Occupational Therapy News OTnews February 2019_Joomag | Page 31

INTERMEDIATE CARE FEATURE
Two types of service have been provided in the Redcar and
Cleveland Borough Council intermediate care bed settings
for people who are not able to return home from hospital via
reablement routes, or are currently living in the community –
residential reablement beds and assessment and recovery beds.
Typical day of assessment
A typical day at the reablement unit starts with functional
assessments followed by a team meeting to plan for the day. As
some of the team work across two sites, it is important that staff
are flexible and have a positive approach to change (something that
has proven to be essential as the service has grown and adapted).
Residential reablement beds
During the rest of the morning, a physiotherapy exercise
The service started four years ago by providing a dedicated
group is carried out alongside one-to-one sessions, with mobility
therapy-led unit of 12 beds, with appropriately trained staff
and transfer practise. For the occupational therapists, home
who have designed, delivered and monitored individual support
assessments, cognitive assessments or trips home to practise skills
plans, which have maximised independence and promoted the
in individuals’ own environments are completed.
opportunity to return to the most independent living possible.
During the afternoon individuals engage in activity groups and
Leadership was provided via Redcar and Cleveland
these are designed as themed days to allow for variety,
Borough council, along with
but also to meet identified needs. This helps
business support and bed
individuals to socialise, reminisce, problem-
As
a
result,
the
management.
solve and learn something new in a fun
The beds, ‘hotel’ provision
setting.
government has stated
and enabling support has been
‘‘
its belief that intermediate
provided by the care home, with
Overcoming the obstacles
care is an important approach
two members of staff dedicated to the
During this four-year period the
unit who have received the authority’s
team has had numerous issues to
that will help to promote
recognised reablement training.
deal with, which have been actively
independence for older people
Therapy services have been
problem solved to resolve difficulties
and at the same time relieve
provided by South Tees NHS
as they have arisen.
Foundation Trust and have included
The team has had to cope with
pressures on health and
occupational therapy, physiotherapy and
numerous changes in care home
social care services.
therapy assistants.
management, which has brought a
Four years on, the residential reablement
change in dynamics and new working and
beds are operating on average at 76 per cent
communication practices.
to 80 per cent bed occupancy and take around 169
A number of changes in therapy staff have
referrals a year; while about 73 per cent of these individuals return
occurred, as most of the team are rotational, which has its
home in a more enabled way than when they entered the service.
advantages and disadvantages when building new services.
Medical input has been sporadic, due to the temporary
Assessment and recovery beds
registrations of patients being difficult in our locality, although we are
During the pilot phase, it became evident that there was a cohort
about to add to the team with the advent of community matrons
of people that would be deemed not ready for active reablement,
input and service managers are working hard to solve the issue of
but given a period of recovery would then follow this
medical input.
pathway.
It was decided at this time, therefore, to seek a
second care home that could offer a higher level
of enabling/care support while the therapy team
continued to assess these individuals for their
future plans.
Three years after starting this project,
the residential reablement beds are
operating on average at 75 to 77 per cent
bed occupancy and take on average 79
referrals a year.
Of these individuals, 44 per cent return
home, with a further 20 per cent (16) being
transferred to the residential reablement beds
for more intensive reablement, to then enable
them to return home.
OTnews February 2019 31