About our services:
The Rehabilitation Service - provides assertive outreach, and inpatient care and treatment for people with severe and enduring mental illness and associated complex needs.
We provide a specialised rehabilitation service based on culturally appropriate therapeutic engagement and the planning, delivery and implementation of evidence based care, identifying unmet needs and managing risk along with service users, carers and other agencies.
We aim to keep people's illness as well managed as possible and provide optimal care and treatment in partnership with service user, supporting individuals' wellbeing/recovery and, where possible, enabling people to stay in their own homes.
Referrals to the Rehab Team are made via the Adult Community Mental Health Teams.
Community Team
The community rehabilitation team provides a Borders-wide community based supportive service for adults with severe and enduring mental illness and complex needs.
We offer assertive outreach to provide highly co-ordinated and intensive but flexible support and treatment for service users with longer term needs living in the community.
We are a multi-disciplinary team including Medical Staff, Nurses, Psychologist, Occupational Therapists, Physiotherapist, Administration Staff and Social Work.
For most of our service users, the care is co-ordinated under a Care Programme Approach (CPA) which is how the care is assessed, planned and reviewed to identify needs and how to meet those needs on an individualised basis. Each service user will have a care co-ordinator, (key worker) who co-ordinates the assessment and planning process. All service users are encouraged to actively participate in their care planning process.
We work closely with the rehabilitation inpatient unit, East Brig, to provide seamless care between hospital and the community should hospital stay be required.
We work in partnership with Carr Gomm in the provision of a supported accommodation project, bridging the gap between hospital stay and returning to one's own tenancy in the community for those service users who find this transition difficult.