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Brain injury case management

My career path into case management

Tim Gilbert at ILS Case Management shares his story of the move from nurse to case manager

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Tim Gilbert, professional mentor at ILS Case Management, reveals why he chose to move into case management – having never even heard of it previously! – and where his journey has taken him

Q: Do you remember what your first career choice was?

Yes, it was a car mechanic, but I couldn’t afford the training course!  

Q: And what was Plan B?

There wasn’t one really, but I always loved travel so I found myself in my first job in what I now recognise to be a very prestigious geographical location; Jermyn Street in the West End of London where the likes of the BeeGees and Angela Rippon were clients, and I would pop in with trays of tea or coffee.  It was interesting but didn’t really hold my attention when it came to looking ahead to the future.

I think there was then a bit of family/parental influence towards getting a stable, well-paid job so I part-trained in accounts work and moved into finance but looking back I was in denial for quite some time that, whilst it paid the bills, it wasn’t really my kind of job.

Q: What changed for you?

Around that time, a close friend became seriously ill and, whilst visiting him in hospital, I found myself watching the nursing teams with admiration, witnessing the level of commitment and caring they had towards patients and wondering if I might find a similar role more meaningful.  I undertook three years’ training in general nursing.  

Once qualified, neuro-rehabilitation work appealed to me and whilst other students chose to have a ‘gap year’, I had left home and couldn’t afford that luxury, so I successfully applied for a nursing job at a new NHS Adult Neuro-Rehab facility in Kent. 

I learned about therapy-lead rehabilitation, stroke and brain injury and worked with physiotherapists, OTs, a psychologist, and a speech & language therapist and worked there for four years. A managerial role in a private Brain Injury Unit specialising in extreme challenging behaviour close to my home caught my eye and that was my next step up.  I was so impressed by how dynamic and motivated the staff were.  There was a wide range of therapists and a great sense of teamwork, and it was a fantastic opportunity for me. It was a wonderful job and I only left when relocation of the unit made it impractical for me to stay.

Q: And is that when you diversified into case management?

Yes, before I left one of the OTs at the unit had got a new job as a case manager and said to me one day “Have you ever thought about being a case manager?”  Well, like many people, I hadn’t even heard of case management before, so having given me her manager’s phone number, I rang for a chat and expressed my interest.  I went for a visit and was there for over three hours!  It was fascinating.  When I asked about the possibility of an interview, I was told “that was your interview – the job is yours if you want it!”

From the moment I started the role, I found it a complete change to my previous roles.  There was a central mentor that the team could call on and they were extremely helpful.  One day, at a CMSUK meeting at the House of Lords, I met Elaine Gipson who had fairly recently founded Independent Living Solutions – now known less formerly as ILS Case Management, and we got talking.

I ended up going for an interview with Elaine and Karenmarie Smith. I got such a positive ‘vibe’ whilst there and a feeling I was among good people doing a great job.  I decided I wanted to work with them but had a loyalty to my existing clients so tentatively asked if they would allow me to give three months’ notice.  Their response was so understanding, and it was obvious from that moment that they put the client first in every circumstance which impressed me.

Q: So, was it plain sailing from then on?

Not really.  I didn’t turn up on my first day! Having returned from what was generally a great holiday in Norway, I was ill with a water-borne ‘bug’ and was sick all night. Not a good start but, yet again, the kindness and understanding shown to me and the willingness to be flexible just confirmed that I was working with people whose values aligned with my own.

From then on, I got my first clients and really started enjoying the work, developing an interest in managing the most challenging and sometimes intimidating behaviour and adapting my approach to engender trust. I swiftly recognised how important it is to see the person beneath their injury and to recognise the triggers behind uncharacteristic behaviour that the individual may never have displayed previously. The reality is that brain injury is life-changing and can isolate people from society if they don’t have the right support.

Q: You clearly took to the role. What would you say the advantages are of working as a case manager over and above other jobs within health and social care?

I think the main ones for me are being able to work independently, drawing on all of my skills and experience, whilst having lots of available support at ILS. It’s just there, from the management team to the professional mentors and among colleagues. There is also an objectivity which is important to maintain when supporting clients and I fully appreciate that.

Q: What characteristics do you think you bring to your role?

I think my directness and ability to handle challenging situations without being fazed have stood me in good stead.  There’s also the need for respect and seriousness in much of the role but it’s helpful if that’s coupled with a good sense of humour and the ability to introduce some levity where appropriate.  It helps to build a warm but professional relationship with clients and colleagues alike. 

Whilst these attributes can be present in people from all walks of life, I think it’s disappointing not to see more male applicants when case manager roles are advertised. There’s also less cultural diversity within the sector than ideal and when you consider that client choice is central to everything we do, it matters that clients can be offered a case manager that they can relate to or may express a preference towards for cultural or gender-based understanding.  Seeking ways to increase cultural diversity is an ongoing focus for the company.

Q: What do you think would need to happen in order to encourage more diversity to consider working as a case manager?

I think ensuring that there is diversity on the interview panel is a real plus and helps to put applicants at their ease. ILS places great importance on taking candidates on their own individual merits rather than making comparisons to the existing workforce which I think is also key.  Our clients are a diverse group of individuals, and I am pleased that ILS continually strives to reflect that, bringing a healthy balance to the organisation. 

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