Gillian Levey, Advanced Rheumatology Specialist Podiatrist
I was interested in a career in healthcare but I didn’t want to be a nurse. It was my Nan who gave me a newspaper article about podiatry and I thought I would like to have a look at doing that because it was something different. My Dad inspired me to become a Rheumatology Specialist because he is a Rheumatoid Arthritis sufferer and so I know what a patient with this condition goes through and how it affects the whole family.
Jessica Wood, Specialist Podiatrist
For as long as I can remember, I have always wanted to work for the NHS. My mother was a police woman and my father was a fireman, so I wanted to do something along the medical lines.
I don’t think people realise how much there is involved in becoming a Podiatrist and what valuable knowledge we as a profession have. So that’s always been a challenge, getting others to understand our job and just what we are capable of. Funnily enough the pandemic has helped with this. We took on some of the district nurses’ caseloads in the thick of the pandemic and this in turn has led to a better communication pathway with the nurses and a better shared understanding of the different roles.
Jamie Ferguson, Physiotherapist, Community Falls Service (South Staffordshire)
Coventry City fan Jamie says “I had an early interest in working with football clubs as a Physiotherapist as it would have combined two of my greatest passions but I think my university placements influenced my field of interest, like working in the community at present”. Jamie’s advice to people joining the profession “Never be afraid to ask any question (regardless of how dumb it may sound). A good professional & colleague will be more than happy to help you through it. However, trust yourself – you are cleverer than you think and give yourself credit for”.
Ann has been working in the caring profession for 33 years, although she only joined the NHS in January this year. She loves being a member of the Home First team and has nothing but praise for the support and encouragement she receives from colleagues and managers. She particularly values the opportunity to get to know her patients and spend whatever time is needed to assess and meet their individual requirements. Ann and her colleagues work out how best to look after each person they see and develop caring strategies based on what they need. One patient has advanced vascular dementia and can react quite violently to attempts to provide her with personal care. Ann and a colleague visit together and one holds the lady’s hands and chats to her, keeping her calm, whilst the other washes and dresses her.
Zoe has been looking after people for the last 30 years, initially with the council but more latterly with the NHS. She says she has learnt a lot since joining the Home First team and has had lots of opportunities to develop her skills and gain responsibilities, for example she is a medication champion and a local expert on assistive technology. She is also enthusiastic about the way team members share information via their mobile phones which enable them to check their visits and record their observations and assessments. This keeps everyone up to date and informed. Zoe knows she can make a real difference to her patients, for example a gentleman had recently come out of hospital following a serious urinary tract infection. His daughter was concerned he was becoming unwell again and would need to go back to hospital. Zoe was able to carry out a urine test there and then, contact the man’s GP and get antibiotics delivered within the hour.
Jane has a background in fashion but wanted to do something different. She joined Home First 15 years ago – though it wasn’t called that then, and offered a slightly different service.
In particular she likes doing the first visit when someone comes out of hospital, meeting the new patient and finding out how to help them get back to where they were before they had to go to hospital. “As the first member of the team to visit it’s up to you to find out what’s needed and respond to how that person is”.
Much of what Jane does is caring for her patient’s physical needs such as washing, dressing and encouraging them to eat and drink. But it’s much more, constantly evaluating and checking on all aspects of the patient’s wellbeing and also being mindful of the needs of carers and family members, and even pets. The focus is always on getting the patient to do as much as possible for themselves and encouraging them to regain as much independence as possible.
Her patients might have had a fall, such as Bob, who also suffers from dementia and doesn’t really understand what has happened to him. He needs to be encouraged to get out of bed and get dressed. Olive is just out of hospital and was struggling to remember to take her medication. Jane needed to liaise with the family to get permission from the GP to help her, although the hope was this would only be for the short-term so Olive could go back to looking after herself. Terry is living upstairs so Jane can help him access the bathroom as its all on the same level. She explains this is much better because it’s the normal thing to do and offers a break from the same four walls. Jane has helped Freda use a piece of equipment called a ‘dog lead’ which features a loop to hook over your foot to lift your leg up, and as Freda’s muscles have built up she is more able to get into bed herself.
No two days are the same, every person needs something different, and those needs change. “We don’t watch the clock; just do what we can to help the patient get better, even if it’s just sitting with them to make sure they eat something. During Covid-19 when family members may be isolating, we can offer a friendly face – even if we have to wear full PPE, mask, apron, gloves etc”.
“I enjoy meeting so many lovely people and it’s great when you see the end result, though it can be sad knowing you won’t see that person again. Our aim is not to be needed and there’s no better feeling”.
Katherine joined Home First in June and is loving the opportunity to give something back to the community. She has worked as a personal carer in the private sector but enjoys the variety of her new job. On one day she experienced two contrasting situations. Visiting a gentleman who had broken his knee and had to keep his leg up for a couple of weeks she found him recovering and ‘buzzing’ because he had got himself up and made his own breakfast. However the next visit was to a lady who was very poorly and would need ongoing care. In the one case Katherine knew she would be able to step down the number of visits, but in the other she needed to begin the process of getting others involved in making a longer term arrangement. Katherine says it can be quite emotional, but so rewarding when you feel you have made a difference.
Sarah Oliver, Clinical Inpatient Matron
Sarah has led on improving the sexual safety of service users on inpatient wards at the Redwoods Centre in Shrewsbury. She has developed, introduced and embedded cultural and procedural changes on wards and across multi-disciplinary teams. These have included changes to incident reporting, new admission procedures, new patient information, introduction of reflective practice, supervision and role modelling, multidisciplinary team discussions, training sessions, trauma-informed care plans and developing a collective approach to consistent leadership on these issues.
