Service development
Service development
Feature
Facilities Grant ( DFG ) and other adaptations : external review ( Mackintosh et al 2018 ), which states ‘ better local and national data outcomes is required to demonstrate the substantial savings in health and care costs that can be generated by improving the home ’, we looked to find a way of evidencing the impact of our input .
We began by reviewing a variety of standardised outcome measures and guidance from RCOT and Foundations . However , we could not find a quick and easy measure to fit with what we were wanting to capture .
Within the team , we use the Person , Environment , Occupation ( PEO ) model of occupational therapy to guide assessments . We therefore decided to look at a client focused , goal setting approach and developed questions that considered what the service user was struggling with and what they wanted to achieve . We then combined these with the existing satisfaction survey to create a new questionnaire .
How is it administered ?
At the conclusion of our initial assessment visit we ask the service user the following questions :
• How do your health problems affect how you look after yourself on a day to day basis ?
• What do you hope to achieve from having adaptations ?
• Do you have a carer ?
• Do you have a formal or informal carer ?
• How would adaptations assist your carer to look after you ?
There is then a choice of six statements for the service user to identify what they hope to achieve from the adaptation . These range from ‘ to be able to take care of my personal hygiene independently ’, to ‘ to be able to access all parts of my own home ’. There is also an additional comments box to cover other specific areas that a person may give .
These questions were designed to assist the service user to really focus on their needs and what they wanted to achieve . They promote a person-centred approach , ensuring they are part of the process . This also helps the occupational therapists to make robust ‘ necessary and appropriate ’ recommendations .
After the adaptation
On completion of the adaption , we revisit the service user and explore the three key areas :
• Have the original goals been achieved ?
• How did we perform as a team ?
• How did the building contractors perform ?
Above : Before adaptation
With the service user , we look again at their original goals and talk through if these have been achieved . We also ask what impact this has had on their ability to look after themselves on a day-to-day basis and , where applicable , if the adaptation has helped their carer to support them .
Each question has several options to choose from , ranging from ‘ a great
deal ’ to ‘ not at all ’.
In addition , we include questions on how the HIA and contractor performed in terms of timescales , communication and standard of work .
For the question – ‘ How do your health problems affect how you look after yourself on a day to day basis ? – one person said : ‘ I rely on my husband for help with washing and dressing and mobility and transfers . He looks after the home and children .
‘ I feel frustrated that I can ’ t do things around the house and this makes me anxious . My husband has to carry me up and down stairs and help me mobilise ; the adaptations would mean he wouldn ’ t have to do this . I am really worried that he will injure himself as we all rely on him .’
The service user hoped to achieve being able to access all parts of their home and specifically , ‘ to be able to go up and down stairs independently , so as to reduce the stress on my husband ’ s body ’ and ‘ to be able to gain some independence and freedom around the house ’.
Above : After adaptation
For the HIA performance measures , we are achieving close to
100 %
of service users being ‘ satisfied ’ or ‘ very satisfied ’ with our service .
July 2023 OTnews 39