Adult Ability Team - Doing things differently The Adult Ability Team ‘Doing Things Differently In East Staffordshire’ Pam Bostock Consultant Occupational

Adult Ability Team - Doing things Adult Ability Team - Doing things differentlydifferently

The Adult Ability TeamThe Adult Ability Team

‘‘Doing Things DifferentlyDoing Things DifferentlyIn In

East Staffordshire’East Staffordshire’

Pam BostockPam BostockConsultant Occupational Therapist - NeurologyConsultant Occupational Therapist - Neurology

Staffordshire and Stoke on Trent Partnership NHS TrustStaffordshire and Stoke on Trent Partnership NHS Trust



A community based interdisciplinary team ofA community based interdisciplinary team of

specialist professionals working together tospecialist professionals working together to

provide continued case management,provide continued case management,

specialist nursing and neuro-rehabilitation specialist nursing and neuro-rehabilitation

to those in East Staffordshire with ato those in East Staffordshire with a

diagnosis of a Progressive Neurologicaldiagnosis of a Progressive Neurological

Condition. Condition.



Adult Ability Team StaffAdult Ability Team Staff……………………………….The Team consist of:-.The Team consist of:- Pam BostockPam Bostock Team Lead / Consultant OT – NeurologyTeam Lead / Consultant OT – Neurology Mandy BradleyMandy Bradley Team AdministratorTeam Administrator Nichola ManifoldNichola Manifold Specialist OT – NeurologySpecialist OT – Neurology Alison CamiAlison Cami Specialist OT – NeurologySpecialist OT – Neurology Rikta RawalRikta Rawal Senior OTSenior OT Angela McEwanAngela McEwan Specialist Physio – NeurologySpecialist Physio – Neurology Ann EamesAnn Eames Parkinsons Clinical Nurse SpecialistParkinsons Clinical Nurse Specialist Claire BentleyClaire Bentley MS Clinical Nurse SpecialistMS Clinical Nurse Specialist Kate JamesKate James Integrated Support WorkerIntegrated Support Worker VacancyVacancy Senior PhysioSenior Physio……………… ……………… and have access to:-and have access to:- Caroline GaleCaroline Gale Speech & Language TherapistSpeech & Language Therapist Victoria LeemingVictoria Leeming Post Diagnostic CounsellorPost Diagnostic Counsellor Gillian Rudge DieticianGillian Rudge Dietician



History of the development of Adult History of the development of Adult Ability TeamAbility Team

1985/7 : Young Disabled Group1985/7 : Young Disabled Group

1987/8: Adult Disability Team 1987/8: Adult Disability Team

1988/2005: Adult Ability Team (Acute)1988/2005: Adult Ability Team (Acute)

2005+ Adult Ability Team (community) 2005+ Adult Ability Team (community)


The Adult Ability TeamThe Adult Ability TeamPhilosophy of CarePhilosophy of Care

Through proactive client centred caseThrough proactive client centred case

management and therapeutic interventions themanagement and therapeutic interventions the

main purpose of the Adult Ability Team is tomain purpose of the Adult Ability Team is to

support people to self-manage their conditionsupport people to self-manage their condition

as autonomously as possible, optimisingas autonomously as possible, optimising

maintenance of physical, psychological andmaintenance of physical, psychological and

social functioning, by being accessiblesocial functioning, by being accessible

throughout the entire trajectory of thethroughout the entire trajectory of the

condition from diagnosis to end of life,condition from diagnosis to end of life,

responding both to acute episodes and longresponding both to acute episodes and long

term management.term management.


