes to their reassessment, it is often dependent on the social worker dealing with their case as to whether this happens in a timely fashion, and whether the often hidden and fluctuating needs of survivors are understood.

The CEO also told us about broader problems with local authority and NHS services, which are impacting on some of the charity’s survivors as well as the charity itself.  

One brain injury survivor who currently receives support at the Headway has been waiting for reassessment for over a year. The impacts of this survivor’s brain injury mean that he now needs more intensive support than the charity can provide, likely through his own team of personal assistants, because it is not possible for one person to cope with his (often verbally abusive) behaviour for very long. Sadly, he has no relatives or friends available to advocate for him. He needs the local authority to provide an independent advocate, but this has not yet happened.

The Headway has ensured that the local authority is well aware of his situation, and of the huge amount of time and effort that their staff have put into supporting him. However, the local authority has given no indication of when his reassessment will take place, despite the year-long wait, presumably because they know that reassessment will demonstrate that he now has greater and more costly needs. Very soon, it is likely that the charity will be unable to meet his needs, and he will be left with no support despite repeated contact with the local authority.

Another brain injury survivor supported by the local Headway had been experiencing mental ill-health, in the form of psychosis. He lived with his elderly mother but had been having violent thoughts towards her. The charity had repeatedly requested urgent reassessment for this client, but after three months of waiting, his psychosis worsened to the extent that it became necessary for his sister to remove his mother from their home, and out of the immediate danger she was in. However, this meant that the client was left alone, which was an impossible situation due to high levels of need caused by his brain injury.

To support the family in dealing with this urgent situation, Headway called the local mental health crisis team, who said they had no capacity to deal with him, and to call an ambulance. They then called an ambulance, which never arrived.

Another brain injury survivor is supported by the charity’s outreach service. She receives a four-hour visit every two weeks, where she is often supported to do her shopping, and any other tasks which she requires support with. Over Christmas, she had a fall. An ambulance was called, but she faced a long wait. Her son, who lives at the other end of the country, contacted her Headway support worker who was able to go and be with her while she waited for the ambulance. Unfortunately, she had broken a bone and needed to stay in hospital.

This survivor lives on the border of two local authorities. While she was in hospital, they were in dispute as to which of them would pay for her personal care when she was discharged (she does not normally require this). Because they took so long to resolve this dispute, the survivor, against all advice from the charity, discharged herself from hospital, but there was no care in place for her at home. Her son could not afford to pay for interim agency care, so came to a financial arrangement with a local cleaner to support her with her care needs. Throughout this situation, Headway supported the family and repeatedly contacted the local authority that funded her two-weekly Headway support visit, as they were the obvious authority to fund her temporarily increased care needs. The situation was never resolved, presumably because neither authority wanted to pay, and were aware that the survivor had some support in the form of her (non-local) family and the Headway charity. 

These tragic individual stories demonstrate the consequences for brain injury survivors and their loved ones when local authority and local NHS services fail them. Headway services are often the only local support system available to pick up the pieces, often outside working hours, and at their own expense. However, as this report shows, these local Headway charities are on the brink themselves. If they are forced to close due to lack of funding, brain injury survivors will suffer the consequences.