Integrating occupational therapy services – playing the long game

2015 ◽  
Vol 23 (4) ◽  
pp. 185-193
Author(s):  
Janet Kelly
Keyword(s):  
Occupational Therapy ◽  
Health Board ◽  
Critical Factors ◽  
Content Type ◽  
Professional Experiences ◽  
Professional Groups ◽  
Critical Areas ◽  
Health And Social Care ◽  
Therapy Services ◽  
The Right

Purpose The purpose of this paper is to explore some of the critical areas of work in any long-term strategy to develop integrated occupational therapy services across health and social care for adults who are frail and elderly and living in their local communities. It explores the success that has been experienced in Aneurin Bevan University Health Board over the past eight years or more and proposes “keeping the faith” as a helpful personal strategy in avoiding disillusionment and disengagement in the process when setbacks occur along the way. Design/methodology/approach The paper is a combination of personal reflection and experience, with reference to the literature and what has been written about others’ professional experiences at bringing services and professional groups together. Findings Developing integrated occupational therapy services is not easy. However there are several critical factors, which once understood for their role in the overall process, add weight to the “right thing to do” argument. These “critical factors” provide a continued focus for the work when the challenges inherent in developing integrated services are in danger of outweighing the successes and the pressure is strong to revert to the default position of single agency service delivery. Originality/value This paper makes an effort to pursue integrated occupational services to serve as an example of wider attempts to pursue collaboration and integration, highlighting the need for remaining doggedly determined on the final objective – better services for people.

Collaborating across health and social care: joint funding an adult protection Coordinator post in Caerphilly, UK

2015 ◽  
Vol 17 (2) ◽  
pp. 139-147
Author(s):  
Andrea Giordano ◽  
Alison Neville
Keyword(s):  
Social Services ◽  
Social Care ◽  
Service Improvement ◽  
Health Board ◽  
Content Type ◽  
Health And Social Care ◽  
Abuse And Neglect ◽  
Vulnerable Adults ◽  
Adult Protection

Purpose – The purpose of the paper is to improve the consistency and quality of the response to vulnerable adults who experience abuse and neglect within NHS, independent healthcare and social care settings is noted by practitioners, agencies and patients. Health and social care policy frameworks promote principles of service improvement and consistency, along with a focus on outcomes and resource effectiveness and interagency collaboration. The Protection of Vulnerable Adults (POVA) coordinator role carries the responsibility of coordinating a response to individual referrals of abuse and neglect as described as part of the Designated Lead Manager role in the Wales Interim POVA Policy and Procedures for the POVA from abuse (Wales Adult Protection Coordinators Group, 2013). Design/methodology/approach – This paper will explore the benefits realised through a registered nurse being seconded from the Aneurin Bevan University Health Board into a newly created joint adult protection Health Coordinator post within the Caerphilly County Borough Council social services department POVA team. Findings – This is the first example of such partnership working in adult protection in Wales and has provided a number of benefits in relation to: providing adult protection advice; coordinating the response to referrals of vulnerable adult abuse and neglect within health and social care settings; carrying out or buddying others to complete adult protection investigations; facilitating the two day non-criminal POVA investigation training course and, awareness raising within the local Health Board. The development of a student nurse placement in the social services POVA team cements the multiagency collaborative approach that this development sought to achieve. Originality/value – The need to improve the consistency and quality of the response to vulnerable adults who experience abuse and neglect within NHS, independent healthcare and social care settings is noted by practitioners, agencies and patients.

