Occupational Therapy Service

‘Vocational Rehabilitation – Making it Work’

Anita Bowser – O.T Team ManagerSimon Ridley - Occupational Therapist

anita.bowser@southernhealth.nhs.uk

Assumptions! (But the research supports these!)

Work is good for health and wellbeingMost people want to workBeing out of work is detrimental to health and wellbeingYou are more likely to get another job the more recently you have workedThe average length of admission to secure services is almost 5 yearsRole of not just being a patient

How did we get started?

Appointed a Vocational Technical Instructor with relevant experience (Band 5)Developed initial roles

Librarian x 2Clothes shop assistantWard representatives (5 x volunteers)

Application Process

Job BoardTrust application formsInterview/filling in forms –training availableInterviewMDT - Occupational HealthFlexibility within the process depending on the job role

Real Work - Terms and Conditions

Trust fixed term contractBand 1 (£7.12 per hour)Employed under Supported Permitted Work (hours limited)InductionTrainingSupervisedAppraisal and formal supervision

Developing the service

Feedback from Quality Network Peer ReviewFeedback from service users who wanted a greater range of jobs and preferably more physical/manual workVisited other servicesO.T. Away Day/focus

IPS – Individual Placement Support

It aims to get people into competitive employment It is open to all those who want to work It tries to find jobs consistent with people's preferences It works quickly It brings employment specialists into clinical teams Employment specialists develop relationships with employers based upon a person's work preferences It provides time unlimited, individualised support for the person and their employer Benefits counselling is included.

Jobs Created

Paid5 x Ward representatives2 x Librarians1 x Clothes shop assistant1 x Gym cleaner1 x OT kitchen cleaner1 x Workshop cleaner2 x Car washers2 x Wood technicians2 x Seasonal gardeners(Recovery leaflet editor)

Voluntary1 x League of Friends shop assistant1 x Shelter cleaner2 x Dog walkers1 x Allotment assistant

Barriers/Challenges

FundingRelationship with HRResistance from some staffPaperworkObstacles such as insurancePracticalitiesTimeBenefits changed

Benefits

Develop or maintain worker identityImproved self-esteemMeaningful roles and sense of belongingFinancial rewardsImproves employabilityRecovery/quality of life

What has worked?

Occupational Therapist taking on the ‘Vocational Advisor’ roleJob supervisor (OT/OT tech) taking ‘manager’ roleJob BoardSupervising the jobsThinking creativelyVocation sub-group

Current Developments

PortfoliosDeveloping own paperwork which can be gradedMore cleaning rolesExploring feasibility of kitchen work (requested by patients)

Case Studies

Fred – Young manNo work historyAdolescent → Adult Secure UnitsAcute wardReputation in the unitLibrarian jobHe has flourished

“This job has been life changing for me. It has made me feel more important and has given me a sense of purpose. It’s very interesting and I look forward to everything I do as a ward representative!”

“It’s difficult for people with a criminal record and mental health issues to get employment. Any job a service user gets in the system helps; it is a stepping stone to either continue work in service related issues or a different job. You can prove to employers that you have done something”. Ward Representatives

“It’s demoralising being locked up. We have lots of time on our hands. Having a job gives you hope”. Service User

“Work was always my identity so continuing some work related tasks was crucial to my recovery”. Service User, Librarian

“Having a job helped my recovery. To have not done anything would have left a big gap in my CV. Employers expect to see something positive. It’s made it easier to get along with daily life”. Service User

Patients’comments/feedback