As a result, there is a significant and measurable difference with sexual safety incidents being now negligible on the Redwoods wards, demonstrating the continued impact of the quality improvement work. The wards have been formally commended by CQC on this work. Sarah and colleagues have presented at a number of national events and many NHS trusts have visited the wards to understand the work further.
Sarah would say that involving staff, being honest and open and helping them to form solutions so that they are invested in the innovation is crucial to success.
Becky Williams, Ward Manager
Becky Williams always wanted to be a nurse but back in 2007 she didn’t feel university was right for her so she joined MPFT’s bank as a nursing assistant.
For the next 5 years she worked in a number of teams before successfully applying for an Assistant Practitioner role with the community dementia service which enabled her to complete a Foundation degree, attending university one day a week for two years.
At this point Becky was offered an academic secondment and the opportunity to gain her nursing qualifications. As she had completed the foundation degree, this meant two further years of university study alongside her nursing placements. She graduated in September 2017 and gained a post in the Memory Service, applying for and gaining a further Band 6 position after 18 months.
Then, along with NHS services across the country, MPFT needed to review how services were provided due to the Covid-19 pandemic. Staff were asked if they were willing to be redeployed and Becky, feeling that it was important to lead by example, said she was happy to go wherever her services would be most useful. With her experience of older adult mental health care she was placed as a Staff Nurse on Oak Ward at the Redwoods Centre in Shrewsbury.
Becky feels that working on an inpatient ward is very different from her role in the community, highlighting the awareness of physical health needs and the importance of communication with family members. Visiting patients in the community there was more opportunity to get to know the family, but Becky also reflected that it could be difficult to accept the limitations of a service that couldn’t offer the same 24/7 level of support as the ward environment.
However, Becky really enjoyed the post on the ward and when a Ward Sister position became available she applied for that and then for a vacancy for Ward Manager, an appointment she commenced in October this year.
“When I was first training, my mentor Ann always said take every opportunity that is offered and I have really embraced this. My managers have always been very supportive and encouraged me to apply for posts, even if it was just for interview experience. I have been able to build a successful career and would recommend the various nursing trainee roles as great stepping stones. A nursing degree course may be right for some people, but there are lots of other ways to get into the profession.”
Becky says “Nursing is hard work, but very rewarding and offers real career satisfaction. The NHS offers lots of opportunities to develop and grow, with different roles and training available.”
Anne Roberts, District Nurse
Anne was selected as one of just 12 NHS staff whose portrait was captured by acclaimed photographer Rankin as part of a collection unveiled to celebrate the NHS’ 72nd Birthday.
Throughout the pandemic, Anne has not only been an excellent and caring District Nurse, but has worked hard to support her colleagues and raise their morale, organising local school children to share pictures and messages, and coordinating a mass sing along to ‘This is Me’ from 'The Greatest Showman’ to mark International Nurses Day.
She also demonstrated her commitment to her patients and their families, even going so far as to help foster a pet dog to allow a couple needing hospital treatment to be admitted without worrying about their precious pet.
The story generated national and international headlines and Anne’s image has been displayed across the country, most notably on the Piccadilly Circus lights.
Anne said: “I’m not a hero. I’m a nurse just trying to do the best I can. I was inspired by an aunty but I also think being a nurse is ingrained in you.”
Mike Smith, Specialist Practice District Nursing
When I was eight years old, my grandad had terminal oesophageal cancer and was receiving palliative care by a local district nursing team. It was at this young age that I saw the compassion and care nurses gave to him to keep my grandad at home and very comfortable.
At eight years old I could only describe them as ‘superheroes’, but not like Superman or Batman – something more, something real.
Obliviously through my school and teenage years, I never realised men could be nurses, and I found it difficult to settle on a career suitable for me. I returned to college in my early 20s with the intention to be a paramedic. However, everything changed when I volunteered on a ward at my local hospital.
I will never forget my first day on that respiratory ward where I was greeted by a male nurse. It was then I realised that staring back at me was the start of my journey to become the nurse I always wanted to be; to become that superhero figure that inspired me and cared for my grandad all those years ago.
Nursing to me is not just a job or even a career – it has been and is my life. I feel that as nurses we go over and beyond by putting our patients at the heart of everything that we do and with that in mind, I just wanted to take this opportunity to thank those nurses that looked after my grandad and inspired me to be the person I am today. I also want to thank everybody that has been part of my journey and has given me the opportunity to shine.
Nursing has truly brought out the best in my character and it is an honour to work in such a fulfilling job.
Matthew Harvey, Community Mental Health Nurse
I was a Student Mental Health Nurse studying at Staffordshire University in the September 2017 cohort. We were due to head out on our final sign off placement of our degree at the end of April. For me this was due to be in the community with the South Staffordshire Memory Service. Due to the increased risks attached to this patient group, face to face patient contact was stopped and it was felt that they would not be able to facilitate my placement and learning. I was then re-allocated to Ellesmere House (Forensic Learning Disabilities) at St. George’s Hospital Stafford. The whole cohort had their first day on placement and then found out that night that we were all being withdrawn from placement due to safety risks re Covid-19. This left us all in a state of limbo where we didn’t know whether we would be allowed back out on placement or whether we would able to complete the rest of our course. Thankfully the government and the trust initiated an opt-in system whereby we could finish our final placement in an extended format with our own preference in mind. I had already gone through the interview process to get a job in the community in the Psychosis Pathway in Lichfield, so this is where I opted to complete my placement.
