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Claire Wright is an experienced occupational therapist (OT) working in adult care. She describes a typical Thursday when she works from home.
08:30 – It is a beautiful sunny day and today I am working from home. After a relaxed start with a cup of coffee on the terrace, I go to my desk to log in and check and answer my emails.
9:00 am – My first task is supervision; part of my role is to provide clinical supervision for other OTs and OT assistants. Today I am supervising a colleague, Kate*, who is supporting a resident with a physical health condition. Kate describes the challenges of supporting a resident with rapidly declining mobility and no formal care who wants to remain safely in their own home.
We discuss what this means for the resident and conclude that the loss of independence in personal care tasks such as washing and dressing was the biggest challenge. During our conversation Kate identifies a range of strategies to enable the resident to live in line with their personal values and without the perceived intrusion of formal support services.
Kate reports that she feels confident in supporting the resident in maintaining their independence and minimising risk. We then discuss upcoming changes to the practice and training opportunities and explore Kate’s plans for her future personal development.
Together we look at the Royal College of Occupational Therapy career development framework and Kate suggests mapping her experience against the four pillars of practice: evidence, research and development, facilitating learning, professional practice and leadership.
I leave the meeting feeling that our supervision was a valuable conversation that gave us both space to reflect on the ongoing development of our practice. I promise to do the same mapping exercise myself.
10:00 – I make some coffee and quickly write down my supervision notes, which I then send to Kate.
Promoting independence
10:30 – Time to leave for my first visit of the day. As part of my role I visit residents in their own homes to assess their functional ability and provide advice, referrals and equipment to support them to stay there and live as independently as possible.
I cover the whole county so travelling can be a big part of my day. Today it took me 45 minutes to reach Tim who lives with his partner Jane in a beautiful rural part of the county. Tim has motor neurone disease and we have been working together for two years to help him live independently.
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He has a keen sense of humour and knows exactly what he expects from professionals and what he wants to achieve in his life.
Recently, he has been experiencing increasing problems with toileting, which is decreasing his well-being, independence and dignity.
The standard approach in this case would be to switch to a passive transfer method, such as a hoist and slings. However, this would lead to longer transfer times, a greater chance of urinary incontinence accidents and possible additional costs in formal care. This is not what Tim wants, so we investigated possible solutions.
The freedom to innovate
Today we are investigating a new piece of equipment called the Kera sit2sit which Tim was keen to try out as it would allow for a non-weight bearing transfer without the need for a hoist and sling. He could use it with support from Jane without the need for an additional carer.
It is great to have the professional freedom to explore innovative equipment to support a resident in meeting their professional needs. Tim and Jane found the Kera met their needs, so they do not require any additional support.
12:15 – Back in the car for the 45 minute drive home, with time to reflect on the visit along the way.
1:00 pm – I come home and immediately walk the dogs with my partner. I find it really important to manage my schedule and support my work-life balance by scheduling breaks when they are most beneficial to me.
14:00 – I grab a quick bite to eat and then turn on the focus time to write up the case notes from my visit. I fill out a justification and risk assessment for Tim’s piece of equipment, place the request and write up the assessment.
15:00 – I usually take on a task that can be interrupted at this time of day, because my teenage twins come home from school and like to stop by my home office to tell me about their day and ask about dinner. Today I am reviewing and approving recommendations from colleagues for disability services grants, which help people with disabilities make changes to their homes.
I investigate whether the advice is necessary and appropriate and whether it meets the needs of the resident, both now and in the near future.
Supporting the practice of others
4:00 pm – My next task is an audit. Every month I review the assessments of one of my colleagues in occupational therapy. I look for evidence of best practices and possible areas for improvement.
Once I am finished, I schedule a meeting with the therapist to provide feedback on the examples of good practice I have observed and discuss areas where the therapist can receive support in the form of practical guidance or training.
This month I had the pleasure of auditing a truly person-centred assessment, where I was able to hear the voice of the resident. I noted that this resident had been given advice and signposting, as well as referrals to other services and a prescription for equipment to help them maintain their independence in their own home.
I have highlighted areas where we can refer to the Care Act 2014 to further support our professional reasoning and where changes to our own recording systems would capture best practice more effectively.
17:15 – I quickly check my plans for tomorrow and my email inbox and wrap up the day.
*all names have been replaced by pseudonyms
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