INTEGRATION FEATURE rotated into the ICF team at Wrexham social services . I have been here for approximately three months * now and , so far , it has been a challenging , but rewarding experience .
‘ I love the variety of patients and conditions I see on a daily basis . And the team has welcomed me with open arms , ready to answer any questions I have about the new system , how funding works and new pieces of equipment .
‘ I have developed the physiotherapy service within the ICF team , exploring new avenues and introducing new systems to ensure a smooth referral process from one team to another .’
Adaptation training was delivered to social care and health occupational therapists alike , creating a symbiotic culture where health occupational therapists felt equally informed and equipped to refer for minor adaptations , equipment and funding .
Right sized , or single handed , care and support was agreed across the two sectors and citizens were able to return home or to a step-down bed with the appropriate care for their needs and the opportunity for rehabilitation maximised .
Citizens ’ ‘ What Matters ’ documents were central throughout the process , thereby ensuring their wishes were heard and meaningful goals were identified . Citizens were provided with information about what their stay in a care home entailed , why it was necessary and most importantly , they were reassured that they were residing in the care home for rehabilitation purposes to aid their return home .
Social care occupational therapists worked closely with care providers to ensure a rehab focus was maintained throughout their stay and outcomes measures were collected via a citizen questionnaire , to ensure that the project remained flexible and adaptable to citizens ’ needs .
Inevitably , the model had to adapt to the demands and challenges of COVID-19 . The occupational therapy team had to pull together in ways it had not before and we worked closely with our health colleagues , social workers and home care rapid response team to ensure that citizens were not left stranded in residential care during lockdown .
At the same time , the pandemic presented an opportunity to work more closely with care home staff and citizens ’ families , as we had to improvise in our assessments and information gathering , allowing for a more holistic way of working with the whole family .
Occupational therapists also had to work differently by finding alternative ways of delivering therapeutic interventions , sometimes taking on demands that went beyond our usual remit , but always with the philosophy of occupation at the heart .
Because of COVID-19 , barriers had been put in place as the occupational therapists were not able to visit citizens in hospital or care homes ( step-down beds ), therefore communication was key to gathering the relevant information to ensure that the citizen was discharged home speedily and safely .
The focus now was on preventative measures to ensure that citizens remained at home or returned home at the earliest opportunities .
As a result of the combined approach with occupational therapy and physiotherapy there has been a reduction in falls , as citizens are now seen in a timely manner , rather than being placed on a long waiting list .
Also , another essential driver being met is ‘ What Matters ’ to the citizen ; the data captured reports that a very high percentage of ‘ What Matters ’ to the person is being achieved .
Following the pilot , additional occupational therapsits were recruited to dedicated ICF roles . Louisa Dargan , a recent graduate and new occupational therapist to the team says : ‘ Joining the ICF project at the point where it is established , but still evolving , has been a great opportunity for me , as I ’ ve been able to contribute to its development and I feel like I ’ ve jumped straight into a role that genuinely helps people to live as independently as possible in their own home .’
She goes on to add that ‘ working alongside the physiotherapist and having joint training with health occupational therapists has been invaluable and added so much to my own practice ’.
One example of integrated working within the project sees a citizen return home following a catastrophic stroke . Alongside the community neuro physiotherapist , the social care occupational therapist was able to establish functional ability and rehabilitation potential and work towards the citizen being able to sit and watch television with her family , something she had identified as meaningful for her .
A mobile hoist was issued and later a H frame ceiling track was installed ; as the citizen only wanted her family to hoist , training was provided and care calls ended .
A successful funding bid allowed for a bespoke tilt in space armchair to be supplied and the lady is now able to be safely transferred , sit with her family to watch television , and the family are managing well without a care package .
Mary Lowe , ICF occupational therapist , states : ‘ I will never forget the look of sheer delight when the citizen was hoisted into her bespoke chair for the first time – that was job satisfaction in a nutshell .’
The ICF project has allowed for the creation of different resources within a portfolio of interventions , creating a more seamless service for the citizens we support . It also fulfils the criteria of aiding discharge , and we hope to continue the project year on year and build on its successful outcomes .
Reference
Louisa Durose , occupational therapist , Wrexham County Borough Council . * This article was written in June 2021
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