The weeks prior to getting assurances of being able to complete our degrees were quite anxiety provoking and uncertain. Once I found out I was going to Lichfield, I felt much more relaxed and calm. I had been there on placement previously in my first year, so knew the team and it would mean I got a head start on preparing for my role once I qualified. The idea of being in placement during a pandemic was a little nerve racking, but honestly was just happy that I could still complete my training and contribute at a time when needed. The team have been brilliant in supporting and nurturing my learning as well pushing me towards becoming an independent clinician. I was able to manage a small caseload and develop all the skills required to move into my role as a community mental health nurse. This massively helped with my confidence and overcoming some of the anxiety issues I had had prior to placement about the transition from Student to Qualified Nurse. Albeit we are seemingly heading towards another serious wave of the pandemic, which may disrupt service provision, I feel in a good place to manage what comes and to provide care as best I can to my service users.
Abbi, Community Mental Health Practitioner
Trish, Community Mental Health Nurse
Michelle Mellor, Nurse Practitioner
Michelle worked as a care assistant in a care home before she had her family. Once her three children were all at school she decided she was ready to go back to work and keen to be challenged a bit more. She completed her nurse training at Staffordshire University and qualified in 2008.
She initially worked on the female acute ward at what was then Shelton Hospital. Although she gained a lot of useful experience this wasn’t where she wanted to be so she moved to Whitchurch Cottage Hospital to work with people with dementia. She took the opportunity to gain some community experience and when the cottage hospital closed took up a permanent post with the community mental health team which went on to become the Memory Service. By this time she realised her passion lay with the assessment and diagnosis of people with dementia and this has been the focus of her subsequent career. Along the way she has also gained qualifications in physical health and in prescribing as well as becoming a student mentor.
Michelle has held a management position with the memory service but has now returned to a more clinical role as a Nurse Practitioner which she prefers. The role involves the assessment and diagnosis she is passionate about, as well as a medication prescribing role.
Michelle says “No one wants to hear that their loved one has dementia, but if the assessment and diagnosis is done well it can make a difficult situation so much easier. You need compassion, patience and knowledge to carry out the role but it offers me real job satisfaction.
The Coronavirus pandemic has presented some interesting challenges. I was redeployed onto a ward which was a bit of a learning curve as things had changed. We also went virtual and had to work out how to carry out assessments via video calls. I was sceptical at first but it has proved successful and will certainly make us more flexible and resilient in the future – coping with bad weather for example.
I never thought when I started caring for people aged 18 that I would be where I am now, but I have been given lots of opportunities and supported to gain the confidence to make the most of them. I feel MPFT is a very forward-thinking trust which recognises the value of a nurse-led service”.
The Psychological Wellbeing Practitioners are an integral part of the Improving Access to Psychological Therapy (IAPT) Team.
The PWP is often the first point of contact for people receiving support from IAPT. It’s a busy and fast paced role and can be challenging. With no formal referral document, you don’t know the background or problems of the people seeking help so you need to think on your feet and be adaptable. The role is assessment and therapy, providing low intensity interventions. Some PWPs go on to become High Intensity Practitioners.
In the Telford & Wrekin service members of the team are championing different aspects of care and treatment, offering special expertise and advice to colleagues.
Maria, Champion for Long Covid
The service has always had a commitment to responding to the emotional impact of long term conditions and the development of Long Covid has the potential to significantly affect the mental wellbeing of sufferers. Maria’s role is to gather intelligence on services available to offer support and collate useful materials and resources to share.
Covid has also inevitably impacted on how support and treatment has been delivered over the past year and a half but Maria has found this has worked well for many people who are able to fit a call or video conference around their work, caring or social commitments. “The intervention doesn’t change, just the mechanism”.
Working remotely has also meant getting to know colleagues via Teams but Maria has felt supported and connected. She is enjoying being part of a bigger team and gaining exposure to a broader range of conditions, including some more complex cases.
Tessa, Silvercloud Champion
She believes the structured processes and easy to follow information can be helpful to support a variety of mental health problems, although she recognises it can be difficult working on-line rather than face to face. Tessa has found Silvercloud can work really well for some people with autism or a learning disability. Working through the Silvercloud therapy can also be a good introduction to Cognitive Behaviour Therapy for those who have not experienced this before.
Tessa’s route into being a PWP was not via the traditional psychology degree. She worked at a jobcentre but then took a year out to support her Dad who was suffering from Dementia. This enabled her to re-think what she wanted to do and she became a Health Care Support Worker in dementia services. With two years’ health care experience she was then able to join IAPT and undertake her PWP training. Working and attending university at the same time was challenging but very satisfying and Tessa believes not having a degree before she started hasn’t held her back at all. She is still keen to push herself and continue her development, “I am not academic and just really want to help people”.
Sarah, Musculoskeletal (MSK) Champion
Sarah has a long term condition herself. She broke her neck when she was just 15 and suffers chronic migraines and daily pain. She understands the impact of this, and of the physical struggle and need to juggle medication and regular physio appointments with a working schedule.
Although Sarah gained a psychology degree and started work as an Assistant Psychologist this wasn’t really working for her. She found out about the PWP role and felt the formal training and more structured process would suit her better. She started her training as a PWP in the Third Sector before transferring to the NHS. This has really worked out and she has never looked back. She is now not only a qualified PWP but has also acted as a supervisor and mentor for other trainees, and is completing a Master’s degree.
