ABI Care Property: Finding Suitable Acquired Brain Injury Accommodation

A practical guide for care providers, landlords, investors and developers looking for suitable acquired brain injury care property across the UK

Finding suitable ABI care property requires a clear understanding of the people who will use the building and the level of care, rehabilitation and support they require.

Acquired brain injury can affect mobility, cognition, communication, behaviour and independence in very different ways. As a result, a property that works for one ABI care model may be unsuitable for another.

Current CQC examples range from small residential homes supporting a handful of adults to larger specialist care homes providing nursing, rehabilitation and accommodation for dozens of people with ABI and complex neurological conditions.

For providers, landlords and investors, property selection should therefore start with the intended care model and resident profile rather than simply the number of bedrooms available.

What is ABI care property?

ABI care property is accommodation that is designed or adapted to support people with an acquired brain injury.

Residents may require support following:

• Traumatic brain injury

• Stroke

• Brain haemorrhage

• Brain infection

• Brain tumour

• Anoxic or hypoxic brain injury

• Other acquired neurological injuries

The level of support can range from assistance with daily living to intensive personal care, nursing and specialist rehabilitation.

Some services provide long-term residential care, while others focus on rehabilitation and helping people transition towards greater independence. Hothfield Manor, for example, has operated separate rehabilitation and longer-term residential arrangements for people with acquired brain injuries and neurological conditions.

What makes a property suitable for ABI care?

A suitable ABI property needs to accommodate both residential living and the practical requirements of care.

Important considerations can include:

• Accessible entrances

• Suitable bedroom sizes

• Accessible bathrooms

• Safe circulation routes

• Communal living areas

• Dining facilities

• Therapy or activity space

• Accessible kitchens

• Outdoor areas

• Equipment storage

• Staff facilities

• Emergency access

• Appropriate fire safety arrangements

The exact specification depends on the residents and the service model.

For example, a small ABI residential service for relatively independent adults may have very different requirements from a nursing care home supporting people with significant physical disabilities and complex neurological conditions.

Bedrooms for ABI care

Bedrooms should be assessed according to the equipment and support each resident may require.

Depending on individual needs, space may be needed for:

• Specialist beds

• Wheelchairs

• Hoists

• Mobility equipment

• Transfer equipment

• Carer assistance

• Personal storage

• Other specialist equipment

En-suite bathrooms can also improve privacy and reduce the need for residents with mobility difficulties to travel through communal areas.

Providers should physically inspect bedrooms before committing to a property. An apparently large bedroom can become restrictive once a specialist bed, wheelchair and other equipment are introduced.

Accessible bathrooms and wet rooms

Bathroom design is particularly important in ABI care accommodation.

Potential requirements include:

• Level-access showers

• Wet rooms

• Accessible toilets

• Grab rails

• Specialist bathing equipment

• Hoist compatibility

• Wider doorways

• Wheelchair turning space

• Slip-resistant flooring

Older houses may require significant plumbing, drainage and structural alterations before bathrooms can be converted.

The number and location of bathrooms should also be assessed. A property with insufficient accessible facilities can create operational difficulties even if the bedrooms themselves are suitable.

Communal areas and everyday living

ABI care property should provide more than private bedrooms.

Communal spaces can support:

• Shared meals

• Social interaction

• Recreation

• Family visits

• Group activities

• Rehabilitation

• Independent living practice

A suitable property may therefore benefit from a large lounge, dining area, accessible kitchen and additional activity space.

The layout should make it possible for residents to participate in communal activities without creating unnecessary accessibility barriers.

Supporting independence through property design

Property design can play an important role in helping residents develop or maintain independence.

Useful features can include:

• Accessible kitchens

• Laundry facilities

• Independent living areas

• Private outdoor space

• Safe walking routes

• Accessible storage

• Activity rooms

Oakwood Acquired Brain Injury Rehabilitation Service, for example, has provided residents with cooking and laundry facilities to help develop independent living skills. Its purpose-built accommodation also includes ground-floor bedrooms, en-suite facilities, communal areas and therapy rooms.

This demonstrates how the building itself can form part of a rehabilitation and independence-focused environment.

ABI rehabilitation property

Some ABI care properties combine residential care with structured rehabilitation.

Depending on the service, the building may require space for:

• Physiotherapy

• Occupational therapy

• Speech and language therapy

• Exercise

• Mobility practice

• Therapy sessions

• Skills development

• Activities

Park House, for example, provides specialist rehabilitation for people with acquired brain injury and neurological conditions and has used an interdisciplinary team including psychology, physiotherapy, speech and language therapy and occupational therapy.

