OTnews August 2020 | Page 40

FEATURE INTEGRATION The service has become incredibly personalised – staff take on a wider range of roles, meaning they are able to provide a fuller service for each person they work with. Kylie, for example, might go into the local hospital to help support a patient she knows well, or to bring them either to Mardy Park’s rehabilitation facility or to head home under a Discharge to Assess model. She can then set up a reablement or care package without necessarily needing to involve a social worker. If she needs support from a colleague, she can pull them in without needing a formal referral. It means a system where occupational therapists set up long-term care packages, social workers can take people commodes, and physiotherapists can liaise with families around someone’s care needs, all of which adds up to a more straightforward service for patients. ‘If it’s someone we know, then even though I’m usually in the community, I can go into the hospital to see them,’ she says. ‘Take a patient of mine who has dementia: I know him well, I know the equipment he uses, what he likes to be called and what he likes to eat, how he wants a jumper, but everyone needs a different size and wants a different pattern ...what matters is working towards what each person wants to achieve ‘‘Everyone and how they are going to achieve it. likes his hair done and what it takes for him to be a bit happier.’ The service in Mardy Park is also very accessible by anyone, with a helpline staffed in working hours to take calls from friends, family and neighbours about offering support to someone in the community. Says Kylie: ‘This model allows us to answer calls and give accurate advice for our area but also speak to the person directly about their needs and feelings and find a solution that may not need a referral or visit. ‘The focus is on putting experts at the front of the business who can provide the right advice, ascertain if an immediate response is required or give advice that means the individual or family can resolve themselves. It stops the generic referrals from professionals and reduces the screening time for these referrals.’ Changing for the future The service has continued to evolve over the years. Recent changes include the team being forwarded calls from the ambulance service, where the integrated service is better placed to support the person. A member of staff can then visit that person at home and use equipment such as ELK raisers and raiser chairs to help them, or to change their care package, to ensure that person won’t need an ambulance visit, referral and potential admittance to hospital. Occupational therapists also now sit on housing panels to ensure that appropriate stock is available for people with disabilities. They have a strong relationship with the adaptations grants service and meet often with surveyors and contractors to provide adaptations to enable the person to live well at home independently, or reduce their care and support needs. The service also now has access to 16 profile beds from the Integrated Care Fund to support people where they can’t access health-funded ones, as part of a Gwentwide scheme. Says Kylie: ‘I have been working with one man who got out of bed and fell to the floor up to 10 times a night. Rather than having four hoisted calls a day, he now has one call in the morning and a stand aid. It’s a big difference to the family’s life, as well as resources having the profiling bed.’ And the biggest shift is a plan to move to placebased working, dividing Monmouthshire into 12 areas and having teams wrapped around those locations that integrate with care services more. But while the systems in Monmouthshire have helped the service achieve success, Eve is keen to stress that it’s the culture and principles that have been put in place that have made the real difference. ‘Everyone wants a jumper, but everyone needs a different size and wants a different pattern,’ says Eve. ‘Even in Monmouthshire, we have very different community needs – the north is very rural and farming-based, while the south is on the M4 corridor and has a more younger and transient population. You can’t have the same model as it’s not the same community. But what matters is working towards what each person wants to achieve and how they are going to achieve it.’ Andrew Mickel, OTnews journalist, email: andrew. [email protected] 40 OTnews August 2020