Sarah, Champion for Neurodiversity, Learning Disability, and Autism
Before becoming a PWP Sarah had 10 years’ experience in brain injury rehabilitation. She decided to change direction to do more structured, evidence-based emotional support. In her champion role Sarah says the key is improving access for people who may find it difficult to engage and don’t know where to go for help. Many people self-refer to IAPT so how do you make the service accessible to those who may not have the confidence or technical ability to do this? Techniques and processes may have to be adapted for people with different learning abilities. She works with colleagues from different services such as the learning disabilities team and autism hub to identify and respond to different needs. The role also includes developing the skills of IAPT team members and confidence in their ability to support people.
Maggie Makombe, Rehabilitation Officer for Visual Impairment (ROVI)
A Day in the Life of a Rehabilitation Officer for Visual Impairment (ROVI)
Every profession is important, but for a Rehabilitation Officer for Visual Impairment (ROVI) they devote their practice to working with citizens with significant sensory loss that involves Visual, Deafblindness, Visual with additional Physical, Mental, Emotional, and social challenges every day. My job role involves training citizens to develop new skills, training in the use of equipment and providing techniques needed for an individual to promote their independence, health and well-being. Though typical daily routines can vary greatly in this profession depending on the circumstances of the individual.
The time the ROVI starts work; the most important tasks are to check emails, voice calls and calendar as this can help with planning and safety for the day. This task is important as ROVI need to keep written records, produce reports, and attend meetings and occasional regional conferences. Mornings can be busy as I am likely to receiving or liaising with multi-disciplinary teams such as Social Workers, Occupational Therapists, Diabetic Nurses as well as external professionals such as Ophthalmologists, Optometrists and Voluntary Organisations. Maintaining this working relationship is important as most of the time, the ROVI’s role is misunderstood by most professionals
Prior to making a home visit, the ROVI has to contact the individual in advance to make the appointment, identified their eye condition and explored what tasks are challenging. This is an important task as this will help ROVI on the day of the visit to plan the driving route (particularly in cases of Orientation and Mobility) - mostly it takes around 45 minutes travelling to and from a visit, taking into account unplanned issues on the roads and a holistic assessment completion may take around two hours. However, in other cases on home visit it may take more than two hours or a second visit is required to complete the assessment. On the day of the visit due to COVID, ROVI has to contact individual to make sure they are ok for the planned visit to go ahead.
The ROVI prepares in advance a welcome pack folder that is bespoke for an individual in accordance with the NHS England Accessible Information Standards 2015 - Promoting Access to Information, Communication and Language for People with a Sensory Disability / Loss”. In addition, ROVI has to carry bulk equipment that may need to be demonstrated and trialled on the day depending on the risk.
When first meeting with a new client, the ROVI is responsible for talking with individuals to support them in understanding the meaning of Registration of their Sight Loss, assessing their unique abilities, limitations and identifying other professionals that may be involved. When the ROVI identifies the areas of day-to-day life that are causing difficulty an individualised assessment and rehabilitation support plan will be created that meets the citizen's strengths and goals. However in some circumstances, the ROVI will provide training in the home of the individual or where they feel more comfortable to reduce risk, protect and empower the individual during assessment.
The holistic assessment will look into how well the individual can complete day to day tasks such as:
- Communication needs accessing all written literature including use of house phone;
- Maintaining home environment;
- Managing with personal care;
- Kitchen safety when preparing and cooking food, eating meals and drinking;
- Risk assessment of mobility level / need provision of equipment to getting out and about and keeping active;
- Environment risk assessment walking and moving around safely;
- Family circumstances - available support and any other dependence (children, for example);
- Employment and financial circumstances;
- Emotional needs,
Following on from the assessment, both the individual and the ROVI will experience a level of fatigue as the journey of sight loss can be emotionally draining; however the ROVI has to maintain the positive attitude at all times. Due to high demand of the service, most of the times 2 -3 visits are planned for the day. Therefore, this means sometimes extra time is required to travel to source a suitable place for lunch, toilet breaks and to maintain high security for the car due to carrying of sensory equipment. Once a visit is completed, the ROVI has to complete the required assessment form / support plan, ordering of special equipment via medequip, signposting to other services and referrals to other professionals.
However, the UK began to experience a Pandemic alongside the rest of the globe. It was and is still hard to hear how the virus has wiped people across the globe. I felt as if my job role as a key worker was going to be a challenge in being able to continue to provide services. It was a shock as imposed restrictions seemed unrealistic to enable me to do my job. COVID-19 restrictions affected referrals around vision rehabilitation, as well as putting additional pressures on staff and citizens. On the other hand, I have built stronger relationships with my working colleagues and improved on my networking using Microsoft teams - “magic”.
The wonders of technology proved to be vital, for example the wearing of face masks posed communication barriers for other individuals with hearing needs. Sensory Team practitioners were provided with a Personal MiniTech (listening aid) and provision of ClearMasks that could be used to support individuals with hearing needs in improving communication and removing some of the barriers. The introduction of One Consultation was very exciting. The most important thing is the Team remains intact and we continue to explore how we can raise sensory awareness across MPFT and SCC. Using Microsoft Team, has increased the interest of other professionals to join in some of the teams meetings.
