FEATURE ASSESSMENT TOOLS
Measuring outcomes and demonstrating quality of service
Sharon Davenport and Chris Smith reflect on the introduction and use of TOMs in adult social care
Occupational therapists working for the adult social care service covering Wirral local authority were integrated into Wirral Community Health and Care NHS Foundation Trust ( WCHC ) in 2017 . The adult social care teams cover major adaptations , short-term assessment and reablement ( STAR ), the Wirral independence service ( equipment ), the adult social care team and Blue Badge independent mobility assessors .
The referral criteria for adult social care includes any adult over the age of 18 , who appears to require care and support under the Care Act ( 2014 ). Clients can self-refer or can be referred by other health professionals .
Our clients have a range of conditions , including frail older people , those with deteriorating conditions , such as multiple sclerosis and motor neurone disease , and people with complex multiple conditions , including learning disabilities .
Our occupational therapy intervention often involves working with informal and formal carers and enabling safe discharge from care homes during the COVID-19 pandemic .
Our clients ’ occupational performance is challenged by the physical limitations of their medical diagnosis and the social and physical environment they are faced with . Our occupational therapy interventions are aimed at maintaining safety in essential activities of daily living ( ADLs ), falls prevention , moving and handling , seating and housing solutions .
Why measure outcomes ? Use of outcome measures is well documented in occupational therapy and it is a requirement for occupational therapists to measure and record outcomes ( RCOT 2015 ).
The new professional standards for occupational therapy practice , conduct and ethics from RCOT also state to ‘ use outcome measures to monitor , review and demonstrate the ongoing effectiveness of intervention ’ ( RCOT 2021 ), and it is important for demonstrating quality of services ( HCPC 2018 ).
Choice of outcome measure We learned that other allied health professions within the trust were benefitting from using the Therapy Outcome Measures ( TOMs ) ( Enderby and John 2015 ) to demonstrate their effectiveness , including the ‘ Rehab at Home ’ team , which comprises occupational therapists and physiotherapists , and also the dietetics and speech and language services .
As our service was seeking to use an outcome measure to demonstrate social care impact , as part of the integration agenda , the specialist services manager agreed for Sharon Davenport to be trained as a trainer in the use of TOMs , by Professor Pam Enderby , through the Community Therapists Network . This training would cascade to the rest of the staff .
Use of the same outcome measure across the trust also enabled a level of professional integration with our new health colleagues .
Sharon undertook this training as part of her postgraduate work-based-learning module at the University of Liverpool , where she was studying for a post-graduate certificate in advanced practice in healthcare .
What is TOMs ? TOMs is a standardised therapist reported outcome measure , designed by speech and language therapist Professor Pam Enderby and Alexandra John . It allows professionals from many disciplines working in health , social
48 OTnews July 2021