Impact of occupational therapy in an integrated adult social care service: Audit of Therapy Outcome Measure Findings

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Sharon J. Davenport
Keyword(s):  
Occupational Therapy ◽  
Social Care ◽  
Outcome Measure ◽  
Care Service ◽  
Data Gathering ◽  
Sampling Bias ◽  
Therapy Outcome ◽  
Social Care Service ◽  
Content Type ◽  
Health And Social Care

PurposeHealth and social care services should demonstrate the quality of their interventions for commissioners, patients and carers, plus it is a requirement for occupational therapists to measure and record outcomes. Use of the “Therapy Outcome Measure” (TOMs) standardised tool was implemented by an occupational therapy adult social care service to demonstrate outcomes from April 2020, following integration to a community NHS Trust.Design/methodology/approachThe aim was to demonstrate occupational therapy outcomes in adult social care through a local audit of the TOMs. The objective was to determine if clients improved following occupational therapy intervention in the four domains of impairment, activity, participation and wellbeing/carer wellbeing. 70 cases were purposively sampled over a 2-month timeframe, extracting data from the local electronic recording system.FindingsOccupational therapy in adult social care clearly makes an impact with their client group and carers. Evidence from the dataset demonstrates clinically significant change, as 93% of clients seen by adult social care occupational therapy staff showed an improvement in at least one TOMs domain during their whole episode of care. 79% of activity scores, 20% of participation scores and 50% of wellbeing scores improved following intervention. 79% of carer wellbeing scores improved following occupational therapy.Research limitations/implicationsThe audit did not collect data on uptake from the separate teams (equipment, housing, STAR and adult social care work) in occupational therapy adult social care. Potential sampling bias occurred as cases with completed scores only were purposively sampled. Sampling was not random which prevented data gathering on uptake of TOMs across the separate teams. Additionally, the audit results can only be applied to the setting from which the data was collected, so has limited external validity.Originality/valueThese novel findings illustrate the valuable and unique impact of occupational therapy in this adult social care setting. The integration of adult social care into an NHS Community Trust has supported the service to measure outcomes, by utilising the same standardised tool in use by allied health professions across the Trust.

scholarly journals Health and social care workforce planning and development – an overview

2014 ◽  
Vol 27 (7) ◽  
pp. 562-572 ◽  
Author(s):  
Keith Hurst ◽  
Deirdre Kelley Patterson
Keyword(s):  
Social Care ◽  
Workforce Planning ◽  
Care Staff ◽  
Staff Retention ◽  
Policy And Practice ◽  
Content Type ◽  
The People ◽  
Health And Social Care ◽  
The Right ◽  
Main Barrier

Purpose – The purpose of this paper is to discuss the issues relating to getting the right health and social care staff with the right skills in the right place at the right time and at the right price. Design/methodology/approach – Key points arising from several master-classes with health and social care managers, supported by a literature review, generated remarkable insights into health and social care workforce planning and development (WP&D). Findings – Flawed methods and overwhelming data are major barriers to health and social care WP&D. Inefficient and ineffective WP&D policy and practice, therefore, may lead to inappropriate care teams, which in turn lead to sub-optimal and costly health and social care. Increasing health and social care demand and service re-design, as the population grows and ages, and services move from hospital to community, means that workforce planners face several challenges. Issues that drive and restrain their health and social care WP&D efforts are lucid and compelling, which leave planners in no doubt what is expected if they are to succeed and health and social care is to develop. One main barrier they face is that although WP&D definitions and models in the literature are logical, clear and effective, they are imperfect, so planners do not always have comprehensive tools or data to help them determine the ideal workforce. They face other barriers. First, WP&D can be fragmented and uni-disciplinary when modern health and social care is integrating. Second, recruitment and retention problems can easily stymie planners’ best endeavours because the people that services need (i.e. staff with the right skills), even if they exist, are not evenly distributed throughout the country. Practical implications – This paper underlines triangulated workforce demand and supply methods (described in the paper), which help planners to equalise workloads among disparate groups and isolated practitioners – an important job satisfaction and staff retention issue. Regular and systematic workforce reviews help planners to justify their staffing establishments; it seems vital, therefore, that they have robust methods and supporting data at their fingertips. Originality/value – This paper stock-takes the latest health and social care workforce planning and development issues.

Co-production within health and social care – the implications for Wales?

