This article on how one Learning Disability Service adapted during the Covid-19 pandemic was first published in SensorNet Issue 56, August 2020:
Fiona Taylor, Occupational Therapy Professional Lead of the Specialist Learning Disability Service at Hertfordshire Partnership NHS Trust, shares with us how both herself and her team have been adapting their service during this global pandemic. Let’s hear her thoughts.
The Occupational Therapy team, within the Specialist Learning Disability Service at Hertfordshire Partnership University NHS Foundation Trust, work with adults with a learning disability in assessment and treatment units, specialist residential services and within the community. Like everyone, we have been making a lot of changes to our services in light of the Covid-19 restrictions - not least climbing the very steep learning curve of virtual meetings and assessments!
Our working practice during the Covid-19 pandemic has changed significantly. One of the main challenges we found in the initial weeks of lockdown, was the frequency at which things were changing. Within the inpatient service, we had difficulties trying to isolate people when they did not understand the reasons why and the risks associated. Service users were missing having visitors, trips out and their routines changed dramatically which, at times, led to incidents of challenging behaviour. The community teams found themselves working from home and unable to visit service users within the community, due to the new Covid-19 restrictions which involved physical and social distancing.
We have been working hard to ensure service delivery continues by providing assessment and treatment services and making adaptations to the group programme so it is now an individualised 1:1 session. Transition planning has continued with virtual training sessions held with staff teams to ensure discharge dates can be maintained. Socially distanced groups and 1:1 sessions have been delivered to service users to explain the impact of Covid-19 and to provide education on symptoms, testing for infection and environmental change. Some of our service users have had difficulties in processing the additional visual and tactile stimuli that these changes have brought. For those being discharged from hospital, social stories have been used to explain the changes that are required in community living as a result of Covid-19 and how this will be very different to anything they have experienced before.
Our specialist residential service will be hosting an Olympics style sports competition running over a 4 week period. This will include proprioceptive activities that can be carried out on an individual basis indoors and can be graded to the individual’s physical abilities. The aim is to involve all service users and staff in each individual unit, while still implementing social distancing to give the opportunities for socialising, physical activity and (hopefully!) some fun!
In the community teams, we have spent a lot of time working to create activity ideas and planning sensory awareness training sessions for providers. Providing ideas and web links to activities to support service users to develop a new routine, meeting their changing sensory arousal levels throughout the day, has been really beneficial and well received. It has now developed into a monthly newsletter, so new ideas can continue to be shared, while encompassing the Government guidance. We have continued to keep in touch with service users, through phone, video calling and written letters and embracing these new found technological skills in ways we would have previously not thought possible! We are looking at ways to provide sensory based activities virtually and have even managed to successfully facilitate adapted tai chi sessions via zoom calls.
Team members bringing Tai Chi online
A key observation we made is that individuals with some sensory differences which do not generally affect day to day functioning, have suddenly found their thresholds considerably lowered due to anxiety and lack of routine. Sensory processing difficulties have also been noted in service users that did not previously present with them. I think all our thresholds are a little lower at the moment due to the dramatic changes to our lifestyles and the reduction in coping mechanisms we have previously relied on, whether that’s heavy proprioception from the gym and swimming or adjusting to our own environment in terms of lighting and noise. I am personally finding the challenge of work and home schooling has meant that I have had to come to terms with constant background noise! It has certainly made me appreciate how service users living in group homes were coping with the constant noise and traffic that comes with living in a shared communal space.
Social care workers have been developing 'passports' for those who require sensory diets so they can be permitted to engage in these activities outdoors. The “passport” enables them to prove it’s part of a recommended intervention. I think restrictions are lifting slowly and cautiously, but the change in lifestyles and our way of working with services users with a learning disability will continue for the foreseeable future.
From a professional lead perspective, I have been so impressed by the creativity and commitment of the team I lead to recognise the difficulties that service users may be experiencing and how they have worked tirelessly over the last eight weeks to come up with innovative ways to keep providing the services needed.
The Occupational Therapy Team meeting online
With special thanks to: Sarah Curran, Rachel Moatt, Hannah Gurnett, Pat Sillery, Amanda Drake, Steve Burrows, Aoife Quille, Tanya BahutskayaFerdinandez, Graham Tilling, Sandi O’Neill, Sue McGill, Fran Perkins, Kate Hodges, Giedre Varnaite, Sarah Wanigasooriya, Lizzie Druce, Cath Cronk, Claire Plackett, Tracy Howells, Catherine Adkin, Barbara Brinklow, Kerry-Anne Martin, Monaff Lowtun, Rosie Fogarty
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