Pulling together to support the wider community
The rate of change and flexibility has a constant fixture in how we’ve all come together to change the way we deliver services during these uncertain times.
Motherwell’s Rehabilitation Team (MRT) is a wonderful showcase of how we are taking new approaches to ensuring we continue to deliver excellent care to our service users.
We are an integrated allied health professions team which includes physiotherapy and occupational therapists from both health and local authority organisations.
The team’s aim is to provide essential rehabilitation services to facilitate timely discharge from hospital, help prevent admission to hospital and provide early support in preventative approaches to care.
Our service covers all adult age groups and some services for children. We work closely with a wide range of acute services and community services to provide comprehensive services to support people at home.
Mrs A was a patient in Wishaw University Hospital. During discussions her family were keen to support their mother’s needs and for her to be discharged to live with a relative temporarily rather than returning to her own home or nursing home during the COVID-19 pandemic.
Listening to her needs the team worked quickly to access and organise the necessary equipment required for discharge. This involved working with hospital colleagues and the joint equipment service.
On discharge care would normally be passed over the home support teams however the Motherwell Rehab team agreed to provide care in the interim following Mrs As discharge to allow timely discharge.
Mrs A was discharged safely and timeously to her daughters home and this enabled further assessment of what support the family required in line with the principles of Discharge to Assess (D2A) a model that the Rehab Teams promote throughout their work.
Helping service users feel more comfortable
The service user’s daughter thanked the team for their work by saying: “I want to express many thanks again for your help and support in arranging morning care for my mum.I really appreciate your prompt response in dealing with things once the situation reached you and for personally keeping in touch.
“These are difficult days and my wee mum is now settled at home with us and lovely care was given to her this morning.”
Alison Graham, Team Leader of the MRT, said: “On discharge the service user was not achieving as much as she potentially could as she was missing her own home.
“The team supported her for the next eight days which allowed a re-enabling approach to be adopted with consistent members of staff and common goals to work towards. Importantly, the timing of this support assisted home support services in the area who were meeting daily challenges in maintaining service provision.
“Motherwell Rehab team continued to support with physiotherapy prescribed exercise programme the service user could do in bed and also in her chair. Family members were able to manage personal care needs in between the Rehab team and Home Care visits due to upskilling of the family to carry out these tasks safely.
“The service user continues to be well and the Rehab Team will work together with everyone to get her back to her own home when the time is right.
“Providing personal care is not the usual work for the rehab team but in unprecedented times working together to respond to keeping people out of hospital and safe at home is all that we strive to achieve together.”
Empowering and upskilling staff
Margaret Flavell, health and social work manager, added: “At this challenging time the care and upskilling the services have provided for the service user and her family has been excellent.
“This joint working and willingness to be flexible has been excellent and highlights the professionalism and commitment of all involved to meet the family outcomes.”