Table 1 Summary of measures used at the Churchtown centre

Barthel Index

Measure of activities of daily living. The Churchtown centre used the modified Barthel Index [44]. Contains ten items measuring: personal hygiene, bathing, feeding, toileting, stair climbing, dressing, bowel control, bladder control, ambulation, chair/bed transfers, plus an additional item for wheelchair users.

The amount of assistance required for the patient to perform each item is scored at one of five levels. Different descriptors, or 'scoring guidelines' are provided for each level of each item. The numerical score for each level varies for each item, for example, personal hygiene is scored at 0,1,3,4,5; Feeding is scored 0,2,5,8,10; ambulation is scored 0,3,8,12,15. The total scores range from 0 to 100. Lower scores indicate a greater need for assistance.

Northwick Park Dependency Score

Assesses the impact of patient dependency on nursing time. Consists of two sections. The Basic Care Needs has 16 items measuring mobility, bed transfers, toileting bladder, urinary incontinence, toileting bowels, faecal incontinence, washing and grooming, bathing/showering, dressing, eating, drinking, enteral feeding, skin pressure relief, safety awareness, communication and behaviour. The Special Nursing Needs section has 7 items covering tracheostomy, open wound requiring dressing, requires > 2 interventions at night, requires psychological support, in isolation, acute medical/surgical intervention, needs one to one 'specialing'.

Items on the basic care needs section are scored according to the amount of help required to perform the tasks which, for some items, includes and indication of the amount of nursing time needed to provide this help. Items are scored on either a 0–3, 0–4 or 0–5 range, depending on the different specifications of amount of helped needed for each items. Items scores are summed to give a range between 0 and 65. Special care needs are dichotomous variables scored at either 0 (not present) or 5(present) and are then summed to give a total score from 0 to 35. The two scores are then added together to give a composite NPDS ranging from 0 to 100 with higher scores indicating the need for more help.

The Leeds assessment scale of handicap

Assess four of the six 'survival' roles in the WHO definition of handicap (now participation): mobility, physical independence, orientation and social integration

Each item is scored nine point scale from 0 to 8, with 0 indicating the highest level of fulfilment of the role. Different descriptors, or 'scoring guidelines' are provided for each level of each item. For the 'orientation item', two descriptors each are provided for levels four and five.

Waterlow score

Measures risk of pressure scores. Consists of eight items representing different risk factors: appetite, continence, visual skin signs, mobility, build/weight, age, sex and special risks (eg (poor nutrition, sensory deprivation, high dosage of anti-inflammatory drugs, smoking, orthopaedic surgery)

For the first seven items, a single score is allocated on a different, graded scale for each item. These scores are then summed. Individual special risk factors are each allocated a score, which are also summed and added to the total for the first seven items.

'homegrown' scores

Single item assessments of language reception, language expression, functional communication, memory, concentration, confusion, drive/motivation, snacks and meals, anxiety, depression and behaviour.

Anxiety and depression: scored on a three point scale: 1: not present; 2: present but not affecting progress in rehabilitation; 3: present and affecting progress. Behaviour: six descriptors: normal, disinhibited, aggressive, disruptive, withdrawn, apathetic. Language: three items each scored on a five point scale with each item having different descriptors; Others: scored on a 5 point scale indicating the degree of problem in each area ranging from normal (5); slight but not affecting progress in rehabilitation (4); slight but affecting progress in rehabilitation (3); moderate (2) and severe (1).