Presented by Rachel Russell, The College of OTs

1. Collaborative working by Occupational
Therapists and potential role of the TA
NAME
TITLE Occupational Therapist
WORK ADDRESS

2. • Understanding the theory behind what we
do as occupational therapists
• The role of an occupational therapist in the
DFG process
• Exploration of complex and simple housing
adaptation
• Discussion about the role of occupational
therapists and others in assessment of need
Session plan

3. Disablement
Process
Persons needs cannot be
met by the home
environment
Home Modification
- Aids to Daily Living
- Housing
Adaptations
- Home Care
- Assistive
Technology
Functional Restoration
- Medication
- Neural Repair
- Rehabilitation
- Re-ablement
Enablement
Process
Adapted from Brandt and Pope 1997
Answer = When there is a needs to get
the ‘right fit’ between the person and
their home environment.
When does an occupational
Therapist recommend a
home adaptation?

4. Enhancing the person’s capabilities
– Motor
– Sensory
– Cognitive
Reducing the demands of the environment
– Space
– Heights
– Change in level
– Forces
– Noise
– Light
– Temperature
– Moisture
Reducing the demands of the task
– Frequency
– Reduce steps and actions
– Carer strain
– More efficient use of the environment
Building professionals help
Design and construct home
Adaptations by:

5. Necessary
Appropriate
Practicable
Reasonable
Health and
social care
Housing
Therapeutic
Intervention
Design and
Construction/administration of
the DFG
Current challenges

6. Reasonable
Appropriate
Practicable
Necessary
Achieving one process:

7. Is it about cost?????
Simple and inexpensive adaptations
can solve complex health and social
care needs.
Complex and costly adaptations may
be necessary to solve simple health
and social care needs.
What is complexity in
Housing adaptations

8. • Putting the person at the centre of the
process
• Home adaptations solutions Vs the silos
of re-ablement, equipment,
adaptations, re-location etc.
• Challenging the way we’ve always done
things, breaking down the silos
between OTs and housing professionals
• We need to work together to
demonstrate the health and social care
outcomes of home adaptation solutions
Opportunities for integrated
working :

9. • Keep the person, families, and the home
at the centre of any process.
• Respecting and acknowledging the role of
building professionals and occupational
therapist in the design and construction
of home adaptations.
• Working collaboratively to identify ‘cases’
that require hands off approach from
occupational therapists and ensure
adequate supervision.
Key to successful integrated work

10. Local Example:
Qualified occupational therapist case
• Wheelchair user requiring internal alterations for accessing all rooms
• Ramped access to property
• Stairlift to access bathroom and bedroom
• Level access shower
• Provision of wheeled shower chair to access shower facility

11. Local Example:
Use of non-occupational therapist
Refurbishment case:
• Referral to Housing OT direct from contractors
• Assessment of clients functional ability to determine if eligible for an
adaptation
• Recommendation to install a level access shower as part of the refurbishment
• Specification and drawing completed and sent to contractors, client and
refurbishment team

12. Considerations for
unqualified staff in DFG work
• Currently, case workers / OTA / trusted assessors, etc are trained in minor
equipment and adaptations (rails).
• Competency achieved through:
1. Training (classroom and /or on site).
2. Agreed competent between occupational therapist and unqualified
practitioners
3. Personal awareness of person in level of competency and pathways to refer
back to occupational therapist when going beyond competence.
4. Regular formal and/or informal supervision opportunities.
5. Review of competency on a regular basis (usual yearly).
• Potential role of occupational therapist in:
1. Recruitment of appropriate people
2. Training
3. Workload allocation
4. Development and supervision for individual.

13. Panel Discussion

14. Thank you
Contact details