Furthermore, as we hit the 2nd lockdown, there was a panic that this would mean a significant backlog of work, as new referrals were being added to waiting lists as well as those citizens who were still waiting to receive their sensory assessments and rehabilitation programmes from the 1st lockdown. The Sensory Team have worked hard together to make sure that citizens who were on high risk received essential home visits; with resources in place for staff to use such as PPE, use of Risk Assessment forms before home visit and support from management did motivate me to hang on and continue to support our citizen. Of course, we have had to do things in different ways in line with Practice Guidance as provided by the Infection Control Team, Royal National Institute for the Blind and Rehabilitation Workers Professional Network. The pandemic seems to have changed things, but some changes are for the better.
To summarise my “Why” I do what I do because the job role is empowering and rewarding to both citizens and ROVI. “This is me”
Rebecca Oddy, Social Worker, AMHP, Deafblind Assessor
A Day in the Life of a Deafblind Assessor
The day starts with a new referral, a request for a re-assessment for a lady supported by a communicator guide package. Since the Care Act 2014, people with dual sensory impairment which impacts on their communication, mobility and access to information are entitled to have their assessment carried out by a Deafblind Assessor. This is a role with additional training to enable the assessor to consider the specific issues and complexities which come with a combined sight and hearing impairment.
My assessment starts like any other, reading through the history, looking at previous assessments and deciphering what package of care is currently in place and what has led to the request for a review. All standard stuff for any social worker or social care assessor. However, there are a few things that I’m looking for specifically in the records, what health conditions (and specifically sensory impairments) does this person have? Are their sensory impairments congenital (from birth) or acquired (happened later on) and when?
Like any assessment, at this stage it is crucial to have some information about the best methods of communication for the person. How can I arrange a review with them (without automatically going through informal carers if possible)? Can I contact them on the telephone, by text, by email, or perhaps by post? Do they require support from the communicator guide to read my letters or messages?
Arranging a review for a Deafblind assessment can take additional time, I might need to wait until the person has support before I get a reply. It may take smaller messages, with simple wording, perhaps even a number of messages to arrange a meeting. Then there is the question of who the person wants to attend. It is important to ask this, do they want a family member to support, or a friend, do they want the communicator guide to support, or do they want/need an independent advocate? Do I need an interpreter for the review?
Once I’ve got a list of attendees, I need to work out where to hold the review meeting. Can it be facilitated online, or do I need to meet the person face-to-face. We should consider at every review, but do any of the other attendees have their own needs relating to communication? Lots of communicator guides are also Deaf and may need or want their own interpreter (Deaf with a capital indicates that someone identifies as part of the Deaf community, whereas deaf without the capital D is used for those who do not identify themselves in this way). Will the list of attendees fit in the person’s front room, I may have a few more people than seats at this point.
So, the day of the review arrives. Just like any other social care assessment, but with a few extra considerations at this point. I’ve allowed double the time for the review, I know that those with sensory loss suffer from communication fatigue and need regular breaks, those interpreters need regular rests too, so it is best to plan a long visit. On arrival, the environment needs additional consideration, where are the participants sitting to facilitate communication – think lighting, space, reflections, face coverings and even the colour and pattern of clothing! After moving people around a bit to make sure everyone can communicate effectively…we can begin.
The review takes into account all of the care needs, as you would expect. There is a particular focus on the impact of the combined sensory loss on communication, mobility and access to information. Often I’ll hear stories of difficulties and complexities that I have not even considered as a fully sighted and hearing person. But I’m also often blown away by the resilience and strategies that people use to manage to maintain their independence too.
We talk about communication in different settings, different lights, and different times of the day. We discuss moving around familiar environments and what happens when we leave those environments, or someone moves something in our environment. We talk about going outside, where we go, the support we need to get there and to do activities we enjoy. We talk about managing paperwork, finances, booking appointments, watching the TV and other hobbies. We discuss relationships with family, friends and acquaintances; social inclusion or isolation and aspirations. We haven’t even touched on the normal day-to-day activities such as cooking, cleaning and getting dressed yet. I’m tiring, it’s time for a break, imagine how it must be for this person every day.
Obviously every assessment or review will be different and there are many varieties of hearing and sight impairment of varying degrees. From assessing older adults who have age related hearing and sight loss, to assessing those who were born Deafblind and everything in between. There are common themes, but each assessment is unique and each person’s life skills, aspirations and goals will be different too.
Care and support planning links back to the Care Act, the eligibility criteria and the impact on the person’s wellbeing, as with all social care assessments. We look at impact on physical health, emotional wellbeing and social and community integration. We think about the additional time needed for the assessment and mirror that in the additional time required for each daily task which the communicator guide will support with. We factor in the travel time to access specialist groups or social clubs and the support needed to attend. Now just to get funding approved.
Deafblind assessing is a rewarding role, think social care assessment, with an additional focus on the impact of the combined sensory loss.
Victoria Lee, Rehabilitation Officer of Visual Impairment (ROVI)
A Day in the Life of a Rehabilitation Officer of Visual Impairment (ROVI)
Right from the start of receiving the sensory referral, I feel like I’m in investigator mode. Looking at the holistic life of a citizen living with sight loss and how they are managing and the reason they have come to us.
A complex case that gets the heart racing, there often is lot of unpicking and understanding of someone’s circumstances. I have to remain bias and open-minded at all times. I am also learning all the time. I remain reflective after each visit as this helps me to improve my own practice and myself. I find my role extremely rewarding.