A provider looking for an ABI rehabilitation property should therefore assess whether the building can accommodate both residential and therapeutic functions.

Small ABI residential properties

A suitable ABI care property does not necessarily need to be a large institutional building.

Smaller residential properties can work where the care model and resident requirements are appropriate.

Osman House, for example, has provided specialist residential care and ongoing rehabilitation for up to 16 adults with acquired brain injury, with individual bedrooms, communal areas and a large garden following redevelopment.

Other ABI services operate at considerably smaller capacities, demonstrating the range of property models that can be used.

The key question is whether the building supports the intended service safely and practically.

Purpose-built ABI care property

Purpose-built buildings can provide greater flexibility because accessibility and specialist requirements can be incorporated into the design.

Oakwood is one example of purpose-built ABI accommodation, with ground-floor bedrooms, en-suite facilities, therapy rooms, communal areas and facilities designed to encourage independent living.

Purpose-built properties may reduce the amount of structural adaptation required, although their purchase or lease costs can be higher.

For investors, purpose-built specialist property may also have a different market profile from conventional residential real estate.

Converting an existing property for ABI care

Existing houses and care properties can sometimes be adapted for ABI use.

Potential refurbishment works include:

• Creating accessible bedrooms

• Installing wet rooms

• Widening doorways

• Improving internal circulation

• Installing ramps

• Modifying kitchens

• Creating therapy rooms

• Improving external access

• Upgrading fire safety

• Improving electrical systems

• Altering plumbing

• Creating additional communal areas

Before agreeing a purchase or long-term lease, the likely cost and feasibility of these works should be established.

A property with a low asking price may require extensive refurbishment before it becomes commercially viable as specialist care accommodation.

Location considerations for ABI care property

The surrounding location can be important for both residents and care operators.

Providers may consider proximity to:

• Hospitals

• Neurological services

• Rehabilitation professionals

• GP practices

• Pharmacies

• Public transport

• Main road networks

• Shops

• Parks

• Community facilities

Where rehabilitation is a major part of the service, access to healthcare professionals and local community facilities can be particularly valuable.

For London operators, finding large, accessible buildings in suitable locations can be challenging, making specialist property sourcing and early feasibility assessment important.

Buying or leasing ABI care property

Care providers can choose to purchase or lease suitable accommodation.

Leasing can provide access to a property without purchasing the underlying asset, while purchasing can give greater control over refurbishment, alterations and long-term property decisions.

Before entering into either arrangement, providers should investigate:

• Planning position

• Building condition

• Accessibility

• Fire safety

• Electrical systems

• Gas systems

• Plumbing

• Structural condition

• Adaptation costs

• Repair obligations

• Insurance

• Lease restrictions

• Reinstatement requirements

The intended care model should also be clearly understood before property negotiations begin.

What landlords should consider

Landlords considering leasing property to an ABI care provider should understand how the building will be used.

A specialist operator may need to install accessibility equipment, alter bathrooms, reconfigure rooms or make other substantial improvements.

The lease should clearly establish responsibility for:

• Adaptations

• Repairs

• Maintenance

• Compliance works

• Specialist installations

• Building insurance

• External areas

• Reinstatement

Clear contractual arrangements can help prevent disputes when significant property investment is involved.

What investors should look for

ABI care property should be assessed as specialist operational real estate rather than ordinary residential property.

Important considerations include:

• Location

• Property size

• Accessibility

• Bedroom configuration

• Communal space

• Conversion potential

• Planning position

• Refurbishment requirements

• Long-term suitability

• Potential operator requirements

• Maintenance costs

An investor should also understand that specialist care property can require a different approach to due diligence from a conventional buy-to-let or residential investment.

ABI care property and regulatory considerations

Where accommodation and care are provided together as a care home, the regulatory position differs from arrangements where accommodation and care are genuinely separate.

CQC describes care homes as settings where accommodation and nursing or personal care are provided as a single package. CQC regulates both the premises and the care provided in that model.

The proposed use should therefore be established early, particularly when converting an ordinary residential property into specialist ABI accommodation.

Planning, building work, fire safety and other property requirements should also be assessed before major works commence.

Fraser Bond ABI care property services

Fraser Bond supports UK property requirements across property sourcing, acquisition, leasing, refurbishment, construction, maintenance and property management.

For ABI care providers, this can include identifying suitable buildings, assessing property potential, coordinating refurbishment and managing building works required to prepare accommodation for specialist use.

For landlords and investors, Fraser Bond can help assess existing properties and identify practical improvements that may make them more suitable for an acquired brain injury care operator.

The right ABI care property should provide a safe, accessible and practical environment for residents while giving care teams enough space to deliver personal care, rehabilitation and daily living support.