The Canadian Model of Occupational PerformanceThe Canadian Model of Occupational Performance

Spirituality

Institutional

Physical

Cultural

Social

Self Care

Leisure

Productivity

Cognitive Affective

Physical

THIS MODEL IS ADOPTED BY ALL PROFESSIONAL STAFF NOT ONLY OT’S

ENVIRONMENT

OCCUPATION

PERSON

AAT Service Summary:-AAT Service Summary:- Person centred Assessment-and Treatment Person centred Assessment-and Treatment

programme: programme: (Physical/cognitive/psychological/emotional) (Physical/cognitive/psychological/emotional)

Restorative Approach – Rehabilitation targetingRestorative Approach – Rehabilitation targetingneuro impairment with goal of improving deficit /neuro impairment with goal of improving deficit /functionfunction

Compensation strategies – changing approach,Compensation strategies – changing approach,techniques or behaviours to accommodate deficitstechniques or behaviours to accommodate deficitsand manage difficultiesand manage difficulties

Environmental modificationsEnvironmental modifications Encouraging ParticipationEncouraging Participation Life style managementLife style management Liaison with other services – statutory and voluntaryLiaison with other services – statutory and voluntary


The Adult Ability Team PathwayThe Adult Ability Team PathwayPerson diagnosed with Progressive Neurological Condition. Referral to Adult Ability Team made

Referrals go to weekly allocation meeting. Allocation to most appropriate professional for clients specific needs is made

Client and referrer sent letter of acknowledgement. Appointment made with client.

Adult Ability Team MDT assessment & Profession specific assessment completed. Joint goals agreed with Service User. Treatment carried out.

Referral onto other Adult Ability Team Professionals made as appropriate. Referral onto other Key Partners i.e. Social Services / Voluntary Sector / Neurologists / Counsellor / Equipment

Loans Service / Wheelchair Service / SALT / Dietetics / Hospice Teams etc

End of Life Care Review & Reassess

Modify Treatment Plan

Discharge – Clients are not discharged unless:- If requested by client / If move out of area / If care transferred to other provider/ End of Life



The Self Management AgendaThe Self Management Agenda Emphasised on service user informationEmphasised on service user information

leaflet – sent to all new referrals, on initialleaflet – sent to all new referrals, on initial

assessments, at person centred goalassessments, at person centred goal

planning at all subsequent interventionsplanning at all subsequent interventions

Various education sessions:Various education sessions: Newly diagnosed courses – MS Newly diagnosed courses – MS MS fatigue management programmesMS fatigue management programmes Research and FACETSResearch and FACETS

Exercise group for people with early – mid Exercise group for people with early – mid stage MSstage MS



The Adult Ability Team: The Adult Ability Team: Case reviewCase review

East Staffs = 19 GP Practices.East Staffs = 19 GP Practices.

Offer visits to each practice on yearly basisOffer visits to each practice on yearly basis

to review clients (work more closely withto review clients (work more closely with

individual GP’s with very complex serviceindividual GP’s with very complex service

users eg to write ADRT’s)users eg to write ADRT’s)


Dr Charles PidsleyDr Charles Pidsley

Local GPLocal GP

Chair East Staffs CCGChair East Staffs CCG

The Adult Ability Review ProcessThe Adult Ability Review Process


Are there advantages Are there advantages of theof the

Adult Ability TeamAdult Ability Team Model? Model?


Would Dr Pidsley Would Dr Pidsley recommend Adult Ability recommend Adult Ability

team as a model of care?team as a model of care?



The Adult Ability Team SuccessesThe Adult Ability Team Successes April 2000April 2000Measuring Success Award for Adult Ability Team Rehabilitation—Measuring Success Award for Adult Ability Team Rehabilitation—

Multiple Sclerosis SocietyMultiple Sclerosis Society June 2005June 2005 Regional finalist Celebrating Success NHS AwardsRegional finalist Celebrating Success NHS Awards April 2007April 2007The Adult Ability Team is recognised as a National example of good The Adult Ability Team is recognised as a National example of good

practice - “Department of Health Commissioning document” practice - “Department of Health Commissioning document” (Commissioning Services for People with Long Term Neurological (Commissioning Services for People with Long Term Neurological Conditions).Conditions).

April 2013April 20131 of 3 Services to be awarded the Best of Staffordshire Award by the 1 of 3 Services to be awarded the Best of Staffordshire Award by the Staffordshire Neurological Alliance.Staffordshire Neurological Alliance.