2014 ◽  
Vol 15 (1) ◽  
pp. 10-20 ◽  
Author(s):  
Andy Phillips ◽  
Gareth Morgan
Keyword(s):  
Social Care ◽  
Active Role ◽  
Policy Makers ◽  
Content Type ◽  
Professional Groups ◽  
Care Services ◽  
The People ◽  
Health And Social Care ◽  
Wide Range ◽  
Improve Health

Purpose – It is well recognised that individuals have much to contribute to the care that they receive, with attendant benefits on outcomes and reduction in cost. The recognition of individuals who access care services as interdependent citizens embedded in both formal and informal support networks is a shift that acknowledges their active role as partners in management of their own care and in service innovation and development. The purpose of this paper is therefore to explore and illustrate some of the domains of co-production. Design/methodology/approach – In this paper, the authors review the literature, both peer-reviewed and professional, in order to provide a broad and contemporary commentary on this emergent approach. This literature is critically summarised and presented along with a narrative that discusses the context in Wales, where the authors are based. The approach to this paper is to bring together existing knowledge and also propose potential avenues for further research and practise development. Findings – There is a diverse literature on this topic and the application of co-production appears potentially transformational within health and social care. Implementation of the principles of co-production has the potential to improve health and social care services in a range of settings. Real changes in outcomes and experience and reduction in societal cost can be achieved by making the people of Wales active partners in the design and delivery of their own health and social care. Originality/value – This review offers a readily accessible commentary on co-production, which may be of value to a wide range of professional groups and policy makers. This paper also reflects an original attempt to summarise knowledge and propose further areas for work. Most importantly, this paper offers a start point for co-production to become a reality for service provision with all the attendant benefits that will arise from this development.

Commentary on a “unified approach to behaviours that challenge”: getting it right? A family carer perspective

2020 ◽  
Vol 25 (3) ◽  
pp. 153-157
Author(s):  
Vivien Cooper
Keyword(s):  
Learning Disabilities ◽  
Lived Experience ◽  
Best Practice ◽  
Family Carer ◽  
Policy And Practice ◽  
Content Type ◽  
Health And Social Care ◽  
Care Systems ◽  
Display Behaviour ◽  
The Right

Purpose The purpose of this paper is to provide an individual family-carer perspective on navigating the complex child, adult, education, health and social care systems focussing on what might be needed to get the right support in the right place at the right time for individuals with learning disabilities who display behaviour that challenges. Design/methodology/approach This is a conceptual analysis, drawing on lived experience, policy and practice. Findings Policy and best practice advocate a holistic, person-centred, outcome-focussed approach to supporting individuals with learning disabilities whose behaviour challenges, but the existing complex multiple organisational structures are not conducive to delivering this. Making the system work for people requires focussed leadership across all levels to co-ordinate and align the component parts. It is certainly possible to achieve, but it is currently unclear who will take responsibility for making this happen. Originality/value Families are often the only constant in the lives of people with disabilities. This commentary highlights what is important to and for families when attempts are made to get the right support in the right place at the right time for individuals with learning disabilities who display behaviour that challenges.

The development of safer walking technology: a review

2015 ◽  
Vol 9 (2) ◽  
pp. 100-115 ◽  
Author(s):  
Esmé Wood ◽  
Gillian Ward ◽  
John Woolham
Keyword(s):  
Decision Making ◽  
Social Care ◽  
Evidence Base ◽  
Current Evidence ◽  
Content Type ◽  
People With Dementia ◽  
Published Evidence ◽  
Health And Social Care ◽  
Current Evidence Base ◽  
The Right