I am often faced with people who are crying out for someone to listen, spend some time and help them. Moving forward from a moment in time where they feel lost and lacking confidence due to the barriers from trauma, grief or ill-health holding them back, as well as sensory loss. The biggest barrier yet with Covid and overcoming anxiety. I am fully aware that I enter people’s lives when they are feeling most vulnerable, therefore the initial conversation I have with someone is gentle. This includes the way I introduce myself. I aim to break down barriers and not create them. One of the ways I do this is by explaining my role in a non-obligational manner and referring to myself as a Rehabilitation Support Worker, rather than a Sight Loss Rehabilitation Officer. Under the NHS England Accessible Information Standard, this also means to understand and respect their method of communication and if someone requires an interpreter, supporting with open and clear communication by making the reasonable adjustments required and in accordance with The Equality Act 2010.
As a Rehabilitation Officer my time is not limited to supporting someone and this is very important as everyone’s needs are different. I work on the basis that we aim for a realistic goal based on the citizen’s strengths and if they require more time to open up or build trust in those first stages then often this is more important than the required rehabilitation itself because without trust, there is limited participation and lack of motivation. Then comes the difficulty of detachment at the end of rehab, once trust has formed. So it is important to make it clear at the start how many sessions I anticipate the citizen may require so they know it will come to an end at some point, however, reassuring that they can self refer in the future if their needs change and require further support from us.
Once these barriers are reduced, a realistic rehabilitation program can be digested with enthusiasm and motivation allowing the citizen to own their rehabilitation journey within reason and be guided by myself when required. This includes allowing the rehabilitation to change direction with the needs of the person. For instance, money identification teach may be requested before outdoor orientation and mobility cane training or vice versa depending on the citizen. I guide the citizen to reducing risk. If I feel a high risk task needs addressing first, I will advise a priority order of the rehabilitation. It’s about empowering the person and establishing independence in a safe environment.
Consideration to the environment such as contrast, lighting, potential slips and trip hazards in relation to sight loss such as shadows and phantom hallucinations, sight loss techniques and strategies and liaising with other professionals, directing to groups for sight loss support, information and equipment. I support people to be creative in thinking outside the box to come up with better solutions for a task to support sight loss and teach techniques to build confidence moving forward safely. This could be making large labels with someone or teaching a technique that enables them to follow print better when reading.
As a Rehabilitation Officer for Visual Impairment and Deafblind Assessor, it is hard to accept that not everyone will benefit from our services for whatever reason. It is important to understand that, not often but sometimes someone does not want to engage. Although we try not to take work home, empathy still sits with me until after my involvement is closed. This can be tough on emotional well-being and practicing resilience is not always easy.
I ensure that my sensory knowledge is available for health care professionals, keyworker and family care or support agencies to access should I be required through this way. This is where my commitment to educate other people / professionals about sensory continues. Sensory Loss is inevitable in everyone life’s but it is only when it happens to you, family member or someone close to you that you start to realise how it is important to have inclusion within the community for someone with a sensory loss.
Mostly, the end of a rehab program is quite magical. Many a time I have observed a different person emerge like a beautiful butterfly from a cage that they was once held captive within and now they have freedom and the right tools to succeed.
Lorraine Hawley, Student Social Worker
A Day in the Life of a Student Social Worker
My name is Lorraine Hawley, I am a final year Student Social Worker completing my 100 days placement with the Sensory Team. I have found that the support and guidance from the Sensory Team staff have been priceless, which has given me the tools to complete a holistic assessment for all service users who require an assessment.
A short description to give an understanding of my journey from my 1st placement in January 2020. I started my 1st placement within the Adult Social Care Team shadowing Social Workers, Care Act Assessors, I also met the Sensory Team staff members. Due to the Coronavirus pandemic, my placement was cut short and ended on day 37, I left the service not knowing if I would return.
In November 2020 I was given the opportunity to return to complete my 2nd placement working alongside the Sensory Team. Due to the Coronavirus pandemic and the impact, it is having on the UK and also my health conditions, I have been given the choice to work from home or attend the office.
Each morning I am awake at 6.30 am which gives me plenty of time to have breakfast which is normally a banana and a cup of tea. I would have made notes the day before if I have a face to face assessment planned. If I have planned to spend the day at the office my bags would already be packed and ready to go, handbag, lunch bag, laptop trolley, checking before leaving that I have not forgotten something. Not forgetting an umbrella as we all know the UK weather is not reliable.
Each day has been different from completing duty assessments, face to face assessment, virtual assessment and contacting individuals by their preferred format. Working from home, as I had already had some experience of working within the office I was unsure if this new way of working would be right for me. I was not sure how the organisation would apply or duplicate their previous office environment. How is this going to work? Mixed emotions of how I felt about setting up an office in my own home. I need to ensure I find a balance of working at home and home life.
Today I am working from home, so firstly I would switch my work and university laptop and mobile on, and from 8.15am I would check my emails, team’s messages, calendar, and texts or missed calls/voice mails. Making notes for any required follow-ups and order of importance, sending any replies, or completing task notes where required. Throughout the day at different times, there are scheduled group meetings to attend. Outlook calendar on both laptops will remind me of any up and coming scheduled appointments.
When I have received an allocation I read through the previous assessments, task/notes, health conditions and check the preferred form of contact. I gather all relevant information to build my assessment, identifying any communication requirements. At any time throughout completing the assessment, if I were unsure of something I would contact the relevant staff member who is knowledgeable in the field, I require support in. Completing required assessment forms, identifying specialist equipment where required, completing referrals to other services.
