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Contributed by
British Home


British Home is a charity that provides residential care, therapy, support and hope for people with neuro-disability, typically resulting from injuries to the brain or nervous system sustained from accidents, strokes and other acquired conditions.

This recipe outlines how a High Dependency Unit provides personalised one-to-one care, therapy and activities for residents with more complex and more demanding conditions, facilitated by highly-skilled staff and the most up-to-date equipment.

Recipe status

This recipe has been in use since March 2020.

We are not sharing this recipe as the perfect solution to a problem, but we believe British Home’s learnings could be very useful to other organisations.

Users and needs served

  • As a service user, I need to stay connected with my family and friends, and communicate with staff in the easiest way possible to let them know if I need help or support
  • As a family member of a service user, I need to know that my loved one is safe, supported and able to communicate as much as possible with myself and care staff
  • As a member of staff, I need to allow residents to find their voice and communicate, another key to providing rehabilitation, independence, and hope for anyone affected by neuro-disability

Software and tools used


Eyegaze is a highly-specialised technology designed for users with who are unable to communicate verbally. .

The technology tracks eye movement in order to move the mouse. Users can then select an item on a screen by dwelling, blinking or clicking on it with a switch.

The Eyegaze systems work through a series of sensors that pick up light reflections from the pupil and translate the eye movement into mouse cursor movements.


The complex and bespoke nature of setting up the solution means that pricing will vary from user to user. You can request a quote here.


The software is highly-specialised and is designed with a very particular user in mind. It will not work for a wide range of recipes.


Predictable is a software which enables users to use their eyes as a mouse to scroll and clock on letters and phrases, which is then 'spoken' by the software.


You can request a quote here.


Predictable is designed for people who are literate but don't have the ability to speak, possibly due to cerebral palsy, motor neurone disease (ALS), autism, laryngectomy, stroke, apraxia, or brain injury.

As with Eyegaze, this software is highly-specialised and is designed with a very particular user in mind, and therefore will not work for a wide range of recipes.

Recipe steps

1. Source equipment

While you may already be using software that you feel works well, be aware of developments in the field and ensure that you keep up to date with new software.

Some people may have been assessed for adaptive technologies as part of their care package, while others won’t have been. You will need to consider whether you will require technology that is outside the care plan, and how you can access funding in these instances.

2. Train staff

All staff should be trained on the basics of how to use the software. Any new staff onboarded should meet the minimum requirement of understanding how this communicative software works.

Any training needs to be continuously iterated as users may need different technology and not all users utilise these systems in the same way.

Maintain a good knowledge of alternative communication and consider conducting training sessions every year.

3. Conduct an initial assessment

The package needed to address the requirements of each person with a neurodisability will vary. Assess what an individual user’s communication needs are, what level of understanding they have, and what communication is possible. You can then decide whether the tool will support this communication.

Keep in mind that users will utilise tools very differently. For example, one user may utilise a tool to answer ‘yes’ and another to answer ‘no’. This information will then be used to control most aspects of the user’s life based on this assessment.

It can take a long time to assess these needs, and you should be sure to mitigate the preconceptions of what you think the users’ requirements are, compared to what they want.

4. Familiarise each user with the technology

You should not overload the user with implementing new technology, as any new training can be very tiring.

Each resident will have differences in the way that they are able to learn how to use this tech.

The company who provides this technology provides support to the therapy team. However, therapists should use this knowledge and adapt it to the individual needs of the user.

This process of making sure the user is familiar with the technology can then be handed over to the day-to-day carer.


It’s important to make sure that your service is user-centred and highly individualised. It is common practice to come up with an overarching approach towards enabling people with neurodisabilities to communicate using this technology, but you should make sure to try and understand each individual’s needs and requirements.

Manage the relative and friend relationship reactions to the new tech as this is also a new way of communicating with their loved ones.


Shifts in daily routine can sometimes knock the confidence of a service user who is learning how to use the technology. Furthermore, the user may recover to a point where they are able to reflect on their past and their mental health can be compromised, which can affect their engagement in using the software.


Many thanks to British Home for contributing this recipe.


This recipe is licensed under a Attribution-NonCommercial-ShareAlike 4.0 International Licence.

That means you are free to copy, redistribute, and build on the text of this recipe, but only for non-commercial purposes (if you want to use it for commercial purposes, get in touch with us at [email protected]). You must give credit to both Catalyst and British Home and link back to this page. If you build on this recipe then you must share your version under this same licence.

Recipe published on April 28th, 2021. Last updated August 6th, 2021