Purpose – The purpose of this paper is to gain a greater understanding of the development of safer walking technology for people with dementia through contemporary literature. Design/methodology/approach – A two stage systematic approach to searching the literature was adopted. Initially this involved searching the literature to gain a broad overview of the development of safer walking technology and the context in which it has been developed. Then, this literature was examined in detail to look at published evidence surrounding the use of safer walking technology by people with dementia. These articles were quality appraised and a meta ethnographic approach taken to synthesis of the findings. Findings – There is a small but growing body of literature within this field. Whilst there is only limited evidence to support the use of safer walking technologies for people with dementia, the evidence to date indicates great potential for its use. If provided with the right support and guidance, safer walking technology has the potential to increase freedoms and independence for people with dementia; gaining them improved access to outdoor spaces and environments to support their health and wellbeing. However, if the safer walking technology continues to be associated with only risk management it will not achieve this potential. Research limitations/implications – The published literature within this field is small and has limited generalisability as much of it was generated in recent years has been by the same small research teams, often reusing data sets. There is also very little research that examines the experience of actually using safer walking technology and even less which explores the views of people with dementia. It is evident that a greater breadth and depth of knowledge is needed within this field to develop a clearer understanding of how this technology is used and perceived by all stakeholders concerned. In particular the literature would benefit from greater consideration of the views and experiences of people with dementia themselves. Practical implications – For many people with dementia, health and social care professionals can play an important role in ensuring appropriate assessment and support in the decision-making process when using safer walking technology. However, greater support is needed in decision making for all people with dementia, especially those people not currently engaged with specialist services. Therefore greater awareness of the benefits and limitations of this technology is needed by all health and social care professionals as well as the general public. Originality/value – At the time of conducting this review the author is unaware of any other systematic search of literature or overview of research on the use of safer walking technology and its use by people with dementia. Despite this safer walking technology is growing in popularity, commonly recommended by health and social care practitioners and often marketed and purchased directly by people with dementia and their families. This review offers an insight into the development of the technology and the current evidence base for its use.

scholarly journals Development of occupational therapy in Grangegorman hospital, Dublin: 1934-1954

2020 ◽  
Vol 48 (1) ◽  
pp. 69-87
Author(s):  
Rebecca Cahill ◽  
Judith Pettigrew
Keyword(s):  
Twentieth Century ◽  
Occupational Therapy ◽  
Nursing Staff ◽  
Mental Hospital ◽  
Primary Source ◽  
Psychiatric Hospitals ◽  
Content Type ◽  
Institutional Settings ◽  
Therapy Services ◽  
Rehabilitative Services

Purpose In the early to mid-twentieth century, psychiatrist-led occupational therapy departments emerged in Irish psychiatric hospitals. This marked a transition towards establishing rehabilitative services in institutional settings. This paper aims to examine the development of occupational therapy in Grangegorman Mental Hospital and its auxiliary hospital, Portrane Mental Hospital from 1934-1954. Design/methodology/approach Historical documentary research methods were used to analyse primary source data from Grangegorman Committee Minutes, Inspector of Mental Hospital Reports, Boroughs of Mental Hospitals, Department of Foreign Affairs documents and newspaper archives. The archival data was analysed using both a chronological and thematic approach. Findings The main key event emerged in 1935 when four Grangegorman nursing staff were sent to Cardiff Mental Hospital to undergo a six month training course in occupational therapy. The following themes emerged – “establishing occupational therapy in Grangegorman and Portrane”; “the role of short-course trained nursing staff in providing occupational therapy services” and “therapeutic rationales vs hospital management rationales”. Originality/value This study throws light on the early practitioners of occupational therapy in Grangegorman and highlights the complexities of occupational therapy’s role origins in mid-twentieth century Ireland. In line with contemporaneous psychiatric hospitals, the occupational therapy activities promoted in Grangegorman were mainly handicraft or productivity based. The absence of patients’ voices means there are limitations to determining the therapeutic nature of this early occupational therapy service.

Occupational Therapy in Social Services: A Missed Opportunity?

2002 ◽  
Vol 65 (11) ◽  
pp. 502-508 ◽  
Author(s):  
Jill Riley
Keyword(s):  
Occupational Therapy ◽  
Social Services ◽  
Social Care ◽  
Occupational Therapists ◽  
Local Health ◽  
Theory Approach ◽  
Initial Separation ◽  
Health And Social Care ◽  
Therapy Services ◽  
Missed Opportunity