Planning a face to face assessment I would follow the above checking previous assessments and notes, ensure to make contact in their preferred form, this could be telephone, text, 3rd party or email. Identify if a 3rd party is required to attend the face to face assessment, family member, interpreter, ROVI (Rehabilitation Officer Visual Impairment), ROHI (Rehabilitation Officer Hearing Impairment). Complete a BASW (British Association of Social Workers) Risk Assessment for all face to face assessments and to be agreed upon by the team leader before attending the service users home.
Ensure I have the required PPE for the visit, to place an order of PPE when required to ensure I do not run out. Calculating the time and the distance from home or office to the service users address, identifying any road works or closes that may increase my travel time. Contact the service user to check that there have not been any changes to the BASW Risk Assessment questions asked previously.
On arrival I will wear PPE, a clear face mask to support communication, ensuring a correct fit. Knocking or ringing a doorbell taking into consideration if the service user is alone and unable to hear the doorbell. When the door is answered I will introduce myself showing my ID badge. On entering the property to ensure that we abide by the 2-metre rule I will ask where each person would like to sit, taking into consideration lighting/shadowing that can interfere with communication. Complete a holistic assessment that is person-centred to the individual also considering any carers involvement.
Once gathered all relevant information returning to my workstation I would check for any new emails or missed call prioritising my workload with the highest of priority. I then complete all required documentation. Where a referral is required to other services, I will then complete the required documentation and forward it to the relevant team. If I have identified the need for assistive technology I will discuss this with the relevant team to ensure the correct equipment is ordered for the individual’s needs. For instance, a perching stool is available in different sizes so it is important to identify the service users BMI (Body Mass Index).
Throughout the day I would document on a task/note any contact with a service user or professional. I have at times researched for specialist equipment for service users that is classed as a special order. When completing a special order I am required to identify two separate quotes from different companies. This will then be sent to the team leader who will agree or disagree. Contacting any of the sensory team staff members if I was unsure or required guidance to find the most suitable equipment for the service user.
My working day would finish between 4.30 pm-6.30 pm as I have found that time goes so quickly whilst working as a student social worker. I have extremely enjoyed my time with the sensory team, saddened when it came to my final day. So pleased that the team had been able to find ways in working with each other by using Microsoft teams. This has been a new experience of working within a team, I have learnt so much from all of the team that this has given me the determination to search for a vacancy within an adults social care team with a specialist sensor.
Degree Apprenticeship Students
In 2020 the SWLA were proud to announce the first cohort of 8 social work students undertaking the 3 year level 6 degree apprenticeship in social work. The apprentices were already employed by MPFT in unregistered social care roles and they started their 70 day placement in April this year. Placements have been found in MPFT. North Staffordshire Combined NHS Trust services and with Stoke-on-Trent Local Authority. Apprentices from Staffordshire County Council have joined MPFT in the OP/PD and Hospital discharge services.
Jackie Rowlands, a Social Care Assessor in the South Discharge to Assess Team, has moved to the forensic service for her placement:
“My placement with the Liaison and Diversion team is going fantastic, the team I am working with have been so supportive. I am based within a custody suite and working with people that have been bought into custody to identify vulnerabilities they may need support with when released from custody. The placement has given me a great opportunity to develop my skills and knowledge in social work and to reflect on my own practice and value”.
A move from the older people/physical disability team in Burton-on-Trent has taken Apprentice Sylvia Smith to the Personalisation Social Inclusion Team. She describes her transition into mental health services:
“Day 1 of my 70 day placement the exciting feeling of meeting my Workplace Supervisor in person and my own expectations as well as getting a more in depth understanding of the impact individual’s mental health can have on their overall health; seeing the flip side to my current role within an adult community team. I was surprised how easily I fitted in with my placement team, applying my existing skills and sharing knowledge with other professionals. The newly acquired learning from my first placement will support me in my future practice and newly created connections with practitioners within social care mental health”
Social workers undertaking their Approved Mental Health Professional training within the Trust, are expected to complete a placement away from their substantial post. This is particularly important for social workers who do not have specific mental health team experience. Karen Ferriday, a Social Worker in the Stafford Mental Health Team, has had the opportunity to be the first student AMHP in the Children Eating Disorder team within the Trust. She has taken time to reflect on her experiences:
“As part of the Approved Mental Health Professional Training I have just completed a 43 day placement with the Children Eating Disorder Service at The Bridge, Stafford. This was a pilot placement, so as their first AMHP candidate I would like to take the opportunity to say a big thank you to Bronwen Spence, Andrew Barnett, Emma Fitton and the rest of the team for making me feel welcome and part of the team. I have been a qualified social worker in Adult Services for nine years so the experience to work with Children and Families has been an excellent opportunity for me, especially within in the context of the AMHP role. The placement has given me a valuable insight into the complexities of eating disorders, along with first-hand experience of the referral, assessment, therapy and preventative work this service provides children and their families across Staffordshire. I feel very lucky to have been given the opportunity to work with such a passionate team, their hard work and commitment really does prevent many young children from needing to come into hospital for treatment and for those that do I have gained some useful knowledge and insight into the processes and dilemmas of accessing specialist Tier Four beds, and how these are managed within the team.”
Kally Hawkins, Social Worker
I came into Social Work through the influence of my mother, who used to work with people with physical and mental disabilities and she really advocated for them and tried to help change societal views about their inclusion. I wanted to be just like my mum and break down barriers and discrimination people unduly faced.