June 2013June 2013 Peer review with West Midlands Quality Review, Adult Ability Team Peer review with West Midlands Quality Review, Adult Ability Team identified as an example of Best Practice in the West Midlandsidentified as an example of Best Practice in the West Midlands

2010-20122010-2012 Took part in Research for a multi centre research program for MS Took part in Research for a multi centre research program for MS fatigue management.fatigue management.

2010-20122010-2012 Contributed to multi centre National Research for Outcome Contributed to multi centre National Research for Outcome Measures for people with Long Term Neurological Conditions.Measures for people with Long Term Neurological Conditions.

2012-20132012-2013 Local Service User Satisfaction Audit and Adult of Goal AttainmentLocal Service User Satisfaction Audit and Adult of Goal Attainment 2011-20132011-2013 Team Lead contributing to New MS NICE Guidelines Team Lead contributing to New MS NICE Guidelines 2011-20132011-2013 Team Lead contributed to MNDA National DocumentTeam Lead contributed to MNDA National Document 2014 Team cited in NHS England Quality Document - Rehabilitation2014 Team cited in NHS England Quality Document - Rehabilitation


Service User ViewsService User ViewsOverall, how would you rate the quality of care you have received from the Adult Ability

Team?

36

20

20 0

2

0

5

10

15

20

25

30

35

40

Very Good Good Undecided Poor Very Poor Unanswered

I now feel more confident about living with my condition

19

24

10

3

1

3

0

5

10

15

20

25

30

Strongly Agree Agree Neither Agree orDisagree

Disagree StronglyDisagree

Not Answered


Sample of comments received I personally cannot fault the team. The whole team

from the office staff to the operational staff have been most helpful. When I have needed help I have made a telephone call and someone has sorted the problem. Thank you keep up the good work.

I have recently received excellent care from all members of the team. They have all been sensitive, professional, supportive and understanding of my condition.

I have in the past 10 years not received treatment to equal this. All members of the team have given me the ability to live confidently and independently with my condition. Many thanks to the whole team- and WELL DONE!


ConclusionConclusion Adult Ability Team is an excellent community Adult Ability Team is an excellent community

based model of care- treating people closer to/at based model of care- treating people closer to/at home or the place they are encountering home or the place they are encountering challengeschallenges

Person centred care – individualised treatment Person centred care – individualised treatment goals/plansgoals/plans

Never discharge (unless at persons request)Never discharge (unless at persons request) Excellent communication – within team and with Excellent communication – within team and with

colleagues/other services (particularly colleagues/other services (particularly neurologist/GP) avoid duplication but ensure neurologist/GP) avoid duplication but ensure needs metneeds met

Emphasis on empowering self- managementEmphasis on empowering self- management


Doing Things Differently?Doing Things Differently?

The Adult Ability team do The Adult Ability team do ‘‘do things differently’…do things differently’…

Because they want to make a real Because they want to make a real difference!difference!

Thank you for listeningThank you for listening

[email protected]@nhs.net


Thank you for listening!Thank you for listening!

References:References:Canadian Association of Occupational Therapists.Canadian Association of Occupational Therapists.(1997). Enabling occupation; an occupational therapy(1997). Enabling occupation; an occupational therapyperspective. CAOT. Canada.perspective. CAOT. Canada.FACETS -Fatigue: Applying Cognitive-behavioural andFACETS -Fatigue: Applying Cognitive-behavioural andEnergy effectiveness Techniques toEnergy effectiveness Techniques tolifeStyle(2013).Thomas,S.Thomas,P.Nook,A.Slingsby,lifeStyle(2013).Thomas,S.Thomas,P.Nook,A.Slingsby,V.Baker,R. Hillier,C. MS Society V.Baker,R. Hillier,C. MS Society

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Adult Ability Team - Doing things differently The Adult Ability Team ‘Doing Things Differently In East Staffordshire’ Pam Bostock Consultant Occupational