The College of Occupational Therapists' recent document, A Strategy for Modernising Occupational Therapy Services in Local Health and Social Care Communities - a Consultation (COT 2002), has provoked debate within the profession on the future delivery of occupational therapy services across health and social care. This seems an appropriate time to reflect on events of 30 years ago when, following the initial separation of health and social services, the profession was faced with the dilemma as to where occupational therapists should be located. This paper looks at the events and issues influencing the profession's decisions then, using a grounded theory approach and drawing on literature and documentation. At that time, discussions raised concerns about the division of skills, adherence to the ethical code and the status within the profession of occupational therapists working in local authorities. The profession's immaturity, lack of autonomy and medical orientation were key factors in influencing its response, which focused on drawing all occupational therapists into the health service. Despite lengthy discussions and consultations, the profession could not influence events and some local authority occupational therapists automatically became part of the newly set-up social services departments. Analysis reveals a possible missed opportunity to establish a firm foundation for occupational therapy in social services, the consequences of which are still evident today.

scholarly journals Social care legislation as an act of integration

2016 ◽  
Vol 24 (3) ◽  
pp. 139-149
Author(s):  
Natalie Davies ◽  
Wulf Livingston ◽  
Emyr Owen ◽  
Peter Huxley
Keyword(s):  
Social Services ◽  
Online Survey ◽  
Social Care ◽  
Well Being ◽  
Health Board ◽  
Senior Managers ◽  
Content Type ◽  
Face To Face ◽  
North Wales ◽  
Health And Social Care

Purpose – The purpose of this paper is to investigate health and social care integration in North Wales in a short window of time between the assent of the Social Services and Well-being (Wales) Act 2014 and its implementation in 2016. Design/methodology/approach – The findings are based on the experiences of health and social care professionals from six Local Authorities and one Regional Health Board working in a management role with strategic responsibility, gathered from an online survey (n=43), semi-structured face-to-face interviews (n=14) and supplemented with reflective interviews with regional coordinators responsible for facilitating cross-organisational working (n=2). Findings – Senior managers are devoting considerable energy to understanding the implications of the new legislation, ensuring that their organisations will be ready and able to successfully implement it. This work is perceived to be commensurate with wider agendas to transform and integrate working practices and services, influenced by a range of financial, environmental, organisational, social and policy factors. Originality/value – This research has direct implications for stakeholders in North Wales, having already been used to shape conversations about integration in the region, and furthermore builds upon existing knowledge in the academic and professional field of integration, with additional limited wider implications for policy and research.

“Bringing the future to life: Maureen’s postcard to Beryl”=North Wales Regional Single Point of Access Programme

2015 ◽  
Vol 23 (4) ◽  
pp. 250-262 ◽  
Author(s):  
Jane Moore
Keyword(s):  
Social Care ◽  
Collaborative Work ◽  
Single Point ◽  
Third Sector ◽  
Theory Of Change ◽  
Health Board ◽  
Content Type ◽  
The North ◽  
North Wales ◽  
Health And Social Care

Purpose The purpose of this paper is to reflect on the journey so far for the North Wales Regional Single Point of Access (SPOA) through the lens of programme manager with views from the programme team. SPOA is the integration of access points to community health and social care services with strengthened links to the third sector, one SPOA in each of six local authorities in the Betsi Cadwallader University Health Board footprint. Design/methodology/approach Kotter’s 8 step theory of change model (1996) supplemented by the organisational, cultural and professional and contextual factors from research that impact on integrated working between health and social care (Cameron et al., 2012); the focus is programme level. Findings Kotter’s 8 step model is a useful tool for reflection on the factors identified in research that promote and hinder integrated working. Key messages and innovative ideas of interest for practitioners embarking on a similar “Quest”, including: “keep using your ‘levers for change’”, “Adopt and Adapt”, “right people in the right place”, “it’s ok to tweak your vision, ‘Make it mean something to everyone’, ‘accept and Adapt’, ‘Don’t sweat what you can’t affect’, ‘Find your allies – it’s better together’, ‘Celebrate ‘small wins’’, ‘The people’s voice drives change’ and ‘a sense of humour brings you through’”. Research limitations/implications This is a personal reflection from the North Wales Regional SPOA Programme. Originality/value It makes use of collaborative work focused on delivering a SPOA, helping others to learn from the struggle.

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