My mum is so proud of what I have achieved, how I have achieved it (through my Open University undergraduate and then Think Ahead Masters route) and the work that I do to help people be the best they can be.
That is the best part of my job, when you see a journey through from the start and you get to see their progression, improvement and them blossom and no longer need your support. I feel incredibly privileged to be in this role; helping people and being invited into their lives is a genuine privilege.
For me, good social work is about listening and respecting people in their own rights, as experts in their own lives and how they wish to be supported to achieve their chosen goals.
Shazna Begum, Social Work student
“I came into social work because I had seen how social factors can impact people’s mental health, and I wanted to directly work with people to support them during those challenging situations.
"The positive aspect about social work is that we look at providing holistic care, which enables a person to lead independent and fulfilling lives, and in many cases not letting a person’s mental health diagnosis define who they are.
"Good social work to me is having the ability to build a working relation with service users and families, and being able to understand what their needs and priorities are, in order to support them in making a positive change in their life".
Naomi Taylor, Mental Health Social Worker
“I was always interested in Sociology and came into social work as I felt it would be a rewarding opportunity to work with and support people to improve their circumstances as a result of social injustice. Good social work involves person centred, strengths based practice with a holistic approach, ensuring the person is supported in the least restrictive way”.
Joanna Reeves, Social Worker
Joanna says she fell into social work after working in customer care taking initial referrals and realising that she wanted to do more and felt rewarded by helping people. She feels the positive things about social work are meeting the service users, listening to their stories and helping them through difficult times, varied workload – every day is different. She also values the opportunity for personal growth through overcoming your own fears to help others. To her, good social work is about listening to the individual and helping people to live the way they want to, taking action where necessary and supporting people to help themselves when they can.
Kate Pascoe, Care Act Assessor
“I was drawn to social work as I have a passion for social justice and supporting vulnerable people who struggle to have their voices heard within society. A positive aspect of social work is the empowerment, choice and control it can give back into peoples’ lives through effective professional practice. Good social work will always have the person at the centre of all practice, with their best interests always at the heart of what we do”.
Holly Lakin, Student Social Worker
Holly came into social work because she wanted to be able to make a positive difference to the lives of those who are most vulnerable in our society. She says “I also really enjoy learning about and understanding the diverse life experiences of others”.
She adds, “Social work brings a real feeling of fulfilment when people you have worked and built a relationship with, achieve a positive outcome, their goals, and are able to flourish.
“For me, good social work is centred around having a genuine and respectful curiosity into the lives of those you work with, and using this to build positive relationships so that you can work together with them to reach their goals, whilst being prepared to respond and adapt to change.
Bethan Lally, Social Work, Level 6 Apprentice
Bethan started her first year of study in January 2021. She says she came into social work as it felt like a natural transition after working with people with support needs as a Community Care Worker/Mental Health support worker and Social Care Assessor . She wanted to make more of a difference to service users’ lives - helping them to achieve life targets and support them to remain independent, happy and healthy.
Bethan says “I enjoy working with individuals, getting to know their lived experiences and personalities and having the ability to achieve life changing outcomes for people.
“A good Social Worker has to be creative, passionate and tenacious and have the courage and confidence to challenge injustice and inequality. We also have a chameleon-like quality to understand and engage with each citizen as an individual.
Johanna Shaw, Social Work student
Johanna, from Staffordshire University, is currently completing her 70 day placement with The Moorlands Adult Social Care Team in Leek:
"I feel everyone should feel they have a purpose and a place in society and the lack of this can be at the root of many social issues. I came into social work as I have a genuine interest in people and I strongly believe that society must protect its most vulnerable members and make sure their lives are as integrated as possible.
"A social worker needs the ability to think outside the box and look at a situation holistically and be creative with solutions. I think social work bridges the gaps between families and other disciplines and professions and we can also act as an advocate and ensure equality. It’s important to be genuinely interested in service users and always update your own knowledge and skills. Being aware of how the law and legislation can assist people and what their rights and entitlements are. Adhering to social work values at all times".
Eve Pemberton, Level 6 Social Work Apprentice
Eve works on the Personalisation, Social Inclusion team and started her first year of study in January this year:
"I came into social work because I want to make a difference to the lives of all those in society. I want to support people to achieve their wishes and aspirations and live the way they want to.
"A positive aspect of social work is the diverse nature of the individuals we meet. Social workers encounter many different individuals from all walks of life and it is both intriguing and exciting waiting for the next working day, as no two days are the same.
"Good social work is about compassion, empathy and commitment to supporting individuals in their lives. It is about taking the time to speak with individuals and form effective working relationships to create an environment of comfort and reassurance".
Zoe Skerry, Social Work student
Zoe is from Staffordshire and is completing her final 100 day placement with the Discharge to Assess team at the Haywood Hospital:
"I had been interested in social work for some years but waited to pursue it as a career until my children were at school. I have a particular interest in working in adult social care with a specific interest in unplanned care. I am passionate about being the voice of older adults when considering their care and support needs in an acute setting. I feel that social workers do a lot of good and I want to be part of that.
"I get real satisfaction from helping others and advocating for service users and their families. I like the fact that no day is the same and a lot can be learned daily.
"For me good social work is about having an honest and open non-judgmental approach to practice using our professional knowledge and skills to assess and work with families. To be able to work in an empathetic way but use our authority to achieve goals set with the